KARACHI- Committed efforts within political corridors, education in women and further investment can tremendously improve the existing state of Reproductive, Maternal, Newborn and Child Health (RMNCH) in Pakistan.
The issue was highlighted at a seminar held at the Aga Khan University’s Centre of Excellence in Women and Child Health recently.
Speakers at the event pointed out that maternal and child health-related problems cannot be solved by the health sector alone, but needs an integrated approach from all sections of society in order to be effective. They stressed that the issue needs to be prioritized at political level and good governance. Increased investment is especially essential to improve the RMNCH status.
“Maternal and child health in Pakistan has received insufficient priority and funding for effective action and progress,” said Dr Zulfiqar Bhutta, Founding Director, Centre of Excellence in Women and Child Health, AKU. “Today, at the cusp of the MDGs, we lag far behind many developing countries and most of our immediate neighbors. Without concerted efforts, we are unlikely to achieve significant reduction in maternal and newborn mortality”, he further said.
The seminar reviewed evidence from studies of political economy of nutrition and healthcare financing for Pakistan. Experts suggested strategies like improving the quality of care in referral facilities and helping families overcome financial barriers. A combination of innovative measures, such as community-based platforms for facilitating problem recognition and referrals for care will be essential to reach remote rural population, they said.
Michele Thieren, Country Representative of World Health Organisation, touched upon the hardships faced by rural women in search of better maternal and child health. “Every day, there’s child mortality in Pakistan,” he said, “which means that every five years, there will 20 school buses not going to school.”
The seminar also discussed the performance of provinces with regards to RMNCH which showed mixed results. Dr Bhutta singled out Sindh as an example, where in some districts maternal wasting is more than 30 per cent. The province, he said tails behind most provinces in its health and nutritional indicators despite resources and geographic advantage.
He identified “unbridled population growth, rampant malnutrition and poor governance of the health system,” as main deterrents to progress.
Angela Kearney, Country Representative of UNICEF, stressed on promoting mutual accountability and transparency, government-civil society partnership and involvement of social networking tools to raise awareness. Underlining the importance of preventive measures, she identified immunization and women education as a key area. “Prevention is much less costly than cure,” she stressed.
Speakers also pointed out that Pakistan’s current health spending has been reduced to 0.5 percent, most of which is limited to tertiary hospitals primarily in large urban centers and cities. Almost a third of the rural population, especially the poorest and most remote areas, is still without lady health worker cover.
They also called for linkages with other public sector services, such as LHW programme and referral to secondary hospitals which is only possible with a coherent continuum of care across the district health system.