‘Pakistan has highest maternal, newborn and child mortality in South Asia’

[Naveed Yaseen]

The current level of maternal, newborn and child mortality in Pakistan are among the highest in South Asia, and much higher than many of its neighbors, according to Prof. Zulfiqar Ali Bhutta of Aga Khan University Hospital.

“It is a shame to compare ourselves with Afghanistan”, he said while delivering his presentation at a workshop about maternal and infant mortality at Pakistan Medical Association on Saturday.

He pointed out that the recently concluded Demographic Health Survey 2007 (DHS) in all districts of Pakistan was conducted in more than 100,000 households and revealed that there has been no change in Pakistan’s child survival indicators for the last 15 years. Thus “we have the dubious distinction of being the only country in Asia (other than Afghanistan) to have had almost no impact on our child survival indices despite several programs that have been ostensibly in place”, he said.

He said “we are at major cross roads and without a solid concerted effort the fundamental reasons for poor child survival and care in Pakistan will not change”.

He opined that enhanced reproductive health and maternal care (family planning services, antenatal care and counseling for facility based deliveries, high Lady Health Worker (LHW) quality and monitoring, employing lower level community health workers (CHWs) to cover non-LHW covered areas (representing ~ almost 40% of many districts) are some of the measures, which could make a difference.

He said given the huge gap in Maternal, Newborn and Child Health (MNCH) services in rural and deprived areas, the govt. should consider a time bound scheme for Compulsory Rural Services following house jobs for physicians (for 2 years).

These physicians will receive special training for 2 years and provided incentives in the form of subsequent support for postgraduate training and scholarships. This is the only option to get skilled services in MNCH where it matters in BHUs, RHC and MCH centers.

However, this must be implemented without any concessions to “sifarish” across the board and with the provision of security and appropriate facilities to these physicians.

He said targeted training of staff in key MNCH interventions in all districts was needed to reduce major causes of maternal deaths like hemorrhage, eclampsia and infections. Besides essential “newborn care package”, improved diagnosis and treatment of major killers of older children such as diarrhea, pneumonia and malaria were needed.

He said monitoring and audit of MNCH outcomes and political ownership of this initiative at the highest level were imperative to reduce deaths of mothers and children.

“Pakistan cannot make progress in any field with a sick and undernourished population of women and children,” he said.

http://www.thenews.com.pk/daily_detail.asp?id=157770