No bed for a dying child: the shortage of paediatric intensive care in Pakistan

Area of Science:

• Pediatric critical care medicine
• Public health in South Asia

Background:

• Pakistan has alarmingly high neonatal and under-five mortality rates, ranking among the worst in South Asia.
• A critical shortage of trained pediatric intensive care specialists (<30) serves over 80 million children.
• Many accredited hospitals lack functional pediatric intensive care units (PICUs) and adequate nurse-to-patient ratios, especially in rural areas.

Purpose of the Study:

• To highlight the critical challenges in Pakistan's pediatric critical care system.
• To underscore the impact of staff and resource shortages on child mortality.
• To explore potential scalable solutions for improving pediatric critical care.

Main Methods:

• Analysis of national data on pediatric hospital resources and staffing.
• Review of existing challenges in accessing specialized pediatric care.
• Identification of emerging solutions and their potential for reform.

Main Results:

• Less than 30 trained pediatric intensive care specialists are available for over 80 million children.
• Only 70% of accredited pediatric hospitals have functional PICUs.
• Nearly half of hospitals lack adequate nurse-to-patient ratios, with rural areas most affected.

Conclusions:

• The severe deficit in pediatric intensive care resources contributes significantly to preventable child deaths in Pakistan.
• Telemedicine, integrated neonatal care, and public-private partnerships offer promising avenues for scalable reform.
• Strengthening pediatric critical care is crucial for achieving Sustainable Development Goal 3.2 and reducing child mortality by 2030.