The maternal death emergency in Pakistan
https://arab.news/mgw7z
As most of the world celebrated Mother’s Day last week, one glaring topic that floats much too under the surface in the South Asian region, is maternal health and women who die in childbirth.
The fact is that much of the progress made in lowering Maternal Mortality Rates (MMR) and improving maternal health has recently stalled across the world, while in some regions of the world it has become worse than it was. A recently published report by the World Health Organization (WHO) shows that pregnancy is killing 800 women a day around the world, or more bluntly put, a woman dies every two minutes during pregnancy or childbirth. The report also points out that between 2016 and 2020, the number of pregnant women who died has increased by 3.8% a year. Although MMR in Pakistan has shown major improvements from 2000-2017, a sharp rise since 2019 is of grave concern.
While MMR in 2017 was 140 per 100,000 live births, it currently stands at 186 per 100,000 live births, a 32% increase, especially in the rural areas.
Recently published data by UN agencies casts a grim outlook of the world we live in today. Numbers point at inequalities in all areas of life including access to quality health services, and highlighting the gap between the rich and the poor, the east and the west, and developed nations versus the rest of the world. The MMR in 2020 was 430 in 100,000 live births in low-income countries as opposed to 12 per 100,000 live births in high income countries.
Poverty, health inequity and health inequality are all factors contributing towards this upward trend in MMR, which became glaringly obvious during the COVID-19 pandemic.
This deteriorating maternal mortality rate is a manifestation of the country’s priorities. Covid-19, as well as the recent floods in Pakistan, where over 600,000 pregnant women were displaced, have laid bare the dire need for a robust healthcare system.
Mehreen Mujtaba
The pandemic has also contributed to persistent maternal deaths, not only because it made pregnancies more hazardous due to the risk of Covid-19 itself but also put a strain on healthcare facilities limiting access for routine antenatal checkups.
However, the new report does not fully capture Covid-19’s impact, as lower-income and developing nations have been slower to tabulate Covid-related maternal deaths.
Many women in low and middle income countries, including Pakistan don’t have access to quality healthcare in order to deal with the complications of pregnancy.
Pakistan has one of the highest maternal mortality rates in South Asia and despite being a signatory of Agenda 2030, is currently lagging behind significantly in achieving Sustainable Development Goal 3. There are a large number of systematic, social and political factors which have contributed to this. Maternal mortality in Pakistan is still 26% higher in the rural areas than in urban areas indicating a failure of the state to provide its citizens with equitable access to healthcare. Moreover, during Covid-19, various factors which affected the healthcare system in general also hindered the control of MMR in Pakistan.
Recommendations for reducing the maternal mortality rate in Pakistan are numerous. They start with first increasing the budget and funding in healthcare while prioritizing women's reproductive health particularly in rural areas. The finances can be used to increase training programs that work to provide skilled antenatal and delivery care as well as midwives in general. It can also be used to increase the number of healthcare facilities themselves as citizens living in rural areas tend to have less facilities available and have to travel greater distances to reach healthcare facilities.
This deteriorating MMR is a manifestation of the country’s priorities. Covid-19, as well as the recent floods in Pakistan, where over 600,000 pregnant women were displaced, have laid bare the dire need for a robust healthcare system.
It is pertinent to note that maternal health is not only an indicator for a woman’s health but also reflects the health of the newborn baby. Only a healthy mother will produce healthy children, and hence a healthy nation. Prioritizing maternal health is akin to investing in the country’s future human capital. Maternal deaths usually result due to preventable causes, hence incentivizing safe motherhood programs should be a top priority for the government. Providing quality healthcare during and after pregnancy and childbirth are essential for saving pregnancy related deaths. Investing in Lady Health Worker programs can translate into providing family planning, birth spacing, antenatal care at the grass-root levels. Provision on referral linkages and transport from basic health units to tertiary care hospitals in case of complications, can also help save scores of precious lives.
- Dr. Mehreen Mujtaba is a freelance consultant working in the areas of environment and health.
