By: Sehrish Wasif
ISLAMABAD: For the Balochistan government, population growth seems more important than the life of a mother and child. The provincial government’s new population plan reveals startling facts about mother and child health. Instead of taking measures to curb population growth, the government is discouraging initiatives that make pregnancy, childbirth and childrearing safer.
The plan would actively discourage couples from availing contraceptive and family planning services, while no efforts are being made to improve existing healthcare facilities for the living.
National Institute of Population Studies (NIPS) Director Dr Nasser Mohiuddin told The Express Tribune that the provincial government was not willing to link family planning with the Maternal Neonatal and Child Health (MNCH) Programme.
He said that the provincial government wanted to boost the fertility rate in Balochistan so that they can increase the population.
The bigger problem
“Balochistan presently has the worst indicators on maternal and infant mortality in the country,” Mohiuddin said.
Sharing data, he said that it was estimated that 700 to 900 mothers per of 100,000 lose their lives during pregnancy in Balochistan, compared to 272 in the rest of the country.
Simply put, a pregnant woman is three times more likely to die in Balochistan than the rest of the country.
Similarly, “Neonatal mortality in the province is 72 per 1,000 live births, compared to 54 in the rest of country, which is also worrisome,” the director said.
Meanwhile, for the past six years, the unmet need for FP services has remain stagnant in Balochistan at 31 per cent, whereas in the rest of the county has seen a five per cent drop from 25 per cent to 20 per cent, he said.
Use of modern contraceptive methods in the province stands at 16 per cent, whereas at the national average is 26 per cent, Mohiuddin said.
“Lack of political will, low budget allocations and poor healthcare infrastructure are the major reasons behind high maternal and infant mortality rates in the province. They need to be addressed on an emergency basis,” he said.
A gynaecologist deputed at a public hospital in Quetta, who wished not to be named, said that the provincial government believed that discouraging FP services would lead to a population increase, which while technically possible, was “not the best option”.
“We need to strengthen healthcare services in every district and develop infrastructure in the province to save dying mothers and newborns, rather than encouraging the mothers to have even more babies,” she said.
Given the state of healthcare in Balochistan, the more a woman gives birth, the more she puts her life at stake, the gynaecologist said.
“Women from remote areas of the province die while being transported to urban healthcare facilities across broken roads in tractor trolleys or on bull carts,” she said.
Talking about FP services, she said most rural women were not aware of the service or any reliable contraceptive methods.
The gynaecologist said that many also died due to complications caused by the use of traditional birth control methods.
She said that compared to the other provinces, Balochistan lacked providing FP service centres and the existing facilities did not have trained staff to counsel couples.
The doctor also expressed grave concern over the absence of accurate data on maternal and infant health issues.
“Major public hospitals in Quetta lack online patient registration systems in the gynaecology and obstetrics departments, due to which they do not have accurate figures on births or deaths due to complications,” she said.
The registration of patients is done manually and registers containing this information are often misplaced, leaving hospital staff unable to provide accurate data, the gynaecologist said.
‘Do bachay’ are not ‘sab se achay’
A provincial government health official justified the new plan, saying the government is focusing on increasing the population of the province, but with proper planning.
“We want couples to have three to four children, but follow proper birth spacing,” Balochistan Health Director General Dr Farooq Azam Jan said.
Talking to The Express Tribune, Dr Jan said that the province lacks trained lady health visitors (LHVs) to provide counseling to couples.
He said there was a need to create awareness among couples to avoid having children every year as it will put the life of both, mother and child at risk.
Sharing data, he said there are only 831 LHVs, 800 community midwives and 6,500 lady health workers (LHWs) for a population of 9.3 million, which is “insufficient”.
Moreover, a majority of women give birth at home, as only 16 per cent women in the province give birth at hospitals, compared to the national average of 48 per cent, he said.
“Strong political will, proper planning and increases in budget allocations for the health sector can help Balochistan address its startling health indicators,” he said.