health and nutrition in sindh oct 2016 (dr. sarwat)
TRANSCRIPT
Dr. Muhammad Sarwat MirzaChief Health and Research Executive
HANDS
Health and Nutrition Issuesin Sindh
Contents:• Health and Nutrition issues in Sindh• Pakistan commitment for Health indicators related
to Sustainable Development Goals• Way Forward
• Sindh with population of about 41.5 million
• Majority of the Primary Health Care Facilities not offering 24 hour normal delivery/basic neonatal care services
• There is in general shortage of female staff at Primary and Secondary Health Facility Level
• LHW coverage is 64 %• Early marriages of women (before 18 years of age) =
16.3 %
Health Scenario in Sindh
• Behaviors of communities have improved through consistent health education
• Care seeking for diarrhea improved to 69 %• Care seeking for ARI improved to 75.4 %• Improved drinking water at source is 90 % • Sixty-three percent people are suffering from food security,
according to the National Nutrition Survey of 2011.• 38 percent people live below the poverty line. That means that
nearly one third households can’t earn even $1.25 per day per all family members.
• Children age 6-23 months got food from 4 or more groups = 14.7%• HHs consuming iodized salt = 36 %
Source: MICS Sindh 2014/ NNS 2011
Health Scenario in Sindh
Vicious Cycle Health --- Nutrition
Five million pregnancies
Five million pregnancies
Under nutrition and Anemia during Pregnancy
No antenatal care
• Maternal Mortality• Low birth weight
Under nourished and stunted children
Frequent pregnancies
• Malnourished adolescent• Early marriages
Pregnancy and Outcomes in Sindh
Five million pregnancies
Five million pregnanciesFive million pregnancies
1,245,000 pregnancies Annually
1,150,000 births annually
>3400 Maternal deaths annually due to
complications during pregnancy and delivery
Nearly 500 deaths from Unsafe abortions
> 20000 faced complications after
unsafe abortions
242 210267 246
637
855
15-19 20-24 25-29 30-34 35-39 40-44
Maternal Mortality can drop dramatically by stopping pregnancies after 35
Maternal Mortality Ratio by Age
1990-91 and 2006-07 PDHS
Comparison Maternal Health Status
Indicators MDGs targets 2015
Pakistan Sindh SDGs 2030
Antenatal care visits (4 or more) 90 % 73% 41% 100%
Deliveries conducted by Skilled Birth Attendants >90% 52% 65.7% 100%
Institutional Deliveries 64 %Public Health Facilities 16 %
Private Health Facilities 48 %Total Fertility Rate (TFR)
2.1 3.8 4.0 1.9
Contraceptive Prevalence Rate (CPR) 55% 35.4% 29% 55%
Comparison Children Health Status
Indicators MDGs targets 2015 Pakistan Sindh SDGs 2030
Low birth weight 27.8% 30 % <10%
Under nourished Children <20% 31.5% 42 % <20%
urban 32 %rural 50 %
Stunting among children under 5 years of age 43.7% 48 % <10%
urban 37 %rural 57 %
Breast Feeding Early initiation
20.7 %
Exclusive Breast feeding 28.9 %
Extended BF up to 24 months
48.9 %
Comparison Children Health Status
Indicators MDGs targets 2015 Pakistan Sindh SDGs 2030
BCG coverage 76.3 %
Pentavalent third dose 52.7 %
Proportion of under 1 year children immunized against Measles >90% 81% 38% >90%
Proportion of Fully immunized children (age 12-23 months)
>90% 82% 53% >90%
Neonatal tetanus protection (TT vaccination of Mothers) 54.1 %
Comparison Mortality Status --- Maternal & Children
Indicators MDGs targets 2015
Pakistan Sindh SDGs 2030
Maternal Mortality Ratio140 per
100000 live births
276 per 100000 live
births
276 per 100000 live
births
<70 per 100000 live
births
Children mortality under 5 years of ageNo. of deaths per 1000 live births
52 89 104 25
Neonatal mortality No. of deaths per 1000 live births 20 55 59 12
Infant mortality No. of deaths per 1000 live births 40 74 82 <20
• Improvement in health delivery system • Improvement in coordination between Population
Welfare and Health Department at Provincial and District level
• Inclusion of Birth spacing / FP services in MNCH program
• Strengthening partnership with Civil Society organizations and Community organizations
• Engaging communities in sustained behavior change, monitoring, accountability and voice generation
Way Forward
Thank You