LAHORE: An official report has revealed that 1,000 pregnant women and more than 88,000 newborns and children under five years died at the basic health units (BHUs) and rural health centres (RHCs) in Punjab during 2021, showing the poor state of the rural-level health facilities and critical healthcare issues of poor women and children.

The report prepared by Punjab government’s Planning and Development Board on the Integrated Reproductive Maternal Newborn, Child Health and Nutrition programme (IRMNCH), also mentions that out of total 88,021 deaths of children at the BHUs and RHCs, 62,813 were stillbirths.

“These are alarming figures requiring immediate and serious attention of the project [IRMNCH] team and other stakeholders,” the report suggests to the higher authorities.

The programme was launched by the Punjab government at the primary-level healthcare facilities to reduce maternal, newborn and child morbidity and mortality, promote family planning services and improve nutritional status of women and children.

The report blasted the IRMNCH programme for its failure to prevent maternal and neonatal deaths at the primary healthcare facilities, largely functioning in the rural areas of Punjab.

These state-run facilities are mostly visited by poor rural women for child delivery and related medical issues as they don’t have immediate access to tehsil and district headquarters hospitals.

Sources says the report is just based on the data collected from the RHCs and BHUs in all the 36 districts of the province, while such figures from other state-run healthcare facilities are under process. The health experts fear that the number of maternal and child deaths may rise manifold after the processing of statistics gathered from other state-run healthcare facilities.

The report says the data analysis showed that a total of 624,752 normal deliveries (with a monthly average of 34 deliveries per RHC/BHU) were conducted at the RHCs and BHUs in Punjab during 2021.

“1,000 maternal deaths were reported to the IRMNCH programme in 2021, that is quite a high figure considering the public health significance and sensitivity of this issue,” reads the report.

It says such a high number of maternal deaths shows there are some gaps in service delivery of the programme at these facilities (BHU, RHC) and the community level (Lady Health Workers network across Punjab) which needs to be identified to improve the Maternal Mortality Ratio (MMR) figures.

Similarly, a total 25,208 deaths of under-five children were reported to IRMNCH programme in Punjab during 2021. “These included 13,706 neonatal, 8,045 infant and 3,457 under-5 children’s deaths,” the report said.

In addition to these deaths, a total of 62,813 stillbirths were also reported in Punjab during 2021. Showing flaws in the nutrition programme of the IRMNCH, the report cites data of the Government Sabzazar Hospital, Lahore where a total 1,439 children under five years were identified as Severe Acute Malnourished (SAM) at its OPD in 2021. “Of them, only 138 were admitted to the Stabilisation Centre for acute care and management of SAM,” reads the report.

The nutrition programme was supposed to provide ready-to-use supplementary food (RUSF) and Multi Micro nutrient Sachets (MMS) for underweight children (6 months – 2 years of age), and F-75 (used to prevent death) and F-100 for treatment of SAM children admitted to the stabilisation centres.

“However, it was reported by the hospital medical staff that the supply of these nutrition supplements was not regular during the last one year that affected the management and treatment of the malnourished children,” the report says.

The report shows that there is a dire need to improve the quality of services, both at the health facilities and the community level under the IRMNCH and its nutrition programme across the province.

Published in Dawn, March 24th, 2022