KARACHI, March 12: Women in Pakistan have inadequate access to obstetrics care due to limited health care options and poor knowledge of obstetrics complications. This can be corrected by overall maternal health awareness.

Basic health services and antenatal care to pregnant women should be provided through organized community efforts, as more than half of the babies, who die in the neonatal period, have low birth weight (LBW) and are born to undernourished mothers. So, maternal health and LBW are directly proportional.

These and other recommendations were made at a seminar on “Neonatal Health Issues for 2005” held on Saturday by the Pakistan Paediatric Association (PPA) in collaboration with the Unicef and the Sindh government.

The Secretary Health Sindh, Prof Naushad Shaikh, said the Sindh province was on top in everything like maternal and infant mortality rates etc.

He said the efforts of doctors and the government alone were not enough to solve all problems, strongly suggesting community efforts to overcome the challenges.

“It is shameful for us that we are in the 21st century, but our maternal mortality rate (MMR) and infant mortality rate are still the highest in the world.”

The reason behind this, he said was lack of will and commitment in our work, adding that even regional countries like Sri Lanka and Bangladesh had controlled these rates only due to their will, commitment and sincerity.

“Political instability is another major constraint, as we always suffer from it. We will have to improve our system and health status of people. We have to eradicate polio from Sindh by Dec 2005,” he said.

“We have doctors, who perform the best in foreign countries. Then why can’t they produce good results in Sindh? Everyone should think about the situation.

Responding to the demand of Prof Hassan Memon, he said he was working to finalize the service structure of special cadre doctors and paramedical staff, and despite political constraints both would be announced soon.

Talking about the prevalent situation, the secretary health said there were several buildings in interior Sindh, which lay vacant, while equipment in some centres was not even taken out of its packing.

“Besides, for their proper functioning, neonatal units should be established at all hospitals there,” he added.

The secretary health said that doctors were not interested to work in remote and rural areas. He said he realized their problems, adding that he had suggested double salary and other incentives for such healthcare providers working in rural areas.

“In rural areas, only 400 out of some 1,000 basic health centres are functioning. Purchasing of equipment and construction of buildings is no problem, but the challenge lies in their sustainability. I welcome any proposal regarding the improvement of their functioning,” he maintained.

Earlier, delivering the welcome address, the President PPA Sindh, Prof Hassan Memon, said neonatal care was an important aspect, as it was baseline for human life. “Infant mortality being very high in Pakistan is 80 deaths per 1,000 births and neonatal deaths are 40 per 1,000 births,” he added.

“Care depends on facilities provided at the centre or hospital. We should improve neonatal care and reduce infant mortality all over Sindh,” he said.

He drew attention of the secretary health towards the fact that doctors of grade 18 were still working in the same grade for 20 years, and had not been promoted. He urged the secretary health to solve this problem and consider the proper facilities for neonatal centres especially at district levels.

Prof Rubina Hussain, head of the Department of Gynaecology and Obstetrics at the Ziauddin Medical University spoke about ‘Maternal health and low birth weight’. She said the maternal health status of Pakistani women was poor, and there was a high ratio of maternal morbidity and mortality.

Discussing the ‘Current status of neonatal health-IMCI’, Prof Iqbal Memon of the Dow University of Health Sciences said every year more than 10 million children in undeveloped countries die before reaching their fifth birthday, and 20 per cent of them were due to prenatal causes.

Dr Razia Korejo, secretary of the Society of Obstetricians & Gynaecologists of Pakistan, spoke on ‘Integrating maternal and newborn care in Pakistan: a vision for the future’.

The associate professor and head, Department of Paediatric Surgery, National Institute of Child Health (NICH), delivered a presentation on “Improving standards of care of surgical neonates”, and said neonatology was a highly demanding specialty. He stressed the needed for intensive care of babies, who could easily succumb to minor ailments.

The head, Paediatrics Department of Ziauddin Medical University Dr Zareen Fasih also made a presentation. — PPI