That the state of child and mother health in Pakistan has always been poor was never a secret, but to have this confirmed by a well-reputed medical journal is an indictment of our apathetic attitude towards this important area. According to The Lancet, Pakistan is the worst country in the world in which to be pregnant. This conclusion is drawn based on the fact that out of 186 countries, Pakistan has the highest rate of stillbirths — child death in the final trimester of pregnancy or during labour — at 43.1 stillbirths per 1,000 total childbirths. The average worldwide rate is less than half of that, at 18.4 stillbirths per 1,000 total childbirths, significantly lower than the average in the year 2000 of 24.7 stillbirths per 1,000 total childbirths. While the global community has managed to mitigate the average number of deaths, Pakistan has evidently failed and somehow more than doubled the statistic.
The risk factors for stillbirth include maternal health factors, prolonged pregnancies, infectious and non-infectious diseases, as well as lifestyle and socioeconomic income gaps. We may not be as badly hit by war as some other countries in the world, but we lag behind even the ones that have had their infrastructures completely annihilated, like Syria and Iraq. The lower income groups struggle to access healthcare, the quality of treatment is poor and little heed is paid to crucial aspects of healthcare such as hygiene. Other controllable factors, such as lifestyle, are ignored sometimes even by doctors.
Our various provincial health departments have to work on standardising healthcare, especially with regards to the quality and hygiene of hospitals and clinics nationwide. There are surely controllable and preventable factors in stillbirths and maternal care. If this latest statistic does not shame health departments into acting to implement new policies and bring about healthcare reform, expectant parents may heed this as a caution to perhaps seek obstetric healthcare outside of Pakistan.
Published in The Express Tribune, January 21st, 2016.