Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities
Zulfiqar Ahmed Bhuttaa b✉, Assad Hafeezc, Arjumand Rizvib, Nabeela Alid, Amanullah Khane, Faateh Ud Din Ahmadf, Shereen Zulfiqar Bhuttag, Tabish Hazirh, Anita K. M. Zaidib, Sadiqua N. Jafareyi
- aDepartment of Paediatrics and Child Health, Division of Women and Child Health, Aga Khan University, Karachi, Pakistan. zulfiqar.bhutta@aku.edu
- bDepartment of Paediatrics and Child Health, Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
- cHealth Services Academy, Islamabad Pakistan
- dJohn Snow, Islamabad, Pakistan
- eSave the Children, Islamabad, Pakistan
- fNational Institute of Population Studies, Islamabad, Pakistan
- gJinnah Postgraduate Medical Centre, Karachi Pakistan
- hPakistan Institute of Medical Sciences, Islamabad, Pakistan
- iZiauddin Medical university Karachi Pakistan
- ✉Corresponding author
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Abstract
Globally, Pakistan has the third highest burden of maternal, fetal, and child mortality. It has made slow progress in achieving the Millennium Development Goals (MDGs) 4 and 5 and in addressing common social determinants of health. The country also has huge challenges of political fragility, complex security issues, and natural disasters. We undertook an in-depth analysis of Pakistan's progress towards MDGs 4 and 5 and the principal determinants of health in relation to reproductive, maternal, newborn, and child health and nutrition. We reviewed progress in relation to new and existing public sector programmes and the challenges posed by devolution in Pakistan. Notwithstanding the urgent need to tackle social determinants such as girls' education, empowerment, and nutrition in Pakistan, we assessed the effect of systematically increasing coverage of various evidence-based interventions on populations at risk (by residence or poverty indices). We specifically focused on scaling up interventions using delivery platforms to reach poor and rural populations through community-based strategies. Our model indicates that with successful implementation of these strategies, 58% of an estimated 367,900 deaths (15,900 maternal, 169,000 newborn, 183,000 child deaths) and 49% of an estimated 180,000 stillbirths could be prevented in 2015.
TL;DRAn in-depth analysis of Pakistan's progress towards MDGs 4 and 5 and the principal determinants of health in relation to reproductive, maternal, newborn, and child health and nutrition and focused on scaling up interventions using delivery platforms to reach poor and rural populations through community-based strategies. (Semantic Scholar)