Pakistan is among those countries where an unacceptably high number of mothers and children are lost every year due to mostly preventable causes. Research has highlighted the fact that while ultimately every death has a medical cause, our socio-cultural norms as well as lack of correct knowledge about the health of mothers and babies are among the crucial factors in the loss of these precious lives. Interventions geared towards improving maternal and child health therefore need to focus both on improving health care systems - hospitals, doctors and medical supplies - as well as empowering households and communities to understand their health situation and take correct actions for improving it.

Improving knowledge and attitudes, which is usually referred to as the demand-side of the health equation, is sometimes as crucial as investing in infrastructure, doctors and medicines called the supply-side. Improving knowledge and attitudes paves the way for healthy households and communities significantly reducing the burden on health care system.

Taking note of this important factor, Pakistan Initiative for Mothers and Newborns (PAIMAN) has remained focused on evidence based communication strategies to ensure that the households and communities have the right knowledge and are motivated to take actions for improved health and wellbeing of mothers and children. The Communication Advocacy and Mobilization (CAM) Strategy of PAIMAN has adopted a multimedia approach to ensure that our messages are heard in every nook and corner of our target areas besides ensuring synergy of effort for effective behavior change among the targeted population. PAIMAN has therefore used Interpersonal communication, groups and folk media as well as mass media for ensuring wider reach and effective reach of its health messages.

PAIMAN's mass media interventions cover a wide range of products including radio and television talk shows, television commercials, drama series, documentaries and music videos. This multi-genera approach is to ensure that PAIMAN captures the attention of a variety of its audiences ranging from policymakers to households. Television talk shows therefore have been designed to put on spotlight our policymakers while dramas, music videos and commercials are aimed at ordinary men and women to convey key maternal and child health messages. PAIMAN also feels responsible for sharing its experience with its stakeholders and hence documentaries on its key field approaches are part of this extensive range of products. All this is to ensure that we are able to effectuate a positive change in attitudes and behaviors towards pregnancy and childbirth. The results so far are quite encouraging. Our initial studies have revealed that more than 12 million people had watched our drama series “Paiman”. An impressive five million people have been reached through our interpersonal communication activities. There has been a significant increase (over 50%) in knowledge about the importance of antenatal and postnatal care while care seeking at PAIMAN upgraded hospitals has gone up by 35%.

Message from the COP

To share the progress, successes and barriers in scaling up the best practices identified in 2007, a meeting titled, 'Reconvening Bangkok: 2007 to 2010 Progress Made and Lessons Learned in Scaling-UP FP/MNCH Best Practices in Asia and the Middle East (AME) Region' was held in Bangkok from 5-12 March 2010, and was organized by USAID. The main objectives of this meeting were to :

Present progress, success and barriers in scaling-up best practices since the 2007 Bangkok meetingDevelop work plans to spread successful best practicesTo learn from world experts on new FP/MNCH Best Practices and methodologies for scaling-up

The workshop was attended by more then 400 health managers, service providers, program planners and USAID representatives. The PAIMAN team led by COP Dr. Nabeela Ali, representatives of JSI and PAIMAN consortium partners also attended the meeting and provided their inputs. The inputs of Pakistan Country team were presented by Dr. Rashid Jumma, DG Health -Pakistan. At the end of the workshop work plans were prepared to spread successful practices.

Dr. Nabeela Ali

Scaling up FP/MNCH Best Practices in Asia and Middle East

January - March, 2010 - Issue 10

Tajdeed-e-Paiman A promise renewed message' was held on March 25, 2010 at Serena Hotel in

Islamabad to show the music video for the very first time. The

event was attended by Gerald Feierstein, US Deputy Chief of

Mission, Dr. Rasheed Jooma, Director General Health and

Shokat Hayat Durrani, Secretary Ministry of Population

Welfare, Pakistan and among others were prominent

government, development, media and health representatives.

Sajjad Ali, the vocalist of song Zindagi, was personally there

at the occasion to entertain the audience with his ever famous

classics and unmatched vocals.

Research shows that music videos have become a force that

instigates strong emotions in audience and effects social roles

and behavior. There are countless jingles and promotional

songs related to social issues which have been playing a very

important role in realizing the need of action. In Pakistan, in a

short span of time there are already more than five dedicated

music channels by all major networks. This is just one of the

The launching ceremony also featured a tribute to mothers

presented by famous classical dancer, Nighat Chaudary, the

dissemination of Mass Media Products, Sharing of

Publications and Exhibition of Calendars produced from

2005-2010. The event was also marked to present PAIMAN shields to Mr.

Robert Wilson, Dr. Farooq Akhtar, and Dr. Iqbal Ahmed

Lehri for their dedication to bring a positive change in the

lives of Pakistani mothers and children.

testaments that depict the popularity of the medium of music.

Leveraging the ever growing trend of communicating the

messages through the medium of music, PAIMAN has once

again launched its second music video 'Zindagi' based on the

theme of child care as a shared responsibility of both the

husband and wife. Zindagi takes stock from the successful

launch and airing of the first music video 'Paiman'.The launching event “Tajdeed-e-Paiman” and as termed by a

leading Pakistani English newspaper 'soft sell of a vital

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“An Innovative Intervention to Promote Child Health”Community Integrated Management of Newborn & Child Illnesses

Integrated Management of Newborn and Childhood Illness (IMNCI), is a standard management strategy of WHO for reducing newborn/childhood mortality and morbidity in the developing countries. IMNCI focuses on improving the health system by ensuring availability of essential drugs, improving communication and counseling skills of health workers along with the education of mothers, fathers, child care providers and members of the community.

PAIMAN through this approach is also focusing on activities to support child survival in 23 districts of Pakistan,

It is expected that once these LHWs are trained in CIMNCI, particularly in the last two years. The program is imparting they will be capable of identification, management & timely training to health care professionals at district-level on referral of children suffering from common childhood Integrated Management of Childhood Illness (IMNCI) illnesses. This intervention would effectively contribute in through a well-defined plan which includes Training Need reducing the child mortalities particularly caused by common Assessment, review of existing curriculum and modification illnesses like diarrhea, pneumonia & nutrition related and development of a standardized curriculum, execution of disorders which in most of the cases go unaddressed at trainings, and assessment of impact of the trainings. In primary & advanced stages. addition a robust Operation's Research strategy has been

undertaken to focus on testing interventions and delivery A customized training module has been evolved for this strategies which may improve child survival outcomes in training along with standardized quality assurance & Pakistan and improve determinants. monitoring tools. A pool of facilitators have been prepared at national, provincial & district levels through series of ToTs. Most of the district level trainers are facility based health care providers who were already trained in IMNCI, e.g. MOs, WMOs, LHVs.

These trainers are rolling out CIMNCI training to LHWs at the facility levels which are monitored through external monitors to ensure optimum quality.

So far PAIMAN in collaboration with 'Save the Children' has trained more than 6200 Lady Health Workers in 23 program districts, spread across all four provinces and it intends to train around another 500 LHWs by the end of March 2010.

PAIMAN is addressing the following three components under IMNCI.:

1. Improving the skills of health workers at the facilities.2. Improving access and referral system. 3. Community IMNCI through LHWs

PAIMAN in collaboration with its partner Save the Children is aiming to link IMNCI at the gross root level with the Lady Health Workers. Through this training integrated approach towards management of childhood illnesses is being inculcated in the LHWs to enable them in identifying and managing common childhood illnesses at household levels along with referral of children with dangerous signs to nearby health care facility.

Type of training (CIMNCI) No of participants/trainees National ToT 24 Provincial ToTs 98 District ToTs 653 Roll out (for LHWs) 6265

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For feed back & suggestions please write to: Editor, PAIMAN News RoundupPopulation Council, H # 7, St. 62, F-6/3, Islamabad. Or E-mail: newsletter@paiman.org.pk

M&E and OR Thematic Group Meeting

PAIMAN Monitoring &Evaluation (M& E) and Operations The last leadership training workshop of the District Managers Research (OR) Thematic Group Meeting was held at from the 'new' PAIMAN districts on “Strengthening District Population Council office Islamabad, on February 1, 2010. Health Systems through Leadership and the Client Centered The main objectives of meeting were to review the Services” took place from January 14 20, 2010 in Islamabad. PAIMAN end line evaluations, ongoing operations research Eighteen district managers including the Executive District studies and to get feedback of partners on end line Officer (Health and Finance & Planning), the District household questionnaire. PAIMAN partners from Coordinator National Program, the Medical Superintendent, Population Council, JSI, Save the Children, JHU-CCP and the District Nazim, District Coordinator MNCH Program, Contech International involved in M&E and OR attended

the meeting . Dr Zeba Sathar, Country Director, Population

Council, welcomed all the participants and explained the

backdrop and objectives of the meeting. The peculiarity of

this meeting was the participation of visiting scholar, Dr.

Anrudh Jain who presented the overall scheme of end line

evaluations. He described various PAIMAN inputs and

gave an illustration of various factors involved in

promoting skilled birth attendance (SBA). PAIMAN

partners gave their valuable inputs on end line

questionnaire and suggested a few additions. Preliminary

findings of quantitative and qualitative research under

CMW study were presented by The Population Council. All District Coordinator LHW Program, Deputy District Officer the partners updated on their ongoing, completed or Health, District Population Welfare Officer, Assistant District upcoming evaluations. Dr Nabila Ali, COP PAIMAN, Population Welfare Officer, Social Welfare Officer, Senior praised the efforts of Population Council during the Medical Officer and Chief Coordinator Public Health from exercise to design end line evaluation. She termed the Quetta, Sibi, Peshawar and DI Khan attended this training findings of OR study very informative and said that workshop. Dr. Zeba A. Sathar, Country Director, Population PAIMAN would take action to rectify the shortcomings of Council and Dr. Nabeela Ali, Chief of Party, JSI PAIMAN CMW program. She suggested that Population Council, JSI project addressed the participants in the Closing session on and Contech should join to see the impact of PAIMAN at the January 20, 2010. Heath Facility level.

In total, 142 district managers (135 males and 7 females) have

been trained in eight leadership workshops organized by the

Population Council.

Training District Managers on Leadership:

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CA#391 A-00-05-01037 is funded by the United States Agency for International Development and implemented by JSI Research & Training Institute, lnc.

In conjunction with Aga Khan University, Contech International,Johns Hopkins University / CCP, The Population Council, Save the Children USA

JSI Research & Training Institute, Inc.