Three 'delays' keep infant mortality rate high

CHITRAL, April 25: Because of its remoteness, communities in Chitral are facing serious human development challenges. Maternal and infant mortality rates remain persistently high due to the ‘three delays’ i.e. delays to seek care, to reach care and to receive care. Keeping in view of the challenges, the Aga Khan Foundation is implementing since 2008 the ‘Chitral Child Survival Programme’ (CCSP) in partnership with the Aga Khan Health Service and the Aga Khan Rural Support Programme. The five-year programme is being implemented in 28 of the most remote and isolated clusters of communities in the district. The programme is in conjunction with Pakistan’s National and Provincial MNCH Programmes. All intervention areas have been reviewed and endorsed by the District Health Committee (DHC) of Chitral. Over the years, CCSP has made two significant achievements i.e. (a) training and deployment of twenty five ‘Community Midwives’ (CMWs) to enhance availability of skilled birth attendants at remote communities; and (b) establishing more than four hundred ‘Community-based Savings Groups’ (CBSGs) to reduce financial barriers in accessing skilled obstetric and neonatal care. The institutionalization of CMWs under the Government’s ‘Community Midwifery Initiative’ was made possible through a pioneering public-private partnership between NMNCHP and AKF (P). These CMWs are now providing low-cost, reliable, and accessible services to thousands of women. Whereas CBSGs with a total membership of around eight thousand people across Chitral are improving lives through a unique financing mechanism. The Research The cross sectional study, ‘Role of Community Based Savings Groups Enabling Greater Utilization of Community Midwives in Chitral District of Pakistan’ that was funded by the Maternal and Newborn Health Programme – Research and Advocacy Fund (RAF), tested the hypothesis that membership of women or of their family members with CBSGs is associated with greater utilization of MNH services provided by skilled providers particularly CMWs. As many as 908 women at 24 locations in the programme area were interviewed. Sixteen focus group discussions were held with four communities to understand the use of CMW services by women CSBG-members and non-members (6-10 men and women participated in each group discussion).  ]]>