DEATHS from acts of terrorism may be the overriding concern at present, but it seems that being born itself entails extraordinary risk in Pakistan. According to a report launched on Tuesday by the local chapter of Save the Children, Pakistan’s rate of intrapartum stillbirths (death during childbirth) and first day neonatal mortality is the highest in the world at 40.7 per 1,000 total births, followed by that of Sierra Leone, Somalia, Guinea-Bissau, Lesotho and Angola. Every year, 200,000 infants die in this country either during intrapartum stillbirth or on the very first day of their life. That’s an average of nearly 550 infants every day.
What is most depressing is that Pakistan has barely registered any progress in reducing the newborn mortality rate over the decades; from 52 deaths per 1,000 live births in 1990 to 40.7 deaths per 1,000 live births in 2012. At this rate, achieving a reduction in overall child mortality rates which is one of the Millennium Development Goals looks like a distant prospect, even though Pakistan has made appreciable progress in lowering its under-five mortality rate.
Not surprisingly, poverty and lack of access to quality healthcare are major obstacles in preventing such deaths. According to the report, the number of intrapartum stillbirths and first day deaths could be halved with trained midwives and free healthcare facilities for mothers and babies. In Pakistan, more than half of all women give birth without a skilled birth attendant present, which poses a risk to both mother and child.
The situation is particularly dire in remote areas or those with law and order problems. The provincial governments must take immediate steps to address the issue through expanding the network of community midwives and improving their training — Sri Lanka’s successful programme could offer some pointers — as well as establishing specialised infant care units in district and tehsil hospitals. There is no excuse for such shocking rates of infant mortality in a country with claims to progress and modernity.