Perinatal Mortality Rate in Pakistan and other South-Asian Countries

Abstract

Background: Pakistan reportedly has made little progress in reducing its high burden of perinatal deaths, putting the achievement of the SDG target of ending preventable newborn mortality by 2030 at risk. This systematic review aimed to assess Pakistan's perinatal mortality rate (PMR) compared to other South Asian countries. Objective: To assess the burden of perinatal mortality from 2010-2020 and compare the perinatal mortality rates in Pakistan and other South Asian countries. Methodology: We systematically searched three databases for studies from 2018-2023 reporting stillbirth rate (SBR), early neonatal mortality rate (ENMR), and/or perinatal mortality rate (PMR) in South Asian countries. Sixteen studies met the requirements and provided rates for the four countries—Pakistan, India, Bangladesh, and Nepal—which were then contrasted and graphically depicted. Results: Across all studies, Pakistan had the poorest perinatal mortality outcomes in South Asia. The PMR in Pakistan varied between 58 and 91 per 1000 births, which is much higher than the rates in neighboring countries (India 14-46, Bangladesh 41, Nepal 16 per 1000 births). The SBR (21-57 per 1000 births) and ENMR (31-39 per 1000 live births) were also substantially higher in Pakistan compared to India, Bangladesh, and Nepal. Conclusions: Pakistan's disproportionately high PMR and newborn mortality signifies an urgent public health crisis. Immediate action is needed to implement known strategies that work to reduce perinatal deaths in other South Asian countries. With concerted efforts, Pakistan can accelerate progress towards the SDG target of ending preventable newborn mortality, but this requires strategic policies and investments prioritizing maternal and child health. The future of Pakistan's next generation hangs in the balance.