White Ribbon Alliance

Pakistan

White Ribbon Alliance Pakistan

Ihatsham Akram
National Coordinator


Ihatsham_Akram_WRA

Tel: 0092-51-2100808
Fax:0092-51-2293060

IAkram@whiteribbonalliance.org

Capital City
Islamabad
Population
187,342,721
Lifetime risk of maternal death
1 in 110
Maternal Mortality Ratio
260
Births attended by skilled personnel
39%
Source: World Health Statistics 2015, WHO
Countdown to 2015: Maternal, Newborn, & Child Survival. Click here for the Pakistan country profile.
Although the annual number of maternal deaths in Pakistan dropped from 18,000 in 1990 to 7,900 in 2013, not enough progress was made to achieve Millennium Development Goal 5 - a reduction in the maternal mortality ratio by three quarters.

For many years, White Ribbon Alliance Pakistan (WRA Pakistan) has sought to influence the government and advance improvements in maternal and newborn health. The Alliance has worked with all fourteen provincial and federal ministries of health and population welfare to scale up best practices around maternal health, advocating for the inclusion of magnesium sulfate (to reduce risk of eclampsia) in the provincial drug lists and the standardization of protocols for administering the drug.

Pakistan1

In 2014, WRA Pakistan recognized that the disrespect and abuse experienced by pregnant women was not recognized by the government as a barrier to improving maternal care. This was a critical challenge, as maternal healthcare strategies, protocols and education curricula did not mention Respectful Maternity Care (RMC). Citizens were not aware of their right to RMC and there was no accountability for disrespect and abuse. Therefore, WRA Pakistan brought together community members, health workers, government representatives, and the research community to generate evidence on RMC and use it to drive a campaign that persuades policymakers to include RMC in the legislation and training curricula for health workers.

CAMPAIGN

To foster change, WRA Pakistan relied on gathering evidence, developing partnerships, cultivating champions for the cause within the policy community, and participating in health networks.

For its campaign on RMC, WRA Pakistan has collected evidence via interviews and surveys with mothers and health workers. Citizens have testified to the abysmal state of maternity care. “Because of the way we are treated, we pray to never be sent to the hospital again,” admitted a survey participant in Sindh province. The next step will be to target policymakers to advocate for the inclusion of RMC in service delivery protocols.

WRA Pakistan is already engaging with a number of key organizations and projects associated with improving maternal health and newborn care across the country to include RMC as an important component of their work. For example, WRA’s work with the USAID-led Maternal and Child Health Integrated Program (MCHIP) will generate more support for RMC at the National Policy Seminar. A partnership with high-level partners, such as Jhpiego, will allow the Alliance to leverage their technical capacity to include RMC into the standards of quality of care. With UK Department for International Development and Futures Group, WRA Pakistan will work on including an RMC module into a community based monitoring process, which will allow citizens to report on instances of disrespect and abuse. This effort will ultimately reach 24 million people.

Once the research and data-collection are complete, a national consultation will be organized to build consensus and fine-tune the policy recommendations that will be presented to policymakers.


For a more detailed account on our work in Pakistan, please see this case study.



RESOURCES

Respectful Maternity Care (RMC)

Formative Research: Respectful Maternity Care in Pakistan
Information Brief: Respectful Maternity Care in Pakistan

Barriers to Magnesium Sufate (MGSo4)

Policy Brief - MGSo4
Policy Brief for Professional Organizations
Resource Pack