If you ask me what the government is doing about maternal and reproductive health of women and family planning, my answer will be ‘nothing’, said Planning Commission of Pakistan population section chief Shahzad Malik.
Malik - along with members of provincial assemblies, government officials, gender activists and members of civil society - said this at an event held at the Beach Luxury hotel on Wednesday. Organised by the Shirkatgah Women’s Resource Centre, ‘Next Steps: Achieving universal access to sexual and reproductive health and rights through a coherent post-2015 framework’ was a national consultation with stakeholders.
The discourse remains relevant as ever, with an estimated 30,000 women dying every year due to birth-related mishaps. While Maternal Mortality Rate (MMR) in Pakistan may have improved - dropping from 490 in 1990 to 260 in 2010 - a lot still needs to be done. MMR is the number of women per 100,000 live births who die of pregnancy and childbirth related complications. A staggering number of abortions - somewhere between 800,000 and 900,000 - are carried out in Pakistan every year, and most of them classified as unsafe abortions. Lack of contraceptive facilities and absence of timely family planning are the major reasons, as most women getting abortions are married women getting rid of an unwanted pregnancy.
Representatives from each province shared their experiences and problems. Balochistan’s representation was sorely missing as the speakers could not make it to the event. However, some jarring issues came to the fore in the discussions, such as the fact pointed out by moderator Imran Shirvanee. “Only two political parties bothered to talk to health experts when designing the public health manifesto, before the 2013 general elections,” said Shirvanee, refusing to divulge the names of the parties.
Punjab MPA Dr Najma Afzal Khan shared information about positive reproductive health initiatives and headways made in the province of Punjab. “The Punjab chief minister is committed to improving maternal health,” she said.
“In Punjab, there has definitely been progress,” said Dr Zafar Ikram, provincial coordinator of the Maternal, Neo-natal and Child Health Programme, Punjab. “However, problems such as unmet need of family planning methods persist. Gestational diabetes is on the rise and there is hardly any emphasis on post-menopausal cancer.”
The problems in Khyber-Pakhtunkhwa (KP), as pointed out by MPA Arshad Umerzai, are mostly to do with the security situation. “Also, while the policies of the provincial government in KP may be commendable, a lack of coordination and strained relations between the federal and provincial governments hinders progress.”
Issues related to governance and social and demographic dynamics were also discussed, and recommendations were made to improve the situation. Some of the problems pertaining to funding owe to the confusion that still exists between provincial and the federal governments after the 18th Amendment.
As the participants pointed out, it is time for maternal health to be taken seriously, especially since research shows that when a mother dies, the children that are left behind are more likely to grow into adults with psychological issues. Such issues, experts shared, are likely to fall into extremist behaviour as well.
Published in The Express Tribune, September 12th, 2014.