PAKISTAN is internationally committed to achieving Millennium Development Goals. Through various policies and strategies formulated at the federal and the provincial level Pakistan aims at reducing the under-five mortality rate to 52 per 1000; infant mortality rate to 40 per 1000 and maternal mortality ratio to 140 by 2015.

Despite good policies and planning it seems the country is way behind achieving the above targets as far as its health expenditure in GDP percentage and health situation at district level are concerned. The projected percentage of the GDP for fiscal year 2009-10 is 0.54, which is the lowest in the region.

Impact of low expenditure on health can be easily gauged from the example of Dadu district where infant and under-five mortality rate is alarmingly high.

Dadu represents high infant mortality rate compared to Sindh and Pakistan: 90 out of 1000 infants die here while in Sindh it is 87 and in Pakistan it is 77. The under-five mortality rate in the district is 147 per 1000 while Sindh indicates 112 and Pakistan 101.

Under article 35 of the Constitution, the state (Pakistan) is committed to protect the marriage, family, mother and child. It is far behind fulfilling its constitutional obligations as well as international commitments.

The present democratic government, creature of the Constitution, doesn't have genuine care despite its high claims of being pro-people. Bad governance and corruption at local level has further made the situation worse. It is also very well highlighted in the recent report by the recent Transparency International. At present there are 60,583 pregnant mothers and 257,428 under-five year children in the district who are in a very vulnerable position after the floods.

This situation is likely to deteriorate further as most of the health facilities have either been destroyed by floods or are inadequate enough to provide health services effectively in the district.

Pregnant women in relief camps are at high risk owing to unhygienic conditions. These women are prone to infection during childbirth. This is one of the main causes of maternal death.

A vast majority of people suffer from poverty and underprivileged situation which has been furhter compounded by floods. People have lost their source of income, and health expenditure is drain on their savings --whatever it is. This situation calls for urgent and innovative measures to be taken to provide effective care to infants and pregnant mothers.

ABDUL GHAFFAR BABARDadu