# Mortality rates

### Mortality rates

Q. 1

In a certain population, there were 4050 births in the last one year. There were 50 still births. 50 infants died within 7 days whereas 150 died within the first 28 days. What is the Neonatal mortality rate?

 A 50 B 62.5 C 12.5 D 49.4
Q. 1

In a certain population, there were 4050 births in the last one year. There were 50 still births. 50 infants died within 7 days whereas 150 died within the first 28 days. What is the Neonatal mortality rate?

 A 50 B 62.5 C 12.5 D 49.4
Ans. A

Explanation:

50 [Ref.- Park SPM 20/e p486]

Number of death of children under = $\frac{28&space;days&space;of&space;age&space;in&space;a&space;year}{Total&space;live&space;births&space;in&space;the&space;same&space;year}$ x 1000

In the question;

• Total no. of deaths under 28 days = no. of deaths within 7 days + no. of deaths within the first 28 days.
• Total no. of live births = Total births – still birth.

So,

NMR =$\frac{50+150}{4050-50}$ x1000

=$\frac{200}{4000}$ x1000

= 50per 1000live births

Q. 2

Which of the following is the most common cause of Infant Mortality Rate (IMR) in India?

 A Diarrhoea B Congenital anomalies C Perinatal Conditions D Acute respiratory infection
Q. 2

Which of the following is the most common cause of Infant Mortality Rate (IMR) in India?

 A Diarrhoea B Congenital anomalies C Perinatal Conditions D Acute respiratory infection
Ans. C

Explanation:

Perinatal conditions like low birth weight is the commonest cause of IMR (20%). It is followed by acute respiratory infection (19%), Diarrhoea (15%). Underlying malnutrition is present in 46% in India.

Ref: 1. World Health Report 1999 (WHO).

Q. 3

The socioeconomic status of community is best indicated by

 A IMR B Under 5 mortality rate C Maternal mortality rate D Perinatal mortality rate
Q. 3

The socioeconomic status of community is best indicated by

 A IMR B Under 5 mortality rate C Maternal mortality rate D Perinatal mortality rate
Ans. A

Explanation:

Ans:A.)IMR.
Infant mortality rate (IMR) is defined as the ratio of infant deaths registered in a given year to the total number of live births registered in the same year, usually expressed as a rate per 1000 live births. It is given by the formula:

IMR= No. of deaths of children less than 1 year of age in a year
——————————————————————–×1000
No. of live births in the same year

IMR is universally regarded not only as a most important indicator of the health status of a community but also of the level of living of people in general and effectiveness of MCH services in particular.
Infant mortality rate is given a separate treatment by demographers because:
• IMR is the single largest single age-category of mortality.
• Deaths at this age are due to a peculiar set of diseases and conditions to which the adult population is less exposed or less vulnerable.
• IMR is affected rather quickly and directly by specific health programmes and hence may change more rapidly than the general death rate.

• Socio-economic status of the community
• RCH activities
• Health-care availability
• Health status of community

Q. 4

Which of the following regarding Maternal Mortality Rate (MMR) is not TRUE?

 A Numerator includes total number of female deaths within 42 days of delivery B Denominator includes still births and abortions C It is expressed as a rate and not ratio D It is expressed per 1000
Q. 4

Which of the following regarding Maternal Mortality Rate (MMR) is not TRUE?

 A Numerator includes total number of female deaths within 42 days of delivery B Denominator includes still births and abortions C It is expressed as a rate and not ratio D It is expressed per 1000
Ans. B

Explanation:

The denominator in Maternal Mortality Rate includes the total number of live births in a particular area during a particular year and not the number of stillbirths and abortions.
The denominator is inclusive of the total number of still births while calculating the Stillbirth Rate and Perinatal Mortality Rate.

The numerator of the rate includes the total number of female deaths due to complications of pregnancy, childbirth or within 42 days of delivery from puerperal causes in a particular area during a given year.

Maternal Mortality Rate is expressed as a rate and not as a ratio.
It is expressed as a rate per 1000 live births.

Ref: Park’s Textbook of Preventive and Social Medicine, 19th Edition.

Q. 5

Perinatal Mortality rate includes:

 A Still borns and death within 7 days of birth B Neonatal deaths within 30 days of birth C Abortions and Death within 7 days of birth D Deaths between 7 and 28 days of birth
Q. 5

Perinatal Mortality rate includes:

 A Still borns and death within 7 days of birth B Neonatal deaths within 30 days of birth C Abortions and Death within 7 days of birth D Deaths between 7 and 28 days of birth
Ans. A

Explanation:

Perinatal mortality rate has great significance in assessment of both obstetric and pediatric care before and around the time of birth.

It includes both stillbirths and early neonatal deaths (neonatal deaths under one week of age).

Perinatal mortality accounts for 90% of all fetal and infant mortality in the developed countries.

With improved obstetric and perinatal technologies, the perinatal mortality has gradually declined in the developed countries.

 PERINATAL MORTALITY RATE (In nations with less established vital records of stillbirths)  = LATE FETAL DEATHS (28 WEEKS GESTATION AND MORE) + EARLY NEONATAL DEATHS                                                      (FIRST WEEK) IN ONE YEAR             _____________________________________________________ X    1000                                          LIVE BIRTHS IN THE SAME YEAR

or

 PERINATAL MORTALITY RATE (FOR INTERNATIONAL COMPARISONS RECOMMENDED BY WHO)       = LATE FETAL AND EARLY NEONATAL DEATHS WEIGHING OVER 1000 GMS AT BIRTH    X   1000                      TOTAL LIVE BIRTHS WEIGHING OVER 1000 GMS AT BIRTH

Ref: Park’s Textbook of Preventive and Social Medicine, 19th Edition, Pages 449-451

Q. 6

Which of the following represents the denominator in estimating Maternal Mortality Rate (MMR)?

 A Total Number of Live Births B Total Number of Married Women C Total Number of Births (including still births) D Midyear Population
Q. 6

Which of the following represents the denominator in estimating Maternal Mortality Rate (MMR)?

 A Total Number of Live Births B Total Number of Married Women C Total Number of Births (including still births) D Midyear Population
Ans. A

Explanation:

Maternal mortality rate measures the risk of women dying from “puerperal causes” and is defined as:

Total no. of female deaths due to complications of

pregnancy, childbirth or within 42 days of delivery

from “puerperal causes” in an area during a given year

=       ____________________________________________       X   1000

Total no. of live births in the same area and year

Ref: Preventive and Social Medicine, by K.Park, 19th edition, Page 444-448.

Q. 7

Which of the following accurately reflects the Under-5 Mortality Rate (U5MR) in India in 2015-2016?

 A 50/1000 live births B 126/1000 live births C 74/1000 live births D 100/1000 live births
Q. 7

Which of the following accurately reflects the Under-5 Mortality Rate (U5MR) in India in 2015-2016?

 A 50/1000 live births B 126/1000 live births C 74/1000 live births D 100/1000 live births
Ans. A

Explanation:

Ans:A.)50/1000 live births

Q. 8

A community has a population of 10,000 and a birth rate of 36 per 1000. 6 maternal deaths were reported in the current year. The Maternal Mortality Rate (MMR) is:

 A 14.5 B 16.6 C 20 D 5
Q. 8

A community has a population of 10,000 and a birth rate of 36 per 1000. 6 maternal deaths were reported in the current year. The Maternal Mortality Rate (MMR) is:

 A 14.5 B 16.6 C 20 D 5
Ans. B

Explanation:

Total no.of female deaths due to complication of pregnancy, childbirth or within 42 days of delivery from puerperal causes in an area during a given year.

—————————————————————————————————-    x 1000
Total no. of live births in the same area and year.

6/360 x 1000= 0.0166 x 1000 = 16.6

Ref: Park, 20th Edition, Page 479.

Q. 9

The comparison of mortality rates between two countries requires the application of direct standardization. Which if the following parameters makes it necessary to have standardization?

 A Numerators B Denominators C Causes of death D Age distributions
Q. 9

The comparison of mortality rates between two countries requires the application of direct standardization. Which if the following parameters makes it necessary to have standardization?

 A Numerators B Denominators C Causes of death D Age distributions
Ans. D

Explanation:

Mortality rates between two countries are not comparable because these populations have different Age compositions.

The difference in age between two sets of population (two countries) does not allow the mortality rates of the two populations to be compared.

Direct standardization is used to remove the difference in age distribution thus allowing the comparison of mortality rates.

RefPark’s Textbook of Preventive and Social Medicine 19th Edition; Pages 54 – 55.

Q. 10

A good indicator of the availability, utilization and effectiveness of health care services in a country isâ€‘

 A Maternal mortality rate B Hospital bed occupancy rate C Infant mortality rate D DALY’s
Q. 10

A good indicator of the availability, utilization and effectiveness of health care services in a country isâ€‘

 A Maternal mortality rate B Hospital bed occupancy rate C Infant mortality rate D DALY’s
Ans. D

Explanation:

Ans. is ‘c’ i.e., Infant mortality rate

o IMR is considered a sensitive index of health services as it reflects maternal care, perinatal care, child rearing practices, nutritional practices, and socioeconomic conditions in which people live as well as availability, effectiveness and utilization of health care services.

“IMR is universally regarded not only as a most important indicator of health status of a community but also of the level of living of people in general and effectiveness of MCH services in particular. ”

Q. 11

Simplest measure of mortality â€‘

 A Crude death rate B Case fatality rate C Proportional mortality rate D Specific death rate
Q. 11

Simplest measure of mortality â€‘

 A Crude death rate B Case fatality rate C Proportional mortality rate D Specific death rate
Ans. A

Explanation:

Ans. is ‘a’ i.e., Crude death rate

o The simplest measure of mortality is the crude death rate.

Q. 12

Proportional mortality rate is –

 A Number of death due to particular a cause B Number of death during that year C Number of death in one month D None
Q. 12

Proportional mortality rate is –

 A Number of death due to particular a cause B Number of death during that year C Number of death in one month D None
Ans. A

Explanation:

Ans. is ‘a’ i.e., Number of death due to particular a cause

Q. 13

Which of the following statistics should be adjusted for age to allow comparisons

 A Age specific fertility rate B Crude mortality rate C Perinatal mortality rate D Infant mortality rate
Q. 13

Which of the following statistics should be adjusted for age to allow comparisons

 A Age specific fertility rate B Crude mortality rate C Perinatal mortality rate D Infant mortality rate
Ans. B

Explanation:

Ans. is ‘b’ i.e., Crude Mortality Rate

Crude Mortality Rate (Crude Death Rate) is not a correct parameter to compare death rates of two populations since each population is likely to have different age compositions. Age adjustment or Age standardization is required to compare crude death rates from two different populations.

o Infant Mortality Rate; Perinatal Mortality rate; and Age Specific Fertility Rate all compare populations within a narrow/similar age range and hence these statistics do not require to be adjusted for age.

Q. 14

Death rates of two countries are best compared by â€‘

 A Crude death rate B Proportional crude death rate C Standardized mortality rate D Age specific death rate
Q. 14

Death rates of two countries are best compared by â€‘

 A Crude death rate B Proportional crude death rate C Standardized mortality rate D Age specific death rate
Ans. C

Explanation:

Ans. is ‘c’ i.e., Standardized mortality rate

Q. 15

Which of the following is used to compare the death rates of two different populations –

 A Crude death rate B Age specific death rate C Age standardized death rate D Proportional mortality rate
Q. 15

Which of the following is used to compare the death rates of two different populations –

 A Crude death rate B Age specific death rate C Age standardized death rate D Proportional mortality rate
Ans. C

Explanation:

Ans. is ‘c’ i.e., Age standaridized death rate

Q. 16

Standardised mortality rate is stadardised for

 A Age B Disease C Region D A particular time period
Q. 16

Standardised mortality rate is stadardised for

 A Age B Disease C Region D A particular time period
Ans. A

Explanation:

Ans. is ‘a’ i.e., Age

Q. 17

Denominator of maternal mortality rate is –

 A 1000 total births B Mid year population C 1000 live births D None
Q. 17

Denominator of maternal mortality rate is –

 A 1000 total births B Mid year population C 1000 live births D None
Ans. D

Explanation:

Ans. is ‘None’

Following very important facts have been changed in 21nd/e of Park

Maternal mortality ratio

o Maternal mortality ratio is defined as total number of maternal deaths i.e. deaths due to complications of child birth, pregnancy or within 42 days of delivery from ‘puerperal causes’ in the area during a given year Per 1000 or (100,000) live births in the same area during the same year.

o It is called late maternal death —> Death of women from direct or indirect obstetric causes more than 42 days but less than 1 year after termination of pregnancy.

Maternal mortality rate

o It is the number of maternal death in a given period per 1000 (or 100,000) women of reproductive age during same period.

Total no. of female death due to complication of pregnancy,

childbirth or within 42 days of delivery

Maternal mortality rate –                          x 1000 (or 100, 000) Total no. of women of reproductive age

Therefore

o Denominator in maternal mortality ratio          1000 live birth (or 100,000 live birth)

o Denominator in maternal mortality rate 1000 (or 100,000) women of reproductive age.

Note :

o According to previous editions of park, the answer of this question was 1000 live birth as in previous editions (upto 20th/e) maternal mortality was described as maternal death per 1000 (or 100,000) live birth (which is now described as maternal mortality ratio). Maternal mortality ratio was not given in previous editions of Park; it was described as maternal mortality rate.

o So, according to previous editions of Park, maternal mortality rate was a ratio (not a rate) as numerator (maternal deaths) is not a part of denominator (live births).

o However, according to recent definition (21 st/e Park) maternal mortality rate is rate as numerator (maternal death) is a part of denominator (women of reproductive age group).

Thus, as the name suggests : –

o Maternal mortality ratio (MMR) is a ratio (numerator is not a part of denominator). o Maternal mortality rate is a rate (numerator is a part of denominator).

Q. 18

About Maternal mortality rate which of the following is true?

 A It is rate, not ratio B Numerator includes complications related deaths up to 42 days after pregnancy C Denominator includes still birth and abortions D Expressed as rate per 1000 live births
Q. 18

About Maternal mortality rate which of the following is true?

 A It is rate, not ratio B Numerator includes complications related deaths up to 42 days after pregnancy C Denominator includes still birth and abortions D Expressed as rate per 1000 live births
Ans. B

Explanation:

Ans. is ‘b’  i.e., Numerator includes complications related deaths up to 42 days after pregnancy

Numerator in maternal mortality rate : –

i)    Total number of female death

ii)  Due to complications of pregnancy, childbirth or within 42 days of delivery from puerperal causes. o Denominator in maternal mortality rate is 1000 (or 100, 000) women of reproductive age, i.e., maternal mortality rate is expressed as rate per 1000 (or 100,000) women of reproductive age.

o Maternal mortality rate is a rate (not the ratio) as numerator is a part of denominator.

Note :

o According to previous editions of Park, maternal mortality rate was described as a ratio not a rate (Has been explained already).

Q. 19

Maternal mortality rate is –

 A Maternal death/100 births B Maternal death/ l00 live births C Maternal death/1000 births D None
Q. 19

Maternal mortality rate is –

 A Maternal death/100 births B Maternal death/ l00 live births C Maternal death/1000 births D None
Ans. D

Explanation:

Ans. is ‘None’

Q. 20

Infant mortality rate in India is, per 1000 live births-

 A 25 B 47 C 55 D 60
Q. 20

Infant mortality rate in India is, per 1000 live births-

 A 25 B 47 C 55 D 60
Ans. B

Explanation:

Ans. is ‘b’ i.e., 47

o IMR in India is 47-48 per 1000 live birth.

Q. 21

In a certain population, there were 4050 births in last one year. There were 50 still births. 50 infants died within 7 days where as 150 died within 28 days. What is the neonatal mortality rate-

 A 50 B 62.5 C 12.5 D 49.4
Q. 21

In a certain population, there were 4050 births in last one year. There were 50 still births. 50 infants died within 7 days where as 150 died within 28 days. What is the neonatal mortality rate-

 A 50 B 62.5 C 12.5 D 49.4
Ans. A

Explanation:

Ans. is ‘a’ i.e., 50

Neonatal deaths are deaths occurring during the neonatal period, commencing at birth and ending 28 completed days after birth. Neonatal mortality rate is the number of neonatal deaths in a given year per 1000 live births in that year.

Q. 22

All of the following statements hold true for perinatal mortality rate except –

 A Deaths of neonate within one weak are included B Late still births and deaths beyond 28 weeks are included C Deaths of children weighing more than 1000 gm is are included D Total number of birth’ forms the denominator
Q. 22

All of the following statements hold true for perinatal mortality rate except –

 A Deaths of neonate within one weak are included B Late still births and deaths beyond 28 weeks are included C Deaths of children weighing more than 1000 gm is are included D Total number of birth’ forms the denominator
Ans. D

Explanation:

Ans. is d’ i.e., Total number of births in denominator

o Denominator for perinatal mortality rate is live births and not total births.

o Perinatal mortality includes both  : Late foetal deaths : deaths after 28 weeks gestation .

: Early neonatal deaths : deaths within 1st week of life

o Babies included for perinatal death statistics should have the following features :

a.  birth weight above a minimum of 1000 gm.

b.     If birth weight is not available a gestation period of at least 28 weeks

c.   Where (a) and (b) are not available body lenght (crown-heel) at at last 35 cm . should be used. o Perinatal morality rate is then calculated as perinatal mortality per 1000 live births in the same area. o Thus denominator for perinatal mortality rate is live births and not total births.

Q. 23

Perinatal mortality rate include which of the following?

 A Abortions + Still birth early neonatal deaths B Still birth + early neonatal deaths C Abortions + early neonatal deaths D Deaths up to 42 dys after birth
Q. 23

Perinatal mortality rate include which of the following?

 A Abortions + Still birth early neonatal deaths B Still birth + early neonatal deaths C Abortions + early neonatal deaths D Deaths up to 42 dys after birth
Ans. B

Explanation:

Ans. is b’ i.e., Still birth + early neonatal death

Q. 24

The socioeconomic status of community is best indicated by-

 A IMR B Under 5 mortality rate C Maternal mortality rate D Perinatal mortality rate
Q. 24

The socioeconomic status of community is best indicated by-

 A IMR B Under 5 mortality rate C Maternal mortality rate D Perinatal mortality rate
Ans. A

Explanation:

Ans. is ‘a’ i.e., IMR

Ans:A.)IMR.
Infant mortality rate (IMR) is defined as the ratio of infant deaths registered in a given year to the total number of live births registered in the same year, usually expressed as a rate per 1000 live births. It is given by the formula:

IMR= No. of deaths of children less than 1 year of age in a year
——————————————————————–×1000
No. of live births in the same year

IMR is universally regarded not only as a most important indicator of the health status of a community but also of the level of living of people in general and effectiveness of MCH services in particular.
Infant mortality rate is given a separate treatment by demographers because:
• IMR is the single largest single age-category of mortality.
• Deaths at this age are due to a peculiar set of diseases and conditions to which the adult population is less exposed or less vulnerable.
• IMR is affected rather quickly and directly by specific health programmes and hence may change more rapidly than the general death rate.

• Socio-economic status of the community
• RCH activities
• Health-care availability
• Health status of community

Q. 25

All of the following statements are true about the childhood mortality rates in India except â€‘

 A Almost 3/5′ of infant mortality rate (IMR) occurs in neonatal period B Almost 3/4′ of the under-five mortality occurs in the first year 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
Q. 25

All of the following statements are true about the childhood mortality rates in India except â€‘

 A Almost 3/5′ of infant mortality rate (IMR) occurs in neonatal period B Almost 3/4′ of the under-five mortality occurs in the first year 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. C

Explanation:

Ans. is ‘c’ i.e., About one in ten children die before they reach the age of five years

“In India child mortality rate is 13 per 1000 under five children”.

That means 13 out of 1000 children die before they reach the age of five years. (Not 1 in 10 which will be 100 per 1000).

• “About 50% of infant deaths occur within the first month (neonatal period of life)”

o Most of these neonatal death occur, during first seven days of life (i.e. in early neonatal period).

• “Neonatal deaths make major contribution to infant mortality (70%)” Park
• “Neonatal mortality is greater in boys throughout the world because newborn boys are biologically more fragile than girls”. park

Option d require specific mention

“In all developed countries, male infant mortality rate are higher than female infant mortality rate but in India after the age of one month (post neonatal period) female deaths are invariably higher than male deaths. Social scientist have attributed this phenomenon to social factor unfavourable to female in India”. Park

o From above statement of Park, it is clear that postneonatal infant mortality rate is more in females. o But, maximum infant deaths occur during neonatal period (not in post neonatal period).

o I am not sure whether neonatal mortality is higher among male or female children because it has not been mentioned in the book.

o I am assuming it is more in males because Park has specifically mentioned the female predominance in postneonatal death, which is different from developed countries.

o As no difference has been mentioned during neonatal period, it should be same as in developed (otherwise it would have been mentioned).___________________ I am not sure.

Following data have changed in 22nd/e of Park

Child (Aged 0-4 years) and infant mortality indicators, 2010 (India)

 Indicators Total Rural Urban Child mortality rate 13 15 8 Infant mortality rate 47 51 31 Neo-natal mortality rate 33 36 19 Early neo-natal mortality rate 25 28 15 Late neo-natal mortality rate 7 8 4 Post neo-natal mortality rate 14 15 12 Peri-natal mortality rate 32 35 22 Still birth rate 7 7

Q. 26

Major cause of infant mortality rate in India is –

 A Immaturity B Respiratory infections C GIT infection D Kwashiorkor
Q. 26

Major cause of infant mortality rate in India is –

 A Immaturity B Respiratory infections C GIT infection D Kwashiorkor
Ans. A

Explanation:

Ans. is ‘a’ i.e., Immaturity

Q. 27

You were posted at a PHC catering to a population of 1,20,000. In the year 2006, a total number of 2500 liver born babies were delivered. Number of children dying under one year of age during 2006 was 150. What is the infant mortality rate of this population ?

 A 60 B 70 C 80 D 90
Q. 27

You were posted at a PHC catering to a population of 1,20,000. In the year 2006, a total number of 2500 liver born babies were delivered. Number of children dying under one year of age during 2006 was 150. What is the infant mortality rate of this population ?

 A 60 B 70 C 80 D 90
Ans. A

Explanation:

Ans. is ‘a’ i.e., 60

Q. 28

Which is the best indicator to assess the impact of ASHA-

 A Number of ASHA trained B Infant mortality rate C % of institutional deliveries D Number of ASHA’s attending meeting after one year
Q. 28

Which is the best indicator to assess the impact of ASHA-

 A Number of ASHA trained B Infant mortality rate C % of institutional deliveries D Number of ASHA’s attending meeting after one year
Ans. B

Explanation:

Ans. is b’ i.e., Infant mortality rate

Monitoring and Evaluation of ASII.Vs work

Government of India has set up following indicators for monitoring ASHA (41). 1.Process Indicators

a)   Number of ASHAs selected by due process

b)   Number of ASH As trained; and

c)   % of ASHAs attending review meeting after one year

2. Outcome Indicators

a)   % of newborn who were weighed and families counseled.

b)   % of children with diarrhoea who received ORS.

c)   % of deliveries with skilled assistance.

d)   % of institutional deliveries.

e)   % of JSY claims made to ASHA

f) % of completely immunized in 12 to 23 months age group.

g)   % of unmet need for spacing contraception among BPL.

h)   % of fever cases who received chloroquine with in first week in a malaria endemic area.

3.1mpact Indicators

a)     IMR

b)     Child malnutrition rates

c)     Number of cases of TB/leprosy detected as compared to previous year.

Q. 29

Not included in Infant mortality rate:

March 2012

 A Perinatal mortality B Early neonatal C Late neonatal mortality D Post neonatal mortality
Q. 29

Not included in Infant mortality rate:

March 2012

 A Perinatal mortality B Early neonatal C Late neonatal mortality D Post neonatal mortality
Ans. A

Explanation:

Ans: A i.e. Perinatal mortality

Infant mortality rate/IMR is defined as “the ratio of infant deaths (birth to 1 year of age) registered in a given year to the total number of live births registered in the same year; usually expressed as a rate per 1000 live births”

Numerators in ‘natal’ death

• Perinatal death includes late foetal deaths (28 weeks of gestation and more) + early neonatal deaths (1st week)
• Early neonatal death occurs between births to first 7 days of life
• Late neonatal death occurs between 7th days of life till 28th day of life
• Post-neonatal deaths occurs between 28th day of life till 1 year

Q. 30

Denominator for calculating infant mortality rate is:

September 2005

 A 1000 population B 1000 births C 1000 live births D 1000 pregnancies
Q. 30

Denominator for calculating infant mortality rate is:

September 2005

 A 1000 population B 1000 births C 1000 live births D 1000 pregnancies
Ans. C

Explanation:

Ans. C: 1000 live births

IMR = Number of deaths of children less than 1 year of age in a year X 1000/number of live births in the same year

IMR is universally regarded a s not only as a most important indicator of the health status of a community but also the level of living of people in general, and effectiveness of MCH services in particular.

It is expressed as a rate per 1000 live births.

Q. 31

Maternal mortality rate is calculated as death of a woman upto a period of:

September 2005

 A Immediately after delivery B 42 days after delivery C 7 days after delivery D 21 days after delivery
Q. 31

Maternal mortality rate is calculated as death of a woman upto a period of:

September 2005

 A Immediately after delivery B 42 days after delivery C 7 days after delivery D 21 days after delivery
Ans. B

Explanation:

Ans. B: 42 days after

MMR= Total number of female deaths due to complications of pregnancy, childbirth or within 42 days of delivery from ‘puerperal causes’ in an area during a given year X 1000/Total number of live births in the same area and year MMR is a measure of quality of maternity services.

The MMR should be expressed as a rate per 1000 live births.

In developed countries, MMR has declined significantly. Because of this decline, they use the multiplying factor 100,000 instead of 1000 to avoid fractions in calculating MMR.

Q. 32

Denominator for maternal mortality rate is:

September 2005, 2010, March 2013 (d, e, h)

 A 100,000 pregnancies B 100,000 live births C 100,000 births D 100,000 population
Q. 32

Denominator for maternal mortality rate is:

September 2005, 2010, March 2013 (d, e, h)

 A 100,000 pregnancies B 100,000 live births C 100,000 births D 100,000 population
Ans. B

Explanation:

Ans. B: 100,000 live births

The maternal mortality rate is the number of maternal deaths due to childbearing per 100,000 live births. The crude death rate is the total number of deaths per year per 1000 people.

The perinatal mortality rate is the sum of neonatal deaths and fetal deaths (stillbirths) per 1000 births. The infant mortality rate is the number of deaths of children less than 1 year old per 1000 live births.

The child mortality rate is the number of deaths of children less than 5 years old per 1000 live births.

The standardised mortality rate (SMR)- This represents a proportional comparison to the numbers of deaths that would have been expected if the population had been of a standard composition in terms of age, gender, etc.. The age-specific mortality rate (ASMR) – This refers to the total number of deaths per year per 1000 people of a given age (e.g. age 62 last birthday).

Q. 33

Infant Mortality Rate for Japan is:

March 2007

 A 2 B 3 C 4 D 5
Q. 33

Infant Mortality Rate for Japan is:

March 2007

 A 2 B 3 C 4 D 5
Ans. B

Explanation:

Ans. B: 3

Infant mortality is defined as the number of deaths of infants (one year of age or younger) per 1000 live births during the year.

Related statistical categories:

• Perinatal mortality only includes deaths between the foetal viability (22 weeks gestation) and the end of the 7th day after delivery.
• Neonatal mortality only includes deaths in the first 28 days of life.
• Post-neonatal death only includes deaths after 28 days of life but before one year.
• Child mortality includes deaths within the first five years after birth.

IMR for Japan is 3 IMR for India is 54

Q. 34

Denominator for calculating perinatal mortality rate is:

September 2009

 A 1000 births B 1000 live births C 1000 still births D 1000 population
Q. 34

Denominator for calculating perinatal mortality rate is:

September 2009

 A 1000 births B 1000 live births C 1000 still births D 1000 population
Ans. B

Explanation:

Ans. B: 1000 live births

164. Perinatal mortality, defined as number of stillbirths (28 weeks of gestation and more) and deaths in the first week of life (early neonatal deaths) per 1,000 live births, is a useful additional indicator, and work is ongoing to improve estimates of stillbirth rates, a major component of perinatal mortality.

Q. 35

Infant Mortality Rate of India as per 2007 census is:

March 2010

 A 34 B 44 C 54 D 64
Q. 35

Infant Mortality Rate of India as per 2007 census is:

March 2010

 A 34 B 44 C 54 D 64
Ans. C

Explanation:

Ans. C: 54

Q. 36

Mortality rates are taken into account while calculat­ing:

March 2011

 A General fertility rate B NRR C Total fertility rate D Gross reproduction rate
Q. 36

Mortality rates are taken into account while calculat­ing:

March 2011

 A General fertility rate B NRR C Total fertility rate D Gross reproduction rate
Ans. B

Explanation:

Ans. B: NRR

Net reproduction rate measures the number of daughters a woman would have in her lifetime if she experiences prevailing age-specific fertility and mortality rates

Net reproduction rate/NRR

It is the average number of daughters that would be born to a female (or a group of females) if she passed through her lifetime conforming to the age-specific fertility and mortality rates of a given year.

This rate is similar to the gross reproduction rate but takes into account that some females will die before completing their childbearing years.

An NRR of one means that each generation of mothers is having exactly enough daughters to replace themselves in the population.

The NRR is particularly relevant where sex ratios at birth are significantly affected by the use of reproductive technologies, or where life expectancy is low

Total fertility rate/ TFR/ Fertility rate/ Period total fertility rate (PTFR)/ Total period fertility rate (TPFR)

It is the average number of children that would be born to a woman over her lifetime if (1) she were to experience the exact current age-specific fertility rates (ASFRs) through her lifetime, and (2) she were to survive from birth through the end of her reproductive life.

It is obtained by summing the single-year age-specific rates at a given time.

Q. 37

For international comparisons, perinatal mortality rate is calculated as late fetal deaths (28 weeks gestation or more) plus early neonatal deaths (first week) [weighing over 1 kg at birth] in a year per:

September 2011

 A 100 live births [weighing over 1 kg at birth] B 1,000 live births [weighing over 1 kg at birth] C 10,000 live births [weighing over 1 kg at birth] D 1,00,000 live births [weighing over 1 kg at birth]
Q. 37

For international comparisons, perinatal mortality rate is calculated as late fetal deaths (28 weeks gestation or more) plus early neonatal deaths (first week) [weighing over 1 kg at birth] in a year per:

September 2011

 A 100 live births [weighing over 1 kg at birth] B 1,000 live births [weighing over 1 kg at birth] C 10,000 live births [weighing over 1 kg at birth] D 1,00,000 live births [weighing over 1 kg at birth]
Ans. B

Explanation:

Ans. B: 1,000 live births [weighing over 1 kg at birth]

For international comparisons, the WHO committee on the prevention of Perinatal Mortality and Morbidity recommend a more precise formulation: “Late foetal and early neonatal deaths weighing over 1000 gram at birth, expressed as a ratio per 1000 live births weighing over 1000 gram at birth”

Perinatal mortality (PNM)/ Perinatal death

• It refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate.
• Variations in the precise definition of the perinatal mortality exist specifically concerning the issue of inclusion or exclusion of early fetal and late neonatal fatalities.
• The World Health Organization defines perinatal mortality as the “number of stillbirths and deaths in the first week of life per 1,000 live births”, but other definitions have been used
• Fetal mortality refers to stillbirths or fetal death.
• It encompasses any death of a fetus after 20 weeks of gestation or 500 gm.
• In some definitions of the PNM early fetal mortality (week 20-27 gestation) is not included, and the PNM may only include late fetal death and neonatal death.
• Fetal death can also be divided into death prior to labor, antenatal (antepartum) death, and death during labor, intranatal (intrapartum) death
• Early neonatal mortality refers to a death of a live-born baby within the first seven days of life, while late neonatal mortality covers the time after 7 days until before 28 days.
• The sum of these two represents the neonatal mortality.
• Some definitions of the PNM include only the early neonatal mortality.
• Neonatal mortality is affected by the quality of in-hospital care for the neonate.
• Neonatal mortality and postneonatal mortality (covering the remaining 11 months of the first year of life) are reflected in the Infant Mortality Rate.
• The PNMR refers to the number of perinatal deaths per 1,000 total births.
• It is usually reported on an annual basis.
• It is a major marker to assess the quality of health care delivery.

Q. 38

Current infant mortality rate in India â€‘

 A 29 per 1000 live births B 42 per 1000 live births C 50 per 1000 live births D 20 per 1000 live births
Q. 38

Current infant mortality rate in India â€‘

 A 29 per 1000 live births B 42 per 1000 live births C 50 per 1000 live births D 20 per 1000 live births
Ans. B

Explanation:

Ans. is ‘b’ i.e., 42 per 1000 live births

Q. 39

Least Neonatal mortality rate is seen in –

 A Delhi B Tamil Nadu C Karnataka D Maharashtra
Q. 39

Least Neonatal mortality rate is seen in –

 A Delhi B Tamil Nadu C Karnataka D Maharashtra
Ans. B

Explanation:

Ans. is ‘b’ i.e., Tamil Nadu

Overall, least neonatal mortality is recorded in Kerala. However, among the given options Tamilnadu has minimum neonatal mortaltiy.

Q. 40

Denominator in perinatal mortality rate â€‘

 A Total births B Total live births C Live births + Still birth D Total number of newborns
Q. 40

Denominator in perinatal mortality rate â€‘

 A Total births B Total live births C Live births + Still birth D Total number of newborns
Ans. B

Explanation:

Ans. is ‘b’ i.e., Total live births

Q. 41

Proportional mortality rate is â€‘

 A Number of death due to a particular cause B Number of death during that year C Number of death in one month D None
Q. 41

Proportional mortality rate is â€‘

 A Number of death due to a particular cause B Number of death during that year C Number of death in one month D None
Ans. A

Explanation:

Ans. is ‘a’ i.e., Number of death due to a particular cause

Proportional mortality rate (ratio)

• Proportional mortality rate measures the proportion of total death due to specific cause or proportion of deaths in a particular age group.
• It is defined as “number of deaths due to a particular cause (or in specific age group) per 100 total deaths”.
• It is the ‘simplest measure of estimating the burden of disears’ in the community.
• It is a useful ‘health Status indicator’; indicates magnitude of preventable mortality.
• It is used when population data is not available.
• It does not indicate the risk of members of population contracting or dying from the disease.

Q. 42

Best indicator for burden of disease â€‘

 A Incidence B Crude death rate C Cause specific death rate D Proportional mortality rate
Q. 42

Best indicator for burden of disease â€‘

 A Incidence B Crude death rate C Cause specific death rate D Proportional mortality rate
Ans. D

Explanation:

Ans. is ‘d’ i.e., Proportional mortality rate

Q. 43

Positive mortality indicator is â€‘

 A IMR B Child mortality rate C MMR D Life expectancy
Q. 43

Positive mortality indicator is â€‘

 A IMR B Child mortality rate C MMR D Life expectancy
Ans. D

Explanation:

Ans. is ‘d’ i.e., Life expectancy

Mortality indicators

These are :â€‘

1. Crude death rate
2. Maternal mortality rate
3. Expectation of life (life expectancy)
4. Disease specific mortality rate
5. Infant mortality rate
6. Age specific death rate
7. Child mortality rate
9. Under-5 proportional mortality rate
10. Years of potential life lost
• Among these only life expectancy is a positive mortality indicator, i.e. increase life expectancy means improvement in health.
• All other are ‘negative’ health indicators, i.e. increase value of these indicators implies poor health of community.

Q. 44

Best measure of socioeconomic status â€‘

 A Child mortality rate B MMR C Low birth weight rate D Neonatal mortality rate
Q. 44

Best measure of socioeconomic status â€‘

 A Child mortality rate B MMR C Low birth weight rate D Neonatal mortality rate
Ans. A

Explanation:

Ans. is ‘a’ i.e., Child mortality rate

Under 5 mortality rate (child mortality rate) is the best indicator of socioeconomic status of country.

IMR is best indicator for :-

1. Health status of a community.
2. Level of living.
3. Effectiveness of MCH services.

IMR is second best indicator of socioeconomic status of country (under 5 mortality rate is more refined indicator for socioeconomic status).

Q. 45

In MCH programme, best indicator for mother and child health â€‘

 A MMR B IMR C Still birth rate D Neonatal mortality rate
Q. 45

In MCH programme, best indicator for mother and child health â€‘

 A MMR B IMR C Still birth rate D Neonatal mortality rate
Ans. B

Explanation:

Ans. is ‘b’ i.e., IMR

IMR is best indicator for:-

1. Health status of a community.
2. Level of living.
3. Effectiveness of MCH services.

IMR is second best indicator of socioeconomic status of country (under 5 mortality rate is more refined indicator for socioeconomic status).

Q. 46

In a certain population, there were 4050 births in the last one year. There were 50 still births, 50 infants died within 7 days whereas 150 died within the first 28 days. What is the neonatal mortality rate

 A 50 B 62.5 C 12.5 D 49.4
Q. 46

In a certain population, there were 4050 births in the last one year. There were 50 still births, 50 infants died within 7 days whereas 150 died within the first 28 days. What is the neonatal mortality rate

 A 50 B 62.5 C 12.5 D 49.4
Ans. A

Explanation:

Ans. a. 50

Q. 47

In a certain population, there were 4050 births in the last one year. There were 50 still-births. 50 infants died within 7 days whereas 150 died within the first 28 days. What is the neonatal mortality rate

 A 50 B 62.5 C 12.5 D 49.4
Q. 47

In a certain population, there were 4050 births in the last one year. There were 50 still-births. 50 infants died within 7 days whereas 150 died within the first 28 days. What is the neonatal mortality rate

 A 50 B 62.5 C 12.5 D 49.4
Ans. B

Explanation:

Ans. b. 50

Q. 48

Infant mortality rate includes all of the following except

 A Early neonatal deaths B Late neonatal deaths C Post neonatal deaths D Stillbirths
Q. 48

Infant mortality rate includes all of the following except

 A Early neonatal deaths B Late neonatal deaths C Post neonatal deaths D Stillbirths
Ans. D

Explanation:

Ans. d. Stillbirths

Q. 49

Infant mortality rate in India is, per 1000 live birthsâ€‘

 A 25 B 34 C 55 D 60
Q. 49

Infant mortality rate in India is, per 1000 live birthsâ€‘

 A 25 B 34 C 55 D 60
Ans. B

Explanation:

Ans. is `b’ i.e.,34

The value for Mortality rate, infant (per 1,000 live births) in India was 37 as of 2015.

IMR of India has declined by three points (8% decline), from 37 per 1000 live births in 2015 to 34 per 1000 live births in 2016.