Karachi
: If you ask me what the government is doing about maternal and reproductive
health of women and family planning, my answer will be ‘nothing’, said Planning
Commission of Pakistan population section chief Shahzad Malik.
Malik – along with members of provincial assemblies, government
officials, gender activists and members of civil society – said this at an
event held at the Beach Luxury hotel on Wednesday. Organised by the Shirkatgah
Women’s Resource Centre, ‘Next Steps: Achieving universal access to sexual and
reproductive health and rights through a coherent post-2015 framework’ was a
national consultation with stakeholders.
The discourse remains relevant as ever, with an estimated 30,000
women dying every year due to birth-related mishaps. While Maternal Mortality
Rate (MMR) in Pakistan may have improved – dropping from 490 in 1990 to 260 in
2010 – a lot still needs to be done. MMR is the number of women per 100,000
live births who die of pregnancy and childbirth related complications. A
staggering number of abortions – somewhere between 800,000 and 900,000 – are
carried out in Pakistan every year, and most of them classified as unsafe
abortions. Lack of contraceptive facilities and absence of timely family
planning are the major reasons, as most women getting abortions are married
women getting rid of an unwanted pregnancy.
Representatives from each province shared their experiences and
problems. Balochistan’s representation was sorely missing as the speakers could
not make it to the event. However, some jarring issues came to the fore in the
discussions, such as the fact pointed out by moderator Imran Shirvanee. “Only
two political parties bothered to talk to health experts when designing the
public health manifesto, before the 2013 general elections,” said Shirvanee,
refusing to divulge the names of the parties.
Punjab MPA Dr Najma Afzal Khan shared information about positive
reproductive health initiatives and headways made in the province of Punjab.
“The Punjab chief minister is committed to improving maternal health,” she
said.
“In Punjab, there has definitely been progress,” said Dr Zafar
Ikram, provincial coordinator of the Maternal, Neo-natal and Child Health
Programme, Punjab. “However, problems such as unmet need of family planning
methods persist. Gestational diabetes is on the rise and there is hardly any
emphasis on post-menopausal cancer.”
The problems in Khyber-Pakhtunkhwa (KP), as pointed out by MPA
Arshad Umerzai, are mostly to do with the security situation. “Also, while the
policies of the provincial government in KP may be commendable, a lack of
coordination and strained relations between the federal and provincial
governments hinders progress.”
Issues related to governance and social and demographic dynamics
were also discussed, and recommendations were made to improve the situation.
Some of the problems pertaining to funding owe to the confusion that still
exists between provincial and the federal governments after the 18th Amendment.
As the participants pointed out, it is time for
maternal health to be taken seriously, especially since research shows that
when a mother dies, the children that are left behind are more likely to grow
into adults with psychological issues. Such issues, experts shared, are likely
to fall into extremist behavior as well.
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