Case studies >>Non-medical maternal and newborn health initiative in Pakistan


First published: 2009-11-04

SDDirect's Cowan Coventry reports on a new non-medical initiative aimed at improving maternal and newborn health in Pakistan in line with Millenium Development Goals.

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The Maternal and Newborn Health Research and Advocacy Fund (RAF) was recently launched in Pakistan. A five-year project with a grant fund of £18.3 million, RAF will provide quality, non-clinical research and effective advocacy in support of policy and practice reform to improve the health of mothers and their newborn babies. The aim is to overcome current obstacles to successful service delivery through an understanding of the financial, cultural and physical barriers to increased demand and uptake of these services. The project will deliver research that is relevant, accessible and useful to policy-makers and to support civil society advocacy initiatives that deploy research-based evidence to leverage change in policies and practices related to maternal and newborn health. SDDirect has been providing technical support and, more recently, interim management to the fund.

Applications from the public and private sector and civil society are encouraged. Proposals should address these priority themes:

  • Equitable access to services
  • Improved quality of service provision
  • Institutional context
  • Role of research and advocacy in health policy reform
  • Role of innovation in improving MNH services

The fund is a timely initiative. Government expenditure on health in Pakistan is among the lowest in South Asia - 3.2% in 2002, compared with 4.4.% in Bangladesh, 6% in Sri Lanka and 17.1% in Thailand (World Health Report 2005). Pakistan has some of the worst maternal and child health indicators in the world, despite being a nuclear power and the sixth most populous country in the world. Maternal and neonatal mortality and morbidity is a high proportion of the burden of ill health in Pakistan. One reason for this is that the low social status of poor women and girls in many parts of the country contributes to a low level of demand and uptake of health services among poor women.

In recent years the Pakistan government has made a major effort to improve its maternal and child health indicators in line with the Millenium Development Goals. Key to this is the government-initiated Maternal Newborn and Child Health (MNCH) programme. The UK Department for International Development (DFID) has contributed £90 million to the multi-donor programme which began in 2007 and ends in 2012. A total of £200 million has been invested in the project by international donors.

The ambitious targets set by the MNCH programme are likely to be achieved only if investment in service delivery is accompanied by relevant policy reforms and practice changes. So, while the majority of this funding is being channeled directly to the Ministry of Health, DFID and AusAID are also supporting this exciting new initiative to support research and advocacy relevant to maternal and newborn health.

The fund is only just getting off the ground but the hope is that it will make a real impact on maternal and newborn health in Pakistan by generating research-based evidence relevant to policy-makers and supporting civil society groups to use public knowledge and evidence to advocate for support for policy and practice change.