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Pakistan DHS Finds High Maternal Mortality - new
from MEASURE DHS
Calverton, MD- In Pakistan,
1 in 89 women will die of maternal causes, according to the 2006-07
Pakistan Demographic and Health Survey (PDHS). Among women age 12 to 49,
complications of pregnancy and childbirth are the leading cause of death,
accounting for 20 percent of all deaths for women of childbearing age. The
National Institute of Population Studies recently released the final
report of the 2006-07 PDHS at a ceremony in Islamabad.
The survey findings also show that
under-five mortality has decreased by roughly 20 percent since 1990,
while the infant mortality rate has declined by about 15 percent. Still,
one in every eleven children in Pakistan dies before reaching his or her
fifth birthday, and more than half of these deaths occur during the first
month of life. The PDHS is one of the largest household-based
health surveys ever conducted in Pakistan. Teams collected data from a
nationally representative sample of more than 95,000 households
More key findings from the 2006-07 PDHS
final report are highlighted below.
Maternal Mortality Measured
One of the goals of the 2006-07 PDHS was
to obtain reliable information about maternal mortality. Results from the
PDHS show that women age 25 to 29 are especially at risk for maternal
death. Nearly two out of five deaths for this age group are from
pregnancy-related causes. Postpartum haemorrhage is the leading direct
cause of maternal deaths, followed by puerperal sepsis and eclampsia. Obstetric
bleeding (postpartum and antepartum) is responsible for one-third of all
maternal deaths.
Balochistan has by far the highest
proportion of women dying from complications of pregnancy, childbirth,
and puerperium (the time immediately after delivery). Rural women
are more likely to die of pregnancy-related causes than urban women (23
percent compared to 14 percent).
Cancer, tuberculosis and other
infectious diseases are the next most important causes of death among
women of reproductive age. Younger women are more likely to die from
infectious diseases (20 percent), not including tuberculosis, than older
women.
Maternal Care Improves
Slightly
The percentage of women making four
prenatal visits, as recommended, increased from 16 percent in 1996 to 28
percent in 2006-07. Nearly two-thirds (61 percent) of women in Pakistan
had at least one prenatal visit with a skilled provider, most often from
a doctor (56 percent). Educated women are twice as likely as women with
no education to get prenatal care from a skilled provider (96 percent
compared to 50 percent).
However, one-third of pregnant women, do
not get any prenatal care at all, according to the PDHS. Of these
women, the majority (73 percent) do not think it is necessary, 30 percent
think prenatal checkups cost too much money, and 8 percent say the health
facility is too far away.
Only one-third of Pakistan's births
occur in health facilities-11 percent in the public sector and 23 percent
in private sector facilities. By contrast, two-thirds of births
occur at home. Home births are considerably more common in rural areas
(74 percent) than urban areas (43 percent).
Fertility Declines; Family
Planning Use Steady
Fertility has decreased steadily since
1984, when the total fertility rate (TFR) or the average number of
children per woman was 6.0. Today, a woman in Pakistan will have 4.1
children, on average. Urban women have 3.3 children, on average,
compared to 4.5 children per rural woman. As in other countries,
fertility also varies by the mother's level of education. Women with no
education have 4.8 children compared to women with secondary education,
who have 3.1 children.
The contraceptive prevalence rate is 30
percent, roughly the same as it was in 2003 (32 percent). While 96
percent of married women know about modern methods, only one in five (22
percent) currently married women uses a modern method, most often female
sterilization (8 percent) and condoms (7 percent). Modern method
use in Pakistan lags behind neighboring countries with 49 percent of
married women in India and 47 percent in Bangladesh using modern methods.
Infant and Child Mortality
Rates Decrease
Pakistan's infant mortality rate, 78
deaths per 1,000 live births, has declined since 1990-91 when the PDHS
showed it was 91 deaths per 1,000 live births. Compared to other South
Asian countries, however, children in Pakistan are more likely to die in
the first year of life, according to the new PDHS. Pakistan's
infant mortality rate is higher than the rates in Nepal (48), India (57),
and Bangladesh (65).
The under-five mortality rate is 94
deaths per 1,000 live births, down from 117 deaths per 1,000 live births
in the period 1986 to 1990. Children living in rural areas are at greater
risk for death than those living in urban areas. The under-five mortality
rate is 28 percent higher in rural than urban areas.
More than Half of Children
Lack Immunizations
Nearly half (47 percent) of Pakistani
children ages 12-23 months have all the recommended vaccines; 6 percent
of children do not have any vaccinations. Children are least likely
to get their third DPT vaccine, their Polio 0 vaccine (given at birth),
and their measles vaccine. Compared to children in other South
Asian countries, Pakistani children are less likely to be fully
vaccinated. In Nepal, 83 percent of children have all their vaccinations
and in Bangladesh 73 percent of children are fully vaccinated. In India,
by contrast, 44 percent of children are full vaccinated.
Children whose mothers have no education
are far less likely than children whose mothers have higher education to
be fully immunized (38 percent versus 71 percent). The percentage of
children who are fully vaccinated also varies by province, ranging from a
high of 53 percent of children in Punjab to a low of only 35 percent of
children in Balochistan.
To download a free copy of the final
report for the 2006-07 Pakistan DHS, go to http://www.measuredhs.com/pubs/pub_details.cfm?ID=782&ctry_id=31&SrchTp=ctry&flag=sur.
For more information about the 2006-07
PDHS or the MEASURE DHS Project, please send an email to press@measuredhs.com.
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