KARACHI – According to the first-ever set of nationally reviewed stillbirth estimates undertaken with the World Health Organisation, just 10 countries represent two-thirds of all stillbirths and Pakistan is second on the list with a rate of 47 stillbirths per 1,000 births compared to Finland at two and a global rate of 19 per 1,000. The countries with the highest stillbirth rates are ranked in the following order: 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.
Even though only a few years remain till 2015 – the year that was set to achieve the Millennium Development Goals (MGDs) – Pakistan still stands on the same position in terms of stillbirths. Despite the government’s claims at various levels that it is working to reduce the number of stillbirths in the country, the new data on the stillbirth situation in Pakistan shows a different picture.
Technically when a fetus dies in the uterus after 20 weeks of pregnancy, it is called stillbirth. The official data reveals that 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 percent. The data also reveals that Pakistan’s stillbirth rate has dropped only six percent- from 51 to 47 per 1,000 live births- between 1995 and 2009 and the country’s ranking at 193 in 1995 remains unchanged in 2009.
“Of the 10 suggested interventions, childbirth care reduces the highest number of stillbirths and should be the first priority, especially because of the additional benefits to women and newborns,” said Dr Zulfiqar Bhutta, the founding Chair of the Division of Women and Child Health at the Aga Khan University.
“Antenatal care costs less and is effective against stillbirths related to infection and under nutrition; and can be provided through outreach workers and services, Dr Bhutta pointed out. According to data provided by various organisations, every day, more than 7,000 babies are stillborn – more than 2.6 million lives lost each year. According to The Lancet at the launch of its Series on Stillbirths, there are effective interventions that can make inroads into stillbirth mortality – just 10 interventions, with 99 percent coverage, that would reduce stillbirths by around half in low-income and middle-income countries.
Series on Stillbirths are researches that provide the most comprehensive assessment of stillbirths to date, bringing together an international team of 69 authors from more than 50 organisations in 18 countries who have worked for over 2 years on the analysis. The project is 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.
A research conducted by The Lancet stated the role of community health workers in 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 stillbirth burden by at least 50 percent.
