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Pakistan: grim state of child survival

Pakistan has one of highest number of annual child deaths in the world – more children under five die each year than in the World Health Organization’s Americas and Europe regions combined.

Pakistan has made insufficient progress towards achieving its Millennium Development Goal (MDG) 4 target over the past two decades, and at the current pace of progress, it’s projected to meet it by 2035 at earliest.

Over 100,000 children under five die each year in Pakistan from diarrhoea and pneumonia alone – illnesses that are completely preventable and treatable. Yet only 41% of children with diarrhoea, and half of those with pneumonia, receive the appropriate treatment.

There’s gross heterogeneity in access to care between rural and urban areas, as well as across provinces, with children in Baluchistan lagging far behind those from the rest of the country.

Malnutrition contributes to over one-third of all under-five deaths in Pakistan, yet only 29% of babies are breastfed within the first hour of birth and 37% during first six months. Consequently, almost half of all children under five in Pakistan are stunted.

Save the Children is working to ensure that more babies survive their fragile first hour – with your help we can save more lives. To learn more about barriers to breastfeeding in Pakistan and how overcoming these will save children’s lives, read our new report Superfood for Babies.

Prioritise children’s rights

The Constitution of Pakistan protects the right to health for all citizens who are unable to fend for themselves, yet it doesn’t specify children’s rights to health and other social services.

Pakistan ratified the Convention on the Rights of the Child in 1990, yet little tangible progress has been made to protect children’s rights in Pakistan over the past two decades.

Several national and international agencies, including Save the Children, have made concerted efforts to improve national policies on children’s rights, but progress has been halted since the devolution of social services to the provinces in 2011.

The State of Pakistan’s Children 2012 report identifies inadequate budgetary allocation and dissolution of the Ministry of Health as the two key challenges for children’s health.

With only 27% of the population, entitled to free healthcare, millions of Pakistanis pay for even the basic health services.

Children under five are one of the most vulnerable segments of society and there’s a pressing need to prioritise their right to health and survival in national and provincial policies by ensuring universal access to free, essential healthcare.

More spending needed

A review of national and provincial budgets last year by the Child Rights Movement (CRM) in Pakistan revealed that Pakistan spent a little over 2% of GDP on health during 2010-11.

This figure is the lowest in the South Asia region, much lower than the regional average of 4.6%, and falls significantly under the WHO threshold of 5%.

In a joint submission to the Universal Periodic Review (UPR) Pakistan, the CRM called for a 16% increase in health budget during 2013, and legislative and administrative reforms to improve child survival in the country.

The upcoming general elections in May present a timely opportunity to push the agenda of children’s rights and survival.

Civil society and children’s rights organisations have a crucial role to play in order to ensure that children’s rights are prioritised in political manifestos and that the new federal and provincial governments are supported in adopting and implementing a pragmatic legislative framework.

Civil society is responsible for holding the government to account on implementing the UPR recommendations and making tangible progress towards achieving MDG 4.

Save the Children has been at the forefront of this struggle in Pakistan since 1979 and will continue to contribute to accelerating progress in the coming months and years.

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