KARACHI: The latest Pakistan Demographic and Health Survey 2017 has brought improved indicators for Sindh vis-à-vis mother neonatal child health (MNCH) as compared to other provinces, which the provincial authorities regard as a ‘big achievement’ of the MNCH programme and the health ministry.

The survey shows antenatal care (ANC) coverage in rural parts of Sindh has increased by 9.9pc (from 68pc to 77.9pc) and the same has improved by 2.3pc in the urban parts of Sindh (from 92.2pc to 94.5pc).

Similarly, officials in the health ministry said, percentage of women with four more ANC visits in Sindh had increased from 9.7pc — from 44.4pc to 54.1pc.

Delivery at health facility in rural districts of Sindh has increased by 16.5pc — from 46.5pc to 63pc; while the same has increased by 11.1pc in the cities — from 77.6pc to 88.7pc.

The percentage of women whose last birth was protected against NNT (neonatal tetanus) in the cities of Sindh has increased by 3.1pc — from 74.6pc to 77.7pc. The percentage of such women in urban swathes is 9.9pc — from 38.3pc to 48.2pc.

Unmet need for family planning (FP) in rural districts has reduced by three per cent — from 25pc to 22pc; and the same has reduced by 2.8pc in the cities of Sindh — from 16.5pc to 13.7pc.

Besides, use of any method of FP in rural parts has increased by four per cent — from 17.4pc to 21.4pc; which, in the cities has decreased by 3.4pc — from 42.7pc to 39.3pc.

The use in modern methods of FP in rural districts has increased by 3.4pc — from 17.1pc to 20.4pc — and the same has decreased by 4.6pc in the cities — from 32.6pc to 28pc.

The percentage of demand satisfied from modern methods of FP in rural parts of Sindh has increased by 6.2pc — from 40.5pc to 46.7pc — and the same has decreased by 2.3pc in the cities — from 55pc to 52.7pc.

The survey shows total fertility in Sindh has decreased from 3.9 to 3.6 overall.

Besides, percentage of children given ORS during diarrhoea in the province has increased by 6.8pc — from 45.2pc to 52pc. For the same purpose, percentage of children suffering from diarrhoea given zinc has increased from 1pc to 15.4pc.

What the health authorities in Sindh accord as their greatest success is tangible decrease in the neonatal mortality, which was 55 per 1,000 live births five years earlier and has now decreased to 42 per 1,000 live births.

Similarly, infant mortality in Sindh has decreased as well. It was 74 per 1,000 live births and has now been recorded as 62 per 1,000 live births.

The ratio of mortality of children aged less than five years has also decreased by 15 per 1,000 live births. It is 74 per 1,000 live births now from earlier 89/1,000 — still not a figure which the related authorities could brag about.

Officials in the health ministry, however, called it a big achievement of the MNCH programme, promising that their efforts to improve further would continue in the coming years.

Teenage pregnancy

The survey shows Sindh has still a lot of work to do to improve on the issue of teenage pregnancy, which is 9.9pc with 11.2pc in its rural swathes. However, its cities are equally cause of concern where the ratio is alarmingly at 8.7pc.

The survey says adolescent fertility was important for both health and social reasons. Children born to very young mothers are at increased risk of sickness and death.

It says teenage mothers are more likely to experience adverse pregnancy outcomes and to be constrained in their ability to pursue educational opportunities than young women who delay childbearing.

Overall, 8pc of women aged 15-19 had begun childbearing: 6pc had had a live birth, and 2pc were pregnant at the time of the interview.

“The proportion of teenagers who had begun childbearing rises rapidly with age, from 1pc at age 15 to 19pc at age 19. Rural teenagers tend to start childbearing earlier than urban teenagers.

“Teenagers with more than a secondary education and those in the highest wealth quintile tend to start childbearing later than those with no education or with lower levels of education and those in other quintiles.”

Khyber Pakhtunkhwa’s 15pc teenagers had begun childbearing making the province as the highest in the country while the lowest such ratio is 6pc in the most populous Punjab province.

Published in Dawn, September 21st, 2018