The reason for commissioning this piece was simple, writes Luavut Zahid, Editor of our Pakistan blog. Pakistan does not have a favourable track record of taking care of its children.
Healthcare is not accessible for most people and childbirth practices are in shambles. The millennium development goals are about to expire and Pakistan, is in danger of regression. Such a situation needs to be highlighted as often as possible so that corrective measures can be put into place, hence this blog authored by Ali Sajid Imami.
For a country like Pakistan, there is no shortage of healthcare crises, but one that stands out in particular is the abnormally high rate of infant mortality. According to the World Bank databank, the infant mortality rate in Pakistan for 2013 was 69 per thousand live births. This puts Pakistan in the unenviable position of 212 of the 225 countries with a reported infant mortality rate for the year 2013.
Poor antenatal care is blamed for the infant and neonatal mortality rates in Pakistan (Thomas Koch / Shutterstock)
Despite this current picture, historical data shows that infant mortality has been in a consistent decline since the 1960s for Pakistan and has declined considerable since 2005. As the graph below shows clearly, infant mortality has dropped from 80 per thousand live births in 2005 to 69 in 2013, a 13 per cent decline in less than a decade, dropping from a high of 80.1 deaths per 1,000 live births in 2005 to 69 in 2013.
"The primary causes of infant and neonatal mortality relates to antenatal and neonatal care of the mother," says Sajid Akhtar, a resident of pediatrics and spokesperson for the Pakistan Medical Association.
"Of the three major causes, we see birth asphyxia the most. It can easily be avoided by giving proper antenatal care to the mother and having a birth attendant trained in preventing birth asphyxia and other pediatric complications," he explained while speaking about the high infant mortality rate.
"The major contributor to this is lack of education and awareness among the general public and their reliance on ‘quacks’.
“Our public relies on quacks and untrained birth attendants for antenatal and natal care and care of the newborns. Their incompetence and reliance on unscientific information is detrimental to the health of both the mother and the child," he told me.
Things do not look well within the South Asian region either. Pakistan ranks second from the bottom in the eight countries in the region, just behind Afghanistan. South Asia consists of countries mostly classified as Low Income or Lower Middle Income and which, consequently, have little to spend as it is. This translates to very restricted finances available for healthcare, making the already crumbling health infrastructure worse.
As you can see in the graph below, Pakistan ranks second, with only Afghanistan’s infant mortality rate being higher. Owing to similar financial issues, you can see that the rate of decline is almost consistent between all the countries in the region.
However, South Asia has been a focus of many programmes by the international healthcare community, focused on improving Mother and Child Health (MCH) indicators and they seem to be paying off.
In Pakistan, the decline can be attributed to generous programmes by the World Health Organization (WHO) to curb birth asphyxia and malnutrition. Given the current rate, and with the help of the international community, this trend is expected to continue.
In contrast, the biggest reason Pakistan still has such a high infant mortality rate can be attributed to lack of awareness, lack of a proper healthcare infrastructure leading to several misconceptions and the inability of people to access specialists for antenatal, natal and pediatric care.
For the situation to improve, Pakistan needs a multi-pronged approach. Educating healthcare professionals, awareness campaigns in the public and fixing the healthcare infrastructure to make sure that all people have access to those facilities is vital.
Ali Sajid Imami is writer based in Multan, and has a deep interest in social issues including education and access to healthcare. He tweets @doctor_no.