ISLAMABAD  -   The early childhood mortality rate in the country still remains a challenge as one child out of fourteen does not survive to celebrate his fifth birthday, Demographic and Health Survey (DHS) revealed on Monday.

Fourth DHS 2017-18 was launched here by Ministry of National Health Services (NHS), National Institute of Population Studies (NIPS) and other international partners who collaborated and provided technical assistance for the study.

The survey conducted focused on the areas including reproductive health, nutrients, family planning, disability, migration and violence against woman.

The study revealed that though more children in Pakistan are surviving early childhood than ever before as under-five mortality has sharply declined.

But, still the under-five mortality rate is 74 deaths per 1,000 live. Which means that approximately 1 in every 14 children in Pakistan does not survive to their fifth birthday, survey said.

The current mortality rate has declined from 89 deaths per 1,000 live births in 2012-13.

The survey also reported that challenges also remained in the areas of nutrition, family planning, and domestic violence. It said that many children in Pakistan suffer from poor nutrition and one sign of chronic under-nutrition is stunting, as still 38% of children in Pakistan are too short for their age.

It added that women in Pakistan are more overweight or obese than ever before, 52% of women age 15-49 in 2017-18 as compared to 40% in 2012-13.

Survey also found that more than 1 in 4 ever-married women (28%) have experienced physical violence since age 15, and 6% have experienced sexual violence. Seven percent of women who have ever been pregnant have experienced violence during pregnancy. Three in ten women who have ever experienced physical or sexual violence sought help to stop the violence, yet 56% never neither sought help nor told anyone, it reported.

The survey said that the unmet need for contraception also remained high at 17% and more work needs to be done to improve the availability and choice of family planning information and services.

 It added that Pakistan has one of the highest fertility rates in the region with an average of 3.6 births per woman. The use of family planning among married women has stagnated around 34% over the last five years.

The survey for the first time reporting on disable people said that among adults age 15 and older, 9% of women and 7% of men have a lot of difficulty or cannot function in at least one domain of disability  seeing, hearing, communicating, remembering or concentrating, walking or climbing steps, and washing all over or dressing.

The fourth Pakistan Demographic and Health Survey (PDHS) conducted after 18 years found that families in Pakistan are though getting healthier while progress has been slower in nutrition and family planning use among women. 

Parliamentary Secretary for NHS Nosheen Hamid while addressing to the ceremony said that Pakistan demographic and health survey 2017-18 provides important data on reproductive health, nutrients, family planning, disability, migration and violence against woman.

It provides useful information for program managers to develop effective strategies and planning for maternal and child health initiatives, she said.

She said that the survey highlights how much more work has to be done on child and maternal health programs to make it more result oriented.

Nosheen Hamid said that basic vaccination coverage has improved and two in three children age 12-23 months have received all eight basic vaccinations, an increase from more than half of children in 2012-13. Basic vaccination coverage is lowest in Balochistan (29%) and highest in Punjab (80%).

The survey reported that reproductive health care coverage has also improved and every 09 in 10women age 15-49 receive antenatal care from a skilled provider such as a doctor, nurse, midwife, or lady health visitor.

Additionally, more than half of women have their first antenatal care visit in the first trimester, as recommended. Half of women make four or more antenatal care visits, a notable increase from 37% in 2012-13. More births are delivered in a health facility, from 48% in 2012-13 to 66% in 2017-18. Yet, 1 in 3 births are delivered at home.

Head of Basic Services at the UK’s Department for International Development (DFID) Dr Ruth Lawson said on this occasion that good data leads to evidence-based decision making both by the Government and development partners.

“I’m glad that this survey reports on disability as well, as DFID’s programmes are especially focused on leaving no-one-behind,” she said.

USAID Deputy Mission Director, Helen Pataki, noted that the PDHS is not just a report card on the last five years; it also directs our efforts for the next five.

“Together, we can review what has worked well and where further support could make a difference to improve basic health care and end preventable deaths,” she said. 

The 2017-18 PDHS provides estimates at the national level; for urban and rural areas separately; for four provinces including Punjab, Sindh, Khyber Pakhtunkhwa, and Balochistan; for two regions including Azad Jammu and Kashmir (AJK) and Gilgit Baltistan (GB); Islamabad Capital Territory; and FATA. The national total for indicators does not include AJK and GB.