Development of this program is a way forward not only to continue existing interventions through an integrated approach but to expand their scope and introduce new interventions. Some of the program/ interventions which will be integrated and implemented through this program are as following:
1. The National Program for Family Planning and Primary Health Care
The National Program for Family Planning and Primary Health Care, also known as the Lady Health Workers Program (LHWP), launched in 1994. The Program objectives contribute to the overall health sector goals of improvement in maternal and newborn child health and provision of Family Planning services. This country wide initiative extended outreach health services to rural populations and urban slum communities through deployment of over 46,000 Lady Health Workers (LHWs) and 1850 Lady Health Supervisors (LHSs) in all over the Punjab are working with 70% coverage (37% in Urban and 85% in Rural area) and contributed to bridge the gap between health facilities and communities.
- Access to Reproductive Health and Nutrition services.
- Improving Maternal, New-born and Child health.
- Providing Family Planning services.
Scope of work of LHWs:
- To register all family members in the catchment area especially the eligible couples (married women age 15-49 years) in their respective area.
- To organize community by developing women groups and health committees in her area and to discuss with the community, issues related to better health, hygiene, nutrition, sanitation and family planning emphasizing their benefits towards improved quality of life.
- To coordinate with local Community midwives or other skilled birth attendants and local health facilities for appropriate antenatal, natal and postnatal services.
- The LHWs also participate in various campaigns for immunization against EPI target diseases e.g. polio, MNT, measles etc. in her catchment's area only.
- To motivate and counsel clients for adoption and continuation of family planning methods. She provides condoms, oral pills and administer Injectable contraceptives, as per defined protocols, to eligible couples in the community.
2. National Maternal and Newborn Child Health (MNCH) Program
National Maternal and Newborn Child Health (MNCH)Program (2006-2012) was lunched nationwide with a goal to improve maternal, newborn and child health of the population, particularly among its poor, marginalized and disadvantaged segments. The program is contributing to strengthen Emergency Obstetric care services at DHQ, THQ hospitals and RHCs. Further, this program has introduced a new cadre of Community-Midwives (CMWs) for skilled deliveries at community level.
Community Midwife (CMW):
CMWs are internationally recognized as frontline workers that can reduce maternal mortality. The National MNCH program introduced a new cadre of skilled birth attendants called "Community Midwives" (CMW). Training of CMWs started in 2007/08. Candidates were trained by at least 3 tutors both for theoretical and clinical supervision in designated midwifery schools, after which they received 6 months of practical training (on ANC, normal domiciliary deliveries, PNC and new born care) at practice sites in communities or health facilities with at least one instructor (WMO/Nursing Instructor). On completion of training course and Passing of examination from PNC, CMWs receive diploma certificates from PNC and permission from District Evaluation Committee they are being deployed in the community around 5,000/10,000 people (Rural area and urban slums). There are currently 6500 CMWs are training and deployed in Community (1 CMW per 5,000 & 10,000) to provide MNCH Services. CMWs has been linked with BHUs and RHCs through LHWs meeting in the Health Facility & in the DMUs.
24/7 Basic EmONC Services:
Initially 24/7 Basic EmONC services were started in 2010 in the selected BHUs of 7 flood effected districts (D.G. Khan, Layyah, Muzafargarh, Rajanpur, Mianwali, Bhakkar and R.Y.Khan). By achieving the good results of this initiative, the Government of the Punjab had decided to implement it all over the Punjab in 3 phases. 150 BHUs in Phase-1 were upgraded in 16 districts in 2013-14. 550 BHUs (Including 150 Remaining BHU of Phase-1, 200 BHUs of Phase-2 & 200 BHUs of Phase-3) were upgraded in 32 districts in 2014-15 as per direction of Chief Minister all 550 BHUs have to be functional in 2014-15. Overall 302 RHCs and 700 BHUs are providing MNCH services 24 hours and 7 days of week in all over the Punjab.
3. Nutrition Program
Preventive services are being provided in 36 districts of Punjab through LHWs which include screening of under 5 children and PLWs, IYCF counselling, Provision of IRON, Vitamin-A and MMS to Mother and Child. Curative Nutrition services were initially started in 2010 in the selected BHUs of 7 flood effected districts (D.G. Khan, Layyah, Muzafargarh, Rajanpur, Mianwali, Bhakkar and R.Y.Khan). By achieving the good results of this initiative, the Government of the Punjab decided to implement it all over the Punjab in 3 phases. Now Total 589 Outdoor Therapeutic Programs (OTPs) in 22 District at RHC/BHU level and 18 Stabilization Centers (SCs) in 14 Districts at DHQ/THQ level. Treatment of Severely Acute Malnourished Children without medical complication by provision of Ready to Use Therapeutic Food (RUTF) is carried out at OTPs. Treatment of Severely Acute Malnourished Children with medical complication by provision of medical treatment and therapeutic formulas F75 and F100 carried out at SCs.