A few quick steps can save 10,000 mothers in Pakistan

KARACHI: Pakistan can easily prevent around 10,000 maternal deaths every year happening in the country due to unsafe abortions just by providing an enabling environment to the nationwide network of large self-sustaining service providers and general practitioners to provide the essential maternal health services in a safe manner.

“Karachi-based CEO of non-profit organization Greenstar Social Marketing, Dr. Syed Azizur Rab, in an interview stated that Greenstar has a footprint of 7,000 Sabz Sitara clinics across the country, providing mainly family planning and maternal health services for the past 30 years in the essential non-governmental sector.

Dr. Rab said that Pakistan has around 10 million pregnancies every year and approximately four million of them are unwanted, while an estimated 2.6 million abortions annually take place in the country.

He said that these 2.6 million women opt for abortion owing to the lack of family planning services in the country. Every abortion is a testimonial that we have failed these women twice. First when we did not offer them the choice of birth spacing with one of the methods, and secondly by not providing them with a choice to manage this serious emergency at a trained service provider’s facility. Abortion-related deaths occur due to untrained birth attendants providing such emergency medical services in an unsafe environment, not following Infection Prevention protocols and using unsterilized surgical instruments.

He said the Pakistan government has taken the steps in the right direction by publicizing guidelines at the federal-level enabling any health care facility across the country to provide post abortion care service (PAC) for necessary treatment. He said the guidelines has prescribed the bona fide medical and surgical methods to be carried out under the specified medical conditions ensuring safety of the mother.

Greenstar CEO said the use of Manual Vacuum Aspirator (MVA) kits by the trained service providers/doctors could easily prevent abortion-related deaths that occurred mainly due to the application of unsafe surgical methods for the purpose. He said that one of the main issues is that MVA kit was not freely available these days due to its high cost after levy of the exorbitant import duty. He said that earlier an MVA kit had been available in the country for Rs. 3,000 as now its cost had increased to up to Rs. 9,000 due to increase in import duty coupled with devaluation of Pak Rupee.

“The three-time increase in the price of an MVA kit means that the service providers/GPs have been unable to dispense the post abortion care services through a prescribed and approved method. Moreover, he said that the combination pill of misoprostol and mifepristone should be made available in the country as the safest medical method for PAC services, for saving life of mother and for necessary treatment as outlined in approved national guidelines.

As Pakistan faces rise in Covid-19 cases again, it can affect maternal health as experienced in the first wave early this year. Hence, it is essential that public and private sector work together and utilize their strengths for serving women in Pakistan. The private sector can bring in their quality of services, trained service providers and management skills while public sector can support by provision of commodities, good governance and enabling environment.

Dr. Rab also mentioned that information-care and counselling around abortion and post abortion rehab is a neglected area. Government can play a vital role by allowing toll free calls from mobile phones from women in distress, calling to Greenstar’s 24/7 POOCHO helpline. Finally he highlighted that regulations regarding stocking of essential products for women care should be allowed at service providers clinic for quick access and support to women in need, especially in areas where no chemist shops are available. Implementation of the recommendations given and a strong public-private partnership can go a long way in reducing mothers’ mortality.

He concluded by sharing that it took 70 years for maternal mortality and growth stunting to find a space in the opening address of a Prime Minister. With over 70% of women going to private sector and paying out of pocket, it’s time for our nation to take leverage from this opportunity and save these women life. It’s a rear opportunity which has knocked on our doors, so we urge the decision makers take forward the agenda of mother and child-care to build a healthy nation.