Pakistan’s commitment toward Sustainable Development Goals, if nothing else is making us realize the significance of maintaining the data for record and keeping us informed about the progress on a few fundamental indicators like poverty, education and wellbeing. The third goal in 2030 agenda is ensuring good health and wellbeing at all ages. SDGs agenda suggest that we should reduce our infant and child mortality rate to 12 and 25 per 1000 by 2030. Thanks to Federal Bureau of Statistics and USAID for providing few data sets, which are not exceptional but they are enough to shake us awake on these vital indicators.
According to latest Census 2017, 14.80 percent of children are below the age of 5 and 15% between ages 5-9 years. Pakistan Demographic and Health Survey (PDHS) reveal that infant and child mortality rates (per 1000) in Pakistan are 62 and 74 respectively. By doing simple mathematical calculations for progress on infant and child mortality rates, the trends suggest that, if continued with the same pace the targets of 2030 agenda on child mortality rates will hardly be achieved in 2050. Similarly, the incidence of most common type of illnesses, for instance, the incidence of diarrhea, cough and fever was 12, 29 and 25 percent in 1991-92 and these rates increased to 16.5, 36 and 35 percent in 2017-18. Amongst the older cohort of children those attending school but not learning, beside many other frequently discussed reasons, one major cause is poor health.
For many girls in Pakistan, motherhood comes too early. Many adolescent mothers are not aware about childcare and prevention of common illnesses, which result in high child mortality, morbidity and also maternal mortality
Investment in women’s education has high social return, especially in improving child health. PDHS also, reveals that under-5 mortality is 91/1000 live births if the mother is illiterate. The under-5 mortality decreases to 83, 65, 48, and 38 per 1000 live birth as mother’s education increases to primary, middle, secondary and higher level of education. Similarly, among all the children under 5 who have experienced diarrhea 84% of the mothers are illiterate. Another important aspect is physical weakness: 23% of all children under 5 are underweight, and 8 percent are severely underweight. Huge difference exists between educated and illiterate mothers i.e., 33% versus 8%. Child stunting is high in Pakistan and one of the main reasons for stunted children is lack of awareness, even a bigger reason than poverty. Pakistan has high burden of infectious-diseases related child deaths as well as crippling diseases such as polio. We can learn from practices of selected countries that marginal improvement in some key variables, especially in mother’s education, can bring a significant improvement in child wellbeing. Few examples are Sri Lanka, Indonesia, Bangladesh, Cuba, Korea and Taiwan; these countries reduced child mortality in short period through investments in women’s education and awareness. Bangladesh performed exceptionally well in improving child mortality rate, 46/1000 to 26/1000 live births from 2007 to 2017 and have achieved SDGs target on this indicator. They have achieved this much reduction in child mortality indictor through multiple interventions, especially creating awareness among women to give child supplements, oral rehydration therapy (ORT), for diarrhea, beside supply side interventions like provision of antibiotics for pneumonia, increased coverage of vaccines and vitamin A etc.
For many girls in Pakistan, motherhood comes too early. Many adolescent mothers are not aware about childcare and prevention of common illnesses, which result in high child mortality, morbidity and also maternal mortality. Longer stay in schools will delay the pregnancies and the benefits of every additional year in school are very high. Girls survival rate in Pakistan only to grade five is 67%, which keep on decreasing as they graduate from primary. Thus the investment in girls’ education whether through formal or non-formal methods will improve the wellbeing of our children.
The writer is associate professor at Institute of Business Administration, Karachi