Bhutta Z A, Rehman S
Department of Pediatrics, Aga Khan University, Karachi, Pakistan.
J Perinatol. 1997 Jan-Feb;17(1):54-9.
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.
巴基斯坦是世界上人口最多的国家之一，据估计其围产期死亡率为每千例出生60至90例，其中近一半为死产。尽管近年来婴儿死亡率有所下降，但几乎60%的死亡发生在新生儿期，并且在几十年间变化相对较小。这主要归因于对孕产妇和新生儿护理项目的关注不足。巴基斯坦政府最近实施的社会行动和医疗保健项目承诺通过使用经过培训的助产士和社区工作者来提供家庭孕产妇和新生儿护理服务。初级卫生保健服务网络也在进行改革，以努力提高对高危妊娠的及时识别并促进迅速转诊。新生儿期的重要性在儿科本科和研究生培训项目中以及通过继续医学教育也得到了强调。然而，最重要的长期解决方案是提高妇女的教育和社会地位，以及在政治上给予更大支持，以便将有限的资源转向适当的初级和二级卫生保健。
