AIPGMEE 2016 SPM mcq

All of the following statements are true about the childhood mortality rates in India except:

(a) Almost 2/3rd of infant mortality rate (IMR) occurs in neonatal period

(b) Almost 2/3rd of the under -five mortality occurs in the first year of life

(c) About one in ten children die before they reach the age of five years

(d) Neonatal mortality is higher among female children as compared to males

Ans. (d) 

[Ref. http://www.ncbi.nlm.nih.gov/pubmed/23151996 , Park 21/e p51S-30, Park 22/e p520-32]

Infant mortality is higher in boys than girls in most parts of the world. This has been explained by sex differences in genetic and biological makeup, with boys being biologically weaker and more susceptible to diseases and premature death. At the same time, recent studies have found that numerous preconception or prenatal environmental factors affect the probability of a baby being conceived male or female. I propose that these environmental factors also explain sex differences in mortality. I contribute a new methodology of distinguishing between child biology and preconception environment by comparing male-female differences in mortality across opposite-sex twins, same-sex twins, and all twins. Using a large sample of twins from sub-Saharan Africa, I find that both preconception environment and child biology increase the mortality of male infants, but the effect of biology is substantially smaller than the literature suggests. I also estimate the interacting effects of biology with some intrauterine and external environmental factors, including birth order within a twin pair, social status, and climate. I find that a twin is more likely to be male if he is the firstborn, born to an educated mother, or born in certain climatic conditions. Male firstborns are more likely to survive than female firstborns, but only during the neonatal period. Finally, mortality is not affected by the interactions between biology and climate or between biology and social status.

Almost 2/3rd of IMR occurs in neonatal period (IMR = 47 per 1000 LBand NNMR = 32 per 1000 LB)

Almost 2/3rd of the U5MRoccurs in the first year of life (IMR= 47 per 1000LBand U5MR= 63 per 1000 LB)

About one in ten children die before they reach the age of five years (U5MR= 63 per 1000 LB).

• Post-neonatal mortality rate (PNNMR): Is the number of neonataldeaths (deaths within completed28days after birth) per 1000 live births in that year

• IMR = NNMR + PNNMR = ENNMR + LNNMR + PNNMR