KARACHI - Adequate support from the district and provincial governments is crucial to improve the performance of the community midwives, said speakers at a seminar jointly organised by MNCH, Pakistan Nursing Council (PNC) and Research and Advocacy Fund (RAF).

Representatives from public and private sector healthcare programmes as well as the policy making and policy implementers were unanimous that community based midwives have established their usefulness as the backbone of the Maternal, Neonatal and Child Health (MNCH) Programme.

This, they said demanded their regularization in the provincial and district level healthcare programmes.

Sindh Health Secretary, Inamullah Khan Dharijo on the occasion acknowledged that midwives were a crucial section to meet the specified as well as generalized health needs of women and children at grassroot levels. He was also appreciative of the information regarding the new online MNCH database and monitoring system, presented during the seminar and cited it to be an innovative, open sourced and user-friendly system developed for the public health sector.

Information that it offers an excellent opportunity for improving the MNCH Programme especially at the district level is highly appreciative, he said.

This is with particular reference to the fact that dearth of information regarding actual field activities has been a long standing flaw in health care provision, said the Health Secretary. He was also of the opinion that alongside the District Health Information System (DHIS), the MNCH system was a hopeful step towards evidence- based policy making in health care.

Chief Coordinator of MNCH Programme, Dr Sahab Jan Badar said the role played by community midwives (CMWs) can further bring down the infant and maternal mortality rates in Pakistan.

She said the event was aimed to present policy briefs based on assessments of the Community Midwives (CMW) Programme; its quality of training and deployment protocols and the newly instituted online CMW Management Information System (MIS).

MNCH Programme is jointly funded by Pakistan government and Department for International Development (DFID) of UK government. DFID also supports MNCH Programme through Technical Resource Facility’s (TRF) health projects as well as the Research and Advocacy Fund (RAF) for introducing innovative approaches related to mother and child health. Dr Sahab Jan Badar said evidence shows that the prevailing rate of infant and maternal mortality in Pakistan continues to be among the highest in the region.

“Global experiences indicate that one way of bringing about an improvement in this situation is a proficient front line of Skilled Midwives, along with supportive supervision and strong linkages with the referral system,” she said.

Nighat Durrani of TRF said the Government of Pakistan launched the MNCH Programme in 2007 to accelerate progress towards Millennium Development Goals (MDGs) 4 & 5.  “This was to be achieved primarily through providing emergency obstetric and new-born care services, training and deployment of a new cadre of community midwives and institutional strengthening,” she said.

The overall vision of the Programme has been to improve quality and coverage of MNCH services, especially at primary and secondary levels of the health system, coupled with community outreach services through integrated system-wide approaches. Representatives of The CMWs spoke about certain cases in which they were able to make a vitally important difference to their communities and were able to save lives because of their specialized training.