Topic Summary on Infant Mortality

This JSNA provides a summary of the evidence and data regarding the health issues and associated inequalities that are known to affect pregnant women, babies in their first year of life and women of childbearing age living in Manchester.​ It also describes what Manchester City Council and other organisations working in the city are doing to support this cohort of people as well as some of the opportunities for action that exist.​

The JSNA provides an overview of national, regional and local evidence and data on infant mortality. It highlights the existence of inequalities in the experiences and outcomes of pregnant women, women of childbearing age and babies, particularly in their first year of life, both nationally and in Manchester. The latest infant mortality rate for Manchester is almost double the national average and has been on the rise over the last decade. Programmes to reduce inequalities and improve the quality of services available to women and their babies should support a reduction in infant mortality in Manchester and help to improve outcomes for residents across the life course. The recommendations emerging from the JSNA will underpin the new Safe and Healthy Beginnings Strategy for the city. 

• Infant mortality is an important measure of the health of a population and is a useful indicator of other factors that affect overall health outcomes (the social determinants of health).​
• The UK has some of the highest mortality rates in Europe. In 2022, the infant mortality rate for England and Wales was 3.9 deaths per 1,000 live births. The infant mortality rate in Manchester is higher at 6.7 deaths per 1,000 live births.​
• Immaturity related conditions due to pre-term birth (<37 weeks' gestation) remain the most common causes of death in the first year of life.​
• There is a higher risk of infant mortality among infants born with a low birth weight, to mothers from an ethnic minority, particularly those from Black and Pakistani ethnicities and to families associated with higher levels of deprivation.
• The age of mothers at time of birth is also associated with higher rates of infant deaths, with mothers aged under 20 years old associated with the worst outcomes.
• Modifiable factors that lead to poorer outcomes include unsafe sleeping practices, breast feeding, smoking, substance and alcohol abuse, obesity and late access to antennal care.
• Manchester currently has some programmes and services aimed at improving overall health outcomes for mothers and their babies, but there are opportunities for action to reduce the local infant mortality rates.

There are a range of local services already in place in Manchester to help improve health outcomes for pregnant women and their babies. These include:

•    Health Visiting and Infant Feeding Service
•    Vulnerable Baby Prevent and Protect Service
•    Room 2 Breathe Project
•    Douala Programme/UMEED
•    Manchester Start Well Strategy (including the Family Hubs Programme)
•    Greater Manchester Equity and Equality Action Plan
 

The JSNA contains a series of opportunities for action to further strengthen Manchester’s commitment to reducing infant mortality rates and improving health outcomes for pregnant women and women of childbearing age in the city. These include:

• Create culturally appropriate opportunities to support increased physical exercise among for women from Black and minority ethnic communities, for example, subsidised gym memberships for women identified with high BMI.
• Reduce the availability of fast-food outlets, by limiting approval for new applications, especially in areas associated with deprivation and poor health outcomes.​
• Support the wider Obesity Strategy in Manchester, specifically targeting women of childbearing age to increase the chances of women entering pregnancy at optimal weights and reduce complications due to obesity.​
• Improve uptake of the Healthy Start Scheme by raising awareness of the programme among eligible residents to increase access to financial support for pregnant women from lower income families, those under 18, and families with children under four years old to help improve their diet and reduce the risk of low birthweight.​
• Continue to support the genetic literacy programme and expand the Umeed project to include all vulnerable women across Manchester.​ Additionally, consider the creation of a doula service in Manchester to support women during pregnancy and after birth.​
• Engage with local communities and VCSE organisations to tailor information and awareness of the risk factors for infant mortality.​
• Consider actions to improve access and use of healthcare among cohorts who traditionally use it less, particularly among women of childbearing age and pregnant women. Include representatives from Black African and Pakistani communities in the planning and delivery of maternity and childcare services​
• Engage with ethnic minority groups, especially the Pakistani and Black communities, through Sounding Boards, and third sector organisations to understand how improved use of healthcare can be achieved to improve overall health outcomes. ​
• Create opportunities for interactions between community group representatives and health professionals to provide insights on dealing with any challenges encountered during healthcare delivery from pregnancy and during infancy to improve outcomes resulting from late access to antenatal care and reduced use of healthcare overall.​
• Strengthen links between housing colleagues, public health, midwives and maternity support professionals to highlight poor living conditions and overcrowding. ​
• Target smoking cessation programmes to women of childbearing age, pregnant women and nursing mothers and well as any members of their household. ​
• Support Manchester’s Start Well Strategy, which includes support for 30 Sure Start centres, with some offering enhanced support through the Family Hubs programme, funded for 3 years (2022-2025). ​
• Ringfence and, where possible, increase the early years spending for children under five years old to improve their health outcomes and reduce both infant and child mortality rates in Manchester.​

This JSNA was completed in August 2024 and was presented to the Health and Wellbeing Board on 18 September 2024.

A full copy of the JSNA can be accessed as part of the papers for that meeting.