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EDITORIAL: The infant mortality rate (IMR) in Pakistan has been falling it is way behind achieving the desired goal, though. According to the Pakistan Demographic Survey 2020 (the latest survey) reported the other day, the average IMR — the number of deaths per 1000 live births of children under one year of age — stands at 56 as against 60 in 2018-19 and 62 in 2017-18.

If that looks like some progress compare it with the UN Sustainable Development Goal 3 which seeks to ensure health and well-being for all, the rate should be no more than 12 per 1000 live births. Clearly, this country has a lot of catching up to do.

One significant cause of such a high child mortality ratio is inequities between the rural and urban populations. The mortality rate during the survey period was 59 in rural areas and 50 in urban centres. The reasons for this disparity may be different, such as relative lack of education among rural mothers, poor sanitation, poverty, environmental conditions as well as developmental levels in different regions.

The biggest factor of inequity affecting infant health, however, is that whereas neonatal and postnatal care is accessible in cities, basic health facilities in rural areas are either missing or are not properly staffed and provided with sufficient medical supplies and necessary equipment. The survey also shows that the male IMR at 58 was higher than that of female IMR of 55. In the rural areas, the rate was 62 and 56, respectively.

Which is not surprising considering that females have better chances of survival and also living longer than males all over the world, with a handful of exceptions, of course. A rather intriguing revelation of the survey is that the IMR rate in urban areas for males was 48 and 51 for females. What needs to be done to set things right is suggested by the National Health Vision Pakistan 2016-2025.

Among other important recommendations, it calls for pro-poor distribution of health services with an equity-based approach targeting rural areas, urban slums, and other disadvantaged sections of society. Also emphasised is the importance of initiatives aimed at provisions of obstetric and neonatal care at primary health level along the pattern of Integrated Reproductive, Maternal, Newborn & Child Health and Nutrition Programme, Punjab.

Other key findings of the demographic survey show the total fertility rate — average number of children that would be born to a woman during her fertility period was 3.7. The general fertility rate, the number of births in a year per 1000 women of childbearing age, was 124. And the crude birth and death rates — the number of births and deaths in a year per 1000 people — were 27 and 6.7, respectively. A particularly noteworthy finding was that the rate of natural increase, or natural population change calculated by dividing natural increase by 10, was 2. In simple words, the population growth rate is 2 percent! This amounts to zero growth rate, which is too good to be true.

Copyright Business Recorder, 2022

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