High death rate exposes unsafe childbirth practices

250,000 newborns die every year

Zahid Chaudhary

Islamabad–Pakistan has one of the highest neonatal and infant mortality rates in the region mainly due to the prevalent unsafe delivery practices, mostly in the rural and far flung areas.
According to officials of ministry of health, presently exact numbers of new born deaths at district level are not captured, however surveys conducted at national level reflect urban, rural and province wise breakdown of neonatal mortality rates. Based on those surveys it is estimated that there are 250,000 deaths of newborns per year.
The sources om health ministry said the neonatal mortality rate in Pakistan is 55 per 1000 live births while The UN agencies put the infant mortality rate in Pakistan at 61 per 1000 while in Bangladesh and India, it is 31 and 38 respectively.
According to health officials, next to birth asphyxia, sepsis is the leading cause of neonatal deaths. A baby’s newly cut umbilical cord can be an entry point for bacteria, which can lead to cord infection and potentially life threatening sepsis.
Infection can cause more than half of the neonatal deaths in poor resource and high mortality settings, they said adding as 50 per cent of births take place at home and 72 per cent of these are attended by traditional birth attendant or relative, unsafe and unhygienic practices are common in most of the births across Pakistan. Some of the most common unsafe delivery practices include: use of unsterilized instruments for cutting of cord, use of harmful material on the umbilical cord. These unsafe and unhygienic practices drive Pakistan’s high maternal and newborn mortality. The real causes of such a high maternal and newborn mortality are due to untreated or poorly treated maternal complications, inadequate neonatal care, and harmful homecare practices, such as discarding of colostrums, application of unclean substances to the umbilical cord stumps, and the failure to keep babies warm.
The health ministry officials said the Planning Commission and Ministry of National Health Services, Regulations and Coordination in collaboration with World Health Organization are in process to develop Civil Registration of Vital Statistics (CRVS) that would capture all the deaths occurring in Pakistan both at national and provincial level in future.
The sources said that for bringing specialization in midwifery field in order to reduce maternal mortality rate (MMR) and neonatal mortality rate (NNR), 02 years degree program i.e. Bachelor of Midwifery (BSM) has been started.
To flourish nursing profession in the country, Government has currently signed an MOU with Government of Bahrain for setting up a Nursing University in Islamabad. New online Registration system has been started to facilitate and update the Nursing/ Midwifery Profession like other developed parts of the world. To meet the deficiencies of nursing professionals in the country, new seats have been created in different colleges. Government has also decided to constitute Pakistan Allied Health Professional council for Paramedics for which legislation is under process. The consent of Sindh Government is awaited for the establishment of this council which will help to regulate the profession.

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