Universal children’s day takes place annually on 20th November. It was established to encourage all countries to institute a day, firstly to promote mutual exchange and understanding among children and secondly to initiate action to benefit and promote the welfare of the world’s children.

In many countries, children celebrate the day with full of joy and happiness and make it “well memorable” of their lives, but when, on Monday 20th November, children’s day came to Pakistan the innocents were really unaware about what to do and how to observe, as they were far away from pleasures and enjoyments. 29.5% of the country’s population lives below the national poverty line. The first victims of poverty are children, the weakest and most vulnerable, who face a complete deprivation of their rights in the country. Research and reports sadly convey the figures that 22.6 million children in Pakistan are out of school. Over 12.5 million are involved in child labour. An estimated 1.2 million children are on the streets, and often sleep hungry. Thousands of children in Pakistan die every year from preventable diseases. There is a troubling increase in the cases of abuse, kidnapping, and violence. The reports also show that children are sold, rented, or even kidnapped in order to force them to beg, serve, and even to prostitute. It is indeed an alarming sign that around 90% of the street children are subjected to the sex trade.

Health issues are the worst among all the problems; innocents are facing in the country. Especially, rural healthcare lacks in quality, affordability, and accessibility for several reasons. The main reason at the back of mounting child mortality in Pakistan is lack of child healthcare facilities especially in the remote regions, where the majority of the population lives. Every year about 400,000 infants die during the first year of their life. Every one among 10 children dying before reaching the age of five and one among 30 just after they are born. The child mortality rates for Pakistan are amongst the highest in the world. Although there is a consistent decrease in child mortality rate since last two decades still Pakistan has the lowest reduction rate of child mortality in Asia.

Asphyxia, preterm delivery, sepsis, and tetanus are chief causes of deaths among infants and newborns. Similarly, diarrhoea, pneumonia, measles, malaria, HIV/AIDS, and the underlying cause of malnutrition. It is believed that malnutrition alone causes 50% of infant deaths. Routine immunization coverage rates in Pakistan remain significantly below desired rates of 90% fully immunized children. Medical reports reveal that one child dies every minute from the diseases and acute respiratory tract infection. Illnesses related to diarrhoea are the fourth biggest cause of child deaths in Pakistan.

Poor social conditions and lack of interest of the responsible authorities is causing the increased spread of these diseases. Many of these illnesses spread due to pollution and mismanagement of administrative services for instance diarrhea spreads due to drinking of contaminated water and malaria occurs due to mosquito bite that is born at stagnant water. Low state spending on healthcare, abject poverty, low literacy, lack of skilled birth attendants, widespread communicable diseases, insufficient emergency child health services in government-run district and rural hospitals are amongst other major reasons behind growing diseases in children. Due to unavailability of transportation facilities in remote regions, a number of pregnant women lose their child before reaching the hospital.

The situation of child related issues in the country is abysmal and among the most important national issues that needs serious attention and efforts that are needed by the government and civil society to save the lives of thousands of children who are out of school, homeless, malnourished and most importantly, those who die every year from preventable diseases. Major factors which are playing role in death of children should be improved like education of mother, gender inequality and proper secondary as well as tertiary care. A holistic approach is needed to improve children and newborn health, mainly by improving and upgrading facilities at district hospitals. In order to save the lives of children, paediatric institutes should be opened in all districts of Pakistan where emergency services along with trained child-disease experts should be made available all the time. There should be a nationwide training program for doctors of Pakistan to make them aware of how to handle pregnancy cases in order to reduce infant mortality rate. Since neonatal mortality rate (NMR) constitutes about half of under five deaths in the country, any initiative to reduce NMR would in turn help in decreasing under five mortality rate and improve child health status, and with the introduction of the Rotavirus vaccine in routine immunization, across the country, the innocents lives could be saved each year and large number of children under five can be protected against Rotavirus infections. A well-managed water and sewerage system can be helpful in reducing the amplification of such diseases. There should be proper awareness among people in rural areas about save and healthy life, importance of approaching the hospitals for the treatment. Sufficient public transport facilities are also mandatory to connect them to the health facilities to avoid losses.

We all can strive to play a role for the betterment of the deserving children without considering the volume of the struggles. Small efforts can bring giant changes. Indeed, there are examples that can motivate our moral towards sincerely serving the humanity such as Abdul Sattar Edhi and Dr Ruth Pfao.