India's SRS (Sample Registration System) is the primary source for vital statistics. The Crude Death Rate (CDR) is calculated per 1,000 mid-year population. Which of the following health indicators is the BEST single measure of overall health status of a population as per WHO?

• A Crude Death Rate (CDR)
• B Standardized Mortality Ratio (SMR)
• C Under-5 Mortality Rate (U5MR)
• D Infant Mortality Rate (IMR) ✓

Explanation

The Infant Mortality Rate (IMR) — deaths under 1 year per 1,000 live births — is considered the single most sensitive indicator of overall health status and socioeconomic development of a community. It reflects maternal health, nutrition, access to healthcare, sanitation, and immunization simultaneously. WHO endorses IMR as the best single composite indicator. U5MR is used by UNICEF/MDGs. CDR is affected by age structure. SMR is used for occupational comparisons. NFHS-5 reports India's IMR as 35.2 per 1000 live births.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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