TY - JOUR
T1 - Role of community based savings groups (CBSGs) enhancing the utilization of community midwives in chitral district of Pakistan
AU - Noorani, Qayyum A.
AU - Azam, Iqbal
AU - Shaikh, Babar T.
AU - Ranasinghe, Tharanga
AU - Abbas, Shazia
AU - Wali, Shakeela
AU - Rippey, Paul
AU - Javed, Wajiha
N1 - Funding Information:
‘The Aga Khan Foundation Pakistan would like to express their gratitude to RAF (Research and Advocacy Fund) for funding the study and providing technical assistance. We appreciate the support of the provincial (KhyberPakhtunkhwa [KP]) and Chitral District MNCH coordinators and Pakistan Nursing Council. The work would not have been possible without the coordinated team work of the Aga Khan Health Services Pakistan (AKHSP), Aga Khan Rural Support Programme (AKRSP) and the MNCH team in Chitral. The data collectors of the 24 remote areas, supervisors and data management officers worked as a team, making data collection possible in the harsh and challenging conditions. We are also indebted to all the Community Based Savings Groups (CBSGs) and Community Midwives (CMW) participants, their families and community women and men respondents for making themselves available for discussions and interviews. Their level of participation and expression of frank opinions made it possible for us to present reliable and relevant information in the report. We hope that the findings of this study will help the MNCH programmes in KP in improving the services of the CMWs to the women living in the remote rural areas.
PY - 2013/10/11
Y1 - 2013/10/11
N2 - Background: Maternal and infant mortality rates in the district of Chitral in Pakistan are alarmingly high. One of the major reasons for this is the inability of women to access skilled care due to the high costs associated with traveling and utilizing such services. The Aga Khan Health Services, Pakistan (AKHSP) in partnership with the national and provincial Maternal, Neonatal and Child Health (MNCH) program, deployed 28 community midwives (CMWs) in remote villages of Chitral district. This program has also established Community-Based Savings Groups (CBSGs) to support and facilitate access to MNCH services, in particular those delivered by the CMWs. CBSGs are a simple yet cost-effective and sustainable means of providing basic financial services to low income, marginalized, rural populations. The link between CBSGs and utilization of MNCH services is not well understood. This study will assess the relationship between women membership of CBSGs and their utilization of MNCH services, specifically those offered by CMWs, in the community. Methods: The research question will be answered through guided interviews of women in the target population who have delivered within one month. The outcome variable will be the utilization of full continuum of skilled MNCH care (disaggregated by 1+ ANC, 1+ PNC and skilled delivery). The primary independent variable of interest will be participation in a CBSG.Focus Group Discussions (FGDs) will be conducted to generate further understanding and information about the social and financial factors that contribute to health behavior and health provider decision-making during pregnancy.Analysis will be tailored to answer how CBSGs, directly or indirectly, facilitate greater financial and/or social access to CMW services for pregnant women. Furthermore, the extent to which financial or social empowerment through a CBSG leads to greater utilization of CMW services.Discussion: The role of CBSGs and their interlink with the CMWs services to be replicated in other comparable areas in Pakistan as a viable mean to increase MNCH service utilization amongst rural, low income, and marginalized communities. Findings from this research will be disseminated through community, national, and international channels consisting of policy makers and social society groups.
AB - Background: Maternal and infant mortality rates in the district of Chitral in Pakistan are alarmingly high. One of the major reasons for this is the inability of women to access skilled care due to the high costs associated with traveling and utilizing such services. The Aga Khan Health Services, Pakistan (AKHSP) in partnership with the national and provincial Maternal, Neonatal and Child Health (MNCH) program, deployed 28 community midwives (CMWs) in remote villages of Chitral district. This program has also established Community-Based Savings Groups (CBSGs) to support and facilitate access to MNCH services, in particular those delivered by the CMWs. CBSGs are a simple yet cost-effective and sustainable means of providing basic financial services to low income, marginalized, rural populations. The link between CBSGs and utilization of MNCH services is not well understood. This study will assess the relationship between women membership of CBSGs and their utilization of MNCH services, specifically those offered by CMWs, in the community. Methods: The research question will be answered through guided interviews of women in the target population who have delivered within one month. The outcome variable will be the utilization of full continuum of skilled MNCH care (disaggregated by 1+ ANC, 1+ PNC and skilled delivery). The primary independent variable of interest will be participation in a CBSG.Focus Group Discussions (FGDs) will be conducted to generate further understanding and information about the social and financial factors that contribute to health behavior and health provider decision-making during pregnancy.Analysis will be tailored to answer how CBSGs, directly or indirectly, facilitate greater financial and/or social access to CMW services for pregnant women. Furthermore, the extent to which financial or social empowerment through a CBSG leads to greater utilization of CMW services.Discussion: The role of CBSGs and their interlink with the CMWs services to be replicated in other comparable areas in Pakistan as a viable mean to increase MNCH service utilization amongst rural, low income, and marginalized communities. Findings from this research will be disseminated through community, national, and international channels consisting of policy makers and social society groups.
KW - Community based savings groups
KW - Community midwives
KW - Maternal neonatal and child health
UR - http://www.scopus.com/inward/record.url?scp=84885348217&partnerID=8YFLogxK
U2 - 10.1186/1471-2393-13-185
DO - 10.1186/1471-2393-13-185
M3 - Article
C2 - 24112445
AN - SCOPUS:84885348217
SN - 1471-2393
VL - 13
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
M1 - 185
ER -
