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MSS Newsletter

ANOTHER MILESTONE ACHIEVED

In September 2011, MSS achieved a milestone with six of its centers of Karachi district (namely New Karachi, Nazimabad, PECHS, Gulshan-e-Iqbal, Korangi and Orangi) received the ISO 9001:2008 certificate! These centers successfully completed tri-annual review by United Kingdom Accreditation Services (UKAS) and met their quality standards. UKAS has endorsed the certificate for the next 3 years.

FLOOD RELIEF ACTIVITIES

During September 2011, Pakistan experienced immense turmoil due to heavy rains and floods in Sind. According to Pakistan Disaster Management Authority (PDMA) data more than 300 people have lost their lives and 5.5 million are currently displaced from their homes, while 100,000 people are affected from different diseases.

MSS centers in Badin, Mithi, Thatta, Umer Kot, Tando Mohammad Khan, Tando Allahyar and Hala started relief activities by partnering with NGOs, Government sectors and WHO by providing medicines and arranging static and mobile medical relief camps for people affected by the floods.

REPRESENTATIVE OF MSS AS PERMANENT MEMBER OF THE DISTRICT TECHNICAL COMMITTEE (DTC)

Follow up meetings were held between District Population Welfare Officer (DPWO), Director General (DG) Population Welfare Department (PWD) on 13th and 14th June, 2011 and authorities of the Health Department, Mother Neonatal and Child Health (MNCH), National Program and civil society stakeholders for enhancing coordination at the district levels. A committee was formulated which met on 15th June, 2011.

During a series of meetings from May-July, 2011 Terms of Reference (ToR) of the District Coordination Plan (DCP) were developed and membership of the District Technical Committee (DTC) was revised. During this period Marie Stopes Society also got the honour to endorse one of its representatives as a permanent member of this forum.

The committee decided to review contraceptive need assessment of the district on the basis of total estimated number of eligible couples in the district; and decided to classify and analyze the areas deprived of basic Family Planning / Reproductive Health (FP / RH) services through a joint mapping of Service Delivery Outlets at Union Council (UC) level.

Population Welfare Department (PWD) Seeks NGO Feedback and Collaboration

The Population Welfare Department (PWD) Punjab and Sindh held meetings to develop a communication strategy for Population Welfare Department and invite feedback on the PFT (Proposal for Training) submitted by Population Welfare Department to Benazir Bhutto Shaheed Youth Development Programme for training of 120 Family Welfare Workers respectively.

The meeting in Punjab was chaired by Secretary Population Welfare Department and Umer Rasool, DG Population Welfare Department, Dr Mahmood Akhtar, Ms. Bushra Khanum, Dr Ali Mir and Ms. Seemin Ashraf from FALAH, Mr. Javed Iqbal from Greenstar and Ms. Nabila Malik from RAHNUMA along with Mr. Javed Akhtar and Dr. Naveed Ahmed from MSS attended. PWD Punjab will be developing a Pilot Action Plan for Lahore district and later for all other districts focusing on providing family planning services.

Secretary Population Welfare Department Sindh, Mr. Mumtaz Ali Shah, chaired the PWD Sindh meeting held in Karachi. Meeting was attended by representatives of Population Welfare Department, Benazir Bhutto Shaheed Youth Development Programme (BBSYDP), and partner NGOs of Packard Foundation. The meeting invited feedback on the PFT (Proposal for Training) submitted by Population Welfare Department to Benazir Bhutto Shaheed Youth Development Programme for training of 120 Family Welfare Workers.

RESEARCH AND ADVOCACY FUND (RAF)

“EVIDENCE FOR INNOVATING TO SAVE LIVES” is a Maternal and Newborn Health (MNH), RAF supported research project with the aim to improve Maternal and Newborn Health (MNH) through Healthy Timing and Spacing of Pregnancies (HTSP) in rural and underserved areas of Sindh, Punjab and Khyber – Pakhtunkhwa (KPK).

The Maternal and Newborn Health Research and Advocacy Fund (RAF) is a five year national programme funded by Department for International Development (DFID) and the Australian Agency for International Development (AusAID). RAF aims to support research and advocacy initiatives to influence pro-poor policy and practice reform related to MNH in Pakistan.

The project objectives are:

  • To assess and compare the effectiveness and efficiency of MSS implemented SURAJ Social Franchising intervention, model A, and Family Planning (FP) modification in the existing Maternal, Newborn and Child Health (MNCH) services provided by Community Midwives (CMWs), model B, with their respective control (non-intervention) groups in achieving key outcomes related to HTSP.
  • Envisaged that the research project will spark policy dialogue and highlight promising practices and lessons learned which may inform the design, implementation and expansion of future MNH strategies in Pakistan.

This study will compare the efficacy and efficiency of two birth spacing service intervention models A and B and their corresponding control populations. Its results will serve as the foundation/building blocks for similar large scale studies which can provide insights for formulating newer, more effective intervention models as well as better maternal and newborn health policies for the future.

Project Highlights:

  • 30 MSS Suraj Social Franchisers and 20 CMWs have been trained and accredited by a third party consultation (an independent consultant gynecologist). Service providers have been trained for providing good quality Family Planning (FP) services including clients counseling, business training and infection prevention.
  • Provides and Provided IUCD (Intrauterine Contraceptive Device) insertion kits for providing infection free treatment and Female Community Mobilizers (FCM), to raise awareness in the community with reference to the FP services being given by the service provider.
  • The Suraj Social franchising (model A) is an MSS initiative implemented in 33 districts of Sindh, Punjab and KPK.

MSS has to date developed a network of some 190 private providers (based on a strict selection criteria) who have been trained, accredited, provided with a community based Field Worker and branded as ‘Suraj’ providers. Since the project’s service initiation from 14th March till September 2011, Suraj Social franchising has provided free IUCD services to 1,845 clients of low socio-economic status.

Community Support Group (CSG) Meeting Successes:

The project’s CSG have helped raise awareness on benefits of FP with community male stakeholders/gatekeepers. This has proved to be extremely beneficial in these stakeholders’ endorsing of the services being provided by the project’s service providers (belonging to both model A and B in their areas).

Increase in Condom Use Among Males After CSGs:

District August 2011 September 2011
Khanewal 196 1,205
Haripur 695 761
Rajanpur 19 88

The project operations have highlighted service providers being successfully trained to provide the necessary FP services; which have also resulted in the provision of free IUCD services to clients with low socio-economic status. Its CSG meetings are getting the community male stakeholders/gatekeepers to endorsement/support the FP services being provided. That can be shown by the increase in the condom utilization as seen in the above given chart. Further continuation of these project operations (Services and CSGs) can result in reaching and providing services to more communities having similar unmet FP needs.

A PROSPECTIVE OBSERVATIONAL STUDY OF THE CLINICAL PERFORMANCE OF FEMPLANT IN PAKISTAN

This is a twelve month operational research study and aims evaluate the contraceptive effectiveness, safety and acceptability of Femplant® (a 4-year contraceptive implant) during the first year of its use in public and private sector health services facilities of Sindh and Punjab in Pakistan. The study is sponsored by FHI360-USA with the financial support of USAID-USA. MSI UK is providing technical support to this study. This is a multi-country study and being simultaneously implemented in six developing countries. In Pakistan, this study is jointly implemented by Marie Stopes Society (MSS) and Population Welfare Department of Sindh. The study has a full approval from National Bioethics Committee (NBC) Pakistan (reference number: 4-8711/NBC-65/RDC/ 386 (08-Aug-2011).) and Institutional Review Board (IRB) of FHI. The study will comply with all of the applicable Marie Stopes International (MSI) and MSS standard operating procedures and the requirements of the study protocol, NBC and FHI IRB. The time duration for the study is October, 2011-December, 2012.

The present study will provide data on post-implant pregnancy, adverse experience, insertion/removal complications, method continuation and level of women’s satisfaction with services. Further, the findings of this study will contribute to the body of knowledge on the acceptance of the Femplant in Pakistan and help provide timely recommendations for the successful introduction of this new long term method in the country.

MSS – ONE OF THE LARGEST PROVIDERS FOR FAMILY PLANNING / REPRODUCTIVE HEALTH (FP / RH) SERVICES

Health and Population Welfare Department played a major role as representatives from both the departments met on 25th May, 2011 and decided to strengthen the collaboration amongst them towards FP / RH services.

In a letter written by the Deputy Director (M & E), PWD Punjab to Dr Mahmood Akhtar (MSS), efforts of implementing the district coordination plan for Punjab were commended and a follow up meeting was also called for at the Deputy Director’s office which took place on 6th July, 2011. Strong emphasis was also given on the sharing of reporting system and statistical data between all the departments in order to gain firsthand knowledge about all the regions and its population.

Furthermore, in this meeting representatives of the Marie Stopes Society were able to convince the honourable chair that the MSS’s network is the most widespread in the entire country with an immensely strong presence in 34 districts of the Punjab province where fully functional and operational centers are serving the locals at extremely affordable costs. During this meeting, it was also agreed that Marie Stopes Society will also share monthly plans of all center based activities like free medical camps and Mobile Service Unit (MSU) camps, other special occasions like Mothers’ and Fathers’ day at all DTC meetings and the representatives of PWD and DoH would be directed to support mobilization campaigns for all such activities. As a gesture of goodwill, representatives of MSS also confirmed their full support and coordination for all such activities organized by the government sector.

Uniject – A potential for change

PATH with Marie Stopes Society, Pakistan, as its lead country partner, initiated a 12 month project to enhance family planning options on 8th February, 2011. In this regard, a follow-up meeting of core members was held on Thursday 16th June, 2011 in Karachi that concluded with the development of an Advisory Board to support the development of an ‘acceptability study’. The Advisory Board members, Dr. Yasmeen Qazi (Packard Foundation), Dr. Sohail Aga (Greenstar), Dr. Huma Qureshi (National Bioethics Committee), Dr. Tariq Majid (Consultant-MSS), Dr. Khurram Azmat (MSS), Dr. Sadaf Khan (PATH-Via Phone), Dr. Ashfaque Ahmed (PATH-MSS) and Mr. Waqas Hameed (MSS) held rich discussions and recommended seeking community feedback, conforming to full drug registration procedure and adoption of an ongoing acceptability study within the framework of Pakistani laws and regulations as the way forward!

Postabortion Care in the Outreach-Learnings from the Field & Introducing Misoprostol Use in Postabortion Care: A Service Delivery Toolkit

A group of erudite individuals in the field of sexual and reproductive health and family planning, met on 22nd June, 2011 in Karachi at the (Pakistan Alliance for Postabortion Care) PAPAC annual assembly for an ‘exchange’ and discussion on the issue of “Postabortion care in the outreach” and launch of Misoprostol Use in Postabortion Care: A Service Delivery Toolkit. Discussions revolved around the issues of Efficacy of Misoprostol-alone regimen; trainings & addressing provider bias, Launch of Misoprostol Service Delivery Toolkit, Difference of Dynamics in Outreach and In-centre service provision, Client Satisfaction – what it means to client and service provider and Insights from Research and Scaling Up PAC as a Best Practice – The Journey…

Presentations/discussion points were shared by the key players in the field namely: (in order of panel) Mr. Siddiq Kiyani (MSS), Ms. Amina Mazhar (Ipas), Dr Siddiqua Jafarey (NCMNH), Dr. Tasneem Fatima (MSS), Dr. Sadia Ahsan (NCMNH), Dr. Samina Afzal (Greenstar) and Dr. Haleema Yasmeen (SOGP). Also attending were Dr Nadeem Khalid (RAHNUMA), Shahrukh Butt (MSS), Dr Nighat (SoGP) and Gulali Ismail (Aware girls) along with Mr Sikandar Sohani (Ipas), Mr Waqas Hameed (MSS), Ms Ayesha Khan (Collective for Social Science Research-CSSR), Mr Aslam Fareed (Greenstar), Dr Babar Shaikh (Health Services Academy-HSA), Dr Yasmeen Qazi (Packard Foundation), Ms. Sahib Jan (MNCH Sindh), Dr Tauseef (Pathfinder) and Dr. Arshad Chandio (Lady Health Workers (LHW) program).

“FATHERS LIKE MOTHERS ARE NOT BORN. MEN GROW INTO FATHERS; AND FATHERING IS A VERY IMPORTANT STAGE IN THEIR DEVELOPMENT”

participant from Sialkot:

Since 2010, MSS Behtar Zindagi centres and teams acknowledge, appreciate and commend the role of a father in raising a happy and healthy family on ‘Father’s Day’. This year too, awareness sessions for men were organized at all 85 Behtar Zindagi Centers. Contraceptive promotional activities were also carried out by Contraceptive Social Marketing (CSM) MSS’s sister concern.
Television commercials and celebrity messages were aired on local TV cable networks and leading national channels. Furthermore, Radio FM 100 ran a full day ‘Father’s Day’ branded transmission with public service messages.

Press clips, media coverage and articles were published in leading national and local newspapers.

In appreciation of the event, one of the participants from Sialkot said, “Fathers, like mothers, are not born. Men grow into fathers; and fathering is a very important stage in their development.”

MSS PARTICIPATES IN ‘WORLD FAMILY DOCTORS DAY’

Doctors Day was celebrated at the Pakistan Medical Association (PMA) house on 26th May, 2011. A seminar was organized and stalls of different pharmaceutical companies were arranged. Amongst these, MSS’s stall gained great popularity as it was providing free medical examination, such as measuring blood pressure and weight and counseling on family planning along with distributing condoms to a large number of visitors.

MSS’s initiative was appreciated and a certificate was awarded as recognition of its efforts to promote sexual and reproductive health and family planning.

ENGAGING THE YOUTH THROUGH PARTNERSHIP

MSS partnered with RAHNUMA-Family Planning Association of Karachi, Pakistan to create awareness amongst the youth about the social, physical & psychological aspects of reproductive health with a goal to create awareness about reproductive health and family planning issues.

Interactive sessions were held on 7th and 21st June, 2011 at RAHNUMA’s Lyari and Mouch Goth youth centers respectively. MSS encouraged the youth to use the MSS call centre and online bilingual interactive website on Sexual and Reproductive Health Matters (www.srhmatters.org) for any information needs. Participants also received branded key chains, mugs, pens and biker jackets bearing messages as mementoes.