I congratulate all partners and stakeholders working for improving the lives of mothers and children in Pakistan on the signing of the Karachi Declaration by Ministry of Health and Population Welfare on October 1, 2009. This historic document is a pledge made by the decision makers of Pakistan along with representatives of donor organizations to scale up maternal, newborn, child health and family planning Best Practices in the country- a step that has the potential to help us make significant progress in achieving millennium development goals regarding maternal and child health.

As we are all aware that Pakistan has one of the highest maternal mortality rates in the world with estimates varying ,from 276 to 750 deaths per 100,000 live births. Similarly, with a child mortality rate of 94 per 1,000 live births the

country witnesses around 300,000 deaths of children under the age of five every year. The tragedy, and opportunity, is that most of these deaths and disabilities can be prevented through initiatives both at household and health facility levels. There is a need to take medium and long term measures to ensure that women and children enjoy their right to

life and health in Pakistan and that the country achieves the Millennium Development Goals 4 and 5.

While the health of mothers, newborns and children remains a challenge for Pakistan, examples of success in improving these indicators exist in the regional countries as well as Pakistan many of whom have demonstrated remarkable progress by adopting simple yet highly effective Best Practices. Learning from the USAID sponsored ANE Best Practices meetings held in Bangkok in 2007, a team of experts from Pakistan represented by government officials, donor agencies, development sector partners and subject specialist shortlisted ten key high impact low cost interventions that could substantially improve the health of mothers and children in Pakistan. The package of these ten Best Practices called the Pakistan Country Action Plan, was presented in the two day Policy Seminar on Scaling Up MNCH-FP Best Practices in Pakistan held at Karachi on October 1-2 2009. International experts hailing from various countries presented global evidence in favor of the Pakistan Country Action Plan which was followed by the signing of Karachi Declaration. The declaration was signed by a high level panel including Federal and Provincial secretaries of Ministry of Health and Population Welfare, representatives of government of AJ&K, FATA, Gilgit Baltistan and donor agencies who assured full support to scaling up the chosen Best Practices in Pakistan.

While all those involved in its preparation and approval of the Karachi Declaration need to be congratulated, the real challenge of translating the Declaration into action starts now. We would need to make concerted efforts at federal provincial and district levels to ensure that we avail this golden opportunity of giving the right to life and health to the mothers and children of this country. As one of the organizers of this landmark Policy Seminar, I would like to thank USAID for its financial and technical support through PAIMAN, which went a long way in making the event a success.Thanks are also due to the Ministries and departments of Health and Population for their leadership, White Ribbon Alliance- Pakistan for handling the management and organization of the meeting as well as donor agencies, national and international presenters and participants of the seminar for being part of this historic event. Dr. Nabeela Ali

Pakistan Country Action Plan(High Impact Low Cost Best Practices)1. Maternal Health:

a. Active Management of Third Stage of Laborb. Post Abortion Care (PAC)c. Expanding Contraceptive Choiced. Introducing Healthy Timing and Spacing of Pregnancy

(HTSP)e. Postnatal Care (PNC) Protocol

2. Newborn Health:a. Newborn Resuscitationb. Essential Newborn Care

3. Child Health:a. Introduction of Low Osmolarity ORS & Zincb. Pneumonia Case Management by Lady Health Worker:

4. Cross Cutting:Ulama and Advocacy

Message from the COP

July - September, 2009 - Issue 8

Yet another event of strengthening the access to MNCH services at district level was held on 19-Aug 09, at Frontier House Islamabad when 5 ambulances were handed over to department of health NWFP, in presence of USAID team including Mission Director, Chief of Health and CTO-PAIMAN. Two ambulances were handed over to EDO-Health of Mardan and Charssada and one was handed over to EDO health Buner replacing the ambulance snatched by the militants. The ceremony was hosted by COP Dr. Nabeela Ali, and was warmly participated by Sec. Health NWFP, EDO-H Mardan, Charsadda, Buner, DCO Charssadda, and JSI-Team.

PAIMAN provides Ambulances for NWFP

PAIMAN’s Leader Leads

Life Time Achievement Award for Chief of Party , JSI-PAIMAN

Handing Over of Equipment to the CMWs in Jaffarabad and Lasbella

Celebration of Breast Feeding Week

scientific Seminars, Pamphlets, TV and Radio Talk Show (Arrange by MoH), Awareness Walk, PAIMAN sponsored The recognition of PAIMAN at the highest level in the Islamabad women Football Team in the national tournament, country is a source of inspiration and encouragement for the Mega events focus on breast feeding, Putli tamasha conveying PAIMAN Family. A moment to cherish for a long time to

th massages on Breast feeding, LHWs organized meeting with come for the PAIMAN family was, when on 11 July, 2009 community and talked about breast feeding and Special news The World Population letter on breast feeding.Day, the Prime Minister

of Pakistan, Mr. Yousuf PAIMAN sponsored Islamabad Women Football team Raza Gillani conferred participated in Pakistan National Women football tournament the National Population held at Islamabad, during the breast feeding week. award upon PAIMAN in Dr. Theo Vice President JSI and Mr. William Conn, CTO recogn i t ion o f i t s PAIMAN from USAID praised the team during the meeting valuable contribution to held at JSI office Islamabad, on Aug 6, 2009. Dr Nabeela Ali, t h e c a u s e o f COP JSI-PAIMAN and JSI team also praised the efforts of the Reproductive Health in Women Football team.Pakistan. The award

was received by Dr. Nabeela Ali Chief of Party, JSI-PAIMAN. The distinction that PAIMAN has achieved is ent i re ly due to inspirational leadership, devotion and effort of Dr. Nabeela Ali, Chief of

Party JSI/PAIMAN and the team.

On August 17, 2009, PAIMAN enjoyed another pride when Chief of Party JSI-PAIMAN, Dr. Nabeela Ali was Awarded by Nestle “for life time achievement in working for the

The first batch of community midwives (CMWs) trained by health and well being of Women of Pakistan”. The PAIMAN in Lasbella and Jaffarabad received equipment in ceremony was held at Expo Center Karachi. Dr. Nabeela Ali, two different handing over ceremonies in their respective

Madam Benazir Bhutto, Dr. Maleeha Lodhi and Ms. Sherry districts. The first handing over ceremony of equipment to the

Rehman were of the 30 women from different walks of life CMWs of Jaffarabad took place at District Assembly Hall, who were given Life Time Achievement Award, in Karachi. Dera Allah Yar, on September 16, 09 and the second was held

at District Assembly Hall, Uthal, on September 18, 09 in which the CMWs of Lasbeela received the equipment. The quipment received by the CMWs includes delivery tables, weighing machines, stethoscope, BP apparatus, tables and chairs etc. The PAIMAN supported MOH in celebration of the

st DCO and EDO health of both the districts highly appreciated breastfeeding week from 1 Aug 2009 in all PAIMAN and acknowledged the efforts of PAIMAN for training districts. PAIMAN participated with full zeal to the Community Midwives and establishing CMW Homes. Dr. internationally celebrated Breast feeding Week though Hasan Zaidi presented an overview of PAIMAN Project and its

various activities including City branding in all PAIMAN contribution in Jaffarabad. Ten CMWs in Jaffarabad and 21 in

districts with display of banners displayed along with TVCs Lasbella were given the equipment and furniture to open on breast feeding; Drama on breast feeding on ATV, Video Midwive Home in their respective Union Councils.on wheel to telecast drama on breast feeding, General and

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Supervision and Training ActivitiesSupervision of CCA Training, DI Khan

Workshop on LQAS MethodologySupervision of CCA Training, Peshawar

Financial Management Trainings & FINSOFT®

Leadership Workshop

DDOH, District Coordinator NP for FP & PHC (DPWOs) MS, MNCH Coordinator, Community Coordinator/Social Organizers, Provincial Coordinator NP for FP & PHC and

The supervision of first batch of CCA trainings which was Provincial EPL Program Manager from Bhimber, Sudhnoti, organized at Margalla Hotel for DI Khan district was Muzaffarabad, Vehari, Multan and Rawalpindi districts completed by the Population Council from July 6 to 10, participated in the workshop. with this training, the number of 2009. The district trainers of Health Department DI Khan trained district official has raised to 123 in total. conducted the training for their participants.

The four days training of service providers in 'Client Centered Approach for Reproductive Health Services' was successfully carried out in Islamabad from August 10 to 13, 2009. The training was organized by JSI and Health Department, NWFP for service providers of Peshawar district and was supervised by the Population Council. Seventeen (17) participants from Peshawar district

thThe 4 PAIMAN training workshop on Lot Quality Assurance Sampling (LQAS) was successfully held from September 28-29, 2009 at Islamabad. The training was organized by the Population Council in collaboration with JSI. A total of 24 Health Managers from 7 (New) PAIMAN Districts ( Gwadar, Zhob, Khairpur, DI Khan, Swat, Bhimber and Sudhnoti) participated in this training workshop including 4 EDOs included doctors and paramedics. Training was conducted Health . With this training PAIMAN has trained Health by the local training team comprising of two doctors and Managers of all the PAIMAN districts in LQAS technique. one female paramedic; who had received CCA training

through a TOT during December 2008 in Islamabad.

A 3-days trainings on 'Financial Management' for the new

PAIMAN districts in four separate batches was completed by thThe 7 Strengthening District Population & Health Systems

Contech. A total of 61 staff members were trained which Through Effective Leadership and Client Centered Service included managers (EDOH, MS DHQH), accountants and for the PAIMAN was organized by the Population Council computer operators. Hands on training was also provided to the from July 29 to August 04, 2009 at Islamabad. Seventeen participants regarding budget preparation, using and filling of District and Provincial Managers, District Officer (Health,

Finance& Planning and Community Development), budget forms as detailed under Budget rules 2003. Participants

were also oriented on Finsoft®, a budgeting and financial

management toolkit, developed by Contech International to

assist managers and accountants in preparation of annual

budget as per budget rules 2003 and tracking expenditures.

A second workshop on 'District Health Management

Strengthening' was organized by Contech on 23-24 July, 09 at

Muzaffarabad for continuous performance improvement. The

main agenda of workshop was to jointly review the progress of

various district health system strengthening interventions and

suggest ways for any improvement and sustainability.

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For feed back & suggestions please write to: Editor, PAIMAN News RoundupPopulation Council, H # 7, St. 62, F-6/3, Islamabad. Or E-mail: newsletter@paiman.org.pk

CA#391 A-00-05-01037 is funded by the United States Agency for International Development and implemented by JSI Research & Training Institute, lnc.

In conjunction with Aga Khan University, Contech International, Greenstar Social Marketing, Johns Hopkins University / CCP, PAVHNA, The Population Council, Save the Children USA

JSI Research & Training Institute, Inc.

Supervising the District TBA Trainers during Roll-out trainings on “Client Centered Safe Delivery Practices”

During July-September 2009, Seven (7) district training

teams were followed and supervised for roll-out TBAs

training on “Client Centered Safe Delivery Practices”. The

district training teams included Vehari, Khairpur, Mardan,

DI Khan, Sibi, Zhob and Sudhnoti. Master trainers from

Population Council Islamabad supervised and facilitated

the district trainers in each case. A total of 17 District TBA

trainers were supervised during these trainings.

EXCHANGE VISIT OF DHMTs

a coordination link between PAIMAN intervention districts by

bringing together a group of health managers in a joint platform

to review/analyze the impact of PAIMAN's system

strengthening interventions in health services delivery system.

It also provided first hand exposure to the best practices for

district health system strengthening and encouraged the

visiting districts to adopt the same in their own settings.

During the visit, a keen

interest was seen among

districts to share their

be s t p r ac t i ce s and

lessons learnt . The

vis i t ing team from

Mardan and DI Khan

also had a meeting with

the DCO, DG Khan and

members of DHMTs followed by visit to the selected health

facilities (DHQH DG Khan, RHC Choti Zairen) upgraded by

PAIMAN. PAIMAN inputs were also discussed with visiting

teams in improving quality of services and management areas

especially in health planning, targets setting, supervisory

system, logistics and

financial management.

Visiting teams' feedback

indicated that they have

learnt good lessons by

closely examining the Contech conducted an “Experience sharing visit” for i n f r a s t r u c t u r e o f DHMT members of two district's health care new PAIMAN districts systems and the impact (Mardan and DI Khan) of interventions on to DG Khan, an existing district's overall performance. They opined that now they have PAIMAN district from a better understanding to apply the learnt lessons in their own 4-6 August, 09. This setup. v i s i t p r o v i d e d a n

opportunity to establish

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