Assessing the causes of infant mortality using verbal autopsy in Jamkhed, India

Background: Despite decrease in child mortality in Jamkhed, more data is needed to evaluate and address factors relevant to infant (below age of one year) death. We assess the causes of infant mortality to provide potential appropriate recommendations. Methods: We applied a verbal survey adapted from the World Health Organization's standard verbal autopsy. We interviewed mothers or close relatives of infants who were present for the illness leading up to the infant's death. Respondents were identified using records of Village Health Workers. Additionally we performed a retrospective review of infant mortality data gathered by Comprehensive Rural Health Project (CRHP)'s hospital, in Jamkhed for comparison. Results: Participants were between 15 and 65 years old. Twenty-seven deaths were reported in four villages over past ten years; 55% were neonatal (28 days or younger). Fifty-two percent were female. The predominant causes of death were prematurity (and subsequent asphyxiation) and pneumonia. There was no report of preceding malnutrition. The number of deaths has decreased over the past 5 years. Comparison with previous health records showed consistent causes of infant death over past ten years, except for septicemia. Majority of death was from families who sought care from private physicians instead of CRHP hospital, and less than 33% of those consulted the Village Health Worker (VHW) for care. Conclusions: Increasing access to low cost health care, expanding prenatal and post-natal health education by VHWs to areas and communities not currently covered by CRHP, and emphasizing prevention and prompt management of common mortality causes are warranted.