# Situation: The public health nurse of a Rural Health Unit (RHU) prepares the annual health statistics report of a municipality with a midyear population of 62,000. Last year the municipality recorded 1,240 live births and 31 deaths of infants under 1 year of age; 18 of these infants died within the first 28 days of life. What is the infant mortality rate (IMR) per 1,000 live births? Round off to one decimal place.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627087  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The public health nurse of a Rural Health Unit (RHU) prepares the annual health statistics report of a municipality with a midyear population of 62,000.

Last year the municipality recorded 1,240 live births and 31 deaths of infants under 1 year of age; 18 of these infants died within the first 28 days of life. What is the infant mortality rate (IMR) per 1,000 live births? Round off to one decimal place.

## 보기

1. 0.5
2. 10.5
3. 14.5
4. 25.0 **✔ 정답**

**정답: 4**

## 해설

IMR = deaths under 1 year ÷ live births × 1,000 = 31 ÷ 1,240 × 1,000 = 25.0 per 1,000 live births. The denominator is live births, not the midyear population, and the numerator includes all infant deaths, both neonatal and post-neonatal.

## 심화 해설

Key concept: computing the infant mortality rate

The infant mortality rate (IMR) is a classic vital statistic used to describe the health of a community. It is calculated as the number of deaths of infants under 1 year of age in a given year, divided by the number of live births in that same year, then multiplied by 1,000. The formula is:

IMR = (deaths under 1 year ÷ live births) × 1,000

In this municipality, the numerator is 31 infant deaths, and the denominator is 1,240 live births. The midyear population of 62,000 is not used in this calculation because the IMR is a ratio of infant deaths to live births, not a rate per total population. The computation is:

31 ÷ 1,240 × 1,000 = 25.0 per 1,000 live births

The numerator includes all infant deaths, meaning both neonatal deaths (within the first 28 days of life) and post-neonatal deaths (from 28 days up to 1 year). In this case, 18 deaths were neonatal, and the remaining 13 were post-neonatal. Both are counted in the IMR.

Watch out! The denominator is live births, not the midyear population. Using 62,000 would produce a completely different and incorrect value.

Key point! The IMR is a sensitive indicator of maternal and child health, access to prenatal care, nutrition, sanitation, and the overall effectiveness of the health system. Because it reflects conditions affecting the most vulnerable age group, it is often used to compare health status across communities or over time.

The abstract by Reidpath and Allotey notes that the IMR has been criticized for being narrowly focused on a small segment of the population [1]. However, it remains widely used, especially in resource-limited settings, because it is relatively simple to calculate and interpret compared with more comprehensive measures such as disability-adjusted life expectancy. For a rural health unit preparing an annual report, the IMR provides a practical and actionable summary of infant survival in the municipality.

| Component | Value in this problem | Role in IMR |
| --- | --- | --- |
| Deaths under 1 year | 31 | Numerator |
| Live births | 1,240 | Denominator |
| Midyear population | 62,000 | Not used |
| Neonatal deaths (first 28 days) | 18 | Included in numerator |
| Post-neonatal deaths (28 days to 1 year) | 13 | Included in numerator |

The correct answer is therefore 25.0 per 1,000 live births.References (research sources)

- [1]Infant mortality rate as an indicator of population health.Research articleReidpath DD, Allotey P (2003) · DOI: 10.1136/jech.57.5.344

## 임상 시나리오

Infant Mortality Rate CalculationUse live births, not midyear population
The infant mortality rate is calculated as deaths under 1 year divided by live births, multiplied by 1,000. In this case, 31 ÷ 1,240 × 1,000 = 25.0 per 1,000 live births.

The numerator includes all infant deaths, both neonatal (first 28 days) and post-neonatal (28 days to 1 year). The midyear population of 62,000 is not used in this formula.

CautionUsing the midyear population as the denominator is a common error and produces a falsely low rate. Always confirm the denominator is live births for IMR.

## 핵심 개념

- **Infant mortality rate** — Deaths of infants under 1 year per 1,000 live births in a given year; a key indicator of community health.
- **Live births** — The denominator for IMR, representing all infants born alive in the same year, not total population.
- **Neonatal deaths** — Infant deaths within the first 28 days of life; included in the IMR numerator.
- **Post-neonatal deaths** — Infant deaths from 28 days up to 1 year; also included in the IMR numerator.
- **Vital statistics** — Quantitative data on births, deaths, and other life events used to assess population health.

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