Pakistan, one of the most populous countries in the world, has an estimated perinatal mortality rate of 60 to 90 per thousand births, of which almost half are stillbirths. Although infant mortality rates have declined in recent years, nearly 60% of all deaths occur in the neonatal period and have shown comparatively little change over several decades. This is attributed mainly to inadequate attention to programs of maternal and newborn care. The recently implemented Social Action and Health Care Programs of the Government of Pakistan promises to provide domiciliary maternal and newborn care services through the use of trained birth attendants and community workers. The primary health care services network is also being revamped in an effort to improve timely recognition of high-risk pregnancies and to facilitate prompt referral. The importance of the newborn period is also being emphasized in pediatric undergraduate and postgraduate training programs, as well as through continuing medical education. However, the most important long-term solution would be improvement in the educational and social status of women, as well as a greater political support for diversion of limited resources to appropriate primary and secondary health care.
PIP: Pakistan has an estimated perinatal mortality rate of 60-90 per 1000 births, of which almost half are stillbirths. Infant mortality rates have declined in recent years, but the proportion of deaths occurring during the neonatal period has remained rather stable over several decades at almost 60% of all deaths. This latter mortality is largely the result of inadequate attention to programs of maternal and newborn care. The government of Pakistan's recently implemented social action and health care programs will deliver domiciliary maternal and newborn care services through trained birth attendants and community workers. Pakistan's primary health care services network is also being overhauled in an attempt to improve the timely recognition of high-risk pregnancies and to facilitate prompt referral. The importance of the newborn period is also being stressed in pediatric undergraduate and postgraduate training programs, as well as through continuing medical education. Health status and spending in Pakistan, the organization of health care services, maternal mortality, and the causes of infant and neonatal mortality are discussed.