Daily Times

World Children’s Day affords us an invaluable opportunity to impress upon policymakers the importance of fulfilling child rights, seriously evaluate how our children are doing in Pakistan and devise the appropriate strategies in our national context. We do so in the belief that we are investing towards our future. The theme of World Children’s Day for 2018 is “Children are taking over and turning the world.” Pakistan is essentially a young nation with close to 65 million children under the age of 14 years. As such, our child population is comparable to the total population of the United Kingdom or France. We have the honour of having the youngest Nobel Prize winner in the world; Malala Yousafzai got the award as a young adolescent of 17. We are also justifiably proud of Arfa Karim who at nine became the youngest Microsoft Certified Professional before her tragic death a few years later. Then there was Haroon Tariq who broke all records by securing 87 As in his A&O levels and it was actually that — eighty-seven! There are several other such children who have brought glory to Pakistan, some for achievements that I do not even properly comprehend fully in this high-tech century. Yet we intrinsically know that all is not really well with our children.

For starters, Pakistan has anunder-5 mortality of 75 per 1000 live births, an infant mortality rate of 52 per 1000 live births including a neonatal mortality rate of 44, stunting (low height for age) at 38 percent, wasting (low weight for age) seven percent and 23 percent of the under-5 children being underweight. Obese children are three percent, only 49 percent of children are exclusive breastfed for the first six months of life, while the proportion of low birth weight babies is 19 percent. Amongst the top ten (10) causes of death in Pakistan, four relate directly to very young children such as preterm birth complications, diarrheal diseases, birth asphyxia and neonatal sepsis/infections. Furthermore, 37 percent of the children in Pakistan are not fully immunized with huge disparities between provinces, making it one of the two countries in the world with indigenous poliovirus circulation. The prevalence of all types of disabilities in children is approximately 2.5 percent, which includes physical, visual, intellectual, mental, speech and hearing disabilities.

The honest truth is whether it is the Sustainable Development Goals or other social sector targets, no single sector can achieve its targets by itself. The challenge lies in being less compartmentalized, coming out of silos and working together towards the common public good

Furthermore, Pakistan has a low Human Development Index ranking in terms of gender inequality. While the overall literacy rate in the country is 58 percent, for women it is even worse being parked at 48 percent. Gender inequalities and human rights violations encompassing health are crucial barriers to achieving optimal health outcomes, equity and health for all. Lastly, while Pakistan has ratified the Convention on the Rights of the Child (CRC), the first legally binding international instrument to incorporate the full range of human rights, our track record does not reflect that very nicely based on the critical indicators enumerated above, while eschewing mention of child labour, other human rights’ violation, gender-based violence, insecure areas or displaced children.

While it is undoubtedly a tall order to address all the indicators mentioned, it is nevertheless doable and has actually been done in many of our regional countries with comparable resources. The honest truth is whether it is the Sustainable Development Goals or other social sector targets, no single sector can achieve its targets by itself. The challenge lies in being less compartmentalised, coming out of silos and working together towards the common public good.

Adherence to the Convention on the Rights of the Child (CRC) for child protection, promoting safe playgrounds, gyms and parks, preventing accidents, controlling infections and preventable illnesses, countering tobacco use, addressing poor dietary habits, providing psychosocial support for childhood mental health disorders, access to electricity, prevention of exposure to toxins such as lead, mercury, pesticides and air pollution, social protection and cash transfers to ensure the dignity of every child are some essential ingredients of a holistic and integrated package.

The requisite policies, programs, services and delivery models in all sectors must be responsive to the needs of girls and boys in all their diversity that prevails across our huge country. An enabling environment extending the inclusive right to health also to the underlying social determinants of health such as primary school enrolment, rectifying erroneous gender perceptions and practices, establishing nutrition surveillance, growth monitoring and nutrition stabilisation as an emergency, provision of safe water and sanitation alongside the imperative of personal hygiene needs to be underlined. An appreciation of the special needs of children is quite critical to the entire effort.

It is evident that the poverty reduction, health, nutrition, education, environment, human rights and gender sectors need to work in tandem to address the issues at hand with robust involvement of the local communities and more significantly the parents. We cannot afford either a lack of sociocultural acceptance on any of these priority actions or compromised coordination mechanisms at any level. The international donor community also needs to modify its working modalities and develop integrated packages rather than providing quick fixes that prove costlier in the long run. The overall exercise is neither easy nor simplistic, yet it constitutes the only sustainable way forward. What we require more than physical or financial resources is a change in mindsets. Above all, we need the realization that the effort is for our children — our very own — and nothing whatsoever takes precedence over them!

The writer is a senior public health specialist of Pakistan and can be reached at gnkaziumkc@gmail.com

Published in Daily Times, November 21^st 2018.