Evaluating primary healthcare service revitalization interventions though a knowledge, practice and coverage survey in earthquake-affected areas in Pakistan

Abstract

The study evaluated a primary healthcare service revitalization project in the 2005 earthquake affected areas in northern Pakistan by comparing the 2010 endline survey results with the 2007 baseline. A two-stage stratified sampling was used to sample 3,000 households in Bagh district of Azad Jammu and Kashmir. The data indicates significant improvements in majority of the indicators including use of tetanus toxoid injections during pregnancy, postnatal care coverage, mothers’ knowledge of danger signs in newborns, immunization coverage for children and infant and under-5 mortality rates. The endline survey child mortality rates in the intervention area are close to Pakistan’s Millennium Development Goals (MDG) target for 2015, which indicates that revitalizing health systems can lead to considerable improvement in primary healthcare in Pakistan. Carrying out a before and after comparison in absence of a matching control group is an important limitation of this evaluation; nevertheless, the study clearly signifies the importance of health system reform in a post-disaster setting. Further research could consider the sustainability of the intervention without donor support and allow for time-series analysis of public health indicators. Key words: Earthquake, primary health, revitalization, intervention, evaluation, Pakistan.