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IN THE wake of devolution of health management at district level, integrated planning is the key factor to prepare health plans at district level. Women friendly health system acted as pioneer initiator in this field. District health management teams comprising of all stakeholders were constituted and trained in integrated planning and management of health issues and are working successfully.
Globally an estimated 600,000 women die each year of treatable complications of pregnancy and child birth. Of these deaths, 99 percent occur in developing countries, where the life time risk of maternal death is approximately 100 times higher than that in the developed nations of the world.
Advocacy and awareness has a key role to play for drawing much needed focus on this area which remained overlooked for a long time thus leading to disparities and imbalances in access to women health services. This has resulted in far from satisfactory maternal and neonatal health indicators.
Focus on women and child specific programmes are essential in almost all the spheres of life to alleviate gender disparity. Moreover to achieve the health related targets of Millennium Development Goals (MDGs) an integrated and holistic approach is required.
The government recognises and acknowledges the access to essential healthcare as basic human right. "This is the reason that the vision of our health policy is health for all", said an official of the ministry of Health.
This commitment is reflected in our national health policy which envisages promotion of gender equity in the health sector as one of the key areas and focuses on provision of reproductive health services, and access to quality primary healthcare services, he added.
This commitment, he said is translated through programmes and projects conceived and implemented to address the serious situation of maternal health including national programme for family planning and primary healthcare, national nutrition programme, national EPI programme and women health project launched in 20 deserving districts.
Mrs. Shaheen Masud, Project Director, Women Health Project (WHP) said the project was launched with the major objective of reducing maternal and infant mortality and morbidity through increasing the availability of quality and timely healthcare services.
Women Health Project's contribution for improvement of the health of women, girls and children can be assessed from the fact that at federal level the project recruited 8000 Lady Health Workers for expansion in primary healthcare activities. This was also to support the ongoing reproductive health related research activities at the National Institute of Health (NIH).
Women Health Programme was also instrumental in strengthening the recently established PIMS Satellite Hospital with top of the line equipment for MNCH services amounting to Rs 73 million. Nursing profession always remained at the backburner at the policy level. WHP seriously identified issues hampering quality of nursing care and recommended a comprehensive framework to the government for improvement for this sector.
Dr Shazia Khan, a Gynaecologist said the maternal mortality rate can only be reduced through the integrated efforts comprising of strengthening of services for safe motherhood, making friendly health system for women at district level and behavioural change through effective communications etc. She urged for doctors training in the prevention of common gynaecological problems at primary level. She said the government has started some programmes related to women health particularly at local level.
An official of Health Ministry said the Ministry has recently initiated a major project worth Rs 27 billion of National Maternal, Neonatal and Child Health (NMCH) Programme, which will be implemented over the next five years.
The project is expected to enable the country in reducing its maternal mortality ratio by 2015, reducing child mortality rate by two thirds, reducing infant mortality rate by two third and reducing neonatal mortality rates by a half.
Similarly, another project of Rs 420 million named National Programme for early Detection and Treatment of Breast Cancer has also been initiated as a part of which free mammography and screening services will be made available at five centres expected to be made functional in few months.
At provincial level the project completed additional work and rehabilitated health outlets. These include eight District Headquarter, 17 Tehsil Headquarters and 36 RHCs in Punjab. In Sindh the project completed civil works at 12 Tehsil Headquarters, 500 Basic Health Units, eight Schools of Midwifery and hostels and 55 MCH Centre. Similarly, civil works at four DHQs, two THQs, seven RHCs and eight Civil Hospitals were completed in NWFP.
In Balochistan, the districts selected for the project were the least developed and scattered in Baloch and Pashtoon area.
The project management, with the incessant efforts completed civil works at 61 BHUs, 80 health units and residences of these facilities.
It also addressed the weaknesses of referral linkages by providing 41 ambulances in Punjab, 20 ambulances in Sindh, 11 ambulances in NWFP and 10 in Balochistan.
The project contributed tremendously in the quality of healthcare by providing medical and general equipment and essential medicines in the project districts.

Copyright Associated Press of Pakistan, 2007

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