With Pakistan topping the league of stillbirths, the news comes with a sense of indignation and yet another sad indictment of Pakistan's health and well being. Here in the UK, stillbirths are the highest among most of the developed countries. Although one can apportion some of these causes to placental problems, infections or congential abnormalities, there is still a significant number which cannot be explained.

At this point, when we can begin to address the question of how we tackle this problem in light of this latest research, unfortunately, Pakistan and the UK will part ways at this juncture. Perhaps somewhat predictable.

In the UK, major investment in research will often follow to investigate the causes of such high rates of stillbirths. This follows its natural progression to policy research and investment in healthcare. Although seasoned critics, politicians and scientific bodies will argue the methodology and implementation, a conclusion and decision is eventually reached.

The above course of events often leaves Pakistan lagging behind. Regrettably, any attempt to understand and address this latest health dilemma does not return the political capital for the governing party in Islamabad. As a result, it absolves any form of accountability.

I was able to witness the frustrations of introducing some form of gynecological and obstetric service in a rural village in Pakistan, which had been devastated by the floods last year, while I was working for an international NGO. We advertised for an obstetrician and gynecologist with an extremely competitive salary and benefits. The reason for this move stemmed from our concern that an untrained female dai was delivering babies without any clinical knowledge. There was no question of her dedication but as a group of health professionals, it would have been clinical negligence to avoid this fissure in our services. After much deliberation, we managed to hire an obstetrician but due to some unclear reason, I was to learn at a later point that she had submitted her resignation.

This event was a snapshot of a national crisis in medical care for women. One can appreciate the argument of Pakistan's economic woes as one of the reasons for lack of investment, but I often quote the success of Cuba. A country which has suffered decades of various sanctions continues to deliver healthcare comparable to many developed nations. This is not a debate about political ideologies but of priorities, investment and accountability. Otherwise we maintain the status quo and await the next set of incriminating revelations for Pakistan.

Dr Naveed Iqbal MBChB, MChem, is a doctor based in the UK.

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