RELATIVE overall improvement in health services over the last decade has resulted in a decrease in the country’s maternal mortality rate from 276 deaths to an average of 186 deaths per 100,000 live births, according to the latest Pakistan Maternal Mortality Survey. Hearteningly, the survey reveals that a greater number of pregnant women are also seeking medical care due to enhanced awareness about their condition. The provincial breakdown of maternal mortality rates, however, shows that this improvement is not consistent across the country. With 157 deaths per 100,000 live births, Punjab has the lowest MMR; followed by KP at 165; then Sindh at 224; while Balochistan has the highest, at 298 maternal deaths per 100,000 live births. The lowest MMR of all regions in the country is in Azad Jammu & Kashmir at 104 deaths, while in Gilgit-Baltistan it is 157. This data indicates that though health services and women’s access to them might have improved in Punjab and KP, leading to the decrease in overall maternal mortality rate, Sindh and Balochistan still have a lot of ground to cover in terms of improving and enabling adequate service delivery in this area. Similarly, the disparities in health services in urban and rural areas are also reflected in the corresponding MMRs. The ratio of deaths is 26pc higher in rural areas — 199 as compared to 158 in urban areas.
Pakistan used to have one of the highest MMRs in the region. The overall decrease is encouraging, but this progress can easily be reversed if the authorities keep shying away from dealing with the problems that contribute to it. One of the biggest factors is the high number of pregnancies in women. The country’s population continues to grow at an alarming rate at the expense of women’s health. The MMR may have reduced over the last decade, but Pakistan has the highest fertility rate in Asia and the fifth largest population in the world. This means that a large population of women undergo more pregnancies than their bodies can bear. Birth control remains a controversial subject due to opposition by the country’s religious right, but it is illogical to expect a sustained reduction in MMR without tackling the issue of family planning. The authorities must not shy away from doing what needs to be done for the sake of the health of millions of women and children in the country.
Published in Dawn, August 24th, 2020