|Arbeli, 25 with her newly born son whom she plans to name Sagar|
By: Fatima Shahryar
LARKANA DISTRICT, PAKISTAN, January 6, 2014 – In far flung areas of Pakistan, even today, women have to travel several kilometres to seek maternal and child health care and family planning (FP) services. It not only takes a long time and effort, but also requires them to incur heavy costs in transport and other expenses. To avoid this, women and their families prefer seeking the services of a “dai” a traditional birth attendant (TBA), serving within the community. It is thus due to lack of proper health care services and shortage of skilled health care providers (HCP), that many women lose their lives and their newborns during childbirth.
25 year old Arbeli, a mother of six children and resident of Dokri village, represents hundreds of these women. Arbeli has never delivered any child at a health facility or even in the hands of any skilled HCP. It was only this time, expecting her sixth child, that she visited a health facility and delivered her baby at Taluka Headquarters Hospital (THQ) Dokri, Larkana District.
"I came here at Dokri hospital three days back and delivered a healthy baby boy yesterday.” says a much content and happy Arbeli while sharing her experience.
“I always preferred seeking our community’s dai’s services for delivery of my children as it saved me the cost of travelling to the big hospital in Larkana. But this time the dai said she was unable to handle my case and sent me to Larkana District Hospital, as I was experiencing terrible pain. There, the doctors examined me and informed me that I can avail services at Taluka Headquarter Hospital in Dokri and save money too. I came here at Dokri hospital three days back and delivered a healthy baby boy yesterday.” says a much content and happy Arbeli while sharing her experience.
THQ Dokri is one of the 22 healthcare facilities upgraded in the districts of Larkana and Shaheed Benazirabad under Norway Pakistan Partnership Initiative (NPPI). Under this initiative, UNICEF, in coordination with Provincial Maternal Newborn and Child Health (MNCH) Cell Sindh, is successfully implementing Contracting Out model since June 2012 in the two districts of the Sindh province. The project is being implemented with an objective to increase access and utilization of quality MNCH/FP services.
Achieving the project objective, 22 suboptimal performing or non-functional public sector health facilities have been converted into 24/7 Comprehensive or Basic EmONC facilities, now providing quality MNCH/FP services. Not only the health facilities have been upgraded with additional human resource, equipment, medicines, and revamped infrastructure, but a complete behavior change communication strategy is also being implemented to create demand and increase awareness.
|Dr. Zahida, Women Medical Officer at Taluka Hospital Dokri examines a woman visiting for her antenatal check-up.|
Talking about functionalising the facility, Dr. Amjad Ali Shah, In-charge Medical Officer, Taluka Hospital Dokri, Larkana district says: “It was quite a struggle to change the system. Where initially there was no medical officer available and people were unaware of the facility, now as I see we have surely come a long way. Only yesterday, despite it being a holiday, we catered for three deliveries at the facility.”
Although patient examination is not included in Dr. Shah’s official duties, being the in-charge of the facility, he still examines some patients himself to keep his staff motivated and to serve the people of his community.
The security situation in Pakistan has also deteriorated since past few years, effects of which have reached all corners of the country including interior Sindh. It has become unsafe for residents of interior Sindh to leave their homes and travel, especially during late evenings or early mornings due to incidents of lootings, killings and kidnapping on the way.
“No one is ready to come and work here considering it a farfetched and insecure area. We send a car along with a police guard to bring the staff to hospital for night duties as there can be looters hiding along the way making it unsafe for the staff to travel alone for their duty.” Says Dr. Ghulam Hussain, District Manager, Integrated Health Services (IHS).
IHS is the partner Non-governmental organization (NGO) of UNICEF, implementing the NPPI Health Services Contracting Out project in the target districts.
“Earlier there used to be only one doctor, who was usually unavailable. Now with additional staff and equipment, we have huge numbers of patients coming in at all times...
“Earlier there used to be only one doctor, who was usually unavailable. Now with additional staff and equipment, we have huge numbers of patients coming in at all times. We have women who regularly visit the hospital not only for their antenatal check-ups but also for post natal check-ups. We all work together here and are only a call away” says Dr. Zahida, Women Medical Officer at THQ Dokri.
Dokri along its other neighbouring villages in the Larkana district falls among the areas where people have to struggle for their right to basic amenities of life. However, there are many women like Arbeli and Dr. Zahida who despite the challenges are working towards improving their own and others’ lives utilizing the support and facilitation provided by UNICEF.