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PPF seminar “Giving Basic Priority To Women’s And Children’s Health”

Date: April 7, 2005
Location: Karachi

The Pakistan Press Foundation (PPF) organised a seminar for journalists on “Giving basic priority to women’s and children’s health” on Thursday, April 07, 2005 at its Vicky Zeitlin Media Library, Karachi.

The seminar was held to mark the World Health Day. The theme of 2005 was “healthy mothers and children,” and the slogan “Make every mother and child count” which reflects the reality that the health of women and children is still not considered as priority high enough among many governments and communities. Maternal and infant healthcare facilities in Pakistan were discussed in the seminar and speakers and participants made recommendations for improvement of the current situation of health care.

Dr. Shafquat Abbasi, Additional Secretary of Health, Government of Sindh; Dr. G. N. Qazi, Operation Officer for Sindh, World Health Organization (WHO); Dr. Shershah Syed, Secretary General, Pakistan Medical Association; Prof. Dr. Rubina Hussain, Head, Department of Gynaecology, Ziauddin Hospital and University and Prof. Iqbal Memon, Head of Paediatrics, Civil Hospital addressed the seminar. Samina Ishaq, Director, PPF conducted the seminar and journalists from print and electronic media participated in the seminar.

The speakers emphasised that the factors for such high maternal and infant mortality in Pakistan should be addressed as a mass awareness program with advocacy. Mothers and children should be provided with affordable life saving interventions as an essential human right.WHO Operation Officer for Sindh, Dr. G. N. Qazi said, ‘‘to reduce maternal deaths dramatically, all women needed access to high quality delivery care with at least three key elements including skilled care at birth, emergency obstetric care in case of complication and an effective referral system ensuring access to emergency care.

Dr. Qazi said despite the fact that 40 per cent (60 million) of the people live below the poverty line, the public spending on social sectors remained low. “Despite massive investment, fresh medical graduates are ill-equipped to take on the responsibility of addressing community needs warranting major reforms in medical curricula, teaching environment and methodology,” he added. “Gender inequity persists despite of religious instructions and national policies.

Other determinants of ill health are poverty, population explosion, malnutrition, gender inequality, unsafe water, lack of sanitation, improper waste disposal, environmental pollution, low literacy rate, unsafe deliveries, lack of community oriented medical education, low utilization of health facilities in rural areas, unhealthy lifestyles and lack of health awareness,” he told. Challenges for district health system, he said, were inadequate supportive supervision and monitoring, verticality in preventive programs, lack of human resource development for health care professionals and providers and lack of minimum quality standards at facility level and inadequate inter-sectoral collaboration and community involvement.

To address maternal mortality issues, he emphasized to ensure availability of antenatal, natal and postnatal care for women prior to and during labour and after birth. “Magnesium sulphate should be used to treat severe pre-eclampsia. Antibiotic prophylaxis should be used for women undergoing caesarean delivery. Assisted delivery is performed in cases of obstructed labour, while iron and food supplements should also be given routinely during pregnancy to prevent anaemia, he added.

Additional Secretary Health, Sindh, Dr. Shafquat Abbasi, spoke about provision of mothers and children’s healthcare in the proposed health policy. He said that they have ensured its effective implementation as well.To provide medical help to all in Sindh, there were about 17,000 Lady Health Workers (LHWs) and 5,000 Lady Health Visitors (LHVs) in the province, playing role in reducing maternal and infant mortality.

“We are also planning to launch a campaign and suggesting legislations for legal action against quacks. Media should play positive role to create awareness among masses about this campaign, “he urged. In the provincial health policy, he said, a valid suggestion for the government is to pay at least double basic
salary to healthcare providers (doctors, paramedics), working at Basic Health Units (BHUs) and Rural Health Centers (RHCs), while half of additional basic pay should be given to persons working at taluka facilities.

“This matter has already been discussed with the Chief Minister and he has approved the same. Now it will be implemented in one year after getting approval of finance department. We are making all out efforts to improve facilities in rural areas,” he maintained. Secretary General Pakistan Medical Association (PMA), Dr. Sher Shah Syed explained the role of his association and other such organisations, for improving the performance and responsible ethical practice of doctors attending to mothers and children’s health issues.

He said free education, emergency and primary healthcare and justice were the responsibility of government and it should be provided to people without any cost.”In Pakistan, our women are not empowered. In case of medical emergencies, delays are very common and frequent. First delay happens at home due to the lack of decision-making power in women at the time of emergency. The second delay happens during the way due to heavy traffic and the ignorance. Third delay takes place at hospital due to non-availability of necessary facilities,” he added.

Appreciating Sindh Health Policy, he said dignity of women must be honoured in the society to reduce maternal mortality rate. “Without realizing this responsibility, this goal can not be achieved,” he told. He termed accountability as an essential factor that urgently needs to be developed; at present, there is no concept of accountability for negligence in our medical practices. “The government should not interfere in the affairs of Pakistan Medical and Dental Council, and the PMDC should take strong action against doctors, held responsible for carelessness during their performance and medical practices,” he urged.

Head, Department of Gynaecology, Ziauddin Hospital and University, Prof. Dr. Rubina Hussain delivered talk on safe motherhood saying there was urgent need of interventions to overcome maternal mortality. “Gender inequity should be reduced, nutritional status before and during pregnancy be improved, girls access to education be increased and professional care should be delivered. Skilled attendance during labour and delivery must be ensured. Effective referral system should be built and emergency maternal care for all women must be ensured,” she recommended.

General Secretary Pakistan Paediatric Association (PPA) and Professor at Civil Hospital Karachi, Dr. Iqbal Memon discussed healthcare situation for infants and children.
He said that children, below 15 years age group, forms 45% of Pakistan’s population; such a large segment is entitled to the best, especially healthcare. Every newborn should have a safe and clean birth experience. The baby should be immediately dried and kept warm, preferably put on mother’s chest or stomach- it is a very safe beginning and forms a close bond between mother and child.

Breast-feeding should be started within one hour after birth, colostrums is enriched with all nutrients that protects the child from health problems, for years to come. Exclusive breast-feeding should continue for at least six months, he said. There are certain traditional practices such as giving ‘Ghutti” or honey to the newborn and not taking him out, to safeguard him from evil eye; these need to be ignored. A mother’s milk has all antibiotics and supplements, which no other supplement has.

“He said that researches prove that close family interaction provides security to the child, which stays on with the child as a personality trait. It is cruel to send a child to school before 5 years of age in this way the personality building control is handed to someone other than a child’s parents .Strict check must be kept on minor children while watching TV, play video or computer game for as it affects the growth of the child. Instead, children should interact with family members,” he stressed. He said marriages in early age must be stopped as majority of such girls face many complications during childbirth.

The seminar was followed by a question answer and discussion session.

List of Participants
Dr. Shafqat Abbasi
Additional Secretary of Health
Government of Sindh
Dr. G. N. Kazi
Operation Officer
Sindh World Health Organization (WHO
Dr. Sher Shah Syed
Secretary General
Pakistan Medical Association
Dr. Rubina Hussain
Head Deptt of Gynaecology
Ziauddin Hospital
Prof. Iqbal Memon
Head of Paediatrics
Civil Hospital