Stregenthening the Skills of Midwives in Pakistan

UntitledAn evaluation of the skills of recently-trained community midwives (CMWs) by the Population Council shows that the quality of service provision by CMWs needs substantial improvement. By setting up internships for CMWs with health providers of Greenstar network the RAF project aims to build the capacities of CMWs to provide higher quality services. Provision of opportunity to graduated CMW for improving their:

o Clinical Skills (clinical quality of care)

o Basic Business and & Communication Skills (perceived quality of care)

The internship will emphasize on the importance of CMWs’ work in providing services to rural women who do not have the independence to obtain services essential to their health. An experimental design using a structured instrument was used to evaluate the effectiveness of the proposed intervention. This design was providing baseline and follow-up samples of CMWs from the intervention and control groups. Both qualitative and quantitative research methods will be used to collect the data before and after the intervention. The findings will have strong implications on policies as they will test an approach utilizing an existing resource (providers in the Greenstar network) for practical training of CMWs in maternal and child health service provision.

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Polio Spreads in East Africa

Somalia PolioThe polio outbreak discovered in Somalia this May caused concerns that it would spread to neighboring countries. Today we learned of the first case of polio in Ethiopia since 2008. A total of 105 cases of polio have been recorded this year in Somalia. That is 5 out of every 9 cases of polio around the world.

“It’s very worrying because it’s an explosive outbreak and of course polio is a disease that is slated for eradication,” said Oliver Rosenbauer, a spokesman for the Global Polio Eradication Initiative at the World Health Organization in Geneva to TIME.

“In fact we’re seeing more cases in this area this year than in the three endemic countries worldwide.”

VOA reports on the latest outbreak:

Carol Pandak heads Rotary International’s polio eradication program.

“It’s not surprising that the virus is spreading. This area has been considered high risk because of its proximity to Somalia,” said Pandak.

A Somali refugee camp in Kenya has also seen 12 cases of the paralyzing disease this year.

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Celebrating the life-saving action of breastfeeding

Today is the last day of World Breastfeeding week. The days prior were established by the World Alliance for Breastfeeding Action, WHO and UNICEF to emphasize the value of breastfeeding for mothers and children. Breastfeeding is an important means to protect children from illness and even death. Infants who are not exclusively breastfed are 15 times more likely to die from pneumonia and 11 times more likely to die of diarrhea, the two leading killers of children under five. Although breastfeeding is the world’s most effective solution to reducing child deaths, global breastfeeding rates have stagnated at below 40 percent for two decades. But it is not too late to encourage mothers to give their babies the best start in life.

The television commercial shown below, which aired last month in Pakistan, is produced by a maternal and child health program funded by USAID. Greenstar, PSI’s network member in Pakistan, is one of the implementing partners for this program.

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Dispelling breastfeeding myths in Pakistan to boost child health

TVC-ImageBy Ayesha Leghari, DGM-Behavior Change Communication, MCH Program, Greenstar Social Marketing Pakistan

When my eldest son was born I was told by the elders of the family to dispose of the thick yellow breast milk since it was considered dirty and stale. Having no knowledge on breast milk, I showed no hesitance in wasting it since it did seem stale to me. With the birth of my second baby, because of my experience the first time, I didn’t hesitate to waste this think yellow milk within the first hour of giving birth.

I learned just how wrong I was to waste the milk when I joined the Maternal and Child Health program. A pang of guilt ran through my body when I learned that the “stale think yellow milk” that I had so promptly wasted was filled with the most essential nutrients that I could have given my newborns. I felt like a bus of real truth knocked me out.

The gift of nature that is casually wasted in Pakistan and other developing countries and is commonly referred to as dirty or stale milk is actually called Colostrum. Research studies have proved that “colostrum is very rich in proteins, carbohydrates, vitamin A, and sodium chloride.” These vital nutrients help newborns fight off viral infections, reduces the chances of diarrhea (the leading killer of children) and prevents jaundice.”

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Stories from Pakistan: Mukhtar

By Ambreen Saleh, Deputy General Manager, Communications, Greenstar Social Marketing Pakistan

Mukhtar lives in a semi-urban part of Mohalla Gharib Abad, Multan. He lives in a community of 3000 to 4000 people, mostly uneducated laborers from a low-income background, who earn a meager income of Rs. 400 ($4) a day. He is an honest and hard working man who cares for the welfare of his family, but worries about how to keep them well-fed, healthy and educated. Mukhtar has four young children since both he and his wife were unaware on how to space births. His dream is sending his children to school some day.

Recently, Mukhtar met with Zahid, a health worker, at an awareness session held for men in the community. Zahid encourages men to play a responsible role in planning their families by preventing unintended pregnancies. Zahid directed Mukhtar to a nearby general store, where a range of condoms is supplied by Greenstar at affordable prices. The owner of the general store also manages a small tea corner for the men of the community. His advice is valued and he educates men on healthy birth spacing as a means to lead a better quality life within their meager income. He encourages Mukhtar and other men in the community to visit him regularly and comfortably, to obtain a supply of condoms.

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Stories from Pakistan: Meeting Sitara

In June 2012, along with a team from IPC, I visited a client in Sector 5 F, Karachi. A young mother of five children, she had been contacted by an outreach worker from Greenstar, and encouraged to seek family planning support from a nearby Greenstar clinic. With encouragement and information from the outreach worker and the health service provider at the Greenstar clinic, she had adopted the PPIUCD method. Although this young client was facing serious financial difficulties in life, and working as a cleaning lady at the same time as looking after her children, her defiance, resilience – and desire to make life better for herself and her family – caught the attention of the outreach worker Tasleem. This client became “Sitara”- the “star”, and symbolic of many women in Pakistan. Her story featured in the second issue of “Voice of Sitara”.

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Stories From Pakistan: Sitara

By Ambreen Saleh, Deputy General Manager, Communications, Greenstar Social Marketing Pakistan

Sitara lives in Suraj Miani, near Multan, Punjab. She lives in a village of about 4000 to 5000 people who are Siraiki speaking. Most people in her village are from a low socio-economic background. Her husband is a mason and earns around Rs 8000 to Rs 9000 ($81- $91) a month. They have five children and they all live together in a two bedroom house.

Sitara’s life is representative of the lives of many women in Pakistan.

The couple is frequently under the financial, mental and emotional pressure of surviving and looking after their many children. She was approached by a community educator from Greenstar, who explained the various methods available for her to look after her health and plan the size of her family.

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Challenges and Promise for Polio Eradication

Two years have passed since the last case confirmed case of polio in India. In 2009, India represented more than half of all cases of polio in the world with 741 cases. The achievement of eradication in two years and the sustained gain over the next two years is a testament to the successful implementation of India’s polio vaccination program. The problem of polio is nearing its end with only three countries, Pakistan, Nigeria and Afghanistan, categorized as polio endemic.

The Wall Street Journal’s India Realtime blog marked the occasion yesterday by noting what India is doing to keep polio from coming back.

To prevent polio from resurfacing, every year the government organizes two national immunization days. As many as 170 million children are immunized each time. Health workers also go door-to-door to check whether children have been vaccinated.

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Pakistani Children to Receive Pneumonia Vaccine

Pakistan becomes the first country in South Asia to introduce the pneumococcal vaccine following today’s announcement by Mir Hazar Khan Bijrani, Minister, Inter Provincial Committee (IPC). The government of Pakistan will partner with the GAVI Alliance, UNICEF, the WHO and civil society to tackle a problem that kills an estimated 1.4 million children under the age of five around the world each year. Of that number, roughly 80,000 Pakistani children die from pneumonia each year.

“Today’s historic introduction of pneumococcal vaccine underlines our commitment to the children of Pakistan,” said Helen Evans, deputy CEO of the GAVI Alliance. “Through our partners on the ground and working with the Government of Pakistan we aim to reach millions of children with this lifesaving pneumococcal vaccine.”

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Groundbreaking Intervention Will Save Infants' Lives

The application of chlorhexidine on a newborn’s umbilical cord soon after birth can greatly reduce the risk of infection. A recent study in The Lancet looked at the application of this simple intervention in Bangladesh and Pakistan. The effectiveness of the intervention was documented in prior study done in Nepal, and these two new studies further confirmed that it could save lives in low resource settings.

Data from 54,000 newborns in these two studies and Nepal, showed an aggregate 23% reduction in neonatal mortality, excluding deaths in the first few hours of life, and a 68% reduction in severe infections when comparing the intervention group to the control group. That is stunning.

Four percent Chlorhexidine (7.1% chlorhexidine digluconate ) is currently in use in Nepal for umbilical cord care, The price of a packaged product is estimated between US $0.11 and $0.43. To ensure uptake, product optimization (packaging and consistency) works are underway.  For example, studies show that the gel form of 4% chlorhexidine is preferred in Nepal. On the other hand, a Zambian study indicated a preference for the liquid form.

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