KARACHI, May 27: Out of the over 5.5 million babies born annually in the country, nearly 270,000 die before they are a month old. The percentage is roughly ten times higher than in the developed countries.

According to a report by the National Institute of Child Health, nearly 60 per cent of these deaths occur during the first few days after birth and a vast majority of them are preventable through available and cost-effective means.

The risk factors contributing to high neonatal mortality in the country, according to reports, are the high percentage of home deliveries attended by unskilled care, birth interval of less than 24 months, number of pregnancies greater than six per women and maternal or paternal illiteracy.

Based on the limited data available, a majority of newborn deaths occur at home and remain undocumented. The most common cause of newborn deaths — birth asphyxia (non-breathing), low birth-rate or prematurity and tetanus together account for nearly two-thirds of all deaths.

Although Pakistan is ranked as the seventh most populous country in the world, it has the second highest number of newborn deaths and fourth highest rate of neonatal mortality.

Almost one quarter of all Pakistani newborns suffer from low birth weight and studies have shown that between half and three quarters of all neonatal deaths have occurred among the low birth weight babies.

Studies also suggest a close relation between low birth weight and maternal nutrition and with social and economic status of mothers, particularly due to lack of education and empowernment.

The report suggests emerging evidence of the relationship of low birth weight with long-term chronic diseases in adult life such as diabetes, hypertension and chronic artery diseases. This makes it one of the most important and potentially preventable public health conditions.

Other infections such as diarrhoea, acute respiratory infections, sepsis and meningitis still represents potentially lethal problems for neonates.

Breast feeding, though prevalent and comparatively more in rural women, is often not sustained.

Only around 30 per cent of women seek any kind of ante-natal care. Maternal mortality is also among the highest in the region and studies have shown that newborns whose mothers die are more prone to death.

Certain newborn-care practices such as cord cutting and cord care lack hygiene and contribute to tetanus and other infections resulting in high neonatal mortality.—PPI