Health Sector Assessment of Khyber Pakhtunkhwa

on behalf of the Asian Development Bank (ADB) with focus on Behavior Change Communication (BCC) in the area of Mother and Child Health (MNCH)

Name of assignment or project: Health Sector Assessment of the Asian Development Bank (ADB) of Khyber Pakhtunkhwa/PAKISTAN

Year: from October 2017 to June 2018

Client: Asian Development Bank (ADB), Manila/Philippines

Position held: Behavior Change Communication Expert

Background of the project:
Behavior Change Communication (BCC) should be an integral part of every approach to improve a health system, especially in developing countries and emerging nations. Communication is considered to be a key element in changing behaviors. One of Pakistan’s main challenges is the poor outcomes for Mother and Child Health (MNCH), which are even poorer in KP. The Maternal Mortality Ratio in the province is 206/100000 (178/100.000 in Pakistan), only 48 percent of deliveries take place in the presence of a skilled birth attendant (52 percent in Pakistan) and 60 percent receive ANC from a skilled birth provider (73 percent in Pakistan). Therefore implementing efficient BCC strategies for MNCH to improve the behavior of mothers, their family and of health care providers is an important step into the right direction.

Main project features:
The assessment focused on secondary care facilities since most BCC activities have been focusing on primary care interventions. It aims to analyze if any BCC efforts have been made on secondary level so far and if not, which steps could be undertaken to implement a successful BCC strategy for secondary care facilities.

Activities performed:

• Analyzed the situation of MNCH in KP with a focus on health seeking
  behavior of mothers and their families.
• Identified BCC challenges on demand side, supply
  side and cross cutting level.
• Drafted of a BCC strategy for secondary care interventions for
  KP.
• Reviewed literature on MNCH and BCC in Pakistan and in KP.
  Conducted interviews with important stakeholders (DOH, JICA, UNICEF, WHO, Health Service Academy,
  PIDE, NIPS, LHWP, et al) in Islamabad and Peshawar.
• Conducted a workshop with the government of KP in Peshawar around BCC.