Introduction
Pakistan faces a significant challenge in maternal health, with a maternal mortality rate of 297 per 100,000 live births, one of the highest globally. The government introduced community-based midwives (CMWs) to address this issue, particularly focusing on the poor and socially excluded women. However, questions remain about the effectiveness of CMWs in reaching these marginalized groups.
Research Insights
The study titled "Are community midwives addressing the inequities in access to skilled birth attendance in Punjab, Pakistan? Gender, class and social exclusion" provides critical insights into the barriers faced by CMWs and the women they serve. The research employs a mixed-methods approach, combining quantitative surveys and qualitative ethnographic studies to explore the challenges and barriers in accessing CMW services.
Key Findings
The research identifies several barriers that impede access to CMW services for poor and socially excluded women:
- Financial Barriers: The fee-for-service model poses a significant challenge, as the poorest women cannot afford these services.
- Social and Cultural Barriers: Class and caste dynamics, along with gender norms, influence women's access to CMWs. Social exclusion frameworks reveal how these factors marginalize women from essential health services.
- Organizational Challenges: CMWs face organizational and logistical challenges in reaching remote and underserved areas.
Implications for Practice
Practitioners and policymakers can draw several lessons from this research to improve maternal health outcomes:
- Policy Reforms: There is a need for policy reforms that address financial barriers, such as subsidizing CMW services for the poorest women or implementing voucher systems.
- Training and Sensitization: Training programs for CMWs should include components on cultural competence and sensitivity to the needs of marginalized women.
- Community Engagement: Engaging community leaders and influencers can help address social and cultural barriers, promoting wider acceptance and utilization of CMW services.
Encouraging Further Research
This study highlights the need for further research into the structural barriers within health systems that affect marginalized populations. Practitioners are encouraged to conduct localized studies to understand specific community dynamics and develop tailored interventions.
Conclusion
The research underscores the importance of addressing social exclusion and inequities in maternal health care. By implementing the study's recommendations, practitioners can enhance access to skilled birth attendance and improve health outcomes for marginalized women in Pakistan.
To read the original research paper, please follow this link: Are community midwives addressing the inequities in access to skilled birth attendance in Punjab, Pakistan? Gender, class and social exclusion.
