Perinatal Crisis Widens: Reunion's Infant Deaths Double Mainland France Rate

Reunion’s infant mortality rate stands at 6.9 per 1,000 births, more than double the 3.5 recorded across mainland France, and a newly released Igas (Inspection générale interministérielle du secteur social) report describes the situation as “very serious.” The findings, which document a disparity that has persisted for nearly two decades, point to structural failures in perinatal infrastructure and service delivery across France’s overseas departments.

Between 2004 and 2022, infant mortality in overseas departments reached 8 per 1,000 births overall. Guyana records the highest rate, at nearly 10 per 1,000. Mainland France, by contrast, stays below 5 per 1,000 across all departments and below 4 per 1,000 across all regions. Across the entire country in 2024, 2,709 children died before their first birthday out of 661,822 total births, with most deaths occurring within the first 27 days of life. An April 2025 study from INSEE confirmed that women from overseas departments or African countries face significantly elevated risks of losing their infants during that first year. France now ranks 23rd among 27 European Union countries for infant mortality, a position that has deteriorated over the past fifteen years.

The Igas report identifies precarity as the primary driver. Economic vulnerability, maternal health conditions, premature births, and access to preventive care all shape outcomes. Prematurity and its complications account for 50 percent of infant deaths. Congenital malformations and birth complications, including neonatal asphyxia, represent 15 to 20 percent of cases. Younger mothers often receive inadequate pregnancy monitoring; older mothers more frequently encounter preexisting conditions and pregnancy complications.

What changed, or rather what was dismantled, is central to the political dispute surrounding the report. Deputy Perceval Gaillard has accused the government of deliberately suppressing the Igas findings, which were known since January 2026 but only recently made public. He points to two specific delivery failures: the closure of maternity units over the past two decades and the systematic reduction in maternal and child protection services, known as PMI. Since 1995, he notes, the number of mothers and children followed by PMI centers has been cut in half due to budget constraints. Gaillard characterizes the mortality gap as a direct result of political choices, not inevitable circumstance.

A mission led by Aquilino Morelle, former political advisor to François Hollande, reaches a different conclusion. It argues that the influence of maternity unit organization on infant mortality should be relativized, and that the restructuring of healthcare provision has not had notable effects on neonatal mortality since 2011.

On Reunion, the Regional Health Agency (ARS) describes the situation as multifactorial and has outlined several operational initiatives. The agency points to the Kaz’ des 1,000 premiers jours at the Orchidées Clinic, the first labeled “House of the First 1,000 Days” on the island, which provides comprehensive support to expectant parents and young families. The forthcoming opening of the Mother-Baby Unit at CHU Sud, part of the HOPE project, is designed to strengthen capacity for managing complex perinatal mental health situations, parental support, and early infant care. The ARS frames its role as coordinating local actors, consolidating existing health structures, and developing a coherent perinatal pathway accessible across the entire territory.

The gap between documented need and concrete action remains stark. The Igas report calls for “determined action in favor of perinatality and in combating infant mortality in overseas territories,” yet no specific measures have been announced in response. Maternal mortality in overseas departments also runs twice as high as in mainland France, compounding the operational challenge. Whether the forthcoming CHU Sud unit and the Kaz’ des 1,000 premiers jours initiative represent the beginning of a coordinated response, or isolated projects in the absence of a broader policy commitment, is the question the next budget cycle will have to answer.