January 20, 2002	Sunday	Ziqa’ad 5, 1422

KARACHI, Jan 19: Out of over 53 million babies in the country, nearly 270,000 die before they are one month old — the percentage is roughly ten times higher then that in the developed countries, says a report.

The report, “State of the World’s Newborns — Pakistan” conducted by a United States-based organisation, Save the Children, that has launched a 15-year global programme of maternal and child healthcare funded by the Bill and Melinda Gates Foundation.

The report, launched on Saturday at local hotel, says that nearly 60 per cent of these deaths occur during the first few days after birth and a vast majority of them are preventable through available and cost-effective means.

The risk factors contributing to the high neonatal mortality in the country, according to the reports, are: high percentage of home deliveries unattended by skilled care; birth interval of less than 24 months; number of pregnancies greater than six per women, and maternal or paternal illiteracy.

Based on a limited data available from the hospital — as nearly 80 percent of births and a majority of newborn deaths occur at home and remain undocumented — and community studies, the most common cause of newborn death — birth asphyxia (non-breathing), low birth rate or prematurity, and tetanus — together account for nearly two thirds of all the deaths.

It says that though Pakistan was the seventh most populace country in the world it has the second highest number of newborn deaths and the fourth highest rate of neonatal mortality.

The study says that while the overall infant mortality has continued to decline since 1950, neonatal deaths have remained steady for the past 20 years — and now accounted for more than 50 per cent of all infant mortality in the country.

It says that one quarter of all Pakistani newborns are of low birth weight and studies have shown that between half and three-quarters of all the neonatal deaths have occurred among the low birth weight babies. The data also suggests a close relation between low birth weight and maternal malnutrition and with social and economic status of mothers, particularly lack of education and empowerment.

The report says that emerging evidence of the relationship of low birth weight with long-term chronic diseases in adult life such as diabetes, hypertension and coronary artery diseases, makes it one of the most important and potentially preventable public health condition.

Other infections such as diarrhoea, acute respiratory infections, sepsis, and meningitis still represent potentially lethal problems for neonates.

Breast-feeding, though prevalent and comparatively more in rural women, is rarely exclusive and often not sustained during the first crucial month. Honey is usually the preferred choice as first feed, and the colostrum — the first milk — is traditionally discarded and even regarded as harmful by many women. However, more recent data from Karachi shows a change