Maternal morbidity

The dearth of adequate maternity services killed more mothers and infants in the last ten years in Pakistan than the total number of civilian and military deaths attributable to terrorism. This was just the first of the many thought provoking facts revealed at the National Media Leadership Roundtable on Healthcare for Mothers held at Sheraton Hotel last Sunday.
In other disturbing facts shared by the presenters, Nabeela Ali and Yasmeen Sabeeh, public health experts, was the proof that 70 percent of all maternal and infant mortality in Pakistan can be prevented.
"With 0.56 million deaths under the age of 5,,Pakistan ranks 8th in the world for the number of child deaths," the presenters revealed. They added that nearly three-fourths of all pregnant women have iron deficiency anaemia, which inter-alia, can be attributed to failure to ensure child spacing.
For a typical financial market economist/analyst, this may be just another sob story that does not really make the top agenda. But here is the thing: with rural women- who are usually married at an early age relative to their urban counterparts - bearing children too frequently in their fertile years, poor production is on the rise in Pakistan.
This in turn is increasing the rich-poor divide, and hence the allocation of health resources. Since, the poor who don have the purchasing power for medical services, and since the government usually relies on cutting development expenditures in tough times, the women and children belonging to the poor strata are left out with little option but to submit to quacks.
According to the Ministry of Health, quoted by the experts, some 90 percent of the countrys total population is catered to by Primary Health Centres in rural areas, whereas the distribution of health resources is such that these only get 15 percent of the health expenditure.
Of the many possible solutions to improve on maternal and infant health - some of which have already been discussed at length in the conference - here are a few that involve economic reforms.
First, is the need to increase the tax base, both from the RGST as well as agricultural income amongst others. Failure here will encourage the federal and provincial governments to slash development spending every time they get in a fix.
Second, work on infrastructure such that small pockets of developed market friendly areas emerge, so that the rate of rural to urban migration slows down and resource allocation can be done appropriately.
Third, in so far as the issue of family planning is concerned, the health department and the civil society should work in concert with religious powerhouses. If a consensus is developed amongst the clerics, keeping in view the ground realities, perhaps the health change drivers could better encourage family planning in the traditional rural societies.
Lastly, in order to keep the agenda of maternal and child health alive in popular media, the setting up of a centralised data dissemination body would help.
A province/district wise, cause specific cross-sectional periodically (monthly/quarterly) reported that data of maternal and infant mortality may require enormous costs and efforts initially, but once set up, it would surely provide the necessary flammable material to keep stoking the issue in the arena of mainstream politics.