Abstract
Objectives:To improve maternal health and reduce child mortality through developing health service delivery in a poor and marginalised community in North West Pakistan.Methods:This was a multifaceted intervention to extend and strengthen the range and quality of services provided at an existing health centre, in a rural community in Peshawar District, Khyber Pakhtunkhwa Province. The intervention was developed with community involvement and had four main components: service development, staff capacity development, community engagement and the introduction of a micro-credit scheme. The evaluation assessed the efficiency and effectiveness of project implementation, including a survey of maternal and child health indicators.Results:Between 2014 and 2017, a range of new health services were developed at the health centre. Local volunteers were trained to promote health awareness in the community and refer pregnant women to the health centre. The survey indicated health improvements, such as increased vaccination rates for women and children, and a dramatic reduction in unskilled deliveries.Conclusions:Community engagement was essential to achieve much needed maternal and child health improvements in this poor and marginalised community. Sustainability was achieved by training local volunteers as community health workers.
Highlights
Pakistan was recently ranked 122nd out of 157 countries for progress towards the United Nations’ Sustainable Development Goals.[1]
This paper presents evaluation findings and lessons learnt from this project, which we hope will be useful for other researchers and practitioners working to improve health service delivery in similar settings
Local Setting: The project was implemented in a rural brick kiln community in Peshawar District, Khyber Pakhtunkhwa Province
Summary
Pakistan was recently ranked 122nd out of 157 countries for progress towards the United Nations’ Sustainable Development Goals.[1]. Pak J Med Sci May - June 2018 Vol 34 No 3 www.pjms.com.pk 757 attending antenatal sessions (58%) and the use of contraceptives (31%).[3]. In response to these concerns, the UK Department For International Development (DFID) funded a three-year project (2014-17) to improve maternal health and reduce child mortality through developing health service delivery in a poor and marginalised community in North West Pakistan. Local Setting: The project was implemented in a rural brick kiln community in Peshawar District, Khyber Pakhtunkhwa Province This community includes Afghan refugees, internally displaced people and the host population (approximately 100,000 people in total) who mostly work as labourers in the brick kilns. Girls typically marry in their early teens and have multiple pregnancies with short birth spacing
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