UNICEF and Children mortality in Pakistan

Dr. Jassim Taqui

DG Al-Bab Institute for Strategic Studies

Islamabad, November 17,  2021:  The United Nations Children’s Fund (UNICEF) calls for accelerated efforts to save precious lives of children born prematurely as World Prematurity Day (WCD) is commemorated on November 17, 2021. The theme this year is, Zero Separation Act now! Keep parents and babies born too soon together.

In Pakistan, where preterm birth is one of the three leading causes for neonatal mortality and accounts for more than one-third of all deaths in newborns, UNICEF is collaborating with the Ministry of National Health Services, Regulations & Coordination, and provincial health departments to establish Kangaroo Mother Care (KMC) units in health facilities across the country to save lives of children born too soon.

KMC is one of the best options to provide care for babies born before time in low and middle-income countries.

“Scaling up Kangaroo Mother Care in health facilities across Pakistan, is a cost-effective intervention to save preterm infants,” said Aida Girma, UNICEF Representative in Pakistan.

“Introduced in Pakistan by UNICEF a few years back, KMC has become increasingly popular with health professionals caring for children born before time. The essence of KMC is to keep parents and babies born before time, together as against the past practice of separating small and sick babies from their mothers. The physical and emotional closeness of the baby and parents during birth, delivery, and hospitalization has long-term health benefits for the child. Additional care during pregnancy, complete antenatal care, nutritious food, mental and psychosocial support to pregnant women, and birth spacing can reduce premature births,” Ms. Girma added.

In KMC, the newborn is held closely to the chest by the parent, mother, or father, with a blanket wrapped around both. Skin-to-skin contact provides warmth and prevents hyperthermia. It is medically beneficial for the baby and good for parent-child bonding.

So far, 30 KMC units have been established in Pakistan with support from UNICEF and other development partners for round-the-clock service delivery. UNICEF has provided all the necessary equipment and materials to help establish 24 units in various public health centers - 16 in Punjab, 4 in Sindh, 1 in KP, 1 in AJK, and 2 in Islamabad Capital Territory. It is collaborating with the Government to scale up KMC units across the country.

The government of Pakistan and its development partners are trying to reduce preterm births and newborn mortality due to related complications such as Birth Asphyxia, Prematurity, and Sepsis. These efforts have helped reduce newborn mortality from 55 to 42 deaths per 1,000 live births during the last five years. It has also had a remarkable impact on morbidity in preterm newborns.

The most vulnerable newborns are those born in marginalized groups, rural areas, urban slum environments, and humanitarian settings. UNICEF emphasizes that the reduction in premature births and newborn deaths can be achieved by strengthening health policies and services with a focus on maternal nutrition and improving access and care for mothers and newborns, particularly in rural and underserved areas.

Globally, preterm birth is one of the leading causes of child deaths under age 5 as almost 15 million babies in the world are born prematurely and nearly 1 million die due to related complications. Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born. Small and sick newborns, most of whom are born preterm, have the highest risk of death and contribute to the majority of the world’s disabled children.

Inequalities in survival rates around the world are stark. In low-income settings, half of the babies born at or below 32 weeks die due to a lack of feasible, cost-effective, and basic care, e.g. warmth, breastfeeding support, basic care for infections, and breathing difficulties.