Health matters: Maternal mortality high despite solutions availability

Experts cite education, improving basic facilities as ways to address the issue.

Sehrish Wasif April 11, 2013
Around four per cent of the women were under 20 and 34.2% had less than five years of schooling. PHOTO: FILE


Severe maternal illnesses occur in 12 out of every 1,000 live births in Pakistan. This was among other statistics in the World Health Organisation Multi-country Survey on Maternal and Newborn Health (WHOMCS) 2010-11, which was launched on Wednesday at Pakistan Institute of Medical Sciences (Pims).

Severe anaemia, postpartum haemorrhages and preeclampsia were the most common maternal complications in the country, it adds.

The survey was conducted from May 2010 to December 2011. It was based on 314,623 women at 16 facilities in Punjab, Sindh and Islamabad, who were studied to determine the occurrence and management of maternal and neonatal problems.

Around four per cent of the women were under 20 and 34.2% had less than five years of schooling.

According to the survey, severe anaemia occurred in 50% of women, postpartum haemorrhage in 48.5% and preeclampsia in 9.1%.

Heart, breathing and blood-related problems were the most prevalent among women with severe maternal outcomes, with rates ranging from 34.1% to 59.1%.

There were 94 near-miss maternal mortality cases and 38 maternal deaths, giving a maternal mortality ratio of 299 per 100,000 births.

The WHO observed that the maternal mortality rate in Pakistan was two to three times higher than its assessments for other high mortality countries, even though the interventions needed to reduce mortality were widely available.

Meanwhile, the overall caesarean section rate was 34.5%, while the prevalence of low birth weight and preterm births were 10.9% and 11.2%, respectively.

Talking to The Express Tribune, senior gynaecologists at public hospitals in the twin cities of Islamabad and Rawalpindi said one of the major causes of high maternal mortality is the shortage of beds, staff and other facilities at public hospitals.

Holy Family Hospital (HFH) Head of Obstetrics Dr Rizwana Chaudhry said there are 250 beds at the HFH gynaecology department --- where over 17,000 deliveries are performed every year --- and they are being shared by two to three women at a time.

“Government-run tertiary care hospitals are over-burdened because of the pathetic condition of primary healthcare centres in rural areas,” she said.

Dr Chaudhry also expressed concern over the absence of a centralised data collection system at all levels to record maternal deaths.

“Education is the best way to reduce maternal and neonatal mortality,” she said.

Dr Nasira Tasneem, an associate professor of gynaecology at Pims, said there is an acute shortage of doctors, nurses and beds at the hospital.

At present, there are 60 regular staff members, most of whom are postgraduate trainees who are not trained well enough to handle complicated cases. Besides this, there are 80 nurses and six medical officers in two units, she said.

Every day, over 500 patient’s visits the outpatient department, while the 125 beds are being shared by three patients at a time. On average, 13,000 deliveries are performed every year, 12 to 15 of which result in maternal deaths due to complications, she said.

“In Pakistan maternal mortality can be reduced if primary healthcare services at grassroots levels are improved and urban hospitals upgraded,” she said.

Published in The Express Tribune, April 11th, 2013.


shabana Khan | 9 years ago | Reply Maternal newborn child health program was initiated by government of Pakistan with huge budget of RS 20 billions. but previous government hijacked the program. Through this program every province was bound to established midwifery school in their every district and select one girl from every 10000 population who will work as community midwife in their own catchment area's. and than they should be trained in these district midwifery school and after 18 month of learning will be allowed to appeared in Pakistan nursing board exam if she passed the exam she should be deployed in their catchment area. And in every rural health center one WMO should be hired an posted in RHCs for CMW help and gynecologist should be hired and they should be posted in tehsil hq hospital and District hQ hospital for any complication of pregnant women. And every cmw should be provided free delivery kits and Ambulance should be provided to Every rhc for transportation of pregnant women for further treatment if there were any complication. And there will be district cell who will supervise the activity of program. It was written in PC-1 of program. But instead to followed pc-1 every province followed their own political Agenda. Selected cmw candidates with out following pc--1 criteria even selected full batch of CMW from one constituency. Recruited 17 and 18 grade officer with out consulting PCS. The provincial offices were made recruiting center's and thousands of un competent employs were appointed with the recommendation of party high commands the nursing council were bribed and registered candidates with out registering their schools and even passed them the students without conducting any delivery and due to wrong selection , CMW were not deployed and even completion of first phase of program no province generated even their one monthly report even district didn't generated one month reports in 5 years. Purchase of logistic were also bogus they repurchase the women health project logistic. The substandard vehicle were purchased but not those which were written in PC-1. All health department high ups were involved. Provincial steering committee changed the rules which was only recommended body and the 20 billion rupees went to the accounts of political and bureaucratic ,accounts and health officer account. And the program is still running Every partner I.e WHO ,UNICEF, unfpa, save the children,usaid' pamian,dfid all are involved in this corruption and failure of program. Must be investigated
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