In Pakistan, the poor and vulnerable bear the burden of disease and benefit the least from public health care services, which are either unavailable in their areas or difficult to access. Problems in accessing healthcare services, coupled with a lack of knowledge and restrictive cultural practices means that maternal and child health is a little considered issue in rural Pakistan, where giving birth is thought of as a normal part of life which does not require special medical attention. This problem is particularly prevalent in the Sindh province of Pakistan, which after Balochistan, has the poorest health outcomes for mothers and children. Studies across the world reveal that the vulnerable populations absorb health information well if it is relevant, localized, and integrated well with current cultural and social situations. Research also reveals that health communication is neither delivered nor received in a vacuum. Thus, RSPN has partnered with Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHCCP) to implement the Health Communication Component. The Health Communication Component is one of the five components of United States Agency for International Development (USAID)’s Maternal and Child Health Program. It is a six years program for reducing the Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) in ten focus districts (Mirpur Khas, Umerkot, Matiari, Sanghar, Sukkur, Shikarpur, Jacobabad, Ghotki, Larkano, and Naushehro Feroz) of Sindh. JHCCP is leading the HCC and consortium organizations include Rural Support Programmes Network (RSPN), Mercy Corps and Centre for Communications Program Pakistan (CCPP). The HCC component envisions a Pakistan where individuals, families and communities advocate for their own health, practice positive health behaviors including timely use of Reproductive, Neonatal, Maternal and Child Health (RMNCH) services and engage with a responsive health care system. This component aims to promote mother and child health through knowledge increase, community participation and network building. RSPN is working with three of its partner RSPs namely, National Rural Support Programme (NRSP), Thardeep Rural Development Programme (TRDP) and Sindh Rural Support Organization (SRSO). The proven model of trained, local community resource persons is used called Community Health Workers (CHWs) to generate awareness for family planning and reproductive health and to encourage communities to adopt health seeking behaviour, particularly in the context of maternal and child healthcare. The CHWs will conduct social mobilization, offer health education and counselling in small groups and conduct household visits to Married Women of Reproductive Age (MWRAs) of 15-49 years of age. The CHWs will operate at village level to conduct social mobilization, offer health education and counselling in small groups and conduct household visits to married women of reproductive age. The major activities of the project include the following activities: • Demand creation and referral for Maternal Neonatal Child Health/Family Planning services in non-LHWs covered population through the CHWs. CHWs will be identified based on the set criteria, same as of the Lady Health Worker Program’s Lady Health Worker selection, and after an introductory dialogue with the community. CHWs will create demand through meetings with Women Support Groups and Interpersonal Communication Household visits to married women of reproductive age in their catchment population of 1000 and will refer the target women to health facilities for services. • Engagement with community influencers (faith actors and community notables). • Engagement with journalists and politicians/workers of political parties. • Organize advocacy events/celebration of International days at community level such as celebration of World Health Day, World Population Day, International Children’s Day, International Mother’s Day, International Immunization Week, Mother and Child Health Week, World Breastfeeding Week. • Work with Village Health Committees of Community Health Workers in non-LHW covered areas to establish community support mechanism for CHWs. HCC-RSPN district teams are working diligently in the districts and have progressed so far as, • 1613 potential CHWs have been identified in the 10 focus districts, they will be selected after the interviews by the LHW Program. • 863 Faith Actors have been identified to be engaged at the community level for improving maternal and child health. • 567 journalists have been identified for need assessment of the journalist on health reporting so that their capacity can be strengthened on health reporting skills, leading to building positive professional capacity. • For community mobilization events, three international days have been celebrated at the community level i.e. World Health Day on 7th April, International Mother’s Day on 10 May and World Population Day during the Population Week (August 31 to September 4). • Monthly District level Coordination Meetings are conducted at the district level where all MCH partners participate to not only brief on their current progress and upcoming MCH activities, but also for coordinated work-plan development and information sharing.
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