The New Nation - Internet Edition

BSS, Dhaka

The health related millenium development goals (MDGs) four and five on child and mother survival are achievable, health professionals across south Asia said yesterday suggesting for reaching communities and strengthening public health systems to meet the target by 2015.

They also pleaded for a greater partnership among all health professional societies and associations as well as journalists in the region, hub of the highest number of child and maternal mortality after Africa, to cut child deaths by 50 per cent and mother by three-quarters within next seven years.

"We need greater partnership among pediatricians, midwives, gynecologists, pharmacists, nurses, media and others to reduce child and maternal deaths drastically," Zulfikar Ali Bhutta of Aga Khan University, Pakistan said at a regional workshop here Saturday night.

The Partnership for Maternal, Newborn and Child Health (PMNCH), a new coalition of 250 partners since 2005, organised the three-day workshop at Hotel Sheraton, where delegates from South Asian countries and beyond are taking part.

Deputy Executive Director of BRAC and Dean of James P Grant School of Public Health (JPGSPH) Dr Mustaque R Chowdhury, Coordinator of Ganoshashthya Kendra Dr Zafrullah Chowdhury, Director General of the Directorate General of Health Services (DGHS) Prof. Abdul Faiz and Special Adviser to the Director of PMNCH Andres de Fransisco spoke on the occasion.

According to statistics, south Asia, which accounts for the biggest number child and mother deaths from a total of 11 million annually, has reduced 20 of such deaths between 1990 and 2007. The achievement is not enough as more than 60 percent deliveries in south Asia, nearly 80 percent in Bangladesh, still occur without trained birth attendants and causing many deaths.

Unsafe abortion and malnutrition are the two other major causes for highest number of maternal deaths, while infection claims majority of child lives in the region, the workshop was told yesterday. The World Health organisation (WHO) finds a strong correlation between inadequate health workers at local levels and child-mother moralities.

Abul Faiz, who opened the workshop originally scheduled in Karachi, Pakistan, but later shifted to Dhaka for security reasons, said the health related MDGs are possible to attain within the stipulated time provided local solutions are given more importance than foreign prescriptions.

He said the donors' priority on high-tech solutions at secondary and tertiary levels have caused damage to the ongoing programmes. He, however, appreciated the change of the mindsets of donor communities, now focusing on communities for the quick attainment of development goals set by the United Nations for 2015.

"Bangladesh is very much on track for achieving MDG 4 on child survival," he said adding that MDG 5 on mothers lives needs further steps to be materialised. The child mortality has come down to 65 per 1,000 live births in 2007 from 116 in 1997, but it has to be brought down further to 50 by next seven years in Bangladesh.

The government and donors have been focusing on increasing child delivery at health facilities including clinics and hospitals, a programme Dr Zafrullah appreciated but cautioned that this may lead to privatization, commoditisation and Commercialisation of primary health care for the poor.

Instead, he said, the traditional birth attendants (TBAs), nurses and other health professionals should be trained up, so that the people at local levels can have easy access to safe delivery at low costs. People of a country, where nearly fifty percent, still live below poverty level, could not afford delivery at public or private hospitals for high costs.

"Even if few families rush clinics and hospitals, they would lose their ability to buy nutritious food for mothers," said Dr. Zafrullah, a globally acclaimed figure for his National Drug Policy in Bangladesh in 1990. Such initiatives, he said, would eventually divert family funds to medical costs from nutritional supports.