Maternal mortality: the future of life

The country’s maternal mortality rates reflect inequality and hardships faced by the marginalised women of Pakistan

The issue of Pakistan’s healthcare system is in complete shambles. With rising economic and social inequality, healthcare system is only exacerbating. According to the Unicef’s 2019 report on healthcare, Pakistan has one of the highest ratios of maternal mortality in the world. The reason given behind this deplorable situation is that Pakistan spends less than 1% of its GDP on healthcare provision. Although maternal mortality rate numbers have reduced, especially in Sindh, the statistics are still appalling and constructive steps must be taken to cushion maternal healthcare. It is now high time.

Pakistan ranks at 152 out of 189 countries on the Human Development Report-Gender Inequality Index (GII) 2019 which measures women’s equality based on reproductive health, empowerment, and economic activity. The current government has made promises to elevate the plight of women across the country, but little has been done in practice. Furthermore, Pakistan’s abysmal ranking is also due to the fact that a majority of its female population has low levels of empowerment, limited economic contribution, and underutilisation of reproductive and maternal healthcare.

The underutilisation of reproductive and maternal healthcare is an unfortunate consequence of low levels of empowerment and limited economic contribution. The Gender Inequality Index (GII) report states that the labour force participation rate is 23.9% for women and 80.3% for men. The low social status that many Pakistani women have individually and within their family structures affect their overall health negatively which further impacts their use of reproductive healthcare services.

While the low economic and social status of most women in Pakistan can easily qualify as a major factor behind the ‘limited access to healthcare services’ for women, it is critical to note that there are also multiple external problems that add to restrictions leading to the high maternal and neonatal mortality rate in Pakistan. Underutilisation of public healthcare facilities include factors such as long distances to the facilities, restricted hours of operation, poor facility infrastructure, lack of staff, equipment and drugs, and financial restrictions. Many remote regions in Pakistan simply have no access to basic healthcare facilities.

Curing Pakistan’s deteriorating healthcare system is the need of the hour. Both at federal and provincial levels, the healthcare departments must revamp their budget allocations. Investment in healthcare is urgently required in order to build more hospitals and healthcare facilities, especially for the less privileged and marginalised segment of our society. There is no doubt that the poor and vulnerable class is deprived of basic healthcare facilities which result in the appalling statistics concerning Pakistan. This needs to immediately change for progressive outcomes.

Sindh has been the most progressive out of the four provinces. In 2013, Sindh’s overall maternal mortality rate was 276 deaths per 100,000 live births. But the good news is that now infant mortality rate has been brought down to 140 deaths per 100,000 live births in Sindh. Even though more constructive initiatives are required to further improve the situation, these outcomes must not be neglected. Other provinces must also follow Sindh’s example when it comes to the maternal mortality rate.

Let the new decade bring progressive actions in Pakistan’s healthcare system. The country’s maternal mortality rates are unacceptably high. This clearly reflects the inequality and hardships faced by the marginalised women of Pakistan. However, by further improving and expanding access to the quality of healthcare – including through the Lady Health Workers programme – and by increasing access to education, family and life planning services and increasing overall accessibility for women, we will inevitably pave the way for a more empowered society with healthy mothers.

Published in The Express Tribune, February 1^st, 2020.

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