CHALLENGES IN ACCESS TO AND UTILIZATION OF REPRODUCTIVE HEALTH CARE IN PAKISTAN
AbstractBackground: Pakistan’s maternal mortality rate is high, and adequate and timely emergency servicescould prevent most maternal deaths. A woman’s right to life-saving services of skilled health careproviders in childbirth is undeniable. This paper examines factors restricting women's access toemergency obstetric care services in Pakistan. Method: This cross-sectional survey on emergencyobstetric care services collected information at the health facility level using UN process indicators. Thestudy enrolled 170 health facilities from nineteen randomly selected districts in Punjab and NWFP.Results: Diverse factors limit women’s access to Emergency Obstetric Care (EmOC) services. EmOCservices were unavailable in most health facilities surveyed. Staff absenteeism, geographic remoteness,delayed access, and ambulance shortages jeopardize the transferral of seriously ill patients to higher levelcare facilities. Cultural norms dictate that women should be examined by women doctors, whose dearthmakes these services inaccessible. Conclusion: Many maternal deaths would be avoidable if EmOChealth services were accessible. The geographic obstacles to timely access, poor hospital infrastructure,and high staff absenteeism rates require immediate attention. Health facilities' working hours wereinconsistent with the provision of around-the-clock essential services, depriving and endangering thelives of many in need. It is imperative to increase skilled female workers capable of managing EmOCproblems through proper incentives. A focused approach at local levels through proper supervision,motivation, and management would unquestionably save women's lives.Keywords: Maternal health, social access, women mobility, referral hospitals; EmOC services.
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