KARACHI: More than 100,000 mothers and children die every year in Sindh owing to conditions that can easily be prevented with improved basic healthcare, including access to family planning services, a life-saving intervention that needs to be integrated into the responsibilities of the health department.

These points were highlighted at a consultative meeting held on Thursday in a local hotel where journalists were invited to discuss the creation of an informal network of media professionals to share information, create awareness and build pressure on policymakers regarding population issues.

The gathering was arranged by the Population Council, a non-governmental organisation seeking to improve reproductive health.

The information shared with guests showed that Sindh faced a high incidence of preventable deaths among mothers, infants and young children. Maternal deaths account for 24pc of mortality among women of reproductive age.

“In 2012, the maternal mortality ratio (MMR) was estimated at 214 per 100,000 births, the infant mortality ratio (IMR) was 74 per 1,000 births, and the under-five mortality was 93 per 1,000 births.

“These ratios currently translate into an annual death toll of over 2,800 women, 97,000 infants and nearly 25,000 children aged between one and four (the loss 124,800 lives in a year),” says a policy brief on reducing maternal and child mortality in Sindh, which was distributed among the participants during the discussion.

According to the report, these lives could easily be prevented with improved healthcare, which should include family planning services, among other things. Other ways include increasing women’s access to antenatal and obstetric care, boosting nutrition and expanding immunisation.

Though the latter factors have been focused on over the past 15 years, family planning has been accorded a low role; Pakistan has one of the lowest contraceptive prevalence rates in the region, ie, 27pc, the policy brief points out.

“The contraceptive prevalence rate in Sindh has remained almost stagnant in recent years, increasing from 27pc in 2000-01 to only 30pc in 2012-13,” it adds.

Birth spacing, the report says, has been recognised as one of the strongest interventions to improve child survival rates. Birth intervals of 33 months reduce under-five mortality rate by 13pc. In Pakistan, neonatal, infant and child mortality are almost halved when birth intervals are four years or more, compared to when they are less than two years, it says, citing a study.

Huge unmet need

Raising their concerns over the slow progress on increasing national contraceptive prevalence by 50pc – the initial commitment was of 55pc which was later revised following the government’s consultation with provinces – under a pledge the government made at the London Summit on Family Planning a few years back, advisor with the Population Council Javed Jabbar said efforts needed to be geared up at every level to meet the 2020 target.

“It’s about saving the lives of hundreds of thousands of mothers and children and all of us, including the media have to pay a role,” he said, while dispelling the perception that religious scholars oppose family planning. In fact, he said, they endorsed birth-spacing.

Pakistan, he said, was the first Muslim country to launch a family planning programme and had a visionary political leadership who understood its need.

“Pakistan is now at a critical take-off stage (to make a difference in its poor health and social indicators). At a recent consultation in Quetta, attendees found it ironic that while the neighbouring Iran has over 80pc contraceptive prevalence rate, Balochistan’s is 20pc,” he said, adding that the Diaries of Field Marshal Mohammad Ayub Khan 1966-1972 had many references to the importance of family planning.

Speaking on the unmet need, Seemin Ashfaq, also representing the council, said surveys had shown that a significant number of couples were convinced of the benefits of birth-spacing and wanted to exercise the option but had no access to contraceptives.

“Apart from ensuring accessibility to contraceptives, efforts are also needed to better create awareness about family planning tools and provide help to those who suffer some kind of side-effects from these methods,” she said.

Participants of the meeting agreed that both population welfare and health departments needed to work in unison if the country had to improve survival rates of its mothers and children, and meet the family planning targets.

They also recommended using the services of lady health workers and various non-governmental organisations in this regard.

Published in Dawn, July 15th, 2016