Establishing birthing centers for internally displaced women and children in Pakistan

Since May 2009, approximately 2.5 million people have been displaced from the Pakistan districts of Swat, Buner, and Dir due to conflicts in those areas. Therefore, the Pakistan Initiative for Mothers and Newborns (PAIMAN) has needed to immediately respond to the half a million internally displaced persons (IDPs) now living in camps and the many more living with host families in the two major PAIMAN intervention districts of Charsadda and Mardan.

In order to best serve the needs of displaced women and children, the response included establishing birthing centers in the IDP camps. PAIMAN is working with four local NGOs in the two districts to provide this care. By June 2009, four birthing centers were established in Charsadda and Mardan.

There is already a critical need in Pakistan for modern birthing centers and skilled birth attendance. The country has an infant mortality rate of 78 per 1000 live births, and a maternal mortality rate of 276 per 100,000 live births. The urgency of this situation is intensified by the political instability and military conflict in the country, and therefore PAIMAN is committed to providing proper health care for women and children affected by the conflict.

To measure the success of the established birthing centers, centers report the number of women utilizing their facilities and seeking out the care they offer. During the first week that the four birthing centers were operating, few women came for services. Only about 100 women attended the outpatient department, 17 women came for antenatal checkups, and one woman came for a postnatal checkup. There was only one childbirth at a birthing center that week.

However, these numbers quickly rose in the following weeks as more internally displaced women sought out the birthing centers. The next three weeks saw numbers increase dramatically, with a total of 1,170 women seeking care at the outpatient department. In these weeks 200 women received antenatal checkups, 25 women received postnatal checkups, 16 babies were delivered, and four referrals made. There were also 70 TT vaccinations given to pregnant women, as well as 24 women who used the family planning services offered by the birthing centers. The only consistent number throughout June was that there were zero obstetric or newborn deaths.

In these times of violence and instability, women should not have to relinquish their right to medical care because of the civil conflict in their country. PAIMAN works to meet the demands caused by this conflict and assure that health care is a right these displaced women retain. The birthing centers established by PAIMAN and local organizations in the Charsadda and Mardan IDP camps will continue to grow and save the lives of newborn babies as well as the lives of their mothers, who, without these centers, would not have access to proper medical care when they need it most: during pregnancy and childbirth.