Reducing maternal and child mortality in Punjab: The untapped potential of family planning

Maternal Health Policy Priorities in Pakistan: A Content Analysis of Policy Documents

“…We categorized codes on system and organizational capacity according to the following: investment and improvement, technological and physical infrastructure, performance measurement and management, and strategies and interventions. First, 14 documents mention investment and improvement in the following formats: heavy investment by the government to improve maternal health [13,18,36], low investment by the government [3,17], some improvement in maternal health because of investment (15; 28), and suboptimal improvement in maternal health despite signi cant investment [3,13,17,18,26,30,31,37]. Two documents mentioned the United Nations Sustainable Development Goals in reference to investing resources to improve maternal health outcomes [15,20].…”

“…Two documents suggested to increase the outreach of reproductive planning programs via public and private stakeholders [14,31], whereas one document mentioned birth spacing for improving maternal and child health [13]. Family planning services were generally accessed when available to citizens [3,28], but three documents asserted the need to increase their availability, which might reduce maternal mortality [19,26,29]. Four documents discussed some of the most common methods of family planning, which were barrier methods (e.g., condoms), sterilization, and intra-uterine contraceptive devices [28][29][30][31].…”

“…Two documents asserted that family planning services were mostly accessed through self-or co-payment mechanisms [28,29]. Three documents discussed poverty as a factor leading to higher risk during pregnancy and childbirth with 1 in 4 women without any means to afford family planning [26,29,31]. Two documents discussed government's budget for family planning and its future intent on establishing new mother and child health centers [34,36].…”

“…Interestingly, one document also discussed the need to employ women to make reproductive health care more affordable [14]. 17,19,26,34,41]. Three documents stated that having formal policies conveys that the government prioritizes family planning, reproductive health, and women empowerment and education [3,14,26].…”

“…Second, three documents stressed the need to develop long-term voluntary family planning methods to address birth spacing [26,37,42]. Another three documents emphasized the need to strengthen the existing infrastructure by employing more midwives, providing comprehensive sexual care including preand post-natal care, and establishing nutrition programs [13,19,25] where one document identi ed similar strategies for the province of Balochistan [26]. Increasing the marketing of contraceptives was also discussed by two documents to enhance access [3,33].…”