KARACHI, Aug 16: The only way to check the high maternal mortality ratio (MMR) in Pakistan is to initiate a massive, long-term and efficient midwifery training programme. This was suggested in a report titled ‘Health of Women in Pakistan: Annual Report 2007’, released by the Society of Obstetricians and Gynaecologists of Pakistan (SOGP) at the PMA House on Thursday.

This first ever report prepared by the SOGP on women’s health was presented by its president Dr Shershah Syed, Secretary Ayesha Nasir and Finance Secretary Dr Nighat Shah.

The report contains data on women’s health, status of girl child and menopausal women and also highlights the issue of domestic violence and other problems being faced by women and identifies the flaws in obstetrics and gynaecology training.

Speaking at a press briefing, Dr Shershah said that the basic aim to prepare this document prior to general elections was to make political parties include these important issues in their manifestoes.

“A country has no future with a huge population of uneducated, unhealthy and battered women. All political parties need to resolve that these issues concerning women would be addressed on priority if they come into power,” he said.

The SOGP was ready to help the government uplift the status of women’s health, provided it showed sincerity and a political will in resolving the problems at hand, he remarked.

Underlining the role of midwifery, Dr Syed observed that competent midwives could play a crucial role in the reduction of the maternal mortality rate. The role of midwives, as a catalyst to social change, had long been neglected and their profession had not received the respect and status it deserved, he said.

According to the report, Pakistan loses three women per hour owing to pregnancy-related complications and the MMR stands at 340-500/100,000 pregnancies. Haemorrhage, hypertension and infection are the three major causes of maternal death. Delay in making a decision to consult a doctor or in acquiring transportation and emergency care also contributes to MMR. Under-five mortality rate is 103/100,000.

Over 80 per cent of deliveries take place in the presence of unskilled birth attendants, therefore, a large number of women, around 375,000 women annually, suffer from vaginal fistula, recto-vaginal fistula, depression and chronic pelvic complications after delivery, which are preventable.

About the health facilities and health budget, the report says that the government spends a meager 0.6 per cent of the GDP on health and around 2,400 basic health units, rural health centers and taluka hospitals are non-functional. There is one specialist and one doctor for 14,500 and 2,300 people respectively. There is no national screening programme for breast, cervical and prostate cancers, some of the leading causes of women’s death in Pakistan.

It said that the state of postgraduate education in obstetrics and gynaecology was poor. “There is a need to make sure that all medical students know about maternal death, morbidity and emergency obstetric care,” the report states. It also calls for the need to change social attitudes towards women and mass education for girls on a priority basis.

The SOGP’s demands included provision of free emergency obstetric care in all public sector hospitals and maternity homes round-the-clock; training programme to produce an army of skilled midwives; autonomous status to National Committee on Maternal and Newborn Health to monitor emergency obstetric care in country and consultation with SOGP and Pakistan Medical Association on women’s health.

The report is based on UNDP Human Development Report 2006, Pakistan Millennium Development Goal Report 2005, Human Development in South Asia 2004, Health Situation in South East Asia Region and World Development Report 2003-04.