Like most of the crises in services delivery, the quality of health services delivery is far from keeping masses safe. Maternal health is one of such issues. The state has been making efforts to address this issue but they are meager and insufficient. Some commitments at national and international level have also been made in this regard to reduce maternal mortality and to provide better facilities. Millennium Development Goals (MDG) of United Nations is one such international commitment whereby Pakistan shows its concern in connection to maternal health and realizes the sensitivity of the subject. However recent figures of 2012 show that Pakistan is losing 276 women per 100,000 live births which needs to be reduced to 140 on per 100,000 by 2015. Along with that, the high fertility rate of 4.1 also needs to be reduced to 2.1 by 2015. Similarly if we categorically look at all four provinces, Balochistan would be found in alarming condition where 785 women per 100,000 live births perish during the childbirth. In Khyber Pakhtunkhwa maternal mortality rate is 350 per 100,000 and in Punjab it is 259 per 100,000 live births, while Sindh is suffering from 314 deaths per 100,000 live births. This is no doubt a high number and requires immediate attention to save hundreds and thousands of lives each year.
There are multiple factors contributing in counting maternal mortalities, for instance lack of concern by the stakeholders, lack of awareness, political instability and so on. Unfortunately intentionally or unintentionally some fundamental causes behind issues such as maternal health are usually ignored. Gender role in a given society is one such fundamental obstacle to meet the Millennium Development Goals.
Gender is purely socially constructed whereby men and women are associated with fixed social roles and responsibilities. Over generation gender has evolved into a kind of ideology. According to it, men are responsible for outdoor duties while women are associated with indoor household chores and child bearing activities. In under developed societies such as Pakistan, socio-cultural, religious and moral norms prescribe women to remain under the control of men. Additionally, men having control over financial and social resources make decisions about the reproductive rights of women. Women are not supposed to decide regarding family planning, number of children and the use of contraceptives etc. High fertility, preference for son and early marriages add to the vulnerability of women leading them eventually to a slow death.
From early childhood, the conflict of respective gender roles discriminates against women. This discrimination is reinforced through the web of socio-cultural and religious institutions. Examples of such attitude can be observed in distribution of food, provision of education, health and differences in expectations associated with men and women.
Pakistan is also a signatory in other international treaties for ending violence against women and seeking gender justice. Convention on the Elimination of all forms of Discrimination against Women (CEDAW), Beijing Platform for Action and Universal Declaration of Human Rights are a few major commitments. Apart of that, at national level the Article 25 of the Constitution of Pakistan reserves protection and equal rights for all citizens irrespective of class, race or sex. National Commission on the Status of Women has been established for the empowerment of women. Despite all these commitments, the reality is too obvious that it is not possible to meet the MDG standards of maternal health by 2015. There is an urgent need for public and private partnership in this regard, another objective prescribed by MDGs. We need grassroots support to tackle this issue. Educated men and opinion leaders could be helpful ally in this regard. They need to be sensitized about the severity of the issues with collective efforts of governmental and non-governmental institutions.
Sikander Ali is a young human rights activist and researcher currently working as a Research officer at Agha Khan University Karachi.