Abrejo Farina G, Shaikh Babar T, Saleem Sarah
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Reprod Health. 2008 Sep 10;5:4. doi: 10.1186/1742-4755-5-4.
The ICPD agenda of reproductive health was declared as the most comprehensive one, which had actually broadened the spectrum of reproductive health and drove the states to embark upon initiatives to improve reproductive health status of their populations. However, like all other countries, Pakistan also seems to have shifted focus of its policies and programs towards achieving MDGs. As a result, concepts highlighted in the ICPD got dropped eventually. In spite of specific goals on maternal and child mortalities in MDGs and all the investment and policy shift, Pakistan has still one of the highest maternal mortality ratios among developing countries. Lack of synchronized efforts, sector wide approaches, inter-sectoral collaboration, and moreover, the unmet need for family planning, unsafe abortions, low literacy rate and dearth of women empowerment are the main reasons. Being a signatory of both of the international agendas (ICPD and MDGs), Pakistan needed to articulate its policies to keep the balance between the two agendas. There are, however, certainly some common grounds which have been experimented by various countries and we can learn lessons from those best practices. An inter-sectoral cooperation and sector wide approaches would be required to achieve such ambitious goals set out in ICPD-Program of Action while working towards MDGs. There is a need of increasing resource allocation, strengthening primary health care services and emergency obstetric care and motivating the human resource employed in health sector by good governance. These endeavors should lead to formulate evidence based national policies, reproductive health services which are affordable, accessible and culturally acceptable and finally a responsive health system.
国际人口与发展会议(ICPD)的生殖健康议程被宣布为最全面的议程,它实际上拓宽了生殖健康的范畴,并促使各国开展行动以改善其民众的生殖健康状况。然而,与所有其他国家一样,巴基斯坦似乎也已将其政策和计划的重点转向实现千年发展目标(MDGs)。结果,ICPD所强调的概念最终被搁置。尽管千年发展目标中有关于孕产妇和儿童死亡率的具体目标,以及所有的投资和政策转变,但巴基斯坦仍是发展中国家中孕产妇死亡率最高的国家之一。缺乏协同努力、全部门方法、部门间合作,此外,计划生育需求未得到满足、不安全堕胎、识字率低以及妇女赋权不足,都是主要原因。作为这两项国际议程(ICPD和MDGs)的签署国,巴基斯坦需要明确其政策,以在这两项议程之间保持平衡。然而,肯定有一些共同基础已被各国试验过,我们可以从这些最佳实践中吸取教训。在朝着千年发展目标努力的同时,需要采取部门间合作和全部门方法,以实现ICPD《行动纲领》中设定的如此宏伟的目标。需要增加资源分配,加强初级卫生保健服务和紧急产科护理,并通过善治激励卫生部门的人力资源。这些努力应能促成制定基于证据的国家政策、提供负担得起、可及且符合文化习俗的生殖健康服务,并最终建立一个反应灵敏的卫生系统。