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Revised for Printing Report Autism in Pakistan

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Dismal State of Affairs in Treatment of Autism Spectrum
Disorders in Pakistan
Introduction to Pakistan’s Healthcare Profile
Pakistan is a developing country in Southeast Asia having a population of
more than 181 million, making it the 6
th
most populous country in the world.
More than 38 % of the population is under the age of fifteen years (Population
Reference Bureau 2009). Pakistan has a healthy life expectancy at birth of 56
years only. Sadly the total expenditure on health per capita is $ 129 and total
expenditure on health as a percentage of GDP is 2.6% only which is far lower
than the developed countries (World Health Organization, 2018). Although
significant improvements have been noticed in the last few decades in provision
of pediatric health services, unfortunately the areas of child mental health and
learning disabilities remain largely neglected.
Child Health and Mortality Indicators in Pakistan
The maternal and child health scenario in Pakistan is quite alarming.
Maternal mortality is very high and a similar high trend is seen in infant mortality
as well as mortality of children under the age of five years. Maternal mortality
ratio stands very high at 260 per 100000 live births. On the child mortality side
the neonatal mortality rate of 42 per 1000 live births and an infant death rate of 69
per 1000 live births. Sixty percent of the world’s 5.9 million children died before
their fifth birthday last year, belonged to countries in Asia and Africa. Pakistan
stands at an under five mortality rank of 26 with an under five mortality rate of 86
per 1000 live births. Pakistan tops the list in child death rate among other South
Asian countries. The leading cause for this is complications due to premature
birth, pneumonia, diarrhea, malaria and malnutrition. Pakistan is the seventh
country in the world where 90,000 children die at 5 years to pneumonia annually.
A UNICEF report on child mortality revealed Pakistan to have the worst new-
born mortality rate. The report said babies born in the world’s poorest countries,
most of them in Africa, still face ‘alarming’ risks of death that can be 50 times as
high as those in the richest countries. The differences are stark. A baby born in
Pakistan, the country with the worst newborn death rate faced a one in 22 chance
of death, while a newborn in Japan had only a one in 1,111 risk of dying, the
report demonstrated (UNICEF, 2018). Keeping these figures in mind, it is evident
that child health in Pakistan is quite unsatisfactory and disease outcomes are quite
dismal.
Autism Spectrum Disorders

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One in every 160 children has an autism spectrum disorder (ASD). ASDs
begin in childhood and tend to persist into adolescence and adulthood. Based on
epidemiological studies conducted over the past 50 years, the prevalence of ASD
appears to be increasing globally. While some people with ASD can live
independently, others have severe disabilities and require life-long care and
support.
Evidence-based psychosocial interventions, such as behavioral treatment
and parent skills training programmes, can reduce difficulties in communication
and social behavior, with a positive impact on wellbeing and quality of life for
persons with ASD and their caregivers, which in major part are the parents.
Interventions for people with ASD need to be accompanied by broader actions for
making physical, social and attitudinal environments more accessible, inclusive
and supportive. Worldwide, people with ASD are often subject to stigma,
discrimination and human rights violations. This is truer for the developing
countries like Pakistan, India and Bangladesh. Globally, access to services and
support for people with ASD is inadequate and more so for the developing
countries.
Management of Autism Spectrum Disorders
Intervention during early childhood is important to promote the optimal
development and well-being of people with an ASD. Monitoring of child
development as part of routine maternal and child health care is recommended. It
is important that, once identified, children with an ASD and their families are
offered relevant information, services, referrals, and practical support according to
their individual needs. A cure for ASD is not available. Evidence-based
psychosocial interventions, however, such as behavioral treatment and skills
training programmes for parents and other caregivers, can reduce difficulties in
communication and social behavior, with a positive impact on the person’s
wellbeing and quality of life.
The health-care needs of people with ASD are complex and require a
range of integrated services, including health promotion, care, rehabilitation
services, and collaboration with other sectors such as the education, employment
and social sectors which are nearly non-existent in the developing countries like
Pakistan. Interventions for people with ASD and other developmental disorders
need to be accompanied by broader actions for making their physical, social, and
attitudinal environments more accessible, inclusive and supportive.

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Dismal State of Affairs in Treatment of Autism Spectrum Disorders in Pakistan Introduction to Pakistan’s Healthcare Profile Pakistan is a developing country in Southeast Asia having a population of more than 181 million, making it the 6th most populous country in the world. More than 38 % of the population is under the age of fifteen years (Population Reference Bureau 2009). Pakistan has a healthy life expectancy at birth of 56 years only. Sadly the total expenditure on health per capita is $ 129 and total expenditure on health as a percentage of GDP is 2.6% only which is far lower than the developed countries (World Health Organization, 2018). Although significant improvements have been noticed in the last few decades in provision of pediatric health services, unfortunately the areas of child mental health and learning disabilities remain largely neglected. Child Health and Mortality Indicators in Pakistan The maternal and child health scenario in Pakistan is quite alarming. Maternal mortality is very high and a similar high trend is seen in infant mortality as well as mortality of children under the age of five years. Maternal mortality ratio stands very high at 260 per 100000 live births. On the child mortality side the neonatal mortality rate of 42 per 1000 live births and an infant death rate of 69 per 1000 live births. Sixty percent of the world’s 5.9 million children died before their fifth birthday last year, belonged to countries in Asia and Africa. Pakistan sta ...
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