In the places where our Foundation operates, women and children are often the most vulnerable. In Pakistan 16,500 women die during pregnancy or delivery each year. Most of these deaths occur in rural areas and in the absence of skilled birth attendants. In Chitral, a remote and isolated district in northern Khyber Pakhtunkhwa province, the situation is dire: 82 percent of births take place at home and only 13 percent of all deliveries are attended by a doctor or nurse.

Training for Community Midwives

To address the high levels of maternal and infant mortality in Chitral, the Chitral Child Survival Program (CCSP) has trained and deployed community midwives who are able to deliver vital healthcare to a family’s doorstep. The project has been implemented in partnership with the government of Pakistan’s National Maternal, Neonatal and Child Health Program, which aims to train and deploy thousands of community housewives across the country.

In 2009 the project established the Midwifery School in Chitral in partnership with the government of Pakistan. Over 60 women graduated from the school. The project assists community midwives to open private practices and charge reasonable fees for services, allowing these women a steady source of income while providing a vital asset for the community and protecting the lives of others.

Community-Based Savings Groups for Emergencies

The project also established community-based savings groups in order to improve access to funds for health care and emergency needs. These groups are comprised of self-selected members that meet routinely to save and make small loans and grants within the group. Over 8,000 women joined savings groups, helping them pay for healthcare and other emergencies.

The project has reached 90,000 women and children and delivered much needed hope for healthier lives.Going forward, the Aga Khan Development Network plans to use the critical lessons from the project and take them to scale in Pakistan and other countries where it works with integrated health and finance. For this purpose, the project produced a flyer with key results and lessons. Next steps include using the Network’s influence as a learning institution to share these lessons with a wider audience, and explore other models.

Key Lessons in Healthcare Access

• Increasing access to locally selected and trained healthcare providers can dramatically improve health outcomes in remote communities.
• Women’s savings groups offer a platform for promoting key health messages and empowering women’s participation. Women who had a family member in a savings group were four times more likely to seek services along the full continuum of healthcare than those who didn’t.
• Leadership through village committees is crucial for sustaining the community midwife health service model.

Chitral Child Survival Program (CCSP) is an initiative of the Aga Khan Foundation and the Aga Khan Health Service, Pakistan (AKHS,P) made possible by the generous support of the American people through the United States Agency for International Development.

Download the PDF version of the Chitral Child Survival flyer.