Karachi: National Committee for Maternal and Neonatal Health (NCMNH) arranged an Orientation Seminar on an intervention “Training for and Institutionalization of Post Placental and Immediate Postpartum Insertion of Intrauterine Contraceptive Device”, which outlined the need for provision of Postpartum Family Planning (PPFP) services immediately after childbirth.
Pakistan is the 6th most populous country of the world. It is estimated that Pakistan will become the 4th most populous country by 2050 if the growth rate remains the same. Such soaring population growth, coupled with youthful demographics, high unemployment and a troubled economy pose great challenges for Pakistan.
Pakistan has some of the poorest maternal, infant and child health indicators in the region: Maternal Morality Ratio is 276 per 100,000 live births and Infant mortality rate is 74 per 1,000 live births. Contraceptive Prevalence Rate (CPR) is 35%, the unmet need of family Planning (FP) being 20% as quoted by Pakistan Demographic and Health Survey (PDHS) 2012-13. It also states that 48% of women in Pakistan deliver in health facilities and leave without receiving counselling or any family planning services. Majority of these women do not return for postpartum check and often come back with an unintended pregnancy.
These facts underscore the need for provision of Postpartum Family Planning (PPFP) services immediately after childbirth. To meet this demand, Post Placental and Immediate Postpartum insertion of Intrauterine Contraceptive Device (IUCD) can be advocated as an ideal choice. Postpartum Intrauterine Contraceptive Device (PPIUCD) insertion has been found to be safe and expulsion rates are comparable to insertion of IUCD in the extended postpartum period.
The objective of the initiative is to reduce the unmet need by utilizing the missed opportunity and promoting family planning after childbirth. To meet this demand, Post Placental and Immediate Postpartum insertion of Intrauterine Contraceptive Device (IUCD) has been advocated as an ideal choice.
It was emphasized that Contraceptive options need to be discussed as an integral part of the maternity care package which includes counselling for contraceptive methods available. Women need to be counselled and informed about postpartum IUCD insertion as a choice which is a safe and immediately effective method.
NCMNH is a nationally known organization for its focus on reducing Maternal & Neonatal deaths and disabilities. It has a rich network of partners. It also has an extensive experience of advocacy and training.
NCMNH implemented an intervention providing IUCD services right after childbirth at the Jinnah Postgraduate Medical Centre (JPMC) and Sobhraj Maternity Hospital (SMH), Karachi during April 2012 – June 2013. After the encouraging results of the pilot phase, NCMNH is now implementing scale up of PPIUCD intervention at 14 selected hospitals in Karachi, 3 selected Hospitals in Lahore, 1 in Rawalpindi &1 in Islamabad.
At the Orientation Seminar, held at local hotel hosted by the National Committee for Maternal and Neonatal Health, Dr Azmat Waseem, Additional Secretary, Population Welfare Department (PWD), Dr Sher Shah Syed, President Pakistan Medical Association (PMA) and Dr Sahib Jan Badar, Provincial Program Director, Maternal Neonatal and Child Health (MNCH), Dr Sikander Sohani, Health Advisor, Aahung appreciated the efforts of the NCMNH in organizing this successful event.
The seminar began with a welcome speech by Dr. Sadiqua N. Jafarey, President NCMNH. The mandate of NCMH is to analyze the problem of high Maternal Mortality and Morbidity in the country and to develop and demonstrate workable approaches with the objective of lowering these rates.
Dr. Sadiqua mentioned that provision of PPFP choices and services immediately after delivery is a great chance for reducing Maternal Mortality Rates.
Dr Laila Shah, National Manager, NCMNH – PPIUCD, presented the Overview of Population Scenario of Pakistan and Postpartum & post abortion family planning – A possible solution.
Dr. Azra Ahsan, Technical Consultant, National Committee for Maternal and Neonatal Health (NCMNH) presented the results of pilot phase of “Faisla” Institutionalization of PPIUCD services in two hospitals in Karachi and the up scaling of PPIUCD and way forward.
They were joined by experts from leading National Institutions, Population Welfare Department – Sindh, MNCH – Sindh and professional organizations on this day.
Dr. Sahib Jan Badar appreciated PPIUCD initiative and shared that such initiatives are not only required in Sindh but also of whole Pakistan. Further she said that when there is a will there is a way. There is some ownership of PPIUCD program and PPIUCD curriculum should be included in medical and nursing curriculum.
Dr Azmat Waseem, said that the Provision of Family Planning is a missed opportunity after delivery and it can be overcome by promoting PPIUCD. She committed to do everything possible for PPIUCD.
Dr. Sikandar Sohani shared the steps taken for institutionalization for Reproductive Health Services in Dow University, and that he believes that the involvement of decision makers, power mapping and focusing on the right persons through advocacy can make this possible.
Attended by representatives from the government of Pakistan, Population Welfare Department (PWD), practicing Obstetricians, Civil Society Organizations (CSOs) working on PPIUCD, Philanthropic organizations, and representatives from other NGOs and the media, the event was an opportunity for experts to share their views on Postpartum Family Planning in the implementation of the intervention as a shared responsibility which will have a positive impact on averting maternal and neonatal mortality and morbidity in Pakistan.