KARACHI, April 10: Most of the government-run maternity homes, mother & child health centres and rural health centres in Karachi are simply incapable of providing comprehensive emergency obstetrical care, a scientific study and independent investigations show.

It is because of the absence of such capabilities that the rates of maternal and neonatal deaths have assumed dangerous proportions. Perhaps the only way to check the rising number of these deaths, which overwhelmingly occur in poor families, is by reorganizing the network of more than 30 state-owned maternity homes, mother & child health (MCH) centres and rural health centres (RHCs).

According to a comprehensive study involving a survey of 33 maternity homes, MCHs and RHCs — conducted with the assistance of UNICEF — none of the said health-care units are capable of providing emergency obstetrical care if globally recognized standards are taken into account.

Only 14 per cent of the units can provide basic emergency care. The rest of the facilities, that is 86 per cent, simply cannot provide comprehensive emergency obstetrical care, says the study.

It also says 20 units claim to be operating on a 24-hour basis. “However, in the absence of medical teams at night, it is unlikely that these facilities are able to offer any tangible services during the night.”

Another study, published in a reputable scientific journal, says more than 60 per cent of the deliveries take place in the night. This suggests that most of our maternity units remain closed when they are needed most.

In the meantime the UNICEF study — conducted by eight well-known doctors, says 57 per cent of the facilities surveyed have vehicles to shift the pregnant women if need be. “(However), only 29 per cent have the vehicles in working condition.

“The reasons cited are limited and inadequate maintenance and POL budget allocated for this item.”

Almost half the units surveyed don’t provide parenteral antibiotics, and more than one-third of the facilities make do without parenteral sedatives, according to the study.

The facility of assisted vaginal delivery is not present in almost half the units surveyed. “And except for four facilities, there is no arrangement for blood transfusion.”

One of the reasons of lack of quality services is inadequate human resources available. “In many units, staff have not been posted against the sanctioned positions... This results in little functioning in the day, and no functioning in the night.”

The study says in none of the facilities are postgraduate students working to earn experience, which is a qualification for becoming a qualified gynaecologist or obstetrician. “The induction of postgraduate students is one of the measures which can be undertaken to overcome the shortage of qualified staff.”

Meanwhile, Dawn visited two government-run maternity homes on Tuesday, between 4pm and 5pm. At both the units — the Liaquatabad Maternity Home and SSMK Maternity Home — this reporter was greeted by rows of deserted corridors and locked rooms.

A Lady Health Visitor at the SSMK Maternity Home in the Soldier Bazar area — Parveen Nafis — said there were about 30 beds in her unit. “But only four or five are occupied at this point in time,” she said.

In response to a question, she acknowledged that her facility remained underutilized. “Nowadays the people are richer than the governments. That’s why the government hospitals and clinics present a deserted look.”

The women after delivering their babies don’t stay long at the maternity home, added Ms Nafis. “In the past we used to provide meals to the patients. Those were the days when the patients used to stay for three or four days after delivery.”

A watchman at the Liaquatabad Maternity Home told this reporter that the doctors didn’t stay in their offices after 2pm. He said some nurses were present.

He took Dawn to an office at the first floor. Five nurses, apparently busy in idle talk there, admitted that their maternity home didn’t have the capability to undertake surgical operations round the clock.

“But we are soon going to have an operation theatre which will be open 24 hours a day,” said one nurse.