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  1. 1. Safe MotherhoodSafe Motherhood PakistanPakistan A struggle in the making
  2. 2. Each year in PakistanEach year in Pakistan • 25,000 women die due to complications of pregnancy and childbirth - one woman every 30 minutes ! • More than 300,000 babies die in the first month of life • 165 million – 2% annual growth • 4 births per woman, 1 induced abortion out of 6 pregnancies
  3. 3. Maternal HealthMaternal Health Indicators 2007Indicators 2007 MMR (estimates 2005) 500 Antenatal care 61% Births attended by skilled personnel [health facility] 39% [34%] Postpartum care 22% Contraceptive Prevalence Rate 30%
  4. 4. “The group... Will promote better coordination for making motherhood safer.... will raise awareness in safe motherhood at all levels, each member acting as catalyst for action and change. “The group shall be identified as: ‘Alliance for Safe Motherhood – Pakistan’.” Understanding among professionals, 2001
  5. 5. Vision 2020Vision 2020 • COMMUNITY AWARENESS, SKILLED ATTENDANCE, EMOC • Advocacy and watchdog • Catalyst • Debate and technical assistance • Networking • Voluntary membership of over 400 professionals and SM advocates
  6. 6. Strengths WeaknessesStrengths Weaknesses • Maternal, newborn health on the national agenda • Good numbers of researchers and advocates • Sufficiently large funds for intervention programs • Little coordination between stakeholders • Lack of harmony between research, advocacy agencies • No standard methods for monitoring and evaluation
  7. 7. The White Ribbon AllianceThe White Ribbon Alliance • Formalization and registration - 2006 • National WRA Secretariat • Public meetings in districts • Expansion of membership • Influencing the policymakers • Continued technical support to Ministry of Health • Safe motherhood conference
  8. 8. Ingredients of successIngredients of success (adapted from Shiffmann)(adapted from Shiffmann) • Actor power – leadership, enduring coalitions, civil society participation • Framing the issue – severity, one plan, one set of policies and interventions, one M& E framework • Governance structure of the sector and political context • Funding opportunities
  9. 9. Recent OpportunitiesRecent Opportunities • National MNCH Policy and Strategic Framework • Government’s commitment (Islamabad Declaration April 2005) • Led to the establishment of a A National MNCH Program in 2007 • Synergy, Continuum of Care, Collective Results • DFID, Norway, GAVI HSS, UN (Reform) • Example : skilled birth attendance
  10. 10. Action points for TheAction points for The White Ribbon AllianceWhite Ribbon Alliance • Lobbying decision makers and leveraging resources • Center for accountability – Repository of data – Watchdog – catalyst for implementation – Convener of national stock taking conferences – Brokering partnerships