Transforming healthcare in remote areas of Pakistan

On a cold and hazy winter morning, Rashida Bibi brings her eight-month-old daughter, Aisha, to the Rural Health Unit situated at Ganda Singh Village, a remote settlement in Punjab’s Kasur district. Aisha is coughing incessantly and visibly uncomfortable.

Staff Nurse Kaneez Fatima is on duty and conducts the toddler’s initial checkup. Her assessment form is shared with Dr. Ashraf, the head pediatrician at the facility. He observes Aisha’s symptoms and diagnoses her with a chest infection before providing medicines.

While chest infections are common among young children during winters and easily treatable, until about two years ago, even this could become potentially life threatening due to the absence of proper treatment. 

“We did not have the required medical equipment and our staff also lacked the necessary training to effectively treat children,” explains Dr. Ashraf. “The improvements in this facility and capacity building of the staff have enabled us to save countless young lives.”

Dr. Ashraf is referring to the upgradation of the rural health unit two years ago under a project supported by the Global Muslim Philanthropy Fund for Children (GMPFC), a joint initiative established by the Islamic Development Bank and UNICEF and funded by King Salman Humanitarian Aid & Relief Centre.

The project aimed to improve the immunization coverage and health services for children under the age of five in five districts of Pakistan, including Kasur. Under this, more than 3,000 health care professionals in the targeted districts received specialized trainings and 210 health facilities received essential medical equipment. The cold chain system for vaccines has also been strengthened through solarization of the cold storage rooms and provision of Solar Ice Lined Refrigerators and Cold boxes.

In a district with a relatively low literacy rate, it is important that parents trust the public health system and consult doctors when their child is sick. Otherwise, there’s a tendency to rely on home remedies, rural quacks and informal health care providers which worsen the condition of the child. 

The uplift of the Ganda Singh rural health unit has increased local confidence in the medical staff's capabilities. Aisha is Rashida Bibi’s fourth child and her first one to be born at the health unit post upgradation. Aisha’s birth was a totally different experience for her. 

“The staff was very caring and cooperative. Now, they even have a nursery for newborns where Aisha was kept under observation in a baby warmer because she had difficulty breathing. I also received helpful tips from the doctors regarding her care and keeping myself healthy,’ states Rashida Bibi happily.

The project also helped address the issue of historically high vaccination refusals in the district. Parents hesitated to have their children vaccinated, whether at the hospital or during door-to-door visits by vaccinators. The lack of basic medicines, such as paracetamol, compounded the issue. 

“One of the most common side effects of vaccination in a child is a slight fever. It can be treated with paracetamol, but it wasn’t available. As the child developed fever, the parents would refuse to get the second dose of the vaccine,” explains lady health visitor Farhat Inayath. 

Through strengthening of the immunization system and community outreach, these issues are no longer experienced. The vaccination rates in Kasur have increased and more importantly, children are receiving the complete doses of the relevant vaccines.

With power cuts common in Pakistan, especially during the scorching summers, vaccine storage used to get impacted in Kasur. Under this programme, the cold storage unit of vaccines in Kasur and four other districts of Pakistan have been provided with solar energy. As vaccines need to be consistently stored at temperatures as low as two to eight degrees Celsius, the solar system ensures the cold chain equipment gets uninterrupted power supply. 

The project’s effectiveness is evident by the resulting positive impacts. The footfall of patients in the rural health units and the vaccination rates have increased significantly.

“Children under five years old are highly susceptible to diseases and infections. Through this project, we ensured children as well as women in remote districts of Pakistan get access to quality healthcare and improve their knowledge about immunization and maternal and child health. The positive outcomes have motivated us to plan such projects in other remote districts in the future. We hope the Government will continue to take ownership and sustain the initiatives launched under this project,” says Dr. Muhammad Jaohar Khan, Health Specialist, UNICEF Pakistan.