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Mortality rate and Girls’ education

 District Health Information System (DHIS) of KP Govt has released its report of 1st Quarter 2017. As a continuous monitoring system, reports talk about various health dimensions & profiles in each district. Punjab also had a DHIS which probably now is working under some other name. I tried to find some details from Punjab but couldn’t get yet. However, I will update for comparative study purpose once I get hold of those.

There are few numbers in KP’s report that got my attention. Neonatal mortality (death in 1st 28 days) rate recorded in 1st Q of 2017 is 32 deaths per 1000 live births. In Pakistan average rate of this is 46 and the world average rate is 19.2. Likewise, Infant mortality (death before 1st birthday) rate reported in KP is 27 deaths per 1000. Pakistan’s average rate on this is 66 and the world average is 31.7. Another aspect that came out here is about maternal mortality (death of the mother within 42 days of delivery). KP reported 208 deaths per 100,000 live births whereas Pakistan’s average on this is 178 and the world average is 216. Data for Pakistan & the world is for years 2015 &16. This data is taken from the world bank.

One more thing worth taking seriously is the Low birth-weight babies. It is also of concern when there is so much variation among districts. Only in 3 districts percentage of babies born with low weight (less than 2.5kg) is in double digits (Haripur [30%], Buner [27%] & Battagram [15.5%]) while in all other districts of KP it’s in single digit. The above data covers only the cases at Government Health facilities and the cases attended by Lady Health Workers. Report is available here

Paul O’Neil, an American civil servant, Later US Secretary of the treasury in Bush Administration. He was investigating high infant mortality rate in the US. At that time infant mortality rate in the US was even higher than in Europe. His research analyses lead him to the conclusion that infant mortality is mainly due to malnourishment. For the remedy, he proposed that govt should start educating women about nutrition before they become sexually active. The proposal came in with changes to school curriculum and teacher training. With his focus on curriculum and teacher training, together with other interventions, today the US has 68% lower mortality rate than that when Paul left that role.

Where do we stand and how we tackle this matter? We don’t have only this challenge; we have some other health challenges as well. National Survey 2016-17 on Diabetes revealed that 26% of our population is affected by diabetes. Another research study revealed that even bigger population is at arsenic poisoning risk. There is no stand-alone solution to our problems. Whatever approach we take, we sure will have one thing common in all our approaches. That common thing is our household & our eating habits. Our women need to be well aware of nutritious requirements in a household. This will not only help them but other family members as well.

What can we do?

Like Paul’s approach, we need to target our girls in school. We need to educate them in order to protect our future generations at or around delivery times. We need to educate them to protect our current & upcoming generations from the risks of diabetes and obesity. This solution sure is not the lone-fighter but a frontline soldier against our various health risks. How we do this education thing? My approach to the matter will be to start a program on “Nutrition and Public Health” for the students of class 9, 10, 11 & 12 conducted by Health Department of the province. Health Department, for each district, on a need basis, can engage full-time lecturers on the subject.  Then, together with Education Departments plan out to one lecture to each class ones in every 6 months.

Working out on such rotation is not a difficult thing. Punjab Govt’s has already a plan whereby they have one inspector who visits each School once a month so does the KP Govt. Movement/rotation planning is not an issue at all. This Lecture frequency can be twice a 6 month for students of grade 9 & 10 as in our rural areas post-secondary opt-out chances are higher. Health departments can work out with private schools and chalk out plans to educate students enrolled there. Ultimately these students, too, are as much part of the society as those in Govt schools. To include “Nutrition and Public Health” course for assessment, say shifting a few marks share to it from Pakistan & Islamic studies, will be a bad idea?

Such a program will produce results in 4-5 years’ time. This will assist to significantly improve our eating habits, diets and reduces our chances of illness. Well-nourished moms-to-be can give birth to healthy kids and they may survive early departures associated with malnutrition. In return for Govt, it will reduce Govt’s & public’s medical expenditures. It will help for a shift to more healthy foods and living style


(Featured image is taken from @PH2dayAffairs Twitter feed.)


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Yasir Cheema

Yasir Cheema is a Civil Engineer by training and currently working as Resident Engineer for Surbana Jurong Pte. Ltd. in Singapore. He writes at this portal about Governance, Public policy, Institutional development, Construction practices, and procedures.

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