Behavior Change Communication interventions aiming at having mass appeals cannot make significant inroads unless they are able to develop community ownership and are seen as credible enough to act upon. Ulama, in Pakistan, have the potential of playing a very positive and practical role in alleviating the miseries of ordinary men and women across the Country. They harness significant influence in their communities and are looked up to by a majority of people in rural Pakistan for day-to-day matters and family affairs. In order to tap their potential as effective change agents, PAIMAN has been sensitizing Ulama to advocate for mother, newborn and child health issues from the podium of their mosques and seminaries during Friday prayers and other religious congregations.

Partnering with the National Research and Development Foundation, PAIMAN has so far networked over 800

Ulama of all sects in twelve districts of NWFP and Punjab. Ulama in these districts are using their voluntary

services to reach out to the general populace with behavior change messages regarding health and wellbeing of

mothers and children. This unique intervention is implemented through a strategy that was chalked out by the

Ulama themselves. A 'Central Shoora' (Central Committee) of renowned and influential Ulama has been spearheading the project with overall

strategic guidance and direction. Comprehensive mapping of Ulama in target districts who lead sizeable congregations for Friday prayers and

are respected in their communities has been at the core of this intervention. Mapping not only allows identification of influential Ulama, it also

paves the way for conducting series of individual consultative meetings with identified Ulama to stress upon MNCH issues and convince them

of their prospective role. District based group meetings bring together like minded Ulama to share and learn on Islamic teaching and their role in

maternal and child health and serve as an additional motivational tool. The Ulama project has also been effectively utilizing the services of

female clerics who reach out to women in far-flung villages with their specially tailors lectures on Islam and MNCH.

At the core of the intervention is a small but extremely important book specially written for the Ulama containing MNCH messages supported

by relevant verses from Holy Quran and Hadith. The book has been endorsed by renowned and senior most religious scholars of Pakistan which

has helped enormously in building the authenticity of the resource material. Three editions of this book have been published and distributed so

far. To supplement these activities, a brochure on key MNCH messages has also been prepared for distribution among the attendees of mosques

and seminaries by Ulama.

The impact of the Ulama intervention is far reaching due to its high sustainability. An evaluation study recently conducted in two of the target districts where Ulama intervention is being carried out D. G. Khan and Khanewal - revealed that men who have attended MNCH sermons have 20-25% higher knowledge of right behaviors than those who have not been exposed to similar sermons. The study found the intervention to particularly effective for illiterate men. For instance, they now know to set aside money for the delivery (71% vs. 41% of non exposed illiterate men), feed the newborn colostrums (70% vs. 33%), and ensure that the pregnant woman is examined by a doctor (90% vs. 44%).

Ulama intervention has been a key building-block for PAIMAN in achieving its objective for improving the lives of women, newborn and children across Pakistan.

Message from the COP

A meeting of PAIMAN's International Partners was held at JSI Boston office on November 20, 2009. The objective of the meeting was to review the progress of the Project, utilization of budget, pipeline analyses, cost share and close out of the project. The meeting was attended by Dr. Nabeela Ali COP, Dr. Amanullah Khan, Director Health, SC/US, Mr. Fayyaz Ahmad Khan, Country Representative, JHUCCP and Dr. Shuaib, Director, Program and Grants JSI besides Dr. Anrudh Jain, Population Council, New York and Mr. Steve Wall, Senior Research Advisor and Beth Outterson Reproductive Health Advisor SC/US Washington DC. Dr. Theo Lippeveld, Vice President and Technical Advisor JSI-PAIMAN chaired the meeting. The meeting expressed satisfaction over the progress of the project and appreciated its achievements so far.

Meeting of International PAIMAN Partners

Dr. Nabeela Ali

October - December, 2009 - Issue 9

Upcoming Mass Media Products in PAIMANFatima Shahryar JHUCCP

watched repeatedly. The final product will be ready to go on air by January 2010 and the progress so far assures that it will make waves and hit the charts!

After the success of the PAIMAN Music Video based on 'birth preparedness and male responsibility' in 2008, Johns Another promising product close to its completion is a Hopkins Bloomberg School of Public Health, Center for documentary on Ulama Intervention. PAIMAN is working in

coordination with National Research and Development Foundation (NRDF) to disseminate MNCH messages to far flung and backward areas of Pakistan through support and guidance of Ulama (Religious Scholars). The documentary titled 'Call to Life' is based on the Ulama intervention and beautifully gives a detailed insight into the entire activity in approximately 13 minutes. “Call to Life” comprises brief statements by Muslim scholars, representing different Islamic sects, on the issue of MNCH and success of the intervention. The documentary comes as very convincing that may as well be regarded as a ray of hope.

Call to life starts off with a thought provoking scene a woman being carried to a health facility on a chair. A scene surfacing the difficulties of life in far flung areas where it takes an Communication Programs (JHU-CCP) is now working on

another music video with 'child care' as its main theme. Master of his art, Sohail Javed has directed the video, whereas, Sajjad Ali, a renowned and one of the most sought after vocalists has lent his accredited vocals to the song. A catchy tune, that makes one recall joyous moments and celebrations, completely complements the theme.

It starts off with showing a very happy couple, from rural community, blessed with a baby girl. The couple celebrates these moments of life by going to fields and attending funfairs. Focusing on theme, the video shows a scene in which the baby falls ill - a moment of call for parents' timely action to save this precious life. This video also has other captivating scenes too, like that of the baby taking her first step, grandparents blessing the couple, and the couple, while being each other's strength, enjoying life and

excessive effort to perform the task that may not even be an fulfilling their responsibilities. It is a video that not only

issue for a common urbanite. The documentary very creatively very astutely conveys the message but also ensures that it is

highlights the worth of a mother and newborn's life. It emphasizes the importance of mother's health and highlights the duties of a husband, family members and society in ensuring safe mother and newborn health outcomes. The video has a melodious Naat playing in the background that even plays in your mind while you recall the messages.

This documentary on 'Muslim Scholars speaking for Mother's Rights' is a product that deserves due appraisal and is surely a “Call to Life”.

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Ambulances Handing Over Ceremony in Gwadar

“Video on Wheels”-Health Communication at the DoorstepsShagufta Bano-JHUCCP

An update on Operations Research Studies in PAIMAN

districts Khanewal and Dadu. The initial phase of the study which is still ongoing comprises of the registration of eligible pregnant women. Out of a sample size of 1600, a total of 1082 PAIMAN handed over pregnant women have been registered so far. Since December three more ambulances 2009, the second phase of ths study has also begun in which the to District Headquarter sampled pregnant women are being interviewed. Trainings of H o s p i t a l , G w a d a r birth attendants is also on going in both the districts. Three through the Government women have already delivered in the intervention areas, and of Balochistan for use in were successfully administered Misoprostol.Public Sector Health

Facilities of Gwadar. Assessing the Acceptability of A new cadre of CMWs for The ceremony was held Delivery and Postpartum related Care in Rural Pakistanat PC Hotel Gwadar and

at the EDO Health Office, Gwadar on October 26, 2009. It This study is being carried out in 6 districts of Pakistan i.e. was presided over by Mr. Muhammad Jalal, Secretary Rawalpindi, Jhelum, D.G Khan, Khanewal, Sukkur and Dadu. Health Government of Balochistan and Mr. Pasand Khan The first two phases have been completed, and the Baseline Buledi, DCO Gwadar who was the chief guest. Speaking at household survey is currently in progress. A total of 44 clusters the occasion Secretary Health lauded the efforts of out of 110 clusters have been completed.PAIMAN in making health facilities accessible to the

common men and for the provision of ambulances to these health facilities which help in shifting serious patients to the hospitals to ensure their safety. Mr. Buledi extended his full support to PAIMAN and appreciated the donation of 3 State of the Art ambulances to Gwadar by PAIMAN. Dr. Nazeer Bana EDO Health Gwadar talked about the different In order to have a better, improved and broader viewership of activities being carried out by PAIMAN in Gwadar for PAIMAN media products at the community level, an raising awareness on MNCH issues and for the capacity innovative approach, “Video on Wheels” was introduced by building of Health Care Providers of the district. Dr. Hasan Johns Hopkins University Center for Communication Zaidi, Field Operations Manager Balochistan also Programs (JHU-CCP) in 2008. highlighted the different activities of PAIMAN in Gwadar district. Dr. Aziz Lal DPC Gwadar presented the vote of “Video on wheels” uses mobile vans to take “PAIMAN” plays thanks. series, TV commercials and music video to those who would

otherwise have been unable to watch these shows. The mobile shows aim to provide much needed entertainment to rural population besides information on key health issues. Announcements of these shows are made by NGOs, Lady Health Workers, community representatives and PAIMAN Assessing the Feasibility of Home administration of Community mobilization partners a day prior to the Misoprostol in the Prevention of PPH in Rural Pakistancommencement of shows.

The field work for Misoprostol, an Operations Research After the successful pilot response in Sukkar district, Mobile study in PAIMAN, was started on October 26, 2009 in TV shows have been so far conducted in 6 PAIMAN designated districts of Punjab and Sindh provinces with 100 shows per district. Each show attracts more than 300 men and women who come to watch these media products on big screen in specially designed tents having separate arrangements for both genders. The media products have a flavor of cultural representation as these are dubbed in regional languages for better understanding of PAIMAN messages and enhanced impact. Video on wheels is designed to reach out to more than 150,000 people in the remotest corners of Pakistan with knowledge about maternal and child health issues.

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For feed back & suggestions please write to: Editor, PAIMAN News RoundupPopulation Council, H # 7, St. 62, F-6/3, Islamabad. Or E-mail: newsletter@paiman.org.pk

CA#391 A-00-05-01037 is funded by the United States Agency for International Development and implemented by JSI Research & Training Institute, lnc.

In conjunction with Aga Khan University, Contech International, Greenstar Social Marketing, Johns Hopkins University / CCP, PAVHNA, The Population Council, Save the Children USA

JSI Research & Training Institute, Inc.

Training and Supervision Activities

a. Supportive Supervision

Supervision of Roll out training on 'Client Centered Safe Delivery Practices'

b. District Annual Operational Plans (DAOP)

c. District Supervisory Assessment System (DSAS)

d. Capacity Building of Health Care Providers

medics and paramedics on DHIS in districts Swat, Buner and

Upper Dir from NWFP. Similar trainings have been supported

and completed in the PAIMAN districts of Punjab. Contech International completed a 2-days training on

supportive supervisory system for district Peshawar during

which the participants learnt the concept of supervision,

planning and conduction of supervisory visits,

The Popu la t ion development of supervisory checklists, their usage,

Council supervised feedback and outlining policy framework at district level.

the roll-out TBA

training on 'Client

C e n t e r e d S a f e Contech International also conducted 3-days training on

Delivery Practices' district annual operational planning for the new and

held in Gwadar from existing health managers who could not be trained in a

October 11 to 18, series of DAOP trainings held during the last project year. In

2009. The training this regard, district Multan was selected where a total of 08

was organized by managers were trained on health planning process, rationale

JSI in collaboration and steps leading to the preparation of DAOP with special

with a local NGO, Rural Community Development Council focus on MNCH. Participants were also introduced to

(RCDC) in which 15 TBAs participated. The training was held software “Health Plan® “developed by Contech to assist

at RCDC office and was conducted by RCDC TBA trainers. the process of health planning

Dr. Nazir Bana, EDO Health, Gawadar was the chief guest at

the closing ceremony. Participants of the training gave their

feedback about the training in a highly motivated tone. Dr.

Nazir Bana congratulated and praised the efforts of PAIMAN Furthermore, Contech-International facilitated the district

partners, particularly Population Council, JSI and RCDC for managers in 05 PAIMAN districts (Quetta, Peshawar,

organizing the supervision and training.Sudhnoti, Khairpur and Bhimber) to carry out DSAS. This

With this supervision, the Council has completed the task of exercise includes assessment of supervisory and logistics

supervising all the district TBA training teams during their systems etc in addition to data quality.

first roll-out trainings.

Population Council has also completed all the training and In order to effectively implement DHIS at the facility level,

capacity building activities under PAIMAN project, except one trainings of health care providers were organized to

batch of Leadership training which is scheduled for enhance their specialized knowledge and skills.

January, 2010.Contech facilitated in holding the refresher trainings of

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