President, Vital Pakistan
Saving Children’s Lives in a Pakistani Village through a Perinatal Care and Primary Health Promotion Intervention Package.
Rehri Goth in Karachi, Pakistan
Rehri Goth is one of the oldest peri-urban villages in the metropolitan city of Karachi, Pakistan. Poor infrastructure, lack of access to the basic life necessities and poor health indicators are the major challenges in the village. The under-five mortality in the Rehri Goth is very high, 106 per 1000 live births with a greatest portion (65%) dying in the neonatal age period. Poor care during pregnancy, high malnutrition (70%) rates, unskilled delivery, lack of skilled maternity facilities and poor newborn and child care are the major hurdles in improving child health indicators.
This project proposed the implementation of an evidence-based maternal, newborn and child health intervention package designed to address the major barriers and targeted to reduce under-five mortality in the impoverished fishing village of Rehri Goth in Karachi, Pakistan. The intervention package will include:
- Antenatal Care (ANC) and Counselling for Birth Preparedness: Women will be identified early in pregnancy through surveillance in which trained Community Health Workers (CHWs) will visit each household every three months. The CHWs will perform 2 ANC visits and encourage pregnancy registration at a USAID upgraded government maternity hospital for delivery. Transport will be provided.
- Skilled delivery will be promoted and incentivized by encouraging all pregnant women in the area to give birth at the upgraded government facility. A conditional cash transfer will be given to cover related expenses and emergency obstetric transport will be provided.
- Community Newborn and Infant Care will be provided for all infants; CHWs will make home visits – weekly in the first 2 months, then monthly. They will promote exclusive breast-feeding, clean cord care, recognition of danger signs of illness, water and sanitation advice, and link to local immunization services. Sick infants will be managed according to WHO’s care guidelines for low-resource settings.
- A Nutrition Package will provide maternal calcium, iron, and folic acid supplementation during preconception period and pregnancy, balanced protein energy supplementation in pregnancy, Vitamin A and zinc supplementation for children less than 5 years of age, and complementary feeding advice based on local diets.
Promoting Immunization by ensuring greater than 90% coverage for vaccines in the National Immunization Programme, including BCG, Hib, Measles, DPT, polio, Rotavirus, and Pneumococcal vaccines, and maternal tetanus vaccine.
This project provides a unique opportunity to put evidence-based research findings from separate studies of different interventions recommended by the World Health Organization for resource-limited settings together as a “bundled” maternal-child health intervention package, and demonstrate its tremendous life saving potential.
Dr. Anita Zaidi is passionate about child health and has worked in this area for over 25 years. She trained in the United States as a pediatrician, microbiologist, pediatric infectious disease specialist, and public health professional. Dr. Zaidi left a faculty position at Harvard to return to her home country, Pakistan, in 2000 where she built a child health research program in impoverished urban and rural Pakistani communities designed to find innovative low-cost solutions to saving children’s lives in resource-constrained settings. She possesses extensive project management experience and has successfully completed multi-million dollar projects of many international agencies. Dr. Zaidi’s work has been recognized globally, and you can read more about her in this 2013 profile for the prestigious journal The Lancet.
Dr. Zaidi applied for and won the inaugural 2013 Million-Dollar Children’s Prize as an individual. She established the organization, Vital Pakistan Trust, after her selection as the winner with the mission of improving the well-being of mothers and children in Pakistan.