1. 35
Commercially Viable Community
Midwives:
Mercy Corps Pakistan
CORE Group Spring Meeting
8 May 2014

2. Mission: Mercy Corps exists to alleviate suffering, poverty
and oppression by helping people build secure,
productive and just communities.
History: Operational in Pakistan since 1986, addressing
health (MNCH and infectious disease), emergency
response (2005 earthquake and 2010 floods), WASH,
economic development, and youth programs
Scale: Reaching 50% of Pakistan’s districts in all provinces,
through partners
Mercy Corps in Pakistan

3. CONTEXT: Double burden
High maternal and
newborn mortality
Limited economic
opportunities for women
132nd
out of
134th
Pakistan’s rank for ease
of starting a business as
a woman
1 in 28
babies
in Pakistan do not make
it past the first month of
life

4. Can Community Midwives (CMWs) reduce maternal and
newborn deaths, while generating a viable income?
A regional question….

5. Three tiered solution:
Policy, Service Delivery, and Community
Policy
LEVEL
Advocacy
INTERVENTION
Research
Clinical Training
Business Training
Microloans
Mamta Transport Fund
Women Support Groups
Community
Service
Delivery
OUTCOMES
Enabled policy environment for CMWs
Increased and sustained availability of
quality MNH community-based
services through CMWs
Increased demand and access to
CMW and referral services
Reduced
maternal
and
newborn
mortality
IMPACT
Mobile Technology

6. Policy Interventions
Provincial Steering Committees (PSC) and Technical
Working Groups (TWGs) to facilitate policy changes in
Pakistan’s recently devolved health system
• Misoprostol for PPH
• Inclusion in provincial Essential Drug Lists
• clinical protocols endorsed
• pre-service curriculum endorsed
• Community Midwifery Strategy Roadmaps endorsed and approved
• Chlorhexidine for newborn care (under development)

7. Results to date: Uptake of CMW services
Average # and type of services per month per CMW
within five months of deployment

8. Results to date: Financial Viability of CMWs
Average NET income (USD) per month per CMW
Within five months of deployment
USD 34: Avg. income for women who work
outside the home in Quetta*
*Source: KPC 30 Cluster Survey, Quetta, MC PRM program, Nov 2013

9. Long Term Sustainability
Average # of service and income per CMW two years after deployment

10. Case Study

11. Thank you!