Provision Of Round The Clock Basic Obstetric And Neonatal Care Services In Rural Settings: A low cost, high impact intervention in Punjab, Pakistan

Abstract

Punjab province has a maternal mortality ratio of 180/100,000 live births and neonatal mortality rate of 41/1,000 live births. There are 2,512 primary care facilities (basic health units, BHUs) across the province. The Government of Punjab upgraded these BHUs to provide round the clock obstetric services over the past decade. Currently, 1195 of these 2512 BHUs are functional 24 hours a day, seven days a week. A number of interventions were done, especially around the monitoring of staff presence, availability of minimum inputs and real-time reporting of data based. These interventions ensured provision of a standard set of services across all the 24/7 BHUs. In addition to this, a transport solution was provided in the shape of rural ambulance service for maternal and child health related issues. These interventions have now started showing results in the form of improved coverage for skilled birth attendance, and a decline in mortality rates. The impact is expected to be more evident with the passage of time.