Goal 4: Reduce child mortality

Existing Target 5Existing Target 5Reduce by two thirds between 1990 Reduce by two thirds between 1990 and 2015 the Under Five Mortality Rateand 2015 the Under Five Mortality Rate

Proposed Target 5Reduce by two thirds between 1990

and 2015, the Under Five Mortality Rate for Girls & Boys

• Under-five mortality rate• Infant mortality rate• Proportion of fully immunised

children 12-23 months• Proportion of under 1 year

children immunised against measles

• Prevalence of under weight children (under 5 years of age)

• Proportion of children under five who suffered from diarrhoea in the last 30 days and received ORT

• Lady Health Worker coverage of target population

• Under five mortality rate for boys and girls divided by income quintile

• Infant mortality rate for girls and boys divided by income quintile

• Proportion of 1-year-old children (girls and boys) immunized against all preventable diseases including measles.

• Proportion of women in the reproductive age (15-45) with access to quality, affordable and comprehensive SRHR services, including contraceptive, safe delivery, safe abortion, and safe motherhood services at the primary health care level divided by income quintile.

Existing indicators approved by GOP

Proposed additional Indicators

Rationale for inclusion of Rationale for inclusion of IndicatorsIndicators

• Gender and income quintile disaggregated data help in understanding health seeking behaviours at the household and community levels.

• The already existing system of government measures gender disaggregated data these systems should be further strengthened and maintained.

Early And Late Childhood Mortality Rates

Rate Overall Male FemaleNeonatal Mortality Rate (1997 – 2000) / 1000 live births

54 68 40

Infant Mortality Rate (1997 – 2000) / 1000 live births

85 95 71

Under 5 Mortality Rate (1997 – 2000) / 1000 live births

103 112 93

Child Mortality Rate (1997 – 2000) / 1000 live births

20 15 24

•Neonatal Mortality: probability of dying within the first month of life•Infant Mortality: probability of dying before the first birthday•Under Five Mortality: probability of dying before the fifth birthday•Child Mortality: probability of dying between the first and the fifth birthday, having survived the first year

Source: Pakistan Population Assessment Report 2003 and NIPS 2000-01

Regarding Immunization• Since measles is not the only preventable disease that

threatens Pakistan’s population and TB, hepatitis, diphtheria, pertusis (whooping cough), tetanus etc have a higher incidence in our population it is recommended that the indicator measuring ‘proportion of children immunised against measles’ must be modified to measure ‘proportion of children immunised against all preventable diseases, including measles.’

• Other diseases such as diarrhoea and Acute Respiratory infections (ARI), which account for two-thirds of child and infant mortality rates, must also be considered and measured. This is already part of the Pakistan Government’s plans and should be included as part of the MDG framework.

Source of data: UNICEF State of the World Children - 2005

Name of disease % immunized (2003) 1 year old children

TB 82Diphtheria 67

Polio 69Measles (MMR) 61

Hepatitis No dataDiarrhea N/A

ARI N/APneumonia N/A

Access to Quality Health Services• One of the pressing challenges towards achieving the child

health goal has been mentioned in the MDG progress report as

““Access to high quality essential health services, especially Access to high quality essential health services, especially reproductive and emergency obstetric care” reproductive and emergency obstetric care”

• Since access to quality SRHR services is directly linked to child health, it is proposed that the MDG framework include an indicator that measures ‘the proportion of quality, affordable and comprehensive SRHR services, including contraceptive, safe delivery, safe abortion, and safe motherhood services at the primary health care level.”