Identifying coverage bottlenecks in the Maternal, Neonatal and Child Health Care Services in Panjgur District, Pakistan

Abstract

Background: Ensuring access to Maternal, Neonatal and Child Health (MNCH)
services is of great importance for the life of pregnant women and newborns.
Objectives: This study is aimed to identify coverage bottlenecks in MNCH services
at PHC facilities in Panjgur District, Balochistan province, Pakistan.
Methods: Tanahashi Model of Health Services with six coverage stages was used
for identifying bottlenecks in MNCH services. Through two-stage sampling, the
data were collected from 262 married women of reproductive age 15-49 in the
catchment areas of eight selected PHC facilities. Descriptive statistics were used to
measure the coverage bottlenecks.
Results: The findings indicated that almost two-third (64.9%) of women were 20-
34 years old. Out of the total, more than half (58%) were housewives and 34% were
illiterate. Two-fifth of respondents belonged to the lower-middle income group.
The findings of this study indicated major coverage bottlenecks in the availability,
acceptability, contact and effective coverage. For availability coverage, the
unavailability of lady medical officers, essential medicine, and delivery services
were the major bottlenecks. In the case of acceptability coverage, seeking
permission to access MNCH services and non-responsiveness of staff were
important bottlenecks. Similarly, major bottlenecks were also found in the contact
coverage. This study also confirmed bottlenecks in effective coverage: insufficient
general check-up for MNCH services, shortage of human resource, insufficient
laboratory services, almost non-existing delivery services, lack of health education
and less service timing of PHC facilities.
Conclusions: The poorly managed MNCH services in Panjgur District have adverse
implications for the life of pregnant women and newborns. Integrated actions are
needed for revamping the MNCH services delivery strategies at district level and
ensuring availability of skilled birth attendants, particularly the lady medical
officers, provision of essential medicines, improving laboratories at PHC facilities,
taking serious initiatives for ensuring delivery services at the PHC facilities.