09 January 2004	Friday	16 Ziqa'ad 1424

KARACHI, Jan 8: No government department and no non-governmental organization, in the absence of intervention from the top, can bring about a substantial reduction in the country's rate of maternal death.

So said some experts at a symposium on "Improved Access to Emergency Obstetrical Care", organized jointly by Unicef, the Health Oriented Prevention Education and the Women's Right to Life and Health here on Thursday. They underlined the need for the early formulation of a national policy on maternal health.

The speakers pointed out that despite opposition from the West, Pakistan had developed a nuclear weapon. Also, because the top leadership of the country wanted, the Pakistan Army was a formidable outfit.

Similarly, if the president or the prime minister really wanted, the rate of maternal deaths in the country could be reduced drastically in a short time. "So, it's just a question of political will," said one of the speakers.

The experts said every year more than four million babies were born in the country. About 80 per cent of the births took place in the homes of the parents. And 95 per cent of these births were supervised by traditional birth attendants or Dais.

According to the authorities, the country needed at least 50,000 midwives, they said. Some experts said about 100,000 midwives were required. "Whatever be the total number, the quality of training and education being imparted to the would-be midwives is below par," said one of them. He said there were more than 25 midwifery schools in the province but the quality of education in most of them was poor.

He said many "entrepreneurs" were willing to open medical colleges in two- or three-room bungalows but hardly anyone was interested in setting up a nursing or midwifery schools. "This issue needs to be looked into as soon as possible."

The delays that can lead to the death of a pregnant woman were discussed in detail during the symposium. The husbands of pregnant women needed to be sensitized about the delays, they said.

One of them said some men remained insensitive towards the health issues of women. "However, a majority became very sensitive towards these issues provided they were motivated." She underscored the need for healthcare professionals to come up with educational material to help sensitize these men.

The experts were of the view that drivers, who regularly took pregnant women to healthcare facilities, needed to be educated about the four delays which could cause maternal deaths. One of them pointed out that a programme had been chalked out in which the drivers of the Edhi Foundation's many ambulances were slated to be educated about the delays.

The speakers were of the view that the community needed to be involved in delivery of healthcare to the masses. One of the speakers spoke of his experiences in Khuzdar, Balochistan, where the community was not only involved in policy-making but also management of the healthcare facility there.

Issues in Private-Public Partnership (PPP) were also discussed. The experts said an MoU between a private organization and the senior bureaucrats was useless if the person in charge of a Rural Health Centre was not cooperative and sympathetic to the PPP initiative.

"Problems like non-cooperation may be reduced if the government official at the Rural Health Centre in question was given the importance he or she deserves." Women councillors should also be sensitized about issues in maternal health.

The media can play an effective role in this regard. One of the speakers said the newspapers and electronic channels were responsible for the increasing awareness of maternal health among the people.

"However, we have to go a long way yet." Another speaker criticized the insensitive manner in which some newspapers and TV channels covered certain issues and events.

The experts who took part in the deliberations included: Dr Mubina Agboatwala, Dr Shershah Syed, Dr Farid Midhet, Dr Nabila Ali, Dr Maria Tariq, Rukhsana Shaheen and Dr Sadequa Jaffery.