Karachi : Pakistan has a rate of 47 stillbirths for every 1,000 babies compared to the global rate of 19 per 1,000. Pakistan’s rate, which is the second highest after India, can easily be reduced by half if simple measures are adopted and the local authorities pay a little more attention. The country that boasts the lowest rate if Finland with two stillbirths per 1,000 births.
Everyday more than 7,000 babies are stillborn; causing anguish to thousands of parent expecting to welcome a new life. Every year, high infant mortality rates in Pakistan amount to 2.6 million lives that will never be lived.
Yet there are effective preventive measures that can reduce the number of stillbirths– just 10 interventions, with 99 per cent coverage, would reduce stillbirths by around half in low-income and middle-income countries, according to a research published in a renowned health journal named The Lancet.
The Lancet provides the most comprehensive assessment of stillbirths to date, bringing together an international team of 69 people from more than 50 organisations in 18 countries.
“Key actions by 2020 can halve stillbirths,” says Dr Zulfiqar Bhutta, Founding Chair, Division of Women and Child Health at Aga Khan University. He was also a member of the team that carried out the research.
The 69 researchers have worked for over two years on the analysis, primarily funded by the Bill and Melinda Gates Foundation. With six papers and two research articles, it provides a new overview of the problem and offers solutions.
In the first-ever set of nationally reviewed stillbirth estimates by the World Health Organisation, the new data shows that just 10 countries represent two-thirds of all stillbirths.
In order from highest to lowest, these are India, Pakistan, Nigeria, China, Bangladesh, Democratic Republic of the Congo, Ethiopia, Indonesia, Afghanistan and Tanzania. The top five alone represent half of all stillbirths worldwide.
Around two-thirds of stillbirths occur in rural families worldwide, where skilled birth attendance is at least 50 percent lower. In urban areas, trained doctors are able to perform caesarean sections and reduce the number of stillbirths.
But there have been notable successes in stillbirth reduction in many developing countries. Columbia, China, Mexico and Argentina have all reduced their stillbirth rate by 40 to 50 per cent.
Just 10 interventions across the 68 priority countries of the ‘Countdown to 2015’ initiative to track progress on the MDGs for maternal and child health, would reduce stillbirths by around 45 per cent.
From basic emergency obstetric care and insecticide-treated bed nets to prevent malaria, to folic acid supplementation and management of diabetes of pregnancy and more, some 1.1 million stillbirths could be avoided.
Stillbirth rates can also potentially be brought down by a combination of primary care (outreach) and facility-based interventions in community settings.
The role of community health workers is addressing maternal care and promotion of facility-based births is of special relevance to Pakistan as exemplified in a recent publication based on studies with Lady Health Workers in rural Sindh.
The vision for 2020 is for all countries with a rate over 5 to reduce their stillbirths by at least 50 per cent.
“Pakistan needs to develop and implement a plan to improve maternal and neonatal health that includes a reduction in stillbirths, and to count stillbirths in their statistics and other health outcome surveillance systems,” says Dr Bhutta.
