ISLAMABAD, Jan 22: Despite heavy government spending, there is no tangible improvement in Pakistan’s child mortality figures and the latest report of the United Nations Children’s Fund (Unicef) – State of World Children 2008 – shows that the country’s ranking in a critical category, under-5 mortality, has deteriorated.

Pakistan dedicates over 0.5 per cent of its GDP to different programmes being run by various ministries for reducing child and maternal mortality. The spending is almost as much as the entire health budget, which is 0.67 per cent of GDP, but experts fail to understand why all this money is not producing results.

According to the report launched here on Wednesday, under-5 mortality figures remained at 97 per thousand births, bettering the previous year’s record by just 0.2 per cent, implying that more than 400,000 children continue to die annually in Pakistan from preventable causes before their fifth birthday and many of them do not survive past their first year.

The grim outlook on child survival proves that Pakistan has a long way to go to meet the United Nations Millennium Development goals, including that of reducing child mortality by two-thirds between 1990 and 2015, to fewer than 43 per thousand births. Going by these standards, Pakistan would have to scale up the annual rate of reduction by 6-7 per cent. In overall child healthcare ranking, Pakistan fell behind five countries, sliding to 42nd spot.

Only Afghanistan and a handful of mostly African countries have a poorer record of child survival than that of Pakistan. Averages for other countries in the South Asian region are much better. Poor pre-natal care, more specifically unattended births, is the leading reason for children’s deaths, accounting for almost one-thirds of all their deaths. Respiratory infections, malnutrition, measles and diarrhoea are the other main killers that no longer afflict children in rich countries. Simple, affordable measures could dramatically reduce child deaths, said the report.

“Ensuring a ‘continuum of health care’ for mothers, newborns and young children, extending from the household to the local clinic and beyond, is key to survival,” it said.

Federal Health Secretary Khushnood Lashari defended Pakistan’s performance, saying the average figures did not depict the reality. The under-5 mortality figures for areas covered by Lady Health Workers (LHW) programme were much lower than areas without it.

The LHW programme covers about 62 per cent of the country.