Upscaling Family Planning Practices, Tertiary Care Hospitals in Sindh Province, Pakistan.

Dr Nighat Shah, Dr Nusrat Shah, Dr Farah KHan, Dr Hira Bashir

 

 

Context: Pakistan is fifth most populace country in the world. We have highest maternal  and perinatal mortality the region. Our contraception prevalence at 34% has been stagnant since almost a decade. Tertiary care hospitals see a huge population of poor, pregnant and critical mothers.  The focus is on saving mothers and neonates and in the process family planning practice becomes a lesser priority. The minister of health took note of above and appointed the author as focal person for family planning practices upscale in Sindh province re tertiary care. This research focuses on interventions undertaken to improve the practices

Objective: To upscale the family planning practices in five tertiary care hospitals of Sindh.

Design: Pre and Post Quasi Experimental study

Method: Five of the biggest public setup hospitals doing around 100 thousand delivery per year were engaged through vice chancellors and head of the departments. Counsellors were deployed, Postgraduates were trained and sensitized, regular data entry was checked on Electronic contraception software, commodities were made available and obgyn head of departments were asked to assign focal persons for regular interaction.

Results: The baseline data which was initially evaluated showed less than 5% contraception only in the form of BTL in prior scars or caesarian hysterectomies for accreta placentae. After the intervention the upscale in practice in one year was around 30 % and current census showed postpartum family planning and post abortion family planning in tertiary care hospitals around 42%

Conclusions: Tertiary care hospitals have to play the role in family planning and adapt these practices to improve maternal health and reduce maternal and perintal morbidity and mortality