Maternal, newborn and child health statistics in Pakistan have been historically appalling with little improvement seen in newborn health over the last decade. The rate of neonatal mortality reduction is estimated to be less than 1% per year during 2000-2010.Evidence shows that 40% of newborn deaths could be prevented through simple community based interventions. One of these interventions is immediate, exclusive and continued breastfeeding. Breastfeeding has a string impact on both reducing malnutrition and protecting children in their first 28 days and beyond. Through expanding this simple and free-of-cost measure at a level of universal coverage, the highest proportion of under-five deaths could be prevented.
No wonder, the world’s leaders committed to a global target for at least 50% of children under six months old to be exclusively breastfed by 2025 last year at the World Health Assembly. And this is no rocket science. Individual countries have achieved dramatic increases in exclusive breastfeeding rates over 10-15 years; however, this progress is masked by the stalling rates in countries with largest population resulting in global stagnation. It is discouraging to know that the global rate of exclusive breastfeeding has stayed below 40% despite significant efforts in global policy and initiative over the last 20 years. There is a dire need to understand the key constraints to achieving real positive change in terms of improving infant feeding practices worldwide and more specifically in Asia, where the decline in breastfeeding rate is the maximum.
In an attempt to analyze the key barriers to breastfeeding, Save the Children launched its global report titled “Superfood for Babies” on February 18, 2013, with high level policy roundtable launch events in Geneva and around the world and a concerted media push. In Pakistan too, the report was launched in a formal ceremony presided by Dr. Sania Nishtar, the country’s renowned philanthropist and founder of the think tank “Heartfile”. She acknowledged the report as a right step towards advocating for the critically needed improvement in infant feeding practices in the milieu of the prevailing malnutrition in the country. Dr. Nishtar emphasized on bridging the gap between legislation and implementation to ensure positive impact.
The report launch event was also graced by Dr. Donya Aziz, Member National Assembly, who gave her commitment to fully support the adoption of a bill for bringing the maternity protection up to the International Labor Organization (ILO) recommended 18 weeks duration. Save the Children’s campaign ambassador, Mr. Haroon Rashid, country’s famous rock star, also shared his pledge to take forward the agenda of maternal, newborn and child health through his art. Save the Children’s representatives including Mr. Ghulam Qadri, Deputy Country Director; Dr. Qudsia Uzma, Director Health & Nutrition and Mr. Arshad Mehmood, Sr. Advocacy Manager shared the organization’s commitment and dedication to improving lives of children in the country and bringing lasting positive change in their lives. They highlighted the policy recommendations put together in the report based on the key barriers preventing mothers from breastfeeding. To overcome harmful practices and tackle breastfeeding taboos, countries must fund projects focusing on changing the power dynamics in the community and empowering young women through inclusive interaction with men and well-targeted media campaigns. To make health system stronger to protect, promote and support breastfeeding, adequate resources need to be allocated for long-term health worker training, recruitment and retention with support from international donors. To introduce nationwide breastfeeding-friendly policies and legislation, maternity leave needs to be in line with ILO minimum standards along with financial protection by the governments. To improve breast-milk substitute industry practices, a code of conduct must be adopted by BMS companies and national regulation needs to be comprehensive in line with the International Code with effective implementation ensured by the governments.
 Newborn Survival in Pakistan: a decade of change and future implications Khan, A, Kinney MV, Hazir T, Hafeez A, Wall SN, Ali N, Lawn JE, Badar A, Khan AA, Uzma Q, Bhutta ZA for the Pakistan Newborn Change and Future Analysis Group. 2012. Health Policy and Planning. 27(Suppl. 3):iii72-iii87.
 Jones, G et al., ‘How many child deaths can we prevent this year?’ Lancet Child Survival Series, 2003, 362:65-71
Dr. Qudsia Uzma
Director Health & Nutrition
Save the Children, Pakistan Country Office