Goal 4: Reduce child
mortality
Existing Target 5
Reduce by two thirds between 1990
and 2015 the Under Five Mortality Rate
Proposed Target 5
Reduce by two thirds between 1990
and 2015, the Under Five Mortality
Rate for Girls & Boys
Existing indicators
approved by GOP
• Under-five mortality rate
• Infant mortality rate
• Proportion of fully immunised
children 12-23 months
• Proportion of under 1 year
children immunised against
measles
• Prevalence of under weight
children (under 5 years of age)
• Proportion of children under
five who suffered from
diarrhoea in the last 30 days and
received ORT
• Lady Health Worker coverage
of target population
Proposed additional
Indicators
• Under five mortality rate for boys
and girls divided by income
quintile
• Infant mortality rate for girls and
boys divided by income quintile
• Proportion of 1-year-old children
(girls and boys) immunized
against all preventable diseases
including measles.
• Proportion of women in the
reproductive age (15-45) with
access to quality, affordable and
comprehensive SRHR services,
including contraceptive, safe
delivery, safe abortion, and safe
motherhood services at the
primary health care level divided
by income quintile.
Rationale for inclusion of
Indicators
• Gender and income quintile disaggregated data
help in understanding health seeking behaviours
at the household and community levels.
• The already existing system of government
measures gender disaggregated data these
systems should be further strengthened and
maintained.
Early And Late Childhood Mortality Rates
Rate
Overall
Male
Female
Neonatal Mortality Rate
(1997 – 2000) / 1000 live births
Infant Mortality Rate
(1997 – 2000) / 1000 live births
54
68
40
85
95
71
Under 5 Mortality Rate
(1997 – 2000) / 1000 live births
Child Mortality Rate
(1997 – 2000) / 1000 live births
103
112
93
20
15
24
Source: Pakistan Population Assessment Report 2003 and NIPS 2000-01
•Neonatal Mortality: probability of dying within the first month of life
•Infant Mortality: probability of dying before the first birthday
•Under Five Mortality: probability of dying before the fifth birthday
•Child Mortality: probability of dying between the first and the fifth birthday, having survived the first
year
Regarding Immunization
• Since measles is not the only preventable disease that
threatens Pakistan’s population and TB, hepatitis,
diphtheria, pertusis (whooping cough), tetanus etc have
a higher incidence in our population it is recommended
that the indicator measuring ‘proportion of children
immunised against measles’ must be modified to
measure ‘proportion of children immunised against
all preventable diseases, including measles.’
• Other diseases such as diarrhoea and Acute Respiratory
infections (ARI), which account for two-thirds of child and
infant mortality rates, must also be considered and
measured. This is already part of the Pakistan
Government’s plans and should be included as part of
the MDG framework.
Source of data:
UNICEF State of the World Children - 2005
Name of disease
% immunized (2003) 1 year old
children
TB
82
Diphtheria
67
Polio
69
Measles (MMR)
61
Hepatitis
No data
Diarrhea
N/A
ARI
N/A
Pneumonia
N/A
Access to Quality Health Services
• One of the pressing challenges towards achieving the
child health goal has been mentioned in the MDG
progress report as
“Access to high quality essential health services,
especially reproductive and emergency obstetric care”
• Since access to quality SRHR services is directly linked
to child health, it is proposed that the MDG framework
include an indicator that measures ‘the proportion of
quality, affordable and comprehensive SRHR services,
including contraceptive, safe delivery, safe abortion, and
safe motherhood services at the primary health care
level.”