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Success Story
USAID project
transforms traditional
birthing practices for
healthier communities
Better Birthing in Rural Pakistan
Photo: John Snow, Inc.\John Snow
USAID trains traditional birth attendants
to more safely deliver children in remote
villages.
USAID has trained more
than 250 traditional birth
attendants who now
implement more evidencebased,
medically safe care
for expectant mothers in
their communities.
On a rural road in Taxila, Pakistan, three USAID-supported health
trainers waited in their car for Taxila’s traditional birth attendant, a
woman named Naseem. Their meeting with Naseem should have
begun two hours earlier but she was nowhere to be found. Should
they take Naseem’s absence as a hint that she didn’t want to meet
with them? They did not anticipate an easy visit, but this meeting was
imperative to them, as well as to the community of Taxila.
As a traditional birth attendant, Naseem provides the only obstetric
care in Taxila. She assists pregnant women during birth, and presides
over deliveries. Most women in Pakistan deliver using a traditional birth
attendant, but few attendants have been formally trained and almost
all lack proper medical tools. Traditional practices at times result in the
death of a mother or newborn. While families continued to experience
the anguish of losing a child, little has been done to deal with the
country’s high infant mortality rate.
In response, USAID established the Pakistan Initiative for Mothers and
Newborns (PAIMAN) to address the country’s lack of quality obstetric
care. Supported by USAID, PAIMAN collaborates with communitybased
organizations all over the country to renovate and establish
clinics, distribute medical supplies, educate the public through various
media, and train traditional birth attendants and midwives. When
Naseem finally arrived for the meeting, the USAID workers explained
the contents of the upcoming workshop for traditional birth attendants
and convinced her to attend. The workshop would provide her with
much-needed knowledge and skill in obstetric and prenatal care.
After 15 years of practice, Naseem was reluctant to change the way
she practices midwifery. But, after an hour-long discussion she was
convinced to attend the workshop. Once the workshop got underway,
Naseem’s reluctance softened. During the eight-day workshop,
she learned a client-centered approach, clean delivery practices,
recognition of danger signs, and the importance of timely referrals for
women who need hospital care.
By the end of the workshop, Naseem, along with the 20 other
attendants, renounced their previous methods as dangerous for both
mothers and newborns. “I will stop practicing all harmful practices
while conducting deliveries,” she said. “I will only observe and apply
skills that have been taught to us in the training.”
Naseem is one of more than 250 traditional birth attendants and 2350
community midwives in rural Pakistan who have taken part in the
USAID training and now implement safer medical care for expectant
mothers.
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