ISLAMABAD - Skilled birth attendance improved in Chitral from 33 per cent in 2009 to 82 per cent in 2013 with access to financial services for women seeking maternal and neonatal care in the district after the implementation of the Chitral Child Survival Programme, says a study.A one-day dissemination seminar to share findings of the final evaluation of the 5-year Chitral Child Survival Programme (CCSP) was organised by the Aga Khan Foundation (Pakistan) and programme partners Aga Khan Health Service, Pakistan (AKHSP) and Aga Khan Rural Support Programme (AKRSP). “In the last five years since its implementation, the Chitral Child Survival Programme has achieved remarkable results in improving skilled birth attendance from 33 per cent in 2009 to 82 per cent in 2013, provision of improved care (continuum of care from skilled birth attendants has improved from 3 per cent to 15 per cent in 5 years) and access to financial services for women seeking maternal and neonatal care in Chitral,” said Karim Ali Bhai, CEO Aga Khan Foundation (Pakistan). Implemented in 28 of the most remote and isolated mountainous community clusters in Chitral district during the period 2008 to 2013, the objective of the programme was to reduce maternal, neonatal and child mortality and morbidity by increasing access to and utilisation of the obstetric and neonatal continuum of care in the target communities.The chief guest, Dr Sahib Gul, Provincial Coordinator Maternal, Neonatal and Child Health Programme of Khyber Pakhtunkhwa appreciating the contribution and achievements said “the partnership between the Aga Khan Development Network (AKDN) and Department of Health, Government of Khyber Pakhtunkhwa has been exemplary in many health service areas including child immunization, management of tuberculosis and strengthening health services delivery in three government health facilities at Shagram, Mastuj and Garumchashma tehsils of Chitral district through public private partnership,”. He further stated that as a result of the strong partnership between the Government of Khyber Pakhtunkhwa and AKDN, the health indicators in Chitral have been reported better than the other districts of KPK.”According to the baseline survey conducted in 2009 under the Chitral Child Survival Programme, 26 per cent of pregnant mothers did not have access to antenatal care due to lack of awareness; 27 per cent due to high cost and 36 per cent due to difficulties of travelling to health facilities providing such care.During the programme, Aga Khan Health Service, Pakistan selected and trained 28 Community Midwives who were later deployed in their respective communities. Aga Khan Rural Support Programme mobilised communities and established 421 Community Based Saving groups (CBSGs) in the selected 28 communities. Young and educated women participated in the CBSGs, which were responsible for reducing financial barriers for women to access essential maternal, neonatal and child services.During her presentation at the event, Arusa Lakani, Assistant Professor at the Aga Khan University, School of Nursing and Midwifery (AKU-SONAM) stated that “The performance of CMWs has increased progressively each year since they were deployed in 2011. CMWs acceptance at community level was perceived to be high due to their availability at time of need”. It was also highlighted that the programme had made significant contribution through the implementation of the CMW and CBSG interventions and that the model had great potential for replication in other parts of Chitral district and other districts of Khyber Pakhtunkhwa.Dr Sohail Amjad, Consultant, Aga Khan Foundation (Pakistan) while presenting the findings of the final evaluation report of the Programme said that “through the community-based savings groups women have been encouraged to save money and have had better access to loans for emergency needs including health care. Women who had membership in CBSGs were four times more likely to avail Maternal Newborn and Child Health (MNCH) services from CMWs then those who were not part of any such group”. The evaluation report has also recommended that the Department of Health, Khyber Pakhtunkhwa make an allocation in the health budget to include the 28 CMWs trained under this project in the mainstream health system in order to continue maternal, neonatal and child services in the remote communities of District Chitral. The seminar was attended by key officials of Government Department of Health Khyber Pakhtunkhwa and district Chitral, USAID, other development partners, agencies of the Aga Khan Development Network (AKDN), civil society, representatives of village health committees, community based saving groups and community midwives.