KARACHI: Pakistan could easily prevent about 10,000 maternal deaths from unsafe abortion each year simply by providing an enabling environment for a large national network of independent healthcare providers and general practitioners so that they can provide essential maternal health services.
Dr Syed Azizur Rab, chief executive of the Karachi-based non-profit organization Greenstar, stated this in an interview with The News. He said Greenstar has a network of 7,000 clinics across the country providing family planning and maternal health services in disadvantaged areas for the past 30 years. He stated that Pakistan experiences about 10 million pregnancies every year and about 4 million of them are unwanted while an estimated 2.6 million abortions every year occur in the country. She said that 2.6 million of these women chose abortion because of the lack of family planning services in the country. Every abortion is testimony that we have twice disappointed these women. First, when we do not offer them the option of birth spacing by either method, and secondly by not giving them the option of managing this serious emergency in a trained service provider facility.
Dr Rab is of the view that abortion-related deaths occur because untrained midwives provide such emergency medical services in an unsafe environment by not following infection prevention protocols and using unsterile surgical instruments.
He said the Pakistani government had taken steps in the right direction by publishing guidelines at the federal level that would allow health care facilities across the country to provide post-abortion care (PAC) services. She said the guidelines have established bona fide medical and surgical methods to be performed under certain medical conditions that ensure maternal safety.
The CEO of Greenstar said the use of a manual vacuum cleaner (MVA) kit by a trained service provider or doctor could easily prevent abortion-related deaths that occur primarily due to the adoption of unsafe surgical methods for the purpose. He said one of the main problems is that MVA kits are not freely available these days due to their high price after exorbitant import duties.
He stated that previously the MVA kit was available in the country for Rs3,000 but now the cost has increased to Rs9,000 due to the increase in import duties coupled with the devaluation of the Pakistani rupee. “The tripling of the MVA kit price means that service providers are unable to provide post-abortion care services via the prescribed and approved method,” he commented, adding that the combination pill misoprostol and mifepristone should be available in the country as the safest medical method for post-care services. abortion to save the life of the mother and for the necessary care as outlined in the approved national guidelines.
He is of the view that as Pakistan is facing another increase in Covid-19 cases, it could affect maternal health as experienced in the first wave earlier this year. She appealed to the public and private sectors to work together and use their strengths to serve women in Pakistan. The private sector can improve service quality, trained service providers and management skills, while the public sector can support them by providing commodities, good governance and a supportive environment, he said.
Lastly, she highlighted the need to stock up on essential products for women’s care in service providers’ clinics for quick access and support for women in need, especially in areas where there are no chemical shops available. He said that if these recommendations were implemented, strong public-private partnerships could help reduce maternal mortality. She concluded by sharing that it took 70 years for maternal death and stunting to find space in her opening speech. a prime minister. With more than 70 percent of women going to the private sector and paying for themselves, it is time for our nation to take advantage of this opportunity and save the lives of these women, she said.