Unequal access: Giving mothers and newborns the care they deserve
Study reveals discrepancies in level of healthcare available to the poor.
Giving mothers and newborns the care they deserve. PHOTO: FILE
ISLAMABAD:
Women and children living at the economic and social margins of society continue to die at an alarming rate despite commitments by numerous governments for improving maternal and child health.
A recently released report, “The Role of Community Spaces and Mechanisms in Health Promotion amongst the Poor Communities in Rural Pakistan,” highlights the fact that even today, every 20 minutes, a woman dies during childbirth. Rural women bear a higher risk than urban women and neonatal mortality is about 55 per cent higher for the poorest households compared to the richest 20 per cent.
The study was carried by the Rural Support Programmes Network (RSPN) in collaboration with Maternal and Newborn Health Programme - Research and Advocacy Fund (RAF). It presents key findings and recommendations for healthcare policy and practices to achieve the MDGs with greater emphasis on reducing inequalities in maternal healthcare in the country.
The study found that maternal newborn and child health (MNCH) programmes have improved awareness and healthcare seeking behaviours through provision of facility- based care, door-to-door visits, group awareness sessions and formal groups and committees.
“However, empowerment and social organisation of the disadvantaged is not their agenda as they do not focus on including the poor, and therefore, fail to improve the health outcomes of the poor and marginalised,” reveals the study.
Social exclusion
According to the study social exclusion of the poor and marginalised from facility-based care, door-to-door visits, group awareness sessions was witnessed in rural areas.
A major reason behind this is that most healthcare providers and facilitators were better off and their prejudices led them to ignore and mistreat the poor and marginalised. Also, nomadic groups are not registered as eligible clients.
Some of the MNCH information imparted in formal spaces trickled down to the poor and excluded women
Recommendations
The study recommends that the objectives, roles, structures, operating procedures and monitoring systems of MNCH programmes and their formal community spaces should be reviewed with explicit consideration of existing social and power structures.
“These should be made more inclusive and representative of all socio-economic strata in the community and monitored accordingly,” suggests the report.
Moreover, the study suggests that the training curriculum of MNCH programme facilitators should include developing an understanding of social mobilisation and the empowerment process.
Dr Ayesha Aziz, the principal investigator at RSPN urged the implementers and designers of MNCH programmes to include rural and poor women and men in their community spaces for health promotion.
She said that the role of community spaces in empowering the rural and poor communities had never been brought to light and by ignoring them Pakistan can never address MNCH issues.
Meanwhile, speaking to The Express Tribune, a senior gynaecologist at Pakistan Institute of Medical Sciences (Pims) who wished not to be named, said every day a number of mothers and newborns die in rural areas but their deaths remain unnoticed.
She was of the view that the major reason behind their deaths is unskilled midwives and lack of proper healthcare facilities in their areas.
“There are a number of women in rural areas who want to give birth to their babies through professional healthcare providers but because of their non-availability, they become victim of untrained personnel and usually die,” she said.
Published in The Express Tribune, February 9th, 2014.
Women and children living at the economic and social margins of society continue to die at an alarming rate despite commitments by numerous governments for improving maternal and child health.
A recently released report, “The Role of Community Spaces and Mechanisms in Health Promotion amongst the Poor Communities in Rural Pakistan,” highlights the fact that even today, every 20 minutes, a woman dies during childbirth. Rural women bear a higher risk than urban women and neonatal mortality is about 55 per cent higher for the poorest households compared to the richest 20 per cent.
The study was carried by the Rural Support Programmes Network (RSPN) in collaboration with Maternal and Newborn Health Programme - Research and Advocacy Fund (RAF). It presents key findings and recommendations for healthcare policy and practices to achieve the MDGs with greater emphasis on reducing inequalities in maternal healthcare in the country.
The study found that maternal newborn and child health (MNCH) programmes have improved awareness and healthcare seeking behaviours through provision of facility- based care, door-to-door visits, group awareness sessions and formal groups and committees.
“However, empowerment and social organisation of the disadvantaged is not their agenda as they do not focus on including the poor, and therefore, fail to improve the health outcomes of the poor and marginalised,” reveals the study.
Social exclusion
According to the study social exclusion of the poor and marginalised from facility-based care, door-to-door visits, group awareness sessions was witnessed in rural areas.
A major reason behind this is that most healthcare providers and facilitators were better off and their prejudices led them to ignore and mistreat the poor and marginalised. Also, nomadic groups are not registered as eligible clients.
Some of the MNCH information imparted in formal spaces trickled down to the poor and excluded women
Recommendations
The study recommends that the objectives, roles, structures, operating procedures and monitoring systems of MNCH programmes and their formal community spaces should be reviewed with explicit consideration of existing social and power structures.
“These should be made more inclusive and representative of all socio-economic strata in the community and monitored accordingly,” suggests the report.
Moreover, the study suggests that the training curriculum of MNCH programme facilitators should include developing an understanding of social mobilisation and the empowerment process.
Dr Ayesha Aziz, the principal investigator at RSPN urged the implementers and designers of MNCH programmes to include rural and poor women and men in their community spaces for health promotion.
She said that the role of community spaces in empowering the rural and poor communities had never been brought to light and by ignoring them Pakistan can never address MNCH issues.
Meanwhile, speaking to The Express Tribune, a senior gynaecologist at Pakistan Institute of Medical Sciences (Pims) who wished not to be named, said every day a number of mothers and newborns die in rural areas but their deaths remain unnoticed.
She was of the view that the major reason behind their deaths is unskilled midwives and lack of proper healthcare facilities in their areas.
“There are a number of women in rural areas who want to give birth to their babies through professional healthcare providers but because of their non-availability, they become victim of untrained personnel and usually die,” she said.
Published in The Express Tribune, February 9th, 2014.