Pakistan has distressingly high maternal and child mortality rates despite persistent efforts by the Department of Health. Punjab, though one of the more resourceful provinces, still has certain pockets of area left unattended by government and non-government organizations alike. This has resulted in communities being deprived of basic health facilities. Rajanpur, a district of South Punjab has one of the poorest indicators of maternal and child health. The maternal and child health statistics of Rajanpur portray a grim picture of inadequate and inaccessible healthcare system.
With regards to maternal mortality, it has been realized that though complications during pregnancy cannot be predicted, maternal deaths can still be averted to a major degree by; effective education, screening for high-risk pregnancies and avoiding delay in seeking medical aid. With respect to child mortality, annual report (2011) by Pakistan Medical Association states that, a child dies every minute due to preventable diseases such as, respiratory infections and diarrhea. National Nutritional Survey (2011) concludes that malnutrition is one of the underlying determinants of child mortality and contributes to an alarming 55% of the total deaths under the age of five.
With research suggesting that the major causes of maternal and child mortality are avertable, JSCD proposed an urgent need for community oriented campaigns to equip the masses with much desired and required knowledge and skills. In this regard, JSCD in collaboration with UNICEF has successfully implemented Community Action Process (CAP) in 12 specified Union Councils (UCs) since 2011.
In 2013, it was proposed that, JSCD would extend its geographical coverage to 5 new UCs, in addition to the 12 UCs being served, bringing the total project area to 17 UCs. During the first six months of the project, from a total of 17 UCs, 5 UCs would be identified based on their self-reliance to sustain community oriented activities. JSCD would exit from the specified areas. Consequently, at the end of first six months of project period, JSCD would continue its activities in the remaining 12 UCs.
The project included successful realization of the following major activities from March 2013-December 2014.
1. Mapping of healthcare providers and healthcare facilities to develop and strengthen a system of referral.
2. Conduction of Rapid Rural Assessments; baseline, intermediate and end line surveys to monitor progress of project interventions.
3. Advocacy with the Health Department of Rajanpur, for up gradation of four health facilities to CHARM facilities.
4. Widespread dissemination of information among masses through CAP activity on; maternal and child health indicators and hygienic practices.
5. Capacity building and strengthening of local institutions by trainings on; Infant and Young Child Feeding Practices, Essential Newborn Care and counseling techniques.
6. Training and refresher for peer counselors on Infant and Young Child Feeding practices to provide individual and group counseling in their respective communities.
7. Support to identified and registered vulnerable pregnant women by distribution of newborn kits and facilitation for delivery by skilled birth attendants at healthcare facilities.
8. Endorsement of maternal and child health by celebration of Mother and Child Health Week twice every year.
9. Promotion of nutrition among local community through trainings on kitchen gardening for homegrown vegetables.
10. Promotion of hygienic practices through health and hygiene sessions in different schools.
These efforts resulted in successful realization of various activities directed at empowering and mobilizing the masses on indicators of maternal & child health and hygiene. Moreover since the project was due to end in December 2014, a phasing over (exit) strategy was incorporated into the project interventions. According to this strategy emphasis was placed on building capacity of local institutions so that the positive project activities and outcome may be successfully sustained after the end of the project period.