International differences in infant mortality and the impact of malnutrition: a review.

In the industrialized countries infant mortality continues to decline even though mortality is already at a low level. The greatest number of infant deaths occur in the neonatal period, especially during the first day of life and the main determinants of infant death are perinatal causes and congenital anomalies. In less-developed countries infant mortality remains high, particularly in Africa, the Indian subcontinent and South-East Asia. Observed rates of decline during the last 20 years have been no faster than in the industrialized countries and may indeed have been slower. Although a greater proportion of infant deaths occur postneonatally compared with industrialized countries, the majority nevertheless occur within the first 3 months of life. The main causes of infant mortality are low birth-weight and diarrhoeal disease. The implications in terms of health and nutrition policies are discussed.