Relationship between information and communication technologies development and infant mortality

Background: Information and communication technologies (ICT) can potentially improve infant mortality by decreasing resource scarcity and geographical distance barriers. The International Telecommunication Union (ITU) ICT Development Index (IDI) is a composite index comprised of three sub-indices: Access, Use, and Skills. We hypothesized (1) that countries with greater access to, usage of, and skills for ICT have lower infant mortality, and (2) that differences in country income impact the pattern of sub-index correlation. Methods: Relationships between IDI total and sub-index data from 2008 and Central Intelligence Agency estimated infant mortality data (2010) for 158 countries were analyzed using Pearson correlation and regression analysis. Relationships between ITU data and infant mortality were also examined controlling for country wealth. Results: Increasing IDI was associated with decreasing infant mortality (correlation -0.77; regression 0.86). Correlation coefficients between Access, Use, and Skills sub-indices and infant mortality were -0.74, -0.64, and -0.85 with regression coefficients of 0.82, 0.74, and 0.76, respectively. IDI and Skills sub-index were negatively correlated with infant mortality at all country income levels with P<0.001. Access was negatively correlated (P<0.001) with infant mortality in lower-middle income countries. Use was negatively correlated (P<0.001) with infant mortality in low, lower-middle, and high income countries. Regression coefficients between sub-indices and infant mortality, controlling for country income, varied between 0.04 (low income Access) to 0.66 (lower-middle income Access). Conclusions: Although there are statistically significant correlations between IDI and infant mortality, regression analysis suggests that other factors contribute to variability. Additionally, the relationship between infant mortality and the sub-indices varies according to income classification, suggesting the potential role of other resource-related factors. Further research is needed to determine how the sub-indices impact delivery of perinatal care.