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Children, The Family and Health: What it Takes to Give Children Long Life

The Singapore Workshop: Pakistan - Health Problems Children under 10 in Pakistan

Reported by the All Pakistan Women’s Association (PPSEAWA Pakistan)

Basic Indicators of Pakistan
Under 5 mortality rank	33
Under 5 mortality rate	136
Infant mortality rate (under 1)1997	95
Total population (thousand) 1997	143831
Annual no. of births (thousand) 1997	5250
Annual no. of under 5 deaths (thousand) 1997	714
Primary school enrollment ratio (gross) 1990-96	74
Nutrition
% of infant with low birth weight 1990-97	25
Exclusive breastfed (0-3 months)	16
Underweight 1990-97 - Moderate & severe	38
Severe.	13
Health
% of routine EPI vaccine financed by Govt. 1995-97	100%
% fully immunised 1995-97 (1 year -old children)
TB	90%
DPT	74%
Polio	74%
Measles	74%
Pregnant Women Tetunus	57%

Pakistan now is the 5th most populated country in the world with an estimated population of 14 million.

Pakistan is a male dominated society. The father is the head of the family - he makes all the decisions. Though the Government has signed CEDAW and CRC and is committed to “Health for all” by 2000 and “Education for all” by 2000 we are nowhere near the target goal. The demographic indicators do not show a very encouraging picture.

It is one of those rare countries where men out number women- The male female ratio being 100-92. The maternal death rate per 100,000 live births is 300-600. This reflects the poor Reproductive Health of the female, which is the consequence of discrimination against girl child from birth, son preference, inadequate breast feeding, early marriages, high fertility rates, poor birthing methods, poor ante & post natal services - low nutrition level.

The health & well being of children is closely linked with that of the mother. The giving of life and support for survival of that life. 13 Million children under 5 die each year in the developing countries. 7 million of these peri natal deaths are not only due to problems during pregnancy and labour but to poor health status of the mother.

In Pakistan 74,800 children under 5 years of age die every year - 25 children in every 100 dies before even completing the 1st year of their life, 25% babies are born with low birth weight and 40% are malnourished signifying poor nourishment in the uterus, poor nourishment continuing through out breast feeding, weaning, and child hood period. High rates of malnutrition causes infant mortality, stunting and physical and mental retardation.

Major Diseases:

Diarrhoea / Diseases	229,000 deaths
Acute respiratory infections	250,000
Measles	60,000
Neonatal tautens	30,000

Malnutrition:

A 1987 survey conducted by Ministry of Health reported 51.5% children under 5 were chronically malnourished and out of them 10% severely. 65% children are affected by anaemia. 10-30% children examined showed mild and moderate vitamin A deficiency.

All Pakistan Women’s Association’s Objectives

APWA’s aim since its inception 1949, has been to improve the welfare and status of the disadvantaged women and children living in the urban slums and the poor rural areas.

It attempts to complement and supplement the Government’s efforts to create an awareness of the small family norm - the need for safe mother hood and balanced parent hood- to participate in activities related to women’s welfare which would result in a qualitative improvement in APWA’s health, education, literacy and skill development programmes.

Activities

APWA’s approach is through integrated programmes and its efforts are multi and inter dimensional. e.g. The family planning programme also incorporates health aspects, working through UNESCO sponsored literacy programme. APWA took the message of maternal and child health, better nutrition for the family and the need for immunisation of the grass root population. APWA has conducted several leadership training programmes for rural women. By collaboration with national and international NGOs and donors APWA started projects to help improve the quality of life of women and children.

APWA’s role in care of child:

Care of child starts with care of mother . At APWA family welfare centres all activities are oriented towards Reproductive Health of women.

Mother & Child Health Services:

For Mothers:

1. Family planning and emphasis on small family norm.
2. Antenal care.
3. Postnatal care.
4. Safe mother hood.
5. Promotion of breast feeding.
6. STD/AIDS prevention.
7. I.E.C. awareness programme.
8. Day care facility for working mothers.
9. Special attention to distribution of food, adequate diet during pregnancy and laction.

For Children:

1. Immunisation.
2. Curative care.
3. Primary health care.
4. Day care facility.
5. Nutrition programme.
6. Providing free milk, monthly check up of weight, general conditions of children.
7. Tackling specific nutritional deficiencies, there is a cyclical relationship between malnutrition and infections.
   1. Capitalising on vitamin “A” benefits.
   2. Against blindness.
   3. Strengthen resistance to infections.
   4. Anaemia.
   5. Iron deficiency.
   6. Role of calcium & Vitamin “D”.

Last Modified: November 29, 2002