The initiative of Community Midwives is the backbone of the Maternal, Neonatal and Child Health (MNCH) Programme. A seminar was organized on 27th August, 2013 at the Avari Towers, Karachi, to highlight the importance of the role the CMWs are playing and can further play in bringing down the Infant and Maternal Mortality rates in Pakistan. The aim of this event was 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). Also included was an overview of the revised curriculum of community midwives and the Mid Term Evaluation of the MNCH Programme. The 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
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. 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. 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. The MNCH Programme has been implemented in 134 districts across 4 provinces, Azad Jammu and Kashmir, Northern Areas, Federally Administered Northern Areas and Federally Administered Tribal Areas.
In attendance at the event were a number of senior policy makers from the MNCH Programme and Department of Health, Sindh, MPAs, representatives of international development partners, NGOs, academia as well as representatives from the Pakistan Nursing Council (PNC) and Community Midwives. The CMWs spoke about certain cases in which they were able to make a vitally importance difference to their communities and were able to save lives because of their specialized training. They indicated that adequate support from the district and provincial governments would be crucial to improve their performance further and retention in the health system.
Most importantly, information regarding the new online MNCH database and monitoring system was also presented at the seminar. It is an innovative, open source and user-friendly system developed for the public health sector and offers an excellent opportunity for improving the MNCH Programme especially at the district level. The dearth of information regarding actual field activities has been a long standing flaw in health care provision. Alongside the District Health Information System (DHIS), this MNCH system is a hopeful step towards evidence based policy making in health care.