Kasur, Punjab – November 2014: “My biggest pleasure is to see that the mother and child are both healthy after the delivery,” says Shagufta Shahzadi (30) a Skilled Birth Attendant (SBA) who lives and works in Nandanpura village located in Kasur district, Punjab province of Pakistan.
“There is a huge difference between services provided by a trained birth attendant and an untrained traditional midwife. A skilled person knows how to prevent and deal with complications during pregnancy, at the time of delivery and delivering post natal care for mother and child.”
A hard day’s work for Shagufta could include delivering a baby, advising pregnant women on prenatal care, walking to the neighbouring village to provide postnatal care to a mother and the new born. She takes a lot of pride in her work and feels a sense of achievement in the fact that due to her services, there hasn’t been a case of a pregnant mother or new born death in her area over the last year.
Looking back at the struggle she had to make throughout her life, Shagufta recalls, “I was two months old when my father passed away. My mother raised me and my sister with the little money she earned by stitching cloths. Her resources were meagre, yet she made sure that we both complete our matriculation. Thereafter, we completed our respective trainings. My sister became a Lady Health Worker and I became a Skilled Birth Attendant.”
In 2012, Shagufta graduated from an eighteen-month Community Midwife training course organised by UNICEF at the District Headquarter Hospital in Kasur. It wasn’t easy as the younger one of her two daughters was only a few months old. Support from her husband and the rest of the family helped her complete the training and their support continues while she works as an SBA.
Comparing the prenatal, delivery and postnatal care exercised by untrained birth attendants twenty five to thirty years ago to the modern day services offered by SBAs, Shagufta says, “My mother tells me that when I was born, a traditional midwife came to our house to manage the delivery. She had no concept of hygiene and did not even wash her hands before checking my mother. She placed some ash from the stove on the floor and delivered me there. Things have changed now. Lives lost due to unskilled practices can now be saved.”
Shagufta provides prenatal, antenatal and postnatal services to women and children in ten villages within Kasur district. She is popular being the only SBA in the area and also because of her friendly and pleasant disposition. Women feel comfortable discussing their issues with her.
“I conduct periodic check-ups of the pregnant women keeping a record of their blood pressure, body temperature, pulse rate and oedema,” says Shagufta. “It is important that I keep my contact with her right from early days of pregnancy till the delivery and thereafter to provide postnatal care to the mother and the new born.”
Pakistan is a country with a fairly high rate of maternal and child mortality. One of the reasons is lack of SBAs, especially, in remote rural areas. In collaboration with the Health Department, Punjab and some development partners, UNICEF initiated a training program for SBAs in various district hospitals in 2005. The objective of the programme was to train young women belonging to rural communities so that they acquire the skill and start their own maternity practice within their communities.
“Due to the positive results of this programme, the Government of Pakistan has scaled up the initiative across the country,” says Doctor Tahir Manzoor, Health Specialist UNICEF. “In Punjab province, more than 5,000 women have been trained and are performing valuable services within their own communities. We can already see the positive impact of their services and are certain that it will improve the scenario of mortality and morbidity for mothers and new born children in Pakistan over the next few years.”
Shagufta believes that ensuring health and safety for mother and child is imperative. “If mothers and children are healthy the entire society will be healthy. The future generations will be healthy. We must try to save lives as life is precious and you only get it once.”