@article{9b019c79528e456caaf0e295210de151,
title = "Strengthening Midwifery Response: Implementing updated WHO guidelines in birthing centers in Northern Pakistan",
author = "Rafat Jan and Marina Baig and Sadia Abbas and Farzana Yameen and Kiran Mubeen and Arusa Lakhani",
note = "Funding Information: Healthcare services are not easily accessible in remote mountainous areas of northern Pakistan. The limited number of skilled doctors and hospitals in Gilgit Baltistan and Chitral (GBC) is causing more mothers to die during childbirth than in other parts of the country. The Aga Khan University School of Nursing and Midwifery (AKUSONAM) team has been supporting in updating the maternity guidelines based on the recent World Health Organization (WHO) recommendations and training midwives and nurses in this region in utilizing the revised guidelines in their settings. It was a three-year project from 2021 to 2023 in which antenatal, intrapartum and postnatal WHO guidelines were reviewed and contextualized. Each year input from all the relevant stakeholders was sought on each document and revisions on WHO guidelines were made according to their feedback. Then practical trainings of midwives were arranged as a next step based on the revised guidelines. The team selected 11 MNCH centers across GBC to facilitate training and assess the feasibility of updated guidelines. The team also visited Community Midwives{\textquoteright} birthing centers and their referral facilities. During these visits, the team engaged in discussions with the healthcare providers, assessing the practicality and contextual application of the guidelines within the community-based midwifery service model. The reviews considered cultural considerations, women's financial status, and available resources at maternity centers, proximity to referral facilities, and other infrastructural challenges that could affect the implementation of the guidelines. During the period of three years, the team trained approximately 180 healthcare workers on all three obstetric guidelines in the GBC region and is now proceeding for final consensus and endorsement by the government. This initiative was the part of larger project Sehat Mand Khandan, which was conducted in collaboration between AKHSP, AKU-SONAM, and the Government of Khyber Pakhtunkhwa, and was part of the larger Sehat Mand (SMK) initiative funded by the United Nations Population Funds (UNFPA) Aga Khan Foundation, Canada (AKF, C)",
year = "2023",
language = "English (UK)",
volume = "10",
pages = "64",
journal = "Journal of Asian Midwives",
issn = "2409-2290",
publisher = "South Asian Midwives Association (SAMA)",
number = "1",
}