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Project News Updates/Highlights for 5th and 6th Quarters

Communication is vital for reproductive health

Aneeba Gul is a Community Midwife (CMW), employed by the Maternal, Newborn and Child Health (MNCH), Ministry of Health, Pakistan and has been recruited and trained by Marie Stopes Society (MSS) under the ‘Evidence for Innovating to Save Lives’ project.

This project is an operations research study funded by RAF (Research and Advocacy Fund) and is focused on showing benefits of HTSP (Healthy Timing and Spacing of Pregnancies) on reproductive health of women in the underserved and far flung areas of Pakistan. The project’s intervention districts have two types of FP service providers; i.e. the MSS Suraj Private Providers and Community Midwives (CMW) model from MNCH.

Both Suraj and CMW models have been trained by MSS to provide FP services focused on strong counseling and Infection Prevention (IP). The project studies the impact of such services in these providers areas within the respective intervention districts and compares them to the control districts (districts having little or no properly organized services of similar qualities)

Aneeba was selected from Rasoolpur, a remote area in Rajanpur district of Punjab, She is one of the ten CMWs who were recruited in collaboration with the local government of Punjab province to provide F&P services at their respective areas within the intervention districts. As part of its commitment to provide comprehensive FP information and services, MSS not only equipped Aneeba with the skills to facilitate FP services, but also provided her with a Female Community Mobilizer (FCM) – a local woman hired from within the community to proactively highlight Aneeba’s FP services in the area by visiting door to door, informing womenfolk about HTSP.

Prior to her joining MSS, Aneeba had very few clients visiting her. Aneeba tells, “Most of my community people were uncomfortable in getting services from an unmarried FP service provider. Rasoolpur is a conservative community and the idea of a young girl talking about reproductive health and services was a major reason for discomfort.”

But due to her training in counseling clients and with the additional support of her FCM, Aneeba was able to assist several married couples and help them in making voluntary informed choice from the available range of FP methods.

“Our objective is to inform women and their husbands about the range of modern contraceptives that they can choose from and also assure our clients about MSS Infection Prevention protocols. Thorough counseling both before and after the services, are also part of the services that we provide.”

These efforts bore fruit and as the understanding of the benefits of healthy timing within her community grew her client flow also increased. Today, Aneeba provides about 25-30 Intra Uterine Contraceptive Devices (IUD) services every month. These numbers reinforce the fact that there is a high unmet need for quality affordable Family Planning services.

Aneeba agrees, “My community, owing to its traditional and conservative outlook, was skeptical about an unmarried woman discussing reproductive matters and suggesting FP services. With the support I received from MSS in the form of FCM, IUD equipment, IP standards and protocols and training on counseling skills, I was able to reach out to my clients. I believe one of the major reasons for my effectively reaching out to the community was the strong communication network that my FCM built in the area. Good communication is key to a community’s acceptance and brings about a better understanding of maternal and child health.”

This document is an output from a project funded by the UK department for International Development (DFID) and Australian Agency for International Development (AusAID) for the benefit of developing countries. The views expressed are not necessarily those of DFID/AusAID.

A personal journey benefitting the community

Nasreen Mumtaz is a Female Community Mobilizer (FCM) from Rajanpur, Punjab. As part of the ‘Evidence for Innovating to Save Lives’ project, she is assigned to a local Community Midwife (CMW) by Marie Stopes Society (MSS).

Her job requires her to visit the households in her community and talk to the women and their families (husbands, mother in laws etc.) to inform them on the benefits of Healthy Timing and Spacing of Pregnancies (HTSP) for mother and child’s health.

She also provides information on the range of contraceptive methods available, referring couples to her CMW for a FP service of their choice. Nasreen not only works to promote the uptake of FP services in her community but is also using an FP method herself.

She described her initial association with the project as “quite challenging”. Her husband is a local cleric (Imam) who was against her employment as an FCM and also of her adopting a FP method.

Nasreen highlights her association with this project as a major journey on a personal level. In her feedback she stated, “Initially my husband had a few reservations in my adopting FP practices and working as an FCM for a FP service provider. His stance was that any kind of measures that control birth are strictly forbidden in Islam. And the birth of a child is totally in God’s hands and using any intervention in delaying or spacing pregnancies (or encouraging others to use them) is inappropriate.”

Despite initial resistance from her spouse, she managed to convince him that FP family planning is not only favorable in getting a better quality of life but is also permitted in Islam by quoting and relaying all that she learnt through her training sessions conducted by MSS.

“I managed to convince him that these practices are not only fruitful for our family but are also in accordance with our religion. Spacing between the births of children is necessary for the health of both mother and child. And even Islam places a major responsibility on the parents to bring up their children in a healthy environment. Thus, only a healthy mother can effectively look after her house and children. Now not only am I a FP method user, informing about the benefits of HTSP and FP services, but my husband is also using his influence (as a religious figure in the community) to inform others of the benefit of HTSP. We both believe that by advocating this service within our community we are contributing to safe motherhood and healthy families,” said a content Nasreen.

This document is an output from a project funded by the UK department for International Development (DFID) and Australian Agency for International Development (AusAID) for the benefit of developing countries. The views expressed are not necessarily those of DFID/AusAID.

Encouraging dialogue, saving communities

Hina Fiaz, a Female Community Mobilizer (FCM) from Gharri Serian of Haripur District in the Khyber Pakhtumkwa (KP) Province, has been visiting the area of Mohallah Ratha Dha of her district. Her duties as a community mobilize, come from being a part of the ‘Evidence for Innovating to Save Lives’ project district team in Haripur.

Hina learned soon that despite having a need for a long term contraceptive method, the women of her area, most of them were reluctant to use an intrauterine contraceptive device (IUD) in fear of it being a harmful method; which could dislodge from its insertion site and travel to other body cavities. As a result, majority of these women were using injectables as a Family Planning (FP) method.

Sensing their need for a long term FP method, Hina counseled one of the women about the comprehensive FP services being given by her Service provider. The lady was introduced to the FP service provider at her clinic where she was informed in detail about the available options of FP methods. She was also counseled and her queries were addressed regarding IUDs. After being satisfied, the client opted for an IUD with full confidence. Hina ensured that she will follow up with the client for management of any side effects. With the assurance continued support, the client was fully satisfied and opted for an IUD service.

Word travelled fast and more women started opting for IUDs. So far 10 more clients from the same area have taken up IUD services with Hina’s assistance.

Hina said “My aim is to ensure that I give complete and correct information to everyone I come across. For only by giving accurate information and detailed counseling can we highlight what benefits healthy timing and spacing of pregnancies has on women, their children and families.” Hina is proud of her contribution to her community, for she thinks that her efforts help the women of her community make better FP choices.

This document is an output from a project funded by the UK department for International Development (DFID) and Australian Agency for International Development (AusAID) for the benefit of developing countries. The views expressed are not necessarily those of DFID/AusAID.

Fathers are important too!

The Community Support Group (CSG) meetings are an integral part of MSS ‘Evidence for Innovating to Save Lives’ project. These meetings are styled in the pattern of traditional male village gatherings and are organized by the Male community Mobilizer (MCM) of the district teams.

The primary purpose of the CSG meetings is to engage with CSG members –prominent community male stakeholders and opinion leaders – to get them to endorse Family Planning (FP) services being offered in their communities by MSS service providers.

These CSG members meet-up with other males of their community in local settings, similar to a small town gathering over tea. The purpose of this typical village evening meeting is to make everyone feel at ease with the discussion with special encouragement to any newcomers to express their views and queries.

The CSG meetings start from casual small talk and move on to active dialogue on FP services and benefits of healthy timing and spacing of births not only for the mother and child but for the father as well! The discussion also includes facts and figures regarding Family Planning, their benefit to the communities, question and answer session accompanied with some nervous and embarrassed laughter from the newcomers!

The participants are encouraged to utilize the FP services being offered by MSS for better health of mother and children and even fathers. The members are encouraged not only to talk to the young men of their communities but to also invite them to the follow-up CSG meetings.

These meetings also utilize aspects from local customs, culture and music. Organizers and participants believe these can serve as an important tool in bringing about a behavioral change, leading to better reproductive health for the communities. As commented by one of the participants at the conclusion of one such evening:

“Our culture is rich and diverse; we have strong literature and musical roots. The local culture of poetry, music and performance can actively propagate our message of better health for women and children. Messages conveyed through such mediums will be easier to listen to since they sound more interesting and are also more attention grabbing. ”

This document is an output from a project funded by the UK department for International Development (DFID) and Australian Agency for International Development (AusAID) for the benefit of developing countries. The views expressed are not necessarily those of DFID/AusAID.