Safe Safe Motherhood Motherhood

PakistanPakistan A struggle in the making

Each year in Pakistan Each year in Pakistan • 25,000 women die due to

complications of pregnancy and childbirth - one woman every 30 minutes !

• More than 300,000 babies die in the first month of life

• 165 million – 2% annual growth • 4 births per woman, 1 induced

abortion out of 6 pregnancies

Reproductive and Reproductive and Maternal Health Maternal Health Indicators 2007Indicators 2007

MMR (estimates 2005) 500 Antenatal care 61%Births attended by skilled personnel [health facility]

39%[34%]

Postpartum care 22%

Contraceptive Prevalence Rate

30%

“The group... Will promote better coordination for making motherhood safer.... will raise awareness in safe motherhood at all levels, each member acting as catalyst for action and change.

“The group shall be identified as: ‘Alliance for Safe Motherhood – Pakistan’.”

Understanding among professionals, 2001

Vision 2020Vision 2020• COMMUNITY AWARENESS, SKILLED

ATTENDANCE, EMOC

• Advocacy and watchdog

• Catalyst

• Debate and technical assistance

• Networking

• Voluntary membership of over 400 professionals and SM advocates

Strengths WeaknessesStrengths Weaknesses• Maternal, newborn

health on the national agenda

• Good numbers of researchers and advocates

• Sufficiently large funds for intervention programs

• Little coordination between stakeholders

• Lack of harmony

between research, advocacy agencies

• No standard methods for monitoring and evaluation

The White Ribbon AllianceThe White Ribbon Alliance• Formalization and registration - 2006• National WRA Secretariat• Public meetings in districts• Expansion of membership• Influencing the policymakers• Continued technical support to

Ministry of Health• Safe motherhood conference

Ingredients of success Ingredients of success (adapted from Shiffmann)(adapted from Shiffmann)

• Actor power – leadership, enduring coalitions, civil society participation

• Framing the issue – severity, one plan, one set of policies and interventions, one M& E framework

• Governance structure of the sector and political context

• Funding opportunities

Recent Opportunities Recent Opportunities • National MNCH Policy and Strategic

Framework• Government’s commitment (Islamabad

Declaration April 2005)• Led to the establishment of a A National

MNCH Program in 2007 • Synergy, Continuum of Care, Collective

Results• DFID, Norway, GAVI HSS, UN (Reform)• Example : skilled birth attendance

Action points for The Action points for The White Ribbon Alliance White Ribbon Alliance

• Lobbying decision makers and leveraging resources

• Center for accountability – Repository of data– Watchdog – catalyst for implementation– Convener of national stock taking

conferences– Brokering partnerships