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Improving Maternal Health in Pakistan: 10 Years On

Maternal Health in PakistanMaternal health in Pakistan has been a major issue over the years and has consistently shown many negative outcomes. This suggests that the women of Pakistan are not receiving the attention they require in their months of pregnancy. In 2020, the maternal mortality rate was 154 per 100,000 live births. And as of 2021, Pakistan’s infant mortality rate was 53 per 1,000 live births. The prevalence of low birth control, alongside a disorganized medical system, creates an atmosphere of risk and danger for expectant mothers.

Norway-Pakistan Partnership Initiative

Established in 2009 by U.N. agencies UNICEF, WHO and the United Nations Population Fund (UNFPA), the Norway-Pakistan Partnership Initiative (NPPI) aimed to reduce barriers that prevented pregnant women from accessing safe and reliable medical care in the province of Sindh. This involved strengthening health care systems through better support and using flexible financial approaches to improve the provision of maternal health care.

The project ended in 2013 with underwhelming research that assessed the impact of the NPPI. The overarching narrative was that the project had an insignificant effect on the participating communities. Although there have been some improvements, the rate at which pregnant women are accessing health care has only increased marginally. Despite this, reports indicated the following successes from the NPPI:

  • Support for female health workers: The NPPI created functional community networks in 80% of the participating villages.
  • Creation of an incentive scheme: The rollout of a successful voucher initiative saw 35% of pregnant women using the vouchers to seek medical care.
  • Provision of support and outreach services: All female and community health workers received full training in newborn, infant and child health care.

A Decade Later

A decade after the end of the NPPI, checking back in to assess how maternal health in Pakistan has weathered the recent years, especially through the pandemic, reveals the following. Approximately 20% of all deaths among women of childbearing age are due to pregnancy complications, specifically hemorrhaging and sepsis. The COVID-19 pandemic has also profoundly impacted maternal health in Pakistan. With a sudden lack of available hospital beds, many women found themselves unable to access the medical attention they required as they carried to term. Delays in emergency services and poor organization in facilities have also directly impacted increased maternal and infant mortality.

Rurality and Education

An intersection between education and location has also been identified. In a 2019 study, researchers with the National Institute of Population Studies linked low education levels and rural localities in Pakistan with poorer maternal health outcomes. Maternal mortality was 26% higher in rural areas compared to urban counterparts. Additionally, significantly more women in rural areas are less educated than women in urban spheres. About 96% of educated women sought medical care during their pregnancy compared to 50% of uneducated women. These recent maternal health indicators and contributing factors suggest that education and rural access to medical facilities need to be targeted in future interventions to improve maternal health in Pakistan.

National Committee for Maternal and Neonatal Health

Established in 1994, the National Committee for Maternal and Neonatal Health (NCMNH) is dedicated to reducing the high maternal mortality rate in Pakistan. Its goal is to advise policymakers on effective policies that reduce and prevent maternal and neonatal deaths. So far, the committee has:

  • Assisted the Ministry of Health in the development of the Maternal Health Section policy in 2001.
  • Introduced WHO technologies, including post-abortion care in Pakistan.
  • Established a skills lab, or a medical facility that conducts skill training, equipped with modern medical technology to complement the abilities of Pakistan’s medical professionals.

Bakhabar Noujawan Course

Currently, the NCMNH is developing a course to promote and educate young girls on reproductive health. This is a crucial factor that directly correlates with poor maternal health indicators. Aimed at women aged 15 to 29, the Bakhabar Noujawan course involves educating students about how to maintain and navigate reproductive health. The vision is that participating in this course will contribute to these women’s credit in their educational institutions while encouraging them to become more involved in their own health.

Looking Ahead

Despite the persisting challenges, efforts to improve maternal health in Pakistan have shown some promising developments. Initiatives like the Norway-Pakistan Partnership Initiative have supported female health workers, implemented successful voucher systems and provided comprehensive training. Also, the establishment of the National Committee for Maternal and Neonatal Health and the upcoming Bakhabar Noujawan course demonstrate an ongoing commitment to reducing maternal mortality and improving reproductive health education. Overall, these initiatives hold the potential to make a positive impact on the well-being of women in Pakistan and pave the way for a healthier future.

– Ariana Mortazavi
Photo: Flickr

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5 Organizations Ending Child Marriage in Pakistan

Child Marriage in PakistanIn most areas of Pakistan, the legal age for marriage is 16 years old. Yet, millions of children are a part of marriage contracts prior to reaching this age. Child marriage disproportionately affects Pakistani girls, with UNICEF estimating that in 2022, 4.6 million girls became brides before they reached 15.

Several factors cause child marriage in Pakistan, including patriarchal social norms and economic reasons. Poverty in the nation leads poorer families to marry off their daughters so that they no longer have to economically provide for them.

Child marriage has many negative repercussions for young girls, including an increased risk of being in an abusive marriage, falling pregnant before being physically prepared for childbirth and not being able to complete their studies. Fortunately, there are numerous charities operating to end child marriage in Pakistan.

5 Organizations Ending Child Marriage in Pakistan

  1. Blue Veins: Blue Veins is a charity based in Pakistan which is operating since 1999. Since its creation, its mission has been to better the lives of women, children and transgender people through social change. Ending child marriage in Pakistan is among the charity’s highest priorities. Through its Power to Girls campaign, it has worked to make this goal a reality. The campaign involves creating public awareness of the dangers and realities of child marriage and encouraging policymakers to develop legislation that will protect children from being coerced into marriage contracts before reaching the legal age.
  2. United Nations Population Fund (UNFPA): The UNFPA is an agency responsible for improving women’s reproductive health worldwide. Its work in Pakistan involves empowering women through developing health care and ending child marriage. The UNFPA collaborates with multiple organizations to safeguard children’s rights and support them against being pressured into underage marriage. It researches and advocates for protective legislation and it provides reproductive health guidance and services to girls across the nation. The agency also supports child brides in Pakistan who cannot exit their marriages by providing them with health care and reproductive education. Additionally, it offers counseling services to survivors of underage marriages to aid their mental well-being.
  3. Girls Not Brides: Girls Not Brides is an international NGO made up of more than 1,600 organizations that share the mutual goal of ending child marriage globally. Its work focuses on developing local change. For example, it holds interventions with local and religious leaders in rural communities in Pakistan to educate them on the negative impacts of child marriage on girls and to inspire them to put a stop to the practice within their communities. It also commits to equipping girls with the confidence to refuse marriage at a young age. Girls Not Brides has created safe space programs which provide girls with life skills and the chance to access economic independence through cash transfers.
  4. Save the Children: Founded in 1919, Save the Children is an international charity that aims to alleviate the struggles that children living in poverty face. This involves working to end child marriage in nations where the practice is commonplace, including Pakistan. Save the Children believes that the most effective way to end child marriage as a practice is to champion education for girls and equip them with life skills that will enable them to reject marriage offers at a young age.
  5. Bedari: Bedari is a Pakistan-based NGO that focuses on protecting women’s and children’s rights. Female Pakistani professionals who believed that women and girls living in abusive households lacked the support they needed to be able to escape founded the organization in 1991. The founders of Bedari aimed to create an organization dedicated to helping women in violent domestic situations. Since the organization’s inception, it has extended its work to preventing child marriage in Pakistan. Bedari partners with donors to carry out programs designed to put a stop to child marriage. For example, Bedari worked with the Commonwealth of Learning, Canada, to create the GIRLS Inspire project. This project operated in the Punjab region of Pakistan and aimed to raise awareness among communities about the negative impact of child marriage. The organization achieved this through theatre performances and education sessions for parents and local leaders to encourage them to eradicate the practice. It also offered self-growth sessions for girls to inspire them to stand up for their rights.

The Future

Child marriage in Pakistan remains an issue affecting millions of young girls. The consequences of underage marriage for girls include a deterioration of physical and mental health and a lack of economic and personal freedom. On the bright side, there are charities that publically highlight the dark reality of child marriage in Pakistan. And these organizations continue making efforts to put an end to the practice.

– Mohsina Alam
Photo: Flickr