TechNet-21 - Forum

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  3. Tuesday, 26 November 2013
Afzal Malik (Journalist) The prevailing rate of infant and maternal mortality rate in Pakistan continues to be among the highest in the region. A seminar was organized to highlight the importance of the role Community Midwives (CMW) play in bringing down the infant and maternal mortality rates in the country. The CMW initiative is the backbone of the Maternal, Neonatal & Child Health (MNCH) Programme. The CMWs spoke passionately about certain cases in which they were able to make a vital difference to their communities and were able to save lives because of their specialised training. They indicated that adequate support from the district and provincial governments would be crucial to improve their performance further and retention in the health system. Global experiences indicate that one way of bringing about an improvement in maternal and child health is a proficient front line of skilled midwives, along with supportive supervision and strong linkages with the referral system. The Government of Pakistan launched the MNCH Programme in 2007 to accelerate progress towards Millennium Development Goals (MDGs) 4 & 5. This was to be achieved primarily through providing emergency obstetric and new-born care services, training and deployment of a new cadre of community midwives and institutional strengthening. The overall vision of the Programme has been to improve quality and coverage of MNCH services, especially at primary and secondary levels of the health system, coupled with community outreach services through integrated system-wide approaches. The MNCH Programme has been implemented in 134 districts across 4 provinces, Azad Jammu and Kashmir, Northern Areas, Federally Administered Northern Areas and Federally Administered Tribal Areas. Currently, in Khyber Pukhtunkhwa province 981 CMWs have been deployed while 574 are awaiting deployment. The role of CMWs was highly appreciated by all senior policy makers and managers. The Health Minister ensured his full support to the CMWs and made a public commitment to increase their stipend from Rs. 2000 to Rs. 6000. He further said that the existing strength of the CMWs will be increased by 600 and hoped that “there would be one CMW in each union council”. Participants argued that evidence-based advocacy and policies based on quality non-clinical research can help improve practices related to maternal and newborn health that currently rank the country the sixth in the world. Though the government has tried to overcome neonatal morbidity and mortality over the last 15 years, it has failed to achieve the required level and the rates remain high. The conference presented findings from various RAF funded projects – a baseline survey of eight key family practices in Sindh and Pakistan account for 7 percent of global neonatal deaths, with an estimated 298,000 preventable deaths, while 46 percent of neonates are reportedly immunized. A Balochistan-based study reflects the maternal mortality ratio is significantly higher than the rest of the country with 785 deaths reported per 100,000 live births. Postpartum bleeding, one of the major causes of maternal mortality, is considered healthy for the mother. The unequal access to healthcare and provision of health care vary between the poor and wealthy and even between provinces, which participants believed are among the major reasons behind high mortality rates. This coupled with socio-cultural structures which derail women empowerment and lack access or the propensity to avail basic health facilities, prove a disastrous partnership.

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