ISLAMABAD: System to collect data on stillbirth cases in the country is ineffective which leads to flawed reports and incorrect information. This was revealed by an non-government organisation (NGO), Care Pakistan, at an event where it shared its findings with the media on Wednesday.

The NGO, during a survey of health units in the four districts of Khyber Pakhtunkhwa and Sindh, had detected flaws in the reporting and compilation of stillbirth cases.

It is pertinent to mention here that stillbirth is a term used for a baby born dead after 28 weeks of pregnancy. In most cases, stillbirths are reported among women over the age of 45 or below 20. The most affected women belong to poor families.

The NGO’s consultant, Dr Ahsan Maqbool Ahmed, said during the survey it was observed that two systems – District Health Information System (DHIS) and Lady Health Workers Management Information System (LHW-MIS) – were being applied to report stillbirth cases.

Ineffective systems being applied to gather information on such cases

DHIS receives data from public-sector health institutions and LHW-MIS obtains information from the community.

“Although compilation of reports should commence in the last week of every month, it was observed that only 28 per cent LHWs followed this routine. And only one quarter of the health units prepared their reports before the 5th of the following month,” he said.

“Two third of the health facilities did not have minutes of their monthly review meetings and only 14 per cent had plans of action to improve quality of data,” Dr Ahmed said.

“When the stillbirth record in the register of hospitals and the reports of the DIHS were compared, errors were detected. The DIHS also showed that in most cases data had not been compiled for the last three months,” he said.

“Although medical officers and medical technicians were trained, the administrators of the units had no training in the reporting system,” the NGO’s consultant said.

Dr Ahmed further said there was no proper system to record causes of stillbirth. Almost 50 per cent staff believed that reports regarding stillbirths were of no use.

Policy consultant Dr Suleman Qazi, while sharing recommendations, said although the report was being compiled, as per its findings the information system at the district level should be improved.

“A system should be devised for the private sector because 80 per cent cases take place at private clinics but they are not reported,” he said.

“Staff should be made aware of the importance of data. Protocols for declaring stillbirth emergency should also be defined,” he said.

Speaking on the occasion, Minister of National Health Services Saira Afzal Tarar said the health indicators were shameful and a cause of embarrassment for the nation.

However, the minister said NGOs should spend their funds on addressing health issues in the rural areas instead of holding seminars and briefings in the five-star hotels.

“Unfortunately health is not our priority and health officers, who come from rural areas to participate in the briefings, are more interested in having their pictures printed in newspapers than resolving the issues,” she said.

“Such briefings should be held in rural areas so that people and media visit the region and highlight the issue.”

“We have to revisit our health programme because Nepal, Sri Lanka and other countries in South Asia are way ahead of us and they have tackled most of their health matters,” she said.

The minister said it had been decided that legislation will be carried out to get NGOs registered at the federal level. At present they are registered at the provincial level and the government had no information about their activities.

“In the cabinet meeting it was decided that MoUs would not be signed until all terms and conditions were considered as donor agencies included clauses which could not be implemented,” the minister said.

Senate Standing Committee on National Health Services Chairman Syed Zafar Ali Shah said health of citizens, especially women, was a top priority of the government.

He said there was a dire need to create awareness among women of the rural areas about mother-child health. If the health of mothers improves, it means there will be improvement in the health of the whole nation, he added.

Project Manger Dr Aisha Saher Zaman told Dawn that four districts where the survey was conducted were Nowshera, Mardan, Thatta and Tando Allah Yar.

“During the survey it was observed that there were errors in reports prepared in the district and these reports were sent to the provincial government,” she said.

Published in Dawn, September 18th, 2014