Health experts on Friday said that unassisted deliveries at homes, excessive bleeding during childbirth, delay in reaching healthcare facilities to prevent blood loss, unavailability of trained CMWs, and LHWs during childbirth and infections were some of the major reasons behind high maternal mortality in Sindh, which were tackled through capacity building of staff and now situation in Sindh has improved to some extent.
Speaking to the media at a local hotel, Jhpiego Pakistan Country Director Dr Farid Midhat, accompanied by Jhpiego officials Dr Wajiha Javed and Dr Kamran Baig, said Maternal and Child Health Integrated Programme (MCHIP) was conducted from 2013 to 2018.
The programme was funded by USAID and aimed to take significant steps for saving maternal, neonatal, and child lives in rural areas across Sindh. MCHIP supported programming in maternal, neonatal, and child health; immunisation; family planning and nutrition.
He said under this programme, MCHIP has improved the skills and competencies of approximately 35,000 staff, while building the institutional capacity of training institutions and professional organizations within 16 districts of Sindh. In collaboration with Sindh Health Department, MCHIP registered approximately 850,000 children of less than 2 years of age in 8 selected districts of Sindh.
He said the immunization registry contained the children and pregnant women’s information about immunization status with regular follow up through mobile based short messaging services. Consequently, the Penta-3 vaccination rate has increased from 27pc to 64pc in the targeted districts.
He said during 2013 to 2017, Jhpiego upgraded around 1,100 healthcare facilities in 15 underdeveloped districts of Sindh, trained around 14,000 lady health workers (LHWs) and community midwives (CMWs), improved transportation facilities to shift pregnant ladies to healthcare facilities without any delay and also introduced family planning services which resulted in spacing births and saving lives of women during childbirth.
Dr Farid claimed that under the Maternal Newborn and Child Health (MNCH) Services Project, antenatal care visits at 1100 healthcare facilities in 15 selected districts of Sindh improved from baseline to a total of 4,992,614 during the tenure of the project. In addition to these, facilities based delivery of babies has reached 67pc and contraceptive prevalence rate has increased by 6pc points in interventions districts.
As many as 80,000 misoprostol were prescribed and distributed to prevent postpartum hemorrhage. A significant cause of neonatal mortality is umbilical cord sepsis, the MCHIP distributed 260,000 chlorhexidine tubes were distributed for applying it to newborn cord and preventing infections. Many babies die due to difficulty in breathing at birth, so MCHIP’s intervention of Helping Babies Breathe (HBB) successfully resuscitated around 17,000 babies born with asphyxia.
“We believe that situation in Sindh regarding maternal and infant mortality is improving due to Government of Sindh’s, our and other partners’ efforts and it is hoped that now far less expecting mothers and babies would die as compared to five years back”, Dr Farid added.
He said MCHIP has the vision to prevent maternal, newborn and child deaths by providing high quality MNCH services across selected districts of Sindh through a total market approach, empowered communities, timely referral of complications to hospitals providing emergency obstetric and newborn care (EmONC), and improved access to family planning (FP) and child health services including immunization and nutrition.
It aims at leaving behind at least 1,000 MNCH Centers – functional units in public and private health facilities that provide a full range of high quality MNCH services through an active referral and transportation system.