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The rate of infant mortality (the number deaths of children under one year of ageper 1000 live births) 3 is commonly viewed as an indicator of the general health andwellbeing of a population. A low infant mortality rate is a major contributor toincreased life expectancy for a population.There was a dramatic decline in infant mortality rates in Australia over the 20 thcentury (the rate of infant deaths decreased from 103 deaths per 1000 live births in1900 to 4.8 deaths per 1000 live births in 2003). During the first half of the 20 thcentury, a significant share of the decline in infant mortality was associated withimprovements in public sanitation and health education. By the 1940s, thedevelopment of vaccines and mass vaccination programs resulted in further gains.Improved medical technology (including improvements in neonatal intensive care)and education campaigns about the importance of immunisation, and more recently,in the case of sudden infant death syndrome, infant sleeping position, have led tofurther modest declines in infant deaths in the last half of the century (ABS 1996and 2004).The main causes of Indigenous infant deaths are congenital disorders, sudden infantdeath syndrome, respiratory and cardiovascular disorders, and accidents(ABS 1996).Box 5.2.2‘Things that work’— infant mortalityNSW Aboriginal Maternal and Infant Health StrategyThe NSW Aboriginal Maternal and Infant Health Strategy commenced in 2001. It aimsto improve access to culturally appropriate maternity services for Aboriginal mothers,including antenatal visits for pregnant women. The purpose of antenatal visits is tomonitor the health of both the mother and baby, provide information, identify antenatalcomplications and provide appropriate intervention at the earliest time.In those areas of NSW where the strategy has been implemented, 78 per cent ofAboriginal women had their first antenatal visit before 20 weeks gestation in 2003-04,compared with 64 per cent for these areas in the period 1996–2000 (prior to thestrategy).(Continued next page)3 Infant deaths are usually divided into ‘neonatal’ (occurring in the first 28 days after birth (0–27days)) and ‘postneonatal’ periods (those occurring in the remainder of the first year (28 days to364 days).5.12 OVERCOMINGINDIGENOUSDISADVANTAGE 2007