Addressing Critical Knowledge Gaps in Newborn Health

UN report on MDGs 2012

UN report on MDGs 2012
July 5, 2012
Newborn News
Pakistan
Asia

Article originally featured in the Daily Times.

ISLAMABAD: Out of the total 33 indicators, Pakistan’s progress on 20 is lagging behind, is slow on four, on track on three, off-track on one, while targets against five have been met, reveals the United Nation’s Report on Millennium Development Goals (MDGs) 2012 on Tuesday.

One of the indicators where situation has really worsened in the past four years is the proportion of population below minimum level of dietary energy consumption. This is the core indicator for assessing the level of food insecurity in the country. A number of reasons have contributed to the food insecurity in the country. These include the two-digit inflation (and a much higher food inflation) over the last four years, which has significantly decreased the purchasing power of the people, especially the poor. With 225,450 total estimated annual newborn deaths, each day 618 Pakistani newborns die.

Pakistan’s MDGs situation: Pakistan has adopted 18 targets and 41 indicators against which progress is measured. However, time series data against only 33 indicators is available.

Three important targets on poverty, slums and water have been met three years ahead of 2015, says this year’s report on the MDGs, launched by UN Secretary-General Ban Ki-moon. Meeting the remaining targets, while challenging, is possible but only if governments do not waiver from their commitments made over a decade ago.

The MDG 1: Eradicate extreme poverty and hunger. MDG 2: Achieve universal primary education. MDG 3: Gender equality and women empowerment. MDG 4: Reduce child mortality. MDG 5: Improve maternal health. MDG 6: Combat HIV/AIDS, malaria and other diseases. MDG 7: Ensure environmental sustainability. MDG 8: Develop a global partnership for development.

MDGs achieved: On a total of five indicators, Pakistan is either ahead or has achieved the target. With regard to access to improved water source, Pakistan has achieved the target when three sources of improved water are taken into account: tap water, hand pumps and electric motor propelled water. However, the Pakistan MDG report 2010 has not included the ‘electric motor’ in the category of improved water source, which makes the status at around 63 percent against the 92 percent (if water extracted through electric motor is included). Pakistan has one of the highest ratios of women parliamentarians in the South Asia Region.

MDGs on track: There are three indicators – one each for MDG 4, 6 and 7 – where the progress is on track and the target could be met by 2015.

Slow progress on MDGs: Following are the indicators where there has been some progress but the progress rate is slow. Additional efforts will be needed if the targets, in this category of indicators, are to be achieved by the 2015 deadline. It can be noted that three out of the four indicators on which progress is slow, are related to MDG 3 (gender equality and women empowerment). The remaining one relates to MDG 6: Combat HIV/AIDS malaria and other diseases.

MDGs lagging behind: This is the category of indicators where progress has been lagging behind and target, most likely, will not be achieved. Progress against a few indicators under this category has been unidirectional. The head count poverty (caloric plus basic needs) in Pakistan has been fluctuating. It increased from 26 percent (baseline in 1990) to 34 percent in 2000-01 before declining to 22.3 percent in 2005-06. In terms of $1.25 per day, according to World Bank, 21 percent of the populations were living below this threshold in 2007-08 against a target of 22.8 percent by 2015. So if this yardstick is used, then Pakistan has already achieved the target.

Off-track MDGs: The following is the only indicator where the government of Pakistan has reported progress as ‘off the track’. This relates to the reduction in child mortality. At current in Pakistan, the number of deaths of children under one year of age per 1,000 live births is 75 against the target of 40.
The IMR situation in Pakistan has not improved because the highest proportion of IMR is of neonatal mortality and the neonatal mortality in Pakistan is increasing. According to UNICEF’s Situation Analysis of children and women in Pakistan, “In 2009, Pakistan accounted for 6.9 percent of global newborn deaths and ranked third from the bottom (at 191 out of 193 countries) in terms of the number of newborn deaths. The neonatal mortality rate has actually increased, from 49 per thousand live births in 2000-01 to 53 per thousand in 2007-08. With 225,450 total estimated annual newborn deaths, each day 618 Pakistani newborns die.”

Issues and constraints - summing up: A number of factors have contributed to the under-achievement against most of the MDGs. These include the slow economic growth of less than 3.0 percent over the last three to four years. With a labour force increasing at a rate of 3.2 percent, the slow economic growth is not creating sufficient jobs for the new entrants to the labour market. Besides poverty and unemployment issues, the income inequality in the country has always been on the rise. The share of consumption of the lowest quintile is currently 9.6 percent against 40.3 percent for the highest quintile.

There also exists widespread gender inequalities. The share of women in wage employment is the slowest in South Asia and Pakistan is not an exception to it. Additionally there are regional pockets where status of development is worst than other areas. Not withstanding these challenges, there are a number of opportunities to build on. The New Economic Growth Framework shows the government’s priority to put Pakistan on the path of sustained economic growth. The increase in the share of provinces in National Finance Commission Award and the 18th Constitutional Amendment for the decentralisation of governance at the provincial level will help the development partners to work more closely with the end beneficiaries.