Pakistan lagging behind in child survival, maternal health development

An edited version of this article was first published in The Express Tribune on Sept 27, 2012.

Islamabad – Pakistan is lagging behind in its pursuit of two Millennium Development Goals (MDGs) related to child survival and maternal health, according to a new report launched by a United Nations (UN) review group.

The report titled ‘Every Woman, Every Child: from commitments to action” was published by the independent Expert Review Group (iERG). The group was created in 2011 on the recommendation of a UN commission on women’s and children’s health.

The 2012 report is the group’s first in a series of four reports to be submitted to the UN Secretary General.

The group’s reports are linked to the UN’s Global Strategy on Women’s and Children’s Health, which is an attempt to accelerate progress towards achievement of MDG 4 and MDG 5 in 75 countries that account for 98 per cent of all maternal and child deaths in the world.

“Pakistan does not seem to have improved its health coverage rates, and compared to some other countries in the region, such as Bangladesh, Pakistan has really fallen behind,” Dr Zulfiqar Bhutta, head of the division of women and child health at the Aga Khan University, who has studied the report, told the Express Tribune.

For MDG 4, which requires a two-thirds reduction in mortality rate of children under five in the target countries between 1990 and 2015, Pakistan has shown “insufficient progress” from 1990 to 2010, according to the report.

Pakistan saw an annual reduction of 1.8 per cent in the under-five mortality rate over this tw0-decade period, with 87 deaths per 1,000 live births in 2010. Countries are required to show at least a four per cent annual reduction rate or have less than 40 deaths per 1000 live births for kids under five.

Neonatal deaths, or children dying within a month of being born, make up 46 percent of all under-five deaths in Pakistan, according to the report.

MDG 5 strives to reduce the maternal mortality ratio in the 75 countries by three quarters between 1990 and 2015. It also requires universal access to reproductive health by 2015.

Pakistan is “making progress” for MDG 5, which is the second best category assigned in the report to the 75 countries.

Pakistan saw an average annual reduction rate of 3 per cent from 1990 to 2010 compared to the ideal reduction rate of at least 5.5 per cent, according to the report.

The report said Pakistan has not conducted an annual health sector review in 2011.

Some “impressive” developments mentioned in the report include a 33 per cent and 38 per cent reduction in overall maternity and child mortality numbers respectively from 1990 to 2011.

The report also estimated that out of the 75 countries, only 13 countries are “on-track” for MDG 4 and only 4 for MDG 5.

Among its recommendations, the report has asked for stronger global governance and investment frameworks, setting of country-specific priorities, eHealth initiatives, better human rights tools and better evaluation of health initiatives.

“Evidence is gradually growing to show that investing in adolescent, women’s, and children’s health has important economic as well as health returns. This emerging evidence should give confidence to Ministries of Finance to invest in adolescents, women, and children for long-term prosperity,” the report read, in its conclusion.

Bhutta agreed that health should be a top national priority.

“Health should percolate up in our governmental policies,” he said. “No country has ever made progress without focusing on health.”

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