News Updates

The second batch of training of midwifery tutors (TOT) in “Client Centered Family Planning Services” (CCFPS) has started at Islamabad on March 08, 2011. The training has been organized by FALAH | Population Council in collaboration with National MNCH Program. The training is scheduled from March 08 to 17, 2011.
In this workshop, there are 24 participants from 12 districts;

There are 2 Supervisors as Observers- One each from Sindh and Baluchistan Provincial MNCH Offices.
Earlier, during the month of February, 24 midwifery tutors from 12 districts of Punjab and KPK have already been trained in CCFP. Subsequently these trained CMW tutors will train all the graduated CMWs at their midwifery schools.  
“Client Centered Family Planning Services” (CCFPS)
CCFPS is basically a training of ‘Counseling for Birth Spacing’. The prime objective is to strengthen the counseling skills of the CMWs regarding birth spacing (Healthy timing and Spacing). Approach of this training is holistic one. Concepts of self awareness, empathy and human behavior are central and form the basis of this training. Interpersonal communication skills are an important part of this training and participants practice these skills through innovative exercises e.g. role plays, group practice, videos, games, and energizers.  These concepts then converge on real life clinical situations and a practical checklist of steps of counseling evolve through discussion, comprising the four major steps of Salutation, Assessment, Help and Reassurance (SAHR).  Half of the training time is spent on technical learning of contraceptive methods and technology. Through this all the methods of birth spacing are introduced and latest information is shared.
The main objective to train the midwifery tutors is to (in turn) impart CCFP training to the CMWs who have been graduated. However, this would also serve to train the CMW students who are still under training at the midwifery school, through their tutors.

National MNCH Program is partnering with FALAH | Population Council to build the capacity of MNCH program to implement the training of service providers and CMWs in “Client Centered Family Planning Services” (CCFPS). This includes preparing the master trainers at provincial and district levels and to train the CMW tutors through training of trainers. Overall 48 CMW tutors will be trained through two TOT workshops. These trained midwifery tutors will in turn train all the graduated CMWs in CCFPS through a 6-day training at their respective midwifery schools. Each training batch of CMWs would comprise of 20 CMWs. FALAH| Population Council would ensure quality supervision of these step-down trainings.
As a first step, FALAH | Population Council is conducting the first 10-days training of trainers (TOT) workshop at Islamabad Hotel to train the midwifery tutors in “Client Centered Family Planning Services” (CCFPS) from February 01 to 10, 2011.
In this workshop, there are 24 participants from 12 districts;

• Khyber Pakhtunkhwa (5 Districts – 10 Participants)
• Punjab (7 Districts – 14 Participants)

There are 2 supervisors as Observers- one each from Punjab and Khyber Pakhtunkhwa provincial MNCH Offices and 2 training supervisors from NMNCH Program Office Islamabad
Dr. Farooq Akhtar, National Program Manager, National MNCH Program Islamabad was the chief guest at the opening ceremony. Dr. Farooq Akhtar congratulated and praised the efforts of Population Council, for organizing the training.

A letter of agreement has been signed between National Maternal, Neonatal and Child Health Program and Population Council (FALAH Project) on December 14, 2010.
The Population Council (FALAH Project) will support the MNCH Program in the following areas:

1. Communications
2. Training and Capacity Building
3. GIS Mapping

The LOA signed by the parties is an umbrella document for collaboration. Specific operational details of activities undertaken with reference to the LOA will be discussed and agreed subsequently.
The LOA has entered into force from the date of signature and shall continue from 2010 till December 2011

On July 25, 2010, the National MNCH Program and Health Services Academy organized "New Evidence in Maternal, Neonatal, Child health & Family Planning in Pakistan" Conference. Guests included Minister of Health, Secretary Health and Director General Health, Government of Pakistan.

The key objectives of the conference were to bring together the researchers to deliberate on evidence created and illustrated, to share the experiences of service provision during complex emergencies and to deliberate on how various evidences produced can be main streamed into the MNCH Program for achieving MDGs 4 & 5.

On July 25, 2010, the National MNCH Program Balochistan organized Provincial MNCH Communication Implementation Plan Meeting at Serena Hotel Quetta.  The key objectives of the meeting were to share the National MNCH Communication Strategy Framework with Provincial Stakeholders and develop an Provincial Implementation Plan for National MNCH Program. The activity was conducted with the financial and technical support of Save the Children. Different organizations working for the betterment of the MNCH in Balochistan participated in the provincial planning meeting and pledged commitment for different activities agreed upon in the implementation plan. 

The Provincial Secretary Health Dr Muhammad Jalal Mandokhel honored the meeting with his presence. The National Program Manager MNCHP, Dr Farooq Akhter along with Dr Yousaf Bazinjo were also present in the meeting. The other key participants included representatives of Provincial MNCHP, Provincial Lady Health Workers Program, UNICEF, Save the Children, Balochistan Rural Support Program (BRSP), President Primary Health Initiative (PPHI), Mercy Corp, UNFPA, Institute of Public Health (IPH), Community Midwifery Training School and federal office of National MNCH Program. Mr Ihatsham Akram, the Manager Communication, Advocacy and Research (MNCHP/Save the Children) facilitated the meeting and made a presentation on the National MNCH Communication Strategy Framework. A provincial implementation plan was developed through discussion and consensus.

The partner organizations pledged resources within their existing programs and outside their own activities for the implementation of the different activities. A Provincial Advisory Committee was also constituted to look after the implementation of the activities. As advised by the Provincial Health Secretary, the implementation plan will be formally approved and notified to all partners so as to ensure their commitment for the cause of the MNCH in Balochistan. Further, the 15 unified messages along with the National MNCH Communication Strategy will also be notified at provincial level by Provincial Secretary Health for use at scale and bringing in harmony and reinforcement for Behavior Change Messages and uniformity in other efforts. Dr Farooq Akhter in her concluding remarks appreciated the efforts of the Balochistan MNCH Program and commitment of other stakeholders for coordinating their efforts to bring desired behavior change in communities. The Provincial Secretary Dr Muhammad Jalal Mandokhel emphasized the resolve to commitment of partners and offered all kind of support required from Provincial Health Department in this regard. 

On June 7, 2010, National MNCH Program Sindh organized a meeting for scaling up the use of National MNCH Communication Strategy Framework and developing its Communication Plan for Sindh. The National MNCH Communication Strategy is a national document of National MNCH Program developed for guiding the MNCH Communication efforts in Pakistan. The meeting was held at Indus Hotel Hyderabad. The UNICEF Sindh provided the financial support for holding this meeting..

The meeting was attended by representatives of Sindh Provincial Program Implementation Unit National Program for FP & PHC, Provincial Health Department and Provincial Health Education Cell. The non public sector organizations included UNICEF, WHO, UNFPA, FALAH, PAIMAN and HANDS.

 Dr Sahib Jan Badar chaired the meeting. The pre-noon sessions focused on information sharing through presentations on communication work of different organizations. The after lunch sessions focused the provincial implementation plan development through group work.  The participants were divided into 3 groups and provided with a template to be filled in by activities to be undertaken for demand creation and behavior change in communities for improving behaviors for healthy MNCH outcomes.  The follow up of the implementation will be done through Provincial MNCH Core Committee on communication.

National Maternal Newborn and Child Health Program (MNCH) consultative workshop on Monitoring and Evaluation  system (including Monitoring Frameworks, data collection, data maintenance, reporting mechanisms & utilizing evidence for management decision making) was held at  Bhurban between 3rd and 5th May 2010. The workshop was attended by National  Provincial and Regional MNCH coordinators including AJK, EDOHealth, district focal persons, Provincial M&E personnel, development partners including TRF, WHO, UNICEF , UNFPA & PAIMAN. National MNCH is one of the flagship program of the Ministry of Health in Pakistan. This program  has been envisioned to take the country close to the MDGs (Millennium Development Goals 4& 5) for which Pakistan is one of the signatories to UN. According to a paper published in Lancet in April 2010 Pakistan is among the six countries in the world which account for 50% of all maternal deaths. Annually 30,000 mothers and 420,000 children under 5 years age die in Pakistan  due to preventable causes. Skilled birth Attended delivery (Delivery by doctor, Nurse, Lady health visitor & Community Midwife) in Pakistan is 39% which is the lowest among our South East neighbors.

The National MNCH program with the support of TRF organized this consultative workshop in order to finalize the Monitoring and Evaluation system, plans and databases for the districts, Provinces and Regions of Pakistan including AJK. Dr.Sohail Amjad, Senior Results based Monitoring and Evaluation specialist  and Dr.Ali Yawar Alam, Monitoring & Evaluation Consultant and Section head Community Sciences of Shifa College of Medicine carried out this National work. This system would help the Ministry of Health in monitoring the progress of the program. Pakistan aims to bring the maternal mortality ration to 140 per 100,000 live births, skilled birth attendance  greater than 90% by 2015 and  under 5 mortality rate to 45 per 1000 live births by 2015. The Government of Pakistan is putting in a lot of efforts in improving maternal and child health by increasing skilled birth attendance rate through Community midwives training and deployment in rural areas, improving referral linkages between communities and  health facilities, improved Emergency obstetric services provision and human resource training. The outputs of the workshop were consensus on provincial and regional MNCH monitoring and evaluation frameworks with  annual milestones/targets, agreement on data collection tools/instruments and data flow mechanisms and responsibilities. A database for data maintenance and analysis was also shared and approved. The National Program Manager MNCH Program Dr.Farooq Akhtar thanked the participants of the workshop from the districts, Provinces/Regions and development partners for their valuable input for a strong M&E system for the National MNCH program.

The National MNCH program is making all out efforts to play a catalytic role in the expediting the country’s progress towards achievement of MDG 4 and 5. Important in this regard is its joining hands with Save the Children for the implementation of Newborn and Child Survival – EVERY ONE Campaign in Pakistan.

T h e E V E R Y O N E Campaign is a global Initiative of Save the Children to mobilize global action to reduce t h e n u m b e r o f preventable deaths of children under the age 5. The campaign has four pillars i.e dramatically increase health and nutrition programs on the ground, political and policy change, popular mobilization and income generation to be used to fund newborn and child survival programs. National MNCH Program of MoH would serve as the focal office for this Campaign and The campaign is being co-branded with MoH during its different activities. <<details>>

An important support to MNCH Program is coming through £18.3 million five-year Research & Advocacy Fund (RAF) programme, supported by DFID and AusAid. RAF is trying to play an important role to ensure researchbased evidence contributes to policymaking on MNCH by supporting research and advocacy on key issues.The National MNCH program is making all out efforts to play a catalytic role in the expediting the country’s progress towards achievement of MDG 4 and 5. Important in this regard is its joining hands with Save the Children for the implementation of Newborn and Child Survival – EVERY ONE Campaign in Pakistan.

T h e E V E R Y O N E Campaign is a global Initiative of Save the Children to mobilize global action to reduce t h e n u m b e r o f preventable deaths of children under the age 5. The campaign has four pillars i.e dramatically increase health and nutrition programs on the ground, political and policy change, popular mobilization and income generation to be used to fund newborn and child survival programs. National MNCH Program of MoH would serve as the focal office for this Campaign and The campaign is being co-branded with MoH during its different activities.

Save the Children on January 16, 2010launched its report titled 'Opportunities for Newborn Survival in Pakistan”. The report presents analysis of MNCH situation in Pakistan and brings forward the key areas which need to be focused for achieving MDG 4 & 5 in Pakistan.The authors have dwelled upon newborn centered maternal and child health development activities for achieving MDGs.

The speakers emphasized MNCHP as a key program for Pakistan's progress towards achievement of MDGs. At the end of ceremony shields were given to Dr Zulfiqar A Bhutta, Dr Nabeela Ali, Dr Farooq Akhtar, Dr Arshad Chandio for recognition of their efforts in improving MNCH situation in Pakistan.

National MNCH Program with UNFPA organized a seven days Training for Community Mobilizers and Public Private Coordinators of 10 districts where UNFPA and MNCH Program are working together. The deployment of Community Mobilizers and Public Private Coordinators is an innovative model being piloted to address the gaps with respect to community participation and private sector involvement for communities.

The Community Mobilizers will strengthen the linkages between communities and health facilities whereas Public and Private Coordinators will create linkages between Public and Private Sector health services providers for improvement with respect to data availability on morbidity and mortality.Through the training the participants acquired the understanding of district health system, social mobilization and advocacy.

An orientation workshop on Standards Based Management and Recognition (SBMR) was held at hotel Avari, Lahore on February 10, 2010.

The workshop was a joint venture of PRIDE project and UNICEF and was held to introduce SBMR tools to different stakeholders and also test application of these tools in settings other than the pilot districts. The infection prevention tools were tested at Lady Aitchison Hospital, Lahore. The Medical Superintendent of the hospital Dr Shaguf ta apprec iated the development of these tools and eagerly listened to the results of the assessment.

CMWs is a key intervention of the National M N C H Program. Different pilots have had
been done for drawing out mechanisms of the CMWs deployment. Some key initiatives in this regard are as follows:

UNICEF – MNCHP Community Midwives Pilot in Punjab: UNICEF and National MNCH Program Punjab have piloted deployment of 32 Community Midwives in Sheikhupura and Kasur. Over a period of 9 months, this batch has reported 1640 ANC visits, 256 deliveries and 147 referrals. A one day meeting with key stakeholders was held at Islamabad to share the mapping exercise for field deployment, linkages with Lady Health Workers and referral facilities, recording and reporting tools and a comprehensive communication strategy.

The knowledge generated through CMWs deployment pilot with UNICEF will facilitate National MNCH Program in devising a national strategy for CMWsdeployment so that the dividends of the Program start reaching the actual beneficiaries. Accelerated Education- An Intervention to address the Availability of CMWs in remote areas- PAIMAN Pilot: PAIMAN has piloted a tripartite Public Private Partnership initiative for accelerated education for CMWs of the National MNCH Program. A third partner Idara –e- Taleem –o- Agahi, a Pakistani educational sector NGO with Allam Iqbal University and supported MNCHP in identification and education of the women from the uncovered remote districts of NWFP and Balochistan. The lessons learnt through this initiative would definitely contribute to the Program is addressing the issue of CMWs availability in the uncovered districts. Establishing Community Birth Home in the Centre of the Village is a key to CMWs Success – UNFPA –MNCHP Model: UNFPA and MNCHP together are piloting a project in 10 districts of Pakistan in four provinces and Azad Jammu and Kashmir. The linchpin of this pilot is tha t CMWs need to be supported in establishing their Community Birth Homes. The Homes should be established in Centre of the Village for the effective delivery of services envisaged through this intervention. The pilot is expected to generate some key evidence for MNCHP in implementing its CMWs component.