In 2002, Rowland Hogue and Vasquez aimed to develop a strategy to address disparities in infant mortality to streamline health programs for the issue. One of insights from the study was the relationship of economic status to the rate of infant morality. In a parallel study, Frey, Scott and Field (2000) extended this relationship to include other forms of social exclusion or disenfranchisement such as race or gender discrimination.
In both studies, infant mortality is not just considered as a health issues but as a social issue that can be used as a barometer for the effectiveness of basic health and education programs. The findings of Rowland Hogue and Vasquez (2002) echoed the conclusions developed by Rutstein (2000) as part of a study done for the World Health Organization (WHO) that emphasized the need to consider social, cultural and political factors in developing effective programs to address infant mortality issues.
The study concluded that education was the most critical channel to address the issue and concluded that infant mortality should include school-based and community-based programs and the institution of independent evaluation standards. The impact to communities is also substantial not only in terms of life lost but also the stress made on health services directly and after the death of the infant (Buckley et al, 1998). Condition Specific and People-Specific Dimensions
Condition specific dimensions to be considered include the health of the infant before and after birth as well as any external factor in his context that can contribute to infant mortality. This has been particularly highlighted in the assessment made by Singh and his associates (2007) regarding the persistence of neonatal and postnatal mortality in the last thirty years. Similarly, Zarcadoolas and his associates (2006), have encouraged the development of health frameworks to advocate education, awareness and proactive response among the public regarding health issues particularly when it affects vulnerable groups such as children.
Apart from health or medical determinations, this will include the incidence of infant mortality in the child’s lineage or conditions that can develop leading to mortality. Finally, these will include all factors identified through academic research as factors that can influence infant mortality. For the people specific dimensions, current literature has focused on “unemployment, poor skills, low incomes, poor housing, high crime environments, bad health and family breakdown” as the most critical factors that can create personal social stress (Lang & Wilkinson, 2000, p. 4).
The personal perspective of health officers in delivering information regarding the issue of infant mortality also been seen as a significant factor in the effective of education programs that suggests the relationship between people specific dimensions (Lambert et al, 2004). In particular, parents’ educational attainment, social class, cultural background, gender, disabilities and age are key considerations for evaluation: the NFIMR (2001) report has prescribed unique standards for infant mortality mitigation education and programs to accommodate the fact that the target audience of the programs are not the patients of direct concern.