Institutional Deliveries

It is well established fact that giving birth at a health facility under the supervision of the trained health care provider promotes Child survival and decrease maternal mortality.

In Pakistan the child mortality (Particularly neonatal mortality) and maternal mortality is very high. The maternal mortality of Pakistan as per PDHS 2007-8 is 276/100,000 while in Sindh its more than 300 per 100,000.

Recent PDHS survey 2017-18 shows Delivery at health facility in rural districts of Sindh has increased by 16.5pc — from 46.5pc to 63pc; while the same has increased by 11.1pc in the cities — from 77.6pc to 88.7pc.

The percentage of women whose last birth was protected against NNT (neonatal tetanus) in the cities of Sindh has increased by 3.1pc — from 74.6pc to 77.7pc. The percentage of such women in urban swathes is 9.9pc — from 38.3pc to 48.2pc

PPHI Sindh is one of the leading Organization who is providing 24/7 Delivery care services in the province of Sindh by converting 6/6 BHU plus into 24/7 working BHU plus.

The initiative started in 2015, where strategic sites were identified particularly high case load ANC clinics were converted into round the clock BHU plus, initially in 2016 100 BHU were selected and huge utilization of these BHU plus completed the Organization and Sindh Government to covert more BHUs, For That in 2017 Chief Minister Syed Murad Ali Shah provided etra budget to make 100 BHU plus round o Clock. As female health care providers were issue in hiring in far flung BHUs, therefore those who were passed as midwives but appeared several time in PPHI, but were not able to be recruited due to capacity issue. The data of 400 much midwives were take from PPHI HR and they were offered 6 weeks intensive training to make them able to pass PPHI written & interviews. After completing this training these girls went through recruitment process and we became able to identify 300 plus girls for proposed 100 BHU plus. So far 300 BHU s are being converted into BHU plus. These round the clock maternity centres are equipped with diagnostic labs, standby ambulances, ultrasound services and a supply of nutrition supplements like Iron Folic Acid and Multivitamins Institutional Deliveries : The key intervention PPHI carry out at all 24/7 BHU plus are ,Diagnosis of labour, Monitoring progress of labour, maternal and fetal well-being with partograph - Providing supportive care and pain relief Detection of problems and complications (e.g. malpresentations, prolonged and/or obstructed labour, hypertension, bleeding, and infection). Delivery and immediate care of the newborn baby, initiation of breastfeeding - Newborn resuscitation. Active management of third stage of labour. Immediate postnatal care of mother. Monitoring and assessment of maternal well being, prevention and detection of complications (e.g. hypertension, infections, bleeding, anaemia). Treatment of moderate post haemorrhagic anemia. Information and counselling on home self care, nutrition, safe sex, breast care and family planning - Postnatal care planning, advice on danger signs and emergency preparedness. Recording and reporting BHU Plus, BHU plus are 24/7 round Specialized care while those with severe diseases or complications require "specialized care".

A team of dedicated MNCH mentors is being hied one for each district called MNCH coordinators, who regularly visits these facilities for quality of care and improvs the gaps in maternal and neonatal health service delivery by regular on the job training and coaching.

Emergency Obstetric care services these includes
A) Basic Emergency & Newborn care services (BEmNOC).
B) Comprehensive Emergency Obstetric and Newborn care services (CEmNOC).

BEmNOC services are provided through almost all 300 plus BHU plus while CEmNOC services specially cesarean care services are being provided through our six bigger level hospitals Like MCHC Kausar Khairpur, MCHC Mirpur Mathelo Ghotki, RHC Bhit Shah Matiari, RHC Tando Jam Hyderabad, MCHC Mirwah Mirpur Khas.

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