Pakistani children suffer from lack of basic health facilities

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PESHAWAR – Children, who make up more than half of Pakistan’s population, face an acute shortage of healthcare and immunisation facilities that endangers their lives, according to the Pakistan Paediatrics Association (PPA).

“In Pakistan, only 47% of children get immunisations while 3.5m children face vitamin A deficiency, which adversely affects vision, growth and reproduction,” said Dr Syed Mujahid Hussain, immunisation officer at the Ministry of Health Islamabad. The UN’s Millennium Development Goals (MDGs) call for upgrading the immunisation rate to 90% by 2015.

An adequate level of vitamin A reduces measles mortality by 50% and diarrhoeal mortality by 33%.

“Every year an average 50% of children get scabies, 33% get a respiratory infection and 21% get a gastrointestinal tract infection because of harsh weather and the unhygienic conditions in which they live,” said Dr Sabir Khan, assistant professor at Khyber Teaching Hospital Peshawar, citing a research paper by the PPA.

Pakistan’s children face high mortality rate, shortage of doctors

Pakistan's estimated 2008 mortality rate for children under age 5 was the world's 42nd worst, according to UNICEF. Birth itself is a dangerous time, since more than half (51%) of deliveries take place at home under the care of traditional midwives, meaning that complications can turn rapidly into big trouble.

Adding to the problem, Pakistan has only 5,000 paediatricians for 90m children. The World Health Organisation recommends at least one paediatrician for every 5,000 children — or 18,000 such doctors in Pakistan’s case – according to professor Abdul Hameed of the PPA.

The MDGs call on Pakistan to trim its under-age-5 mortality rate by two-thirds by 2015, Dr Ershad Karim of UNICEF said. “Unfortunately Pakistan is lagging behind,” he said. “The only way to achieve the MDGs is to scale up immunisation, which is the most cost-effective way of controlling vaccine-preventable diseases and ensuring child survival, better health and development,” he said.

The 2001 National Nutrition Survey found that 12.5% of children had vitamin A deficiency, 38% were underweight and 1.2% had night blindness.

Hameed painted a bleak scenario of child health and said that 110 children of every 1,000 under age 5 die every year. In contrast, only 6 children out of every 1,000 under age 5 die in Sri Lanka, where paediatric health facilities are more plentiful.

At present, only 8,000 of the total 60,000 beds in public sector hospitals are for children, even though they comprise more than half of the country’s population of 160m, Hameed said.

The PPA chief described the situation as pathetic, considering that Pakistan is a signatory to about 20 UN conventions relating to the well-being of children. There are only three specialised children’s hospitals in Pakistan, one in each province except Khyber Pakhtunkhwa.

Programmes to help tackle child healthcare issues

The Japanese government had pledged US $20m to establish a state-of-the-art Khyber Institute of Child Health, but the law-and-order situation has frozen action on that front.

The government launched the five-year US $1 billion Maternal, Neonatal and Child Health Programme in 2007 to strengthen, upgrade and integrate the existing child health services in 134 districts and to improve accessibility of quality services at all levels of the healthcare delivery system.

The PPA is organising the National Child Convention in Islamabad to observe Universal Children’s Day November 20 to highlight the problem and seek a solution. Prime Minister Yousaf Raza Gilani is scheduled to attend so he can learn about the many problems children face and elicit high-level support for addressing them.

A PPA delegation will request that the prime minister set aside one day per year dedicated to children. UNICEF, WHO and other nongovernmental organisations will send representatives to discuss the issues hampering child development.

During the convention, organisers plan to promote the Child Protection Bill, which parliament has not yet passed.

Advocates intend to make presentations regarding child health to focus leaders’ attention.