LAHORE - Pakistan has the highest neonatal and infant mortality rate in the region as well as on the globe mainly due to the prevalent unsafe delivery practices, mostly in the rural and far flung areas.

Although neonatal and infant mortality rate has decreased considerably worldwide during the last couple of decades, the situation has not improved in Pakistan as the health authorities here attached little or no importance to address the important issue.

Mortality rate among children under the age of five years has declined globally by almost 50 per cent, from 90 deaths out of 1000 live births in 1990 to 48 deaths/1000 live births in 2012, mainly due to interventions that led to improvement in mothers and infants care.

In Pakistan, under-5 mortality rate is 89 per 1000 live births and two third of these occur during the neonatal period (55 per 1000 live births) while 74 per cent of total neonatal deaths take place in the first week of life. Unlike Pakistan, situation in other countries in the region improved gradually as health authorities introduced interventions that helped reducing newborns mortality rate.

In India, under-5 mortality rate is 61 deaths/1000 live births and in Nepal it is 48 deaths per 1000 live births. In Bangladesh, under-5 mortality rate is 46 deaths per 1000 live births while it is 12 deaths per 1000 live births in Sri Lanka.

As per the experts, developed countries in particular and those in the Asia in general took measures regarding improvement in provision of healthcare to mothers and newborns that caused gradual decrease in under-5 mortality rate.

Still in Pakistan, experts say, traditional delivery methods are used especially in rural and fare lung areas, that is resulting into high under-5 mortality rate.

“Mothers and newborns are dying due to preventable diseases. People at helm of affairs are least bothered to take measures regarding doable interventions like improvement in immunisation and childcare in early stages to save health and life of mothers and newborns”, said a senior doctor.

As per a recent study, next to birth asphyxia, sepsis is the leading cause of neonatal deaths. A baby’s newly cut umbilical cord can be an entry point for bacteria, which can lead to cord infection and potentially life threatening sepsis. Infection can cause more than half of the neonatal deaths in poor resource and high mortality settings.

As 50 per cent of births take place at home and 72 per cent of these are attended by traditional birth attendant or relative, unsafe and unhygienic practices are common in most of the births across Pakistan. Some of the most common unsafe delivery practices include: use of unsterilised instruments for cutting of cord, use of harmful material on the umbilical cord like lead based concoctions surma, ash, ghee/oil and rarely cow dung.

Pakistan Medical Association has pointed out how these unsafe and unhygienic practices drive Pakistan’s high maternal and newborn mortality. The real causes of such a high maternal and newborn mortality are due to untreated or poorly treated maternal complications, inadequate neonatal care, and harmful homecare practices, such as discarding of colostrums, application of unclean substances to the umbilical cord stumps, and the failure to keep babies warm.