Global Report emphasized to reduce urban disparity to give child & maternal health a chance

Monday 1 February 2016

Pakistan sustains high Mother Mortality Ratio (MMR) of 276 per 100,000 live births and accordingly the under-five Child Mortality Rate has hovered around 89 deaths per 1000 live births during the last decade. This alarming maternal & child mortality numbers as prevalent in Pakistan point out that more need to be done if the state of mothers & children aged under-five is to be improved. These statistics become more glaring when the disparity between the rich and the poor in the urban context is taken into account. Although the government of Pakistan has introduced a series of groundbreaking reforms to strengthen countrywide basic health system, however, the benefits of this have not fully reached urban mothers & babies who live under the poverty line. This was revealed during the launching ceremony of State of the World's Mothers Report — The Urban Disadvantage; Save the Children’s 16th annual flagship report which focuses on rapidly urbanizing world and the poorest mothers and children who struggle to survive despite overall urban progress. Launching on the same day across the world, Save the Children Pakistan Country Office shared the state of affairs regarding child & maternal health situation in the urban context in the country where rich-poor disparity is more striking so is the maternal & child survival gap. During the launching event, Members National Assembly Rumina Khurshid Alam (designation yet to be confirmed) & Maiza Hameed (designation yet to be confirmed) along with other Federal & Provincial governments’ high-ups, civil society representatives and concerned government departments’ focal persons were in attendance. A significant number of national & regional media personnel were also present to cover the event. 

While inaugurating the launching event, the chief guest MNA Rumina Khurshid Alam briefed about government’s efforts in mitigating the situation in the urban slums. She agreed to the fact that this health gap between the society’s haves and have-nots is more evident in urban areas of Pakistan. While highlighting government’s efforts to address the situation, she was of the view:  

“ The incumbent government has already took many ground breaking steps in order to reduce the maternal & child survival gap across the country and has also put a special emphasis on improving child & maternal health in the urban slums. We welcome and highly appreciate the role of civil society in this regard”.

 Speaking during the occasion, the Guest of Honor MNA Maiza Hameed reiterated federal government’s resolve to uplift the state of mothers and children living in the slums areas of the urban metropolitans across Pakistan. She emphasized that government along with the assistance of civil society is committed to explore some quick out-of-box ideas to improve the maternal and child health issues in the urban slums.“Of course this report mirrors the true picture of the mothers and children in slums across the world who are vulnerable to preventable diseases, owing to the abject poverty they are living in. However, in Pakistan things are going in the right direction. I am confident that with the assistance of civil society, the government will be able to close the maternal & child survival gap”.

Arshad Mahmood, Director Advocacy of Save the Children in Pakistan, while delivering the welcome note highlighted the objectives behind launching the State of the World Mother’s Report. He pointed out that the report presents a first-ever global assessment of health disparities between rich and poor in cities. He further explained how the urban disadvantages further arrests the possibilities of ending preventable deaths among mothers and children under the age of five years. While elaborating the sections of the report relevant to Pakistan, he said;

 “ The reports findings tell us that in Pakistan, a large proportion of urban poor are living in deplorable conditions. The urban poor are twice as likely to die as the urban rich and the urban poor children are more likely to die than the rural average. But we know that progress is possible and this possibility can be materialized through a variety of services including extending access to high impact services, strengthening health systems, lowering costs, and increasing health awareness.”

Dr. Qudsia Uzma, Director Health & Nutrition Save the Children in Pakistan gave a detailed orientation about the key findings of the report pertaining prevalent child & maternal health indicators in South Asia generally and Pakistan in particular. While elaborating the key findings of the report, Dr. Qudsia explained that the report looks at the health and survival of urban children and reveals a devastating divide between the haves and have-nots.  For babies born in cities, it is more ‘survival of the richest’. The salient features of the report are:

 •    In two-thirds of the surveyed countries, the poorest urban children are at least twice as likely to die as the richest urban children.

 •    The disparity in child survival rates between the rich and poor in urban areas has widened over roughly the past two decades in nearly half of the 40 developing nations surveyed—growing by at least 50 percent in eight countries.

 •    For babies living in overcrowded and unhygienic slums, lack of access to affordable and life-saving interventions—like safe drinking water, immunizations, care for mother and baby during pregnancy and immediately after delivery, treatments for diarrhea, pneumonia and other common illnesses— can equal death.

 •    According to the report, in 60 percent of developing countries surveyed, city children living in poverty are more likely to die than those living in rural areas.

 •    The 10 countries with the greatest survival divide between wealthy and poor urban children are Bangladesh, Cambodia, Ghana, Kenya, India, Madagascar, Nigeria, Peru, Rwanda and Vietnam. In these countries, poor children are 3 to 5 times as likely to die before their fifth birthday as rich children.       

 The guest speaker, Amber Raheem Shamsi, Multi-media Journalist, BBC World Service spoke about the crucial role media can play in creating the awareness about the impending maternal and child health issues which haunt the mothers and children living in the slum areas in cities across Pakistan. In his closing remarks, Arshad Mahmood, Director Advocacy of Save the Children in Pakistan thanked all the audience in attendance. He emphasized on the fact that when the rest of world is looking towards attaining the SDGs, Pakistan is yet to fulfill it commitments towards child & maternal health, which the country pledged to achieve at the advent of this century. While saying so he put forward the following recommendations to uplift maternal & child health in the slums areas of the country: 

The final post-2015 framework should include an explicit commitment to equitably ending preventable child and maternal deaths with measurable targets. 

Commit to leaving no one behind by embedding equity in the final post-2015 framework.

Improve the health of the urban poor by ensuring universal health coverage.

 All provincial governments must follow through on Nutrition for Growth commitments and ensure that the World Health Assembly nutrition targets are met.

Develop comprehensive and cross-sectoral urban plans. 

Invest in data collection.

Mobilize resources to end preventable child deaths in poor urban areas.