Pakistan’s progress towards fighting the high child and maternal mortality is unsatisfactory.

Pakistan, with its population of 180 million, has more child, foetal and maternal deaths than all but two of the world’s nations.

Child survival is “the most devastating and large-scale public health and humanitarian crisis Pakistan faces”.

101-0153_IMGAn estimated 423,000 children under-five die each year, almost half of them new-born babies.

Family planning options are also limited and nearly a million women attempt unsafe abortions each year.

Simple measures like training more nurses and midwives (currently outnumbered by doctors 2:1) could save more than 200,000 women and child lives in 2015.

A lack of adequate nutrition for children contributes to the high number of child and maternal deaths. Nearly 40 percent of children under-five are underweight [ ] and more than half are affected by stunting.

Poor nutrition weakens the body’s natural defence mechanisms.

Malnutrition affects the Pakistani economy, with estimates that it costs the country 3 percent of GDP every year, particularly through reduced productivity in young adults.

In Pakistan, as more widely throughout south Asia, non-communicable diseases like cancer, diabetes and heart problems have replaced communicable diseases like malaria and diarrhoea in the past two decades as the leading causes of death and morbidity.

This general trend has not been matched by an adaptation in the Pakistani health system or government policy.

Poor road safety, cheap cigarettes and high-levels of obesity (one in four adults) all lead to preventable deaths.

So-called “lifestyle diseases” could cost the country nearly US$300 million in 2025.

Higher excise taxes on cigarettes, new legislation, and information campaigns could cut the premature mortality rate from cardiovascular diseases, cancers, and respiratory diseases by 20 percent by 2025.

Humanitarian crises provoked by earthquakes, flooding and conflict over the past decade have mobilized large sums of money both internationally and within the country.

But corresponding sums have not been spent on underlying health services, which have the potential to save many more lives.

Public health spending has declined from 1.5 percent of GDP in the late 1980s to less than 1 percent – equivalent to less than 4 percent of the government budget.

That has left Pakistanis with little support for medical costs, which are responsible for more than two-thirds of major economic shocks for poor families, according to the Ministry of Social Welfare and Special Education.

Rapid population growth [ ] only makes what resources are spent on health