PESH AWAR: Shortage of funds is hampering the initiative of government to improve emergency obstetric care (EmOC) under Maternal, Neonatal and Child Health Programme at public sector hospitals to a desired level, doctors say.

The programme was launched by the federal government in all provinces during 2007-8 to prevent deaths of mothers and newborns due to pregnancy-related complications through availability of EmOC services in the hospitals.

Khyber Pakhtunkhwa, where the programme began in 2009, is facing the challenge to sustain the services it has established under MNCH.

Sources said that federal government owed Khyber Pakhtunkhwa Rs862 million. The centre should have provided Rs2,770 million to the province, its 14 per cent share, by June 2012 in the centre-run programme, they added.

The EmOC services have been provided in 16 of the total 23 district headquarters hospitals, 46 rural health centres and 12 tehsil headquarters hospitals in the province. The women are provided with round-the-clock services at these health centres. The women get services of free checkups from pregnancy to delivery at the state-run hospitals.

The MNCH has employed 1,340 community midwives, 46 woman medical officers and 98 lady health workers to provide EmOC to the patients. An amount of Rs90 million, released per year by centre, is spent on salaries and other expenditures, leaving nothing to improve health services.

The programme is aimed to produce trained birth attendants to ensure normal deliveries as part of the project to put in place EmOC services and improve mother and child health indicators. It has no fund for medical supplies and lool(s for financial and technical assistance to donor agencies for the training of staff and purchase of essential medicines for its centres.

It was planned, under the programme, to start ambulance services for referral of complicated cases but the plan couldn`t see light of the day. The province, where 55 neonates of 1,000 live births die and 206 mothers of the same number of live births die due to pregnancy-related complication, is losing the existing services.

`The centre had outlined to train staff and expand neonatal care services and set up intensive care units, provide incubators to nurseries and children and gynea wards of the hospitals but now the programme has been left in the middle, sources said.

They said that funds were required to install high-tech equipments, used in life-saving procedures of newborn babies and women, in the labour rooms. The provincial government is required to merge MNCH with health department in light of the 18th Amendment after which centre-funded programmes have been devolved to the provinces. The centre will provide funds for these projects till next NFC Award.

MNCH provincial coordinator Dr Sahib Gul told Dawn that the centre had agreed to increase annual amount from Rs90 million to Rs126 million. `Activities like training of workers, awareness sessions, seminars and workshops have suffered. We are also finding it hard to sustain the services, we have been running,` he said.

Dr Sahib Gul said that their plans to upgrade facilities and cut down maternal and infant mortality rate through enhanced health services was facing delay. `We have informed the federal government to release the funds to provide medicines and develop the existing infrastructure at the public sector hospitals,` he added.