Report highlights gaps in maternal health services

An in-depth analysis of Pakistan Maternal Mortality Survey (PMMS) 2019 revealed critical gaps in maternal health services for women of reproductive age in Pakistan.

The survey was produced jointly by the Population Council, National Committee on Maternal, Neonatal and Child Health, National Institute of Population Studies with technical and financial support from World Health Organisation (WHO), and United Nations Population Fund (UNFPA).

The analysis examined the predictors of maternal mortality in Pakistan and unpacks causes of maternal deaths while also identifying the societal and medical factors that contribute to the tragic loss of maternal lives.

Minister for Health and Population Welfare Sindh Dr Azra Fazal Pechuhu, attended the launch ceremony of the report titled “Explaining Maternal Mortality in Pakistan: In-depth Analysis of Pakistan Maternal Mortality Survey, 2019” and reiterated Sindh government’s commitment to improving health outcomes as population welfare. She said this study has been released at a very appropriate time and provides strong research-based evidence to strengthen interventions for mother and child healthcare and contraceptive care. This study will be helpful in policymaking, designing new MNCH initiatives to prevent maternal deaths in Pakistan. She stressed for concerted efforts and investments to meet the public health and human rights imperative of saving maternal lives. She said that strong accountability at the facility level is needed as all maternal deaths must be avoided.

In her opening remarks, Country Director Population Council, Dr Zeba Sathar stressed the need for quality data and more periodic and granular information providing district level situation as far as maternal mortality is concerned. Provision of quality family planning services can reduce repeated and multiple pregnancies as the analysis showed that non-practicing of family planning was a big factor contributing to maternal deaths, she added.

The analytical framework for in-depth analysis of PMMS 2019 used both quantitative and qualitative approaches to investigate levels and causes of maternal mortality across Pakistan which yielded important policy and programmatic implications.

In his remarks, Deputy Country Representative, UNFPA Dr Bakhtior Kadirov, said “Maternal morality of Pakistan and its provinces could be compared to some African countries. Although Pakistan made significant improvement in Antenatal care and delivery in facilities, but number of maternal mortalities did not reduce accordingly. Substantial disparities of maternal mortality ratio among provinces, regions and rural areas call for customised interventions and improvements to access of family planning services and information could actually reduce number of maternal mortalities in Pakistan.”

Authors Dr Ahsan Iqbal and Dr Azra Ahsan shared key findings of the in-depth analysis. They said that the analysis shows that women belonging to younger and higher age groups, with no education and first-time mothers are at a significantly higher risk of maternal mortality in Pakistan. Women in the reproductive age who have never used contraceptive, have a history of caesarean section and low quality of care provided at the facility are also at significantly higher odds of maternal deaths.

Presenting key recommendations of the report, Visiting Scientist, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA Dr Iqbal Shah, said childbearing at an early age (below age 20) and at later ages (over 30) should both be discouraged and given priority attention and quality care.

Published in The Express Tribune, October 22^nd, 2022.