Pakistan Initiative for Mothers and Newborns (PAIMAN)

• Overview
• Current Situation
• PAIMAN Vision for Success
• Illustrative Implementing Strategies by Objectives
• Consortium Members
• Program Area

Overview

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project designed to reduce the country's maternal and neonatal mortality by making sure women have access to skilled birth attendants during childbirth and throughout the postpartum period. Funded by the United States Agency for International Development (USAID), PAIMAN works at national, provincial and district levels to strengthen the capacity of public and private health care providers and to improve health care system infrastructure. PAIMAN has developed a community-based approach that provides a continuum of care to mothers and newborns through supportive linkages from home health care to hospital-based care. PAIMAN's key partners are the Ministry of Health, Provincial Health Departments, the private sector, and PAIMAN consortium members.

Current Situation

Pakistan's maternal and newborn mortality and morbidity rates are high despite an extensive health service network. Insufficient awareness of major maternal and newborn complications among women, families and birth attendants persist. Most maternal and newborn deaths occur at home, with no skilled health provider in attendance. According to available statistics, over 80% of women deliver their babies at home, while skilled birth attendants and trained TBAs conduct only 20% of deliveries. Although substantial gains in the contraceptive prevalence rate (CPR) have occurred in recent years, a high total fertility rate (TFR) continues to expose women and children to increased risks of mortality and morbidity.

Pakistan's extensive network of public sector health facilities reach only about one third of the country's population. The remaining 70% is served by the private sector, mainly for curative services. The public sector, an important service provider in isolated rural communities, needs improvements in physical infrastructure safe water supply, privacy for female clients, regular supply of drugs, logistics and equipment, and provider capabilities.

PAIMAN Brochure

PAIMAN Vision for Success

By the end of the project, PAIMAN envisions a health system in the project area that delivers high quality Maternal and Newborn Health (MNH) services to women, children, and couples, and where all levels of health providers work closely with empowered, educated and organized communities.

Illustrative Implementing Strategies by Objectives

1. Increase awareness and promote positive maternal and newborn health behaviors.

   • Design and implement an evidence-based, multi-channeled communication strategy tailored to local needs and formulated with participation from all stakeholders.

   • Improve interpersonal communications skills among public and private health care providers, including doctors, Lady Health Visitors, Lady Health Workers, NGO staff and other providers.

2. Increase access to and community involvement in maternal and child health services. This includes emergency obstetric and newborn care.

   • Strengthen community-based obstetrical and neonatal care services.

   • Develop and implement a community-based intervention package which resolves issues such as transportation from remote rural areas to health facilities.

3. Improve service quality in public and private sectors, especially the management of obstetrical and neonatal complications.

   • Emphasize quality, client-focused services.

   • Use evidence-based standard protocols and guidelines for care.

   • Upgrade referral facilities in 10 districts

4. Increase capacity of MNH managers and care providers.

   • Design comprehensive capacity-building programs, including individual performance monitoring and supervisory systems.

   • Use competency-based training.

   • Institutionalization of capacity building program.

5. Improve management and integration of services at all levels.

   • Create a more enabling policy environment through a broad range of advocacy activities.

   • Improve logistics management systems at national, provincial and district levels to ensure a continuous supply of contraceptives and medicines.

   • Reinforce supportive supervision

   • Develop sustainable public/private partnerships and other intersectoral linkages.

Consortium Members

The PAIMAN consortium is lead by John Snow Inc. (JSI), a US-based international public health organization. JSI is joined by a number of international and Pakistani organizations to form a powerful team for implementing this project. The consortium partners are:

• Agha Khan University (AKU)
• Contech International
• Greenstar Social Marketing
• Johns Hopkins University Bloomberg School of Public Health Center for Communication Programs (CCP)
• Population Council
• The Pakistan Voluntary Health and Nutrition Association (PAVHNA)
• Save the Children U.S.

Mercy Corps International (MCI) and National Commission for Maternal Health ( NCMH ) will be collaborating partners of PAIMAN.

Program Area

Pakistan Initiative for Mothers and Newborns will be implemented in 10 districts of all the four provinces of Pakistan . These will include:

• Punjab - Rawalpindi , Jhelum , D.G. Khan, Khanewal
• Sindh -Sukkur, Dadu
• Balochistan -Jaffarabad, Lasbella
• NWFP - Upper Dir , Buner

The total population to be covered under the program will be approximately 12.5 million.

Contact Information:
House #6, Street #5, F-83
Islamabad Pakistan
Tel:051-111-000-025
Fax:051-285-2638
Email:info@jsi.org.pk
www.paiman.org.pk