Supporting public private
partnership in rural Pakistan:
Greenstar Clinic Sahoolat reaches out to Shanti Nagar
At a distance of 12 km from Khanewal city, there
is a small Christian Community of Shanti Nagar (Peaceful
Dwelling) with a population of ten thousand inhabitants.
Most of the inhabitants are low income workers who
work in the fields as cotton pluckers. This is a well
knitted community which has established a Community
Clinic with its own resources on self help basis.
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Vaccinator
form the District EPI Program –Fostering
Public – Private Partnership
Shanti Nagar, September 27, 2006
Photograph Courtesy: Khizar, Khanewal |
eptember 2006 was an exciting month for Shanti Nagar
when the Greenstar Interpersonal Communication (IPC)
team visited the community and offered its services.
The enthusiastic community welcomed Greenstar and
requested for free counseling services. The Greenstar
team held preliminary meetings with influential members
of the community: the Padre, Mr. Afzal; the Nazim,
Johnson Gulzar; managers of the community owned clinic,
Faith Health Center; and Sheela David, Traditional
Birth Attendant, to seek further support and cooperation.
One could see the fervor within the community to establish
a Clinic Sahoolat (free counseling) which was going
to be the first ever free counseling service at their
clinic. Local Greenstar health providers offered voluntary
services.
The first Clinic Sahoolat was held at the Faith Health
Center on September 27, 2006. Dr Nuzhat, a renowned
gynecologist from Khanewal and also a GoodLife provider
--provided counseling in antenatal, postnatal, child
and neonatal care as well as in family planning. In
a first Public / Private collaboration, District Expanded
Program Immunization (EPI) facilitated the CS by providing
vaccination services at the clinic for children under
5 years of age and pregnant women. The success of
this Clinic Sahoolat was followed by two other CS
held at the same community health center on October
4 and 11, 2006.
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“I
could never believe that Dr Nuzhat Qaisar would
come to our community and give us free consultation.
How could I miss this opportunity..” |
Gulna Bibi, visiting
Clinic Sahoolat, Shanti Nagar , September 27,
2006
Photograph Courtesy: Khizar, Khanewal
|
The IPC team contacted 3174 people. 74 females benefited
from these Clinic Sahoolats. The EPI coverage was
provided to 32 Pregnant Women & 26 Neonates /
Children.
Clinic Sahoolat is one of the Greenstar and GoodLife
family health services. These Clinics have been instrumental
in building the image of the provider and the franchise
in the community while serving to increase access
to MNH and FP services for the poor.
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USAID Trained Traditional Birth Attendant convinces a woman and her family to deliver in professional hands in Sukur in the Sindh Province of Pakistan
In Pakistan, 80% of women deliver their babies at home, while skilled birth attendants and trained traditional birth attendants (TBA) conduct 20% of deliveries. Only six in ten mothers reported seeing a health professional (i.e. a doctor, nurse, or Lady Health Visitor), at least once for antenatal care, according to the recent Pakistan Demographic and Health Survey (DHS).
Proper medical attention and hygienic conditions during delivery can greatly reduce the risk of complications and infections that often lead to serious illness or death of a mother and/or her baby. In Pakistan, only 39 percent of births are delivered by a health professional and 34 percent of deliveries take place in health facilities. In the Sindh province, 44.4 percent of deliveries are performed by health professionals, according to the Pakistan DHS.
The Pakistan Initiative for Mothers and Newborns (PAIMAN), a collaboration between USAID and Greenstar Social Marketing, is training 400 traditional birth attendants practicing in rural communities. TBAs receive training in the importance of, and techniques related to, pre- and post-natal care, clean delivery techniques, identification of obstetric risk signs and symptoms, and referrals for safe and hygienic delivery.
Shahida, a Greenstar Health Service Officer was
on a routine supervisory follow-up visit to Haleema,
a TBA in Kandhra, a village in Sukkur, when she came
across 27-year-old Najma, who was determined to have
her baby delivered by a traditional birth attendant.
Having been through the PAIMAN training, Haleema was
able to carefully explain to Najma that her stature
and short height were early warning signs and required
special attention by a doctor. Haleema referred Najma
to a hospital for a Caesarian section. Najma’s family,
especially her mother-in-law, insisted that Najma
have a traditional birth by a TBA. After much effort,
Haleema was able to convince the entire family that
it was in the best interest of Najma and the unborn
baby to see a doctor. Najma received a consultation
by Dr. Shazia Khan. Dr. Khan informed the family that
a traditional delivery was not possible for Najma’s
small bony pelvic outlet and short stature might result
in an obstructed labor, which could cause a ruptured
uterus. Thanks to Haleema’s training and dedication,
Najma was admitted to the Red Crescent Hospital in
Sukkur where she delivered a healthy baby boy. “I
was not willing to take my daughter-in-law to a doctor.
Haleema not only convinced us but took us to the doctor.
She has not only saved a mother and child, but my
coming generations too,” said the cheerful mother-in-law
after having a healthy grandchild.
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