KARACHI – Maternal mortality rate can be brought down considerably, if a multi sectoral approach is adopted and coordinated efforts are made.
These views were expressed by experts at a panel discussion with the theme of “Can Pakistan meet its millennium development goals in maternal health?” on December 13, night.
The moot was organized jointly by the Population Council and the Population Association of Pakistan at Karachi University. The programme was organized as part of a three-day fifth annual population research conference. Experts from the United States, Bangladesh, India, Iran, Nepal and Pakistan are participating in the conference.
Federal Health Secretary Anwar Mehmood, Peter C. Miller, Sadiqua N. Jafarey, Zahid Larik, Mahroo Hamayoun, A. Razzaque Rukkanuddin, Muzaffar Mahmood, Sher Shah Syed, Farid Midhet, and others spoke on the occasion.
The experts said that with increasing awareness among people regarding gap between pregnancies, improved healthcare system, easy availability of the contraceptives, the maternal mortality rate had been brought down slightly over the last decade. However, they said, more efforts were needed to improve the situation.
They said that during 1990s maternal mortality rate (MMR) was around 433 deaths per 100,000 live births and at present it was around 340 while it had to be further brought down to 140 by the year 2015.
They said that during the last decade just 18 per cent of the deliveries were handled by the skilled birth attendants, while the percentage had increased to 24 at present and it was expected to be 90 per cent by the year 2015.
According to them, another area of concern is that over 900,000 abortions – an overwhelming majority of which was the unwanted pregnancies -were carried out by untrained or semiskilled people which resulted in a number of deaths.
The experts suggested that if the service delivery mechanism was improved and contraceptives were made easily accessible to the needy people these pregnancies could be avoided, thus, avoiding many deaths.
They suggested that if services of over 70,000 lady health workers were efficiently utilized by providing them training and sufficient quantity of contraceptives, they could play a lead role in bringing down the maternal mortality rate.
The speakers also highlighted the role of the midwives and traditional birth attendants, majority of whom were not properly trained, and stressed on proper training. It would also help bringing down the maternal mortality rate as over 75 per cent of the deliveries were handled by the midwives and traditional birth attendants.
They said that the contraceptive prevalence rate that used to be at around five per cent in 1960s had become around 34 per cent over the years, while the total fertility rate (average number of children a woman has) has also come down from seven to four at present. The mean age of the women at marriage had also increased from 16 years to 22 years during that period.
They said that though the goal was difficult but with better coordination among government departments, NGOs, civil society organizations, and service providers, the MMR could be brought down considerably.
One of the speakers, however, a leading gynaecologist said that things could not improve unless the government changed its priorities and there was a political will to solve the problems.
He said that on one hand President Musharraf considered Turkey as a model, but he was not following the Turkey’s model in all the fields. He said that this year the Turkey was spending more money on education than on its defence, while here the spending on education and health was negligible.