Infant Mortality in the Territorial Entities of Russian Federation in 2013–2025: Differences, Stability, and Its Dynamics

Background. Infant mortality is a major indicator of public health and healthcare system efficacy. Maternity and childcare services in Russian Federation underwent modernization in 2013–2015; however, still there are significant interregional differences. Objective.

The aim of the study is to examine the differences, stability, and dynamics of infant mortality in territorial entities of Russian Federation in 2013–2025.

Methods. Data from Federal State Statistics Service for 83 territorial entities was analyzed. The methods included percentile analysis, calculation of standardized ratios, evaluation of regional mobility (Mi indices), cluster analysis (k-means, k = 4), and Pearson correlation analysis.

Results. The national infant mortality rate declined from 8.2 to 3.6 per 1,000 live births (mean annual rate of decline is 6.8%). The most significant declines were observed in the Far Eastern Federal District (–8.9%) and the North Caucasus Federal District (–8.7%). The long-term mean rate remained highest in the North Caucasus Federal District (7.5 ± 2.4‰) and lowest in the Northwestern Federal District (4.6 ± 0.8‰). Variation coefficient decreased slightly from 0.32 to 0.28. The overall Mi index was 0.69 (8 group changes over 12 transitions). Only the Chukotka Autonomous Okrug (1.2%) turned out to be stable — the only steadily unfavorable region. Relatively consistently unfavorable were 3 regions: Jewish Autonomous Oblast, Republic of Tyva, Republic of Dagestan. Consistently favorable were 2 regions: Chuvash Republic, Saint Petersburg, and relatively favorable — 6 regions. Cluster analysis identified 4 dynamics types: cluster 1 (low baseline level, sustained decline) — 23 regions (27.1%); cluster 2 (high baseline level, rapid decline) — 16 regions (19.3%); cluster 3 (moderate baseline level, moderate decline) — 33 regions (39.8%); cluster 4 (high baseline level, high mobility) — 10 regions (12.0%). Statistically significant positive correlation was revealed between long-term mean infant mortality rate and its interannual variability (r = 0.72; p < 0.001; r² = 0.52).

Conclusion. The period from 2013 to 2025 is characterized by steady decrease in infant mortality in Russia while maintaining interregional differences and high mobility over the regions. The highlighted dynamics types can serve as the basis for differentiated approach to perinatal care management.

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