35

Commercially Viable Community Midwives:

Mercy Corps Pakistan

CORE Group Spring Meeting

8 May 2014

Mission: Mercy Corps exists to alleviate suffering, poverty and oppression by helping people build secure, productive and just communities.

History: Operational in Pakistan since 1986, addressing health (MNCH and infectious disease), emergency response (2005 earthquake and 2010 floods), WASH, economic development, and youth programs

Scale: Reaching 50% of Pakistan’s districts in all provinces, through partners

Mercy Corps in Pakistan

CONTEXT: Double burden

High maternal and newborn mortality Limited economic opportunities for women

132nd out of 134th

Pakistan’s rank for ease of starting a

business as a woman

1 in 28 babies

in Pakistan do not make it past the first month of life

Can Community Midwives (CMWs) reduce maternal and newborn deaths, while generating a viable income?

A regional question….

Three tiered solution:Policy, Service Delivery, and Community

Policy

LEVEL

Advocacy

INTERVENTION

Research

Clinical Training

Business Training

Microloans

Mamta Transport Fund

Women Support Groups

Community

Service

Delivery

OUTCOMES

Enabled policy environment for CMWs

Increased and sustained availability

of quality MNH community-based

services through CMWs

Increased demand and access to

CMW and referral services

Reduced

maternal

and

newborn

mortality

IMPACT

Mobile Technology

Policy Interventions

Provincial Steering Committees (PSC) and Technical Working Groups (TWGs) to facilitate policy changes

in Pakistan’s recently devolved health system

• Misoprostol for PPH

• Inclusion in provincial Essential Drug Lists

• clinical protocols endorsed

• pre-service curriculum endorsed

• Community Midwifery Strategy Roadmaps endorsed and approved

• Chlorhexidine for newborn care (under development)

Results to date: Uptake of CMW services

Average # and type of services per month per CMW

within five months of deployment

Results to date: Financial Viability of CMWs

Average NET income (USD) per month per CMW

Within five months of deployment

USD 34: Avg. income for women who work outside the home in

Quetta*

*Source: KPC 30 Cluster Survey, Quetta, MC PRM program, Nov 2013

Long Term Sustainability

Average # of service and income per CMW two years after deployment

Case Study

Thank you!