Addressing Critical Knowledge Gaps in Newborn Health

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Photo of the Week: Decade of Change - Pakistan

Photo: Jason Tanner/Save the Children

Saphia bibi (left), 25 years old and 9 months pregnant sits with her cousin Sumia, (right), 25. Both women were forced to evacuate their home in the middle of the night when floodwater swept through the village of Shlar in Muzaffargarh District, Punjab, Pakistan in 2010. Both women left their homes accompanied by their husbands. They took 2 days to reach a friend’s house some 12km away on higher ground away from the encroaching water’s edge. They had no time to collect belongings.

Despite years of natural disasters, political and economic turmoil and 203,000 newborn deaths in 2000, Pakistan has been working towards improving the odds for mothers and newborns.

“A Decade of Change for Newborn Survival, Policy and Programmes (2000-2010): A Multi-Country Evaluation of Progress Towards Scale” includes five case studies, one of which is of Pakistan. In it we see that maternal and newborn health official development assistance, per live birth, has increased 263% over that time period. While the neonatal mortality rate has only decreased 0.9%, considerable policy change occurred in the last decade. This has included the integration of newborn care into existing community-based maternal and child packages delivered by the Lady Health Worker Program. Additionally, the National Maternal, Newborn and Child Health Program catalyzed newborn services at both facility and community levels.

Recent policy advances and delivery platforms, offer the potential to substantially accelerate progress in reducing neonatal deaths. Yet, civil society will have an important role in ensuring focus on newborn survival in the post devolution scenario. With handing over responsibilities to the provinces, local leadership and innovative models of financing and effective action will be required to maintain and increase systematic efforts for scale up of interventions. If newborn-related health interventions were universally available in Pakistan assuming political and environmental stability, 84% of newborn deaths could be averted in the year 2015 at scale.