By: Shahid Husain
Karachi: The three-day National Midwifery Conference concluded on Wednesday, highlighting the maternal and newborn health challenges across Pakistan, especially in Sindh where approximately 2,000 women die during childbirth every year and an estimated 46,000 newborns die in their first month of life.
The conference with over 300 midwives in attendance was organised by the Midwifery Association of Pakistan (MAP) in collaboration with USAID’s Maternal and Child Health (MCH) Program (implemented by MCHIP/Jhpiego) along with United Nations Population Fund (UNFPA), International Pregnancy Advisory Services (IPAS) and the Sindh government’s Maternal, Neonatal and Child Health (MNCH) Program.
The three-day conference highlighted the maternal and newborn health challenges across Pakistan, particularly in Sindh where approximately 2,000 women die during childbirth every year and an estimated 46,000 newborns die in their first month of life. Most maternal and newborn deaths can be prevented through timely and appropriate care by skilled providers, yet 20 per cent of pregnant women in Sindh receive no antenatal care during their pregnancies. Four out of every 10 women in the province still deliver at home, and more than half of newborns in Sindh do not receive any health examination after birth.
The midwifery conference brought together leaders from hospitals and academic institutions across Pakistan: to emphasise the importance of midwives in the community; review the latest global evidence on midwifery care; and build leadership skills among midwives. A total of 24 capacity building and skills sessions were conducted, with many focussing on how to address the leading causes of maternal and newborn deaths; newborn resuscitation using the “Helping Babies Breathe” approach; newborn sepsis prevention using chlorhexidine; and prevention and management of postpartum hemorrhage. Other topics included respectful maternity care, family planning and gender-based violence.
Recognising the contribution of midwives as skilled providers in Pakistan, chief guest Michael Dodman, US Consul General in Karachi, said: “Celebrate yourselves! Stop for a moment and think about all you do for others, the impact you have on health statistics, on the emotional health of those you serve and the safety and wellbeing of mothers and newborns everywhere. Think of the changes you have compelled the medical world to make: increasing rate of midwife-attended birth, better support of breastfeeding, family centred birth being made increasingly available in hospitals, respect for alternatives to mainstay interventions, and much, much more.”
Many of the conference participants were community midwives, who are uniquely positioned to provide life-saving care to mothers and newborns. This new cadre of community midwives, however, needs support to build a solid midwifery practice in their community. MAP is one such source of support for these midwives. MAP plays the pivotal role in promoting midwifery as a profession in Pakistan and supporting its members to provide quality care in the communities they serve. MAP works with the Sindh government’s MNCH Program and numerous development partners to increase the numbers of community midwives; improve their skills through training and on-site mentoring; and promote greater awareness among women and families of the valuable services that the midwives offer.
President MAP Dr Rafat Jan said: “I consider MAP not just a professional organisation but also one of the strongest civil society institutions that works for the mothers, newborns and children as well as for early childhood development. We support midwives to gain confidence and develop into leaders through exposure to global standards, competency-based training and evidence-based practices.”
Talking to The News on the second day of the conference, Midwifery Adviser MCHIP (Maternal and Child Health Integrated Program)/Jhpiego, Farida Shah said the people of Pakistan are not getting quality care in hospitals because “better people” are leaving the country due to a host of factors, including sectarian killings.
Asked where were the above mentioned segments of society migrating, she said: “Nowadays brain drain is towards the Gulf countries because new hospitals are coming up there. It is also towards the United Kingdom, Canada and the USA”.
On a query that what would be the repercussions of brain drain, Farida Shah said, “There are multiple layers of repercussions; first the people who are well qualified or meeting international standards are leaving the country. The cream is leaving! The people of Pakistan are not getting quality care in hospitals because better people are leaving the country.”
When asked whether she has any intention to leave Pakistan, she said: “I don’t have any intention to leave my country. In case I go abroad I will go for higher education”.
Asked which country she would prefer to go for higher education, she said: “I will prefer to go to the US because the quality of education in the US is well standardized. But since I am more needed in my country, therefore, I will come back”.
On a question why she has such a strong affinity with Pakistan when tens of thousands of people were leaving the country for good, she said: “My ancestors were freedom fighters. You know Chitral was an independent state until 1960s. My grandfather Pir Syed Munawar Shah was with Muslim League. He was put in jail by the royal family of Chitral when he hoisted Pakistani flag there after meeting prime minister Liaquat Ali Khan in Karachi. He was also tortured. ‘Garm tawey par khada kiya gaya’ He used to show us scars on his body when I was a kid and tell us about the sacrifices rendered by freedom fighters. My father Syed Moulaidin Shah was also put in jail when he was five years old to punish our family. I have plans to write a book. I have intention to jot down all these things. It’s a matter of time”.