PAKISTAN: Military spending at the expense of children's health - UNICEF [News]
With a global under-five mortality ranking of 46, Pakistan could avoid 60 percent of child deaths by focusing on a limited number of treatable diseases like diarrhoea, pneumonia and neonatal infections, the United Nations Children's Fund (UNICEF) said.
Acknowledging Pakistan's progress in getting rid of polio at the launch of UNICEF's annual flagship publication, the State of the World's Children, last week, Executive Director Carol Bellamy said in Islamabad that countries like Pakistan could do more to address children's health interests by diverting resources from institutions like the military - responsible for consuming up to 40 percent of GDP, according to economists.
Public spening on the health system in Pakistan is low at 0,7 percent of GDP. The sector also suffers from poor implementation and governance, uneven quality of services in the public and private sector, and a weak regulatory framework.
"Some government leaders make decisions that actually hurt children. Investing too much in the military ... means that you have too few resources to invest in what I would call the peace and security side," Bellamy said.
And this shows up in the country's poor health grades. According to the UNICEF report, the annual number of under-five deaths is 567,000, with an infant mortality rate (under one year) of 81 per 1,000 live births and an under-five mortality rate of 103 per 1,000 live births.
According to a recent report by the Mexico-based organisation Centro de Investigaci�n de Enfermedades Tropicales (Tropical Disease Research Centre), called CIET, around 250,000 children die of diarrhoea each year in Pakistan.
"For many of those who survive, mounting garbage heaps and other types of environmental hazards double the risk for repeated infections that drain away the vital protein their bodies need to grow. As a result, they may never reach their full physical or mental potential," said CIET, an international group of professionals from a variety of disciplines, including epidemiology, medicine, planning, communications and other social sciences, who bring scientific research methods to communities.
According to a national survey in Pakistan every child gets on average five episodes a year, with no difference between urban and rural areas. Tahir Masood Ahmad, a paediatrician who was part of a team that studied how doctors manage acute watery diarrhoea (AWD) in children, told IRIN that although many doctors were familiar with World Health Organization (WHO) guidelines for management of childhood diarrhoea, most were slow to follow them.
Acute respiratory infections (ARI) such as bronchitis and pneumonia cause 20-30 percent of deaths in children under five. An estimated 15 million ARI intances in children occur annually leading to at least 100,000 child deaths each year, second only to diarrhoeal disease-related mortality.
The government has introduced WHO guidelines for ARI nationwide after training doctors and community health workers to use the technique. "In Islamabad, use of these guidelines to improve the diagnosis and treatment of ARI among hospital outpatients under the age of five has halved pneumonia death rates among children admitted to hospital, reduced the inappropriate use of antibiotics, and led to major savings in healthcare costs," a WHO representative said.
Dr Anita Zaidi, a paediatrician and microbiologist with Aga Khan University Hospital in Lahore, told IRIN that a major obstacle to nationwide implementation of WHO guidelines is most healthcare activity in Pakistan occurs outside the public sector. "The training activities of national WHO-sponsored programme are limited to governmental staff and facilities. Studies of health facility utilisation patterns in the country have shown that self-employed general practitioners working in the community see and treat the largest proportion of ARI patients," Zaidi said.
Out of over 53 million babies in the country, nearly 270,000 die before they are one month old - the percentage is roughly 10 times higher than that in developed countries, according to a report by the international charity Save the Children.
Save the Children works to eliminate maternal neonatal tetanus in 61 districts throughout Pakistan and Pakistan-administered Kashmir through a national Saving Newborn Lives (SNL) Initiative. Save the Children, the government of Pakistan and local partners collaborate to implement this initiative.
Doctors say that nearly 60 percent of these deaths occur during the first few days after birth and a vast majority of them are preventable through available and cost-effective means.
The risk factors contributing to the high neonatal mortality in the country, according to Arshad Humayun, a physician and an official of Pakistan Medical Association, are: high percentage of home deliveries unattended by skilled care; birth interval of less than 24 months; number of pregnancies greater than six per women, and maternal or paternal illiteracy. "Private-sector health providers should be involved in any national child survival programme," he told IRIN. [Source: IRIN]
PAKISTAN: Military spending at the expense of children's health - UNICEF [News]
