PESHAWAR: Lack of facilities, poor antenatal care and maternal diseases are a few of the reasons that may turn the joyful occasion of a delivery into moment of grief: sometimes a baby may be still, with no sign of life, soon after delivery.
Stillbirth refers to an infant who dies in mother’s womb. The data of Khyber Pakhtunkhwa Health Department for first quarter of the year 2017 reveals that Kohat district is ahead of all other districts of the province in terms of reporting the issue, ie130 stillbirths.
According to the figures released by Khyber Pakhtunkhwa health authorities for the first quarter of 2017, a total of 46,382 babies were delivered at health facilities across the province. Of the total figure, 742 stillbirths have occurred at health facilities across the province.
However, the District Health Information System (DHIS), which covers health facilities of the entire province, has not reported any stillbirth case from Tor Ghar district.
Among other districts, 98 stillbirths have been reported from DI Khan, 87 from Swat, 45 from Buner, 44 from Malakand, 39 from Mardan, 35 from Upper Dir, 28 from Shangla, 27 each from Chitral and Peshawar, 26 each from Haripur and Charsadda, 21 from Swabi, 17 each from LakkiMarwat and Mansehra, 15 from Bannu, 12 from Abbottabad, 11 from Hangu, 10 from Lower Dir, 9 from Battagram, 6 each from Tank and Karak, 5 from Nowshera, and one case has been reported from Kohistan.
Speaking to this correspondent, a Peshawar-based gynaecologist said that it is a good step on the part of the health department to release quarterly data on health issues in the province. She added that the health department alone is not responsible for stillbirths, as there are several reasons behind the issue, including maternal diseases like diabetes, hypertension, poor nutrition, maternal stress, intrauterine infection, poor maternity care in some families, etc.
An official of the Health Department said that the department, with the collaboration of WHO, was working on a plan to set up a task force for launching a Surveillance System to control maternal and child mortality rates.
About the highest number of stillbirths in Kohat, Prof Dr MusarratJabeen of the Kohat hospital said that though the health authorities were trying to facilitate people, Kohat has a huge catchment area.
“Not only Kohat, but patients from other nearby areas also visit health facilities in Kohat. This is why the figures of stillbirths are high,” said MusarratJabeen, who also serves as dean of Allied Health Sciences at Khyber Medical University in Peshawar.
She added that the causes of stillbirths are several, like poor antenatal care of women, lack of facilities,
In a research study “Rate and Risk Factors of Stillbirth in Pakistan: A Systematic Review” published in December 2016, Shiyam Sunder Tikmani and NidaZahid of Aga Khan University concluded that the average rate of stillbirths in Pakistan was estimated to be 52.5/1000 births. The study said that antepartum haemorrhage was the most common risk factor, followed by a hypertensive disorder of pregnancy, preterm labour and mismanaged labour, etc.
According to the World Health Organisation, 2.6 million stillbirths occur the world over annually. WHO says that 98% of stillbirths take place in low-income and middle-income countries. It adds that half of all stillbirths, ie 1.3 million, occur during labour and birth.
Despite being an important issue, the stillbirths are absent from the Millennium Development Goals and still missing in the Sustainable Development Goals, that is why stillbirths remain a neglected issue, underfinanced and in urgent need of attention.
The WHO figures say that worldwide in 2015, 18.4 babies out of every 1,000 total births were stillborn, mostly in low- and middle-income countries. It adds that progress in reducing this rate has been slow and at present speed, 160 years will pass before a pregnant woman in Africa has the same chance of her baby being born alive as a woman in a high-income country today.
Published in Daily Times, July 20th , 2017.