ISLAMABAD, Dec 13: The United Nations Children’s Fund (Unicef) has painted a bleak picture of the state of Pakistani children, saying some 0.5 million of them die annually before reaching the age of five, mostly from preventable causes.

Unicef’s flagship report entitled “The State of The World’s Children 2007” reveals that Pakistan has made little progress in terms of reducing the under-five mortality and it is very much likely to miss the Millennium Development Goal of bringing down the mortality rate among children of five or under to two thirds by 2015.

In Pakistan’s case, this goal could be translated to an under-five mortality rate of 43 per thousand births.

Going by these standards Pakistan would have to scale up the annual rate reduction by 6 to 7 per cent. Pakistan had an under-five mortality rate of 109 per 1000 births in 2001, which has now been reduced to 99, but globally it is still the 47th country with the highest under-five mortality. Infant mortality rate (under 1) is now 79 per thousand births. This means out of 4,773,000 children born every year in the country, some 473,000 die.

Poor pre-natal care is the leading reason for children under 5 dying, accounting for almost one-third of all the deaths. Acute respiratory infections and diarrhoea are the other main killers.

Sixteen per cent of under-5 children annually suffer from pneumonia, 34 per cent of them are never taken to a health care provider. Similarly, 64 per cent of the children suffering from diarrhoea are not given oral re-hydration and continued feeding.

Unicef’s acting representative in Pakistan, Mr Terje Thodesen, told Dawn that the progress in the country was too slow. “Pakistan is taking more time than expected.”

The government, he said, would have to attach greater priority to this issue and enhance spending.

One of the other major factors for high mortality rate among children is the high percentage of children born with low weight.

The figure of 19 per cent infants born with low weight has remained static for few years.

Unicef report rated Pakistan’s efforts for improving nutritional status of kids as insufficient.

Reflecting the poor nutritional status of children, the report says 38 per cent of country’s under-5 children are under-weight, while 37 per cent are stunted and 13 per cent suffer from wasting.

Breastfeeding remains low with 16 per cent of infants less than six months of age exclusively breastfed.

The report says progress has been made in Vitamin A supplementation.

More than 95 per cent of children between the ages of 6 months and 5 years in the country are now protected by twice-yearly doses of Vitamin A. But, the consumption of iodized salt is very low and only 17 per cent of families use it.

A rare silver-lining for Pakistan is that it has virtually achieved the MDG target on access to water.

The report says 91 per cent of country’s population use improved drinking water sources – 96 per cent in urban areas and 89 per cent in rural areas. In contrast, only 59 per cent have access to sanitation facilities and that is reflective of some very severe urban-rural disparities.

Immunization coverage is yet another grey area. The coverage rates are on an average 75 per cent, which means some 25 per cent have no protection at all against different diseases.