KARACHI: Pakistan’s maternal and newborn indicators are among the lowest in South Asia, lower than Bangladesh, Bhutan, the Maldives and Nepal.

The country did not meet the millennium development goals (MDGs) of reducing under-five child mortality and improving maternal health by 2015 by a large margin, according to experts at a maternal, foetal and neonatal medicine conference on Wednesday.

Instead, every year, 8,000 Pakistani women have died either from pregnancy-related complications or in childbirth, and a mother’s life was lost every 40 minutes, said experts at the conference organised by the Aga Khan University’s Centre Of Excellence in Women and Child Health, in collaboration with the Pakistan Paediatric Association.

Experts said that the maternal mortality ratio (MMR) might have declined from 521 in 1990 to 332 in 2012 but it was still far behind the proposed MDG target of 130 for the year 2015. There were also wide variations between provinces, with the MMR being lowest in Punjab at 227 and highest in Balochistan at 785 deaths.

They said Pakistan could make progress towards promoting the health of pregnant women and newborns and meeting sustainable development goals on health by strengthening policy, targeting specific health system bottlenecks and improving access to quality health services.

“It is universally agreed that no country can progress without improvement in its health indices, with substantial and meaningful improvement in maternal, fetal and neonatal health,” said Dr Sohail Salat of the neonatology group.

He said ending preventable child deaths required focus on a healthy start.

Globally, close to three million newborns died annually, accounting for 44 per cent of deaths in children five years or less, and an additional 2.6 million babies were stillborn each year, with almost half the deaths occurring during labour.

Experts said Pakistan currently ranked 26th in the world for under5 child mortality rates which had fallen from 141 in 1990 to 89 in 2012, yet still far behind the MDG 4 goal of 46 by the year 2015.

Newborn deaths are a major contributor to under-5 mortality with around half of deaths occurring in the first month of life.

Dr Marleen Temmerman, director, World Health Organization, Reproductive Health and Research, spoke how the generation today has knowledge, resources and opportunity to end all preventable deaths.

A study of newborn survival opportunities in the South Asian Association for Regional Cooperation (SAARC) countries shows that of the eight members, India and Pakistan alone are responsible for 88pc of newborn deaths and 82pc of stillbirths in the region. Across all countries, for women, stillbirths and newborns, the time of highest risk remains the same — birth.

“Birth is the time of greatest risk of death and disability,” said Dr Jai Kumar Das. “Focus should be on care during pregnancy and immediately after birth.”

Pakistan has put together a national Maternal, Neonatal And Child Health (MNCH) 10-Point Action Plan to meet the sustainable development goals on health, remarked Dr Assad Hafeez, director-general health in federal ministry of health services.

He said that the plan covered a broad spectrum; improving the quality of care available at basic health units, rural health centres and district hospitals; investing in nutrition especially of adolescent girls, mothers and children; increasing investments in health; agreeing on meaningful indicators; a monitoring framework and accountability mechanisms; and garnering political will to support the mother and child agenda.

“The ultimate goal is to facilitate adoption of policies that bring an end to preventable deaths among women and newborns and to bring about a more prosperous and sustainable future,” said Dr Zulfiqar A Bhutta.

Published in Dawn, December 3rd, 2015