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In contrast to above, LHWs services were praised in many areas of 4 districts (Khuzdar, Pishin, Sukkur and Jhelum). Some even sympathized with them by saying that these poor women have to visit each and every house and that they should get more medicine from the government. “LHW helps us a lot and she is very good. We take our newborns to them for weighing and they also provide us with advice on family planning and medicines. During pregnancy they come to provide us T.T injections” (FGD- Killi Machan, Pishin). “She goes house to house to give medicines and takes women to hospitals, checks pregnant women and also gives T.T immunization.(IDI, Mo- City One, Pishin). “The LHW advises on taking care of the newborn and tells us about the diseases of the newborn” (Husband, Batezai, Pishin). “We are very happy with the LHW in our area. She goes house to house to give polio drops and medicines whatever she has. We also ask her to accompany us to the doctor” (FGD- Faizabad,Khuzdar). “The LHW is very nice and goes house to house to give polio drops and immunization to women. She also advises on family planning and accompanies the woman to hospital if she has any problem… Everyone here appreciates LHW because she provides everything for free” (FGD- Ghazgi, Khuzdar). “When my baby was born, LHW came and weighed the baby. The baby was weak; she advised me to breastfeed the baby and also gave me nutritional supplements including iron supplement syrup. She advised me to eat fruits and drink milk” (IDI, Mo- Pind Matey Khan, Jhelum). “Everyone considers them good. They have brought a lot of awareness and all women take their opinion” (FGD-Gol Pur, Jhelum). “The LHW takes good care of us and visits the pregnant woman to give T.T. immunization so that newborn does not get convulsions/fits at the time of birth” (FGD-Hangro, Sukkur). 8.2 Attitude towards allowing LHWs to be present at the time of delivery Almost all participants in 40 out of 45 urban and rural UCs of the study mentioned that that they will allow the LHW to be present at the time of delivery to take care of the newborn. “We will allow the LHW to be present at the time of delivery to take care of the newborn because this will provide us relief as we cannot go out if the newborn has any problem and there are no facilities.” (FGD- Karakh, Khuzdar). “(If present at the time of delivery) LHW will take care of the newborn and the dai will attend the mother” (FGD-Darvesh, Haripur). “Why would we not allow them They should assist the dai by providing advices. She will give immunization. If something goes wrong she can advise and can also visit us later” (FGD-Sakhi Sarwar, DG Khan). “She can advise the mother to take proper care of the newborn and will tell about the right medicine to be bought. We do not know because we are illiterate” (IDI, Mo-Arain, Sukkur). A few proposed a condition that they will only allow the LHW to be present at the time of delivery if she doesn’t charge any money. “If she doesn’t charge anything then we will allow her” (FGD-Saleh Pat, Sukkur). The 5 UCs in which participants were not ready to allow LHW to be present at the time of delivery were UC 8 in Sukkur, MC 4 and Nissata in Charsadda, and Wasti and Darvesh in Haripur. “People do not consider LHW as a good profession. Maybe 10-15 families will allow but the rest will not allow because the mothers-in-law say that they have also delivered babies and the babies are to be delivered by mother’s own force, what is the need of gathering other women” (FGD-Nissata) “This village is very backward and people here will not allow” (FGD-Nissata) “We will not allow the LHW to be present at the time of delivery because it is a matter of shame. We ask even the mother-in-law to leave the room and allow only the dai to remain with us inside at the time of delivery. The LHW will break our purdah outside and tell others the stories about how our babies were born. We will never allow the LHWs” (FGD-MC4) 50 l Formative Research on Neonatal Sepsis, Low Birth Weight AND Birth Asphyxia
Participants from UC 8, Sukkur, mentioned that they will not allow LHW because they all have their deliveries at health facilities. While in Wasti and Darvesh in Haripur participants suggested that it is better to provide the same training to the daiyan. The reason for not allowing was that they do not believe in LHWs and that LHWs do not have good attitude towards people. A few LHWs said that they will agree to take care of the newborns at birth only if their salaries are raised, while the others had no objection. “If our salary will be increased we will go to take care of the newborns at the time of delivery. We already have so many things to do and go to so many houses in a day. Our salary is very less.” (IDI, LHW-UC 8) Daiyan interviewed in-depth had mixed opinion. Many said that they will have no objection to let LHWs come along for taking care of the newborn, while few daiyan said that they will not allow the LHWs as they cannot learn to take care of the newborn even after training. Factors Conclusions and Summary Findings Informational • Participants in most areas mentioned polio drops for children as the major service provided by LHWs. • Respondents in some areas acknowledged that the LHWs provide advice for both mother and the babies. Socio-cultural • Only in few areas participants appreciated LHWs role and mentioned that they use the services provided by her. • Participants in other UCs mentioned that they seldom or never see an LHW visit their area. • Participants in only 5 out of 45 UCs said that that they will not allow LHW to be present at the time of delivery. • Some participants conditioned that they will allow the LHW only if she doesn’t charge any money. • Some daiyan seemed to have no objection in allowing LHW to be present at the time of delivery while a few did not believe that the LHW will learn to take care of the newborn even after training. • LHWs had no objection to attend to the newborn at the time of delivery; however, few LHWs said that she will do it only if their salary is raised. SAVE THE CHILDREN l 51
Page 1 and 2:
National Report Formative Research
Page 3:
National Report Formative Research
Page 6 and 7:
Acronyms AAA ANC BPCR DTL FGDs FROs
Page 9: Background and Objectives of the St
Page 12 and 13: Tool 4: Guidelines for In-depth Int
Page 14 and 15: T:44 Janobi Noor Colony (U) 8 Pichi
Page 16 and 17: 8 l Formative Research on Neonatal
Page 18 and 19: Theme 1 - Antenatal Care to Prevent
Page 20 and 21: Some daiyan 1 reported that women a
Page 22 and 23: then they have to go for an operati
Page 24 and 25: dishes. Climbing stairs is also rep
Page 26 and 27: Theme 2 - Low Birth Weight Almost a
Page 28 and 29: 2.2 Management of LBW Two most comm
Page 30 and 31: Factors Conclusions and Summary Fin
Page 32 and 33: “I did not receive any TT injecti
Page 34 and 35: have never seen misses (LHVs/Lady d
Page 36 and 37: put in newborn’s eyes for thee da
Page 40 and 41: Theme 4 - Asphyxia About 5-10% of a
Page 42 and 43: “If the baby does not cry it is n
Page 44 and 45: “This problem is not a disease it
Page 46 and 47: to an hour after delivery. The firs
Page 48 and 49: “In past the babies were given im
Page 52 and 53: Theme 7 - Care Seeking Outside Home
Page 54 and 55: “In civil hospital no body listen
Page 61 and 62: Recommendations The Project should:
Page 63 and 64: Appendix - 1: Terminologies for LBW
Page 65 and 66: Appendix - 2 : Terminologies for Co
Page 67 and 68: Appendix 3: Terminologies for Eye P
Page 69 and 70: Appendix 4: Terminologies for Skin
Page 71 and 72: Appendix 5: Local Terminologies for
Page 73 and 74: White small daney on baby’s skin
Page 75 and 76: Blue baby Unconscious and dies afte
Page 77 and 78: Papules on the skin Swelling or red
Page 79 and 80: Turning blue Unconscious Less activ
Page 81 and 82: Blood deficiency Severe fever. It i
Page 83 and 84: Breathing problems Mucous in chest
Page 85 and 86: She stayed like that for seven days
Page 87 and 88: At delivery, the newborn was not br
Page 89 and 90: Case Study 7 (Charsadda): Low Birth
Page 92: Pakistan Country Office P.O. Box 19
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