Pakistan’s urban poor children 2.5 times more likely to die than their richest counterparts

Islamabad
Even though urban populations are generally considered as enjoying better health in comparison to their rural counterparts, the urban poor children of Pakistan are 2.5 times more likely than the richest urban children to die before they reach their 5th birthday. Similarly, 1 in every 170 women in Pakistan faces a lifetime risk of maternal death, with the country’s overall ranking on the Mothers Index being an undesirable bottom-30th among a total of 179 countries.
These harrowing data are contained in Save the Children’s 16 annual flagship report titled ‘State of the World’s Mothers Report: The Urban Disadvantage.’ Launched across the world, including Islamabad here on Tuesday, the report presents the first-ever global assessment of health disparities between rich and poor in dozens of cities in developing countries and 25 cities in industrialized countries. The purpose is to see where child health and survival gaps are largest, and where they are smallest. The analyses find alarming inequities in almost every country including Pakistan.
According to the report’s Urban Child Survival Gap Scorecard, which examines child death rates for rich and poor urban children in 36 developing countries, poorest urban children in 69 percent of the countries are at least twice as likely to die as the richest urban children before they reach their fifth birthday. In nearly 60 percent of the countries studied, the poorest urban children face worse survival odds than children in rural areas.
Urban child survival gaps are largest in Bangladesh, Cambodia, Ghana, India, Kenya, Madagascar, Nigeria, Peru, Rwanda, Vietnam and Zimbabwe. In these countries, poor urban children are 3 to 5 times as likely to die as their most affluent peers.
The report’s City Health Care Equity Ranking, which shows how access to health care differs among the poorest and wealthiest mothers and children within 22 cities, finds that, on average, about 60 percent of the poorest women in these cities receive the recommended minimum number of prenatal care visits (compared to 90 percent of the wealthiest women), and about 70 percent give birth with a skilled health professional (compared to 95 percent of the wealthiest women). Eighty percent of the poorest children, on average, are vaccinated for measles (compared to 90 percent of the wealthiest children).
The largest coverage gaps between rich and poor were found in Delhi (India), Dhaka (Bangladesh), Port au Prince (Haiti) and Dili (Timor-Leste). Malnutrition gaps are greatest in Dhaka, Delhi, Distrito Central (Honduras), Addis Ababa (Ethiopia) and Kigali (Rwanda).
The report’s launching was attended by Members of the National Assembly Rumina Khurshid Alam and Maiza Hameed along with federal and provincial government high-ups, civil society representatives, and members of the media.
Speaking as chief guest, Rumina agreed that the health gap between the society’s haves and have-nots is more evident in the urban areas of Pakistan. “The government has taken numerous ground-breaking steps to reduce the maternal and child survival gap. We will surely appreciate the role of the civil society in this regard,” she remarked.
The guest of honour Maiza Hameed called for quick out-of-box thinking to handle the looming maternal and child health issues in the urban slums of Pakistan’s metropolitan cities. “Of course this report mirrors the true picture of mothers and children in slums across. However, in Pakistan, things are obviously going in the right direction, and I am sure that with the assistance of civil society, the government will be able to close the maternal and child survival gap sooner than later,” she maintained.
Guest speaker, Amber Raheem Shamsi, from BBC World Service spoke about the crucial part the media can play in spreading awareness.
Earlier, the deputy country director of Save the Children Arshad Mahmood explained how the urban disadvantage further arrests the possibilities of ending preventable deaths among mothers and children under the age of five years. “The report found that in Pakistan, 47 per cent of the population is living in slum areas. Even though the urban poor are twice as likely to die as the urban rich, and the urban poor children are more likely to die than the rural average, we know that progress is possible and this possibility can be materialized through a variety of services including access to high-impact services, strengthening of health systems, lowering of costs, and increased health awareness,” he added.
Arshad Mahmood emphasized that while the rest of world is looking towards attaining the SDGs, Pakistan is yet to fulfil its commitments towards child and maternal health which the country pledged to achieve at the advent of this century.
The report recommends that the final post-2015 framework should include an explicit commitment to equitably ending preventable child and maternal deaths with measurable targets. It also calls for an improvement in the health of the urban poor by ensuring universal health coverage. It urges governments to follow through on Nutrition for Growth commitments and ensure that the World Health Assembly nutrition targets are met. Comprehensive and cross-sectoral urban plans should be developed, investments should be made on data collection, and resources should be mobilized to end preventable child deaths in poor urban areas, it adds.
The report also calls upon national governments to allocate at least 15 percent of their total budget to health, thereby allowing themselves to shed reliance on out-of-pocket and private financing to mandatory, large-scale pooling mechanisms.
Save the Children recommended to the federal and provincial governments to strengthen health systems so women have greater access to skilled birth attendants; fight the underlying causes of newborn mortality, especially gender inequality and malnutrition; improve breast milk substitute industry practices through lobbying for change within the industry whilst also seeking to tighten national regulation in the countries where they operate; and preventing early childhood marriages by implementing existing laws or to legislate new laws if needed.
The key findings of the report were presented by Dr. Qudsia Uzma.