The infant mortality rate (IMR), defined as the number of deaths of infants under one year of age per 1,000 live births, is a key indicator of a nation’s health and socioeconomic progress. It provides insights into a country’s healthcare system, living conditions, and overall societal well-being. China has historically emphasized reducing this metric as part of its public health objectives.
Understanding China’s Infant Mortality
China’s infant mortality rate has substantially declined over several decades. In 2022, China’s infant mortality rate dropped to 4.9 per 1,000 live births. This represents a significant reduction from 37.6 per 1,000 live births in the early days of reform and opening-up. The mortality rate for children under five also reached a record low of 6.8 per 1,000 in 2022.
Looking further back, China’s IMR decreased by 84.3% from 43.2 deaths per 1,000 live births in 1990 to 6.8 deaths per 1,000 live births in 2019. This improvement shows a shift from historically high rates.
Factors Influencing the Rate
Economic development has played a large role in the reduction of China’s infant mortality rate. Rising living standards and poverty reduction have directly improved access to better nutrition, sanitation, and overall living conditions for families, which indirectly benefits infant health. Improved economic conditions allow for greater investment in healthcare infrastructure and services.
Improvements in the healthcare system have also contributed significantly. The expansion of medical infrastructure, particularly in rural areas, has increased access to prenatal and postnatal care. Hospital delivery rates, for instance, increased in rural areas from 93.4% in 2008 to 99.9% in 2020, correlating with a decrease in neonatal mortality rates.
Public health interventions have also been widely successful. Universal child immunization programs, introduced in 1978 and expanded in 2008 to protect against 12 preventable diseases, have reduced vaccine-preventable deaths. Furthermore, efforts to prevent mother-to-child transmission of diseases like HIV/AIDS, syphilis, and hepatitis B, with testing rates exceeding 99% in pregnant women, have lowered the transmission rate of HIV/AIDS to 3%.
While overall rates have fallen, disparities between urban and rural areas remain. In 2019, the infant mortality rate in rural areas was still 1.9 times higher than in urban areas, largely due to varying access to quality healthcare and resources. For example, in the western rural areas, pneumonia and preterm birth continue to be leading causes of infant deaths, indicating ongoing regional challenges.
Strategies for Reduction
China has implemented various policies and programs to further reduce infant mortality. Increased investment in primary healthcare and rural health networks has been a deliberate strategy to address disparities. This includes establishing a three-tier management system at county, township, and village levels, ensuring every newborn is included in a child health management system immediately after birth.
Expansion of health insurance coverage and subsidies for maternal and child health services have made care more accessible. Since 2009, child health management has been included in the National Essential Public Health Service Program, providing free health management services for children aged 0-6 in their local communities. This program aims to ensure equitable and comprehensive coverage.
Targeted programs for vulnerable populations include the establishment of nearly 3,500 treatment centers for high-risk pregnant women and about 3,320 centers for infants needing intensive care nationwide. These centers form a coordinated treatment network for high-risk pregnancies and newborns. Additionally, there are ongoing efforts to improve treatments for high-risk pregnancies and step up screenings for congenital birth defects.
Technological advancements in medical care for infants have also been leveraged. The country has focused on improving prenatal diagnosis and screening facilities for birth defects, alongside strengthening rehabilitation services for children. Environmental regulations, such as air pollution controls imposed in 1998, also contributed to a 20% fall in infant mortality rates in designated “Two Control Zones,” particularly impacting neonatal mortality.
China’s Rate in Global Perspective
China’s current infant mortality rate of 4.9 per 1,000 live births in 2022 places it favorably compared to the global average. The average infant mortality rate globally was 20.8 per 1,000 live births in 2021. This demonstrates China’s significant progress in reducing infant deaths relative to many other developing economies.
When compared to developed nations, China’s rate is higher than countries with the lowest infant mortality rates, such as Slovenia, Singapore, and Japan. However, China’s core health indicators for women and children now rank among the top in upper-middle-income countries globally. This position highlights the substantial strides made while also indicating areas for continued improvement to reach the levels of the most advanced healthcare systems.