Nara MCH Centre - An Example of Public-Private Partnership

The Government of Pakistan recently called on medical colleges to become involved in developing rural health care within their scope of responsibility. AKU, through its Department of Community Health Sciences (CHS) has fostered such developments in rural Sindh for several years.

The Nara Maternal and Child Health (MCH) Centre was set up in June 1999 by the Rural Community Development Project (RCDP) of CHS. RCDP itself has been running for about six years. The Nara MCH Centre was established in response to a critical need for maternal care in an area where there were previously no health care facilities for females. Popularly known for its wildlife and hunting, the Nara area is the largest tehsil (the administrative division of a district) of Khairpur and at the same time one of the remotest and most under-developed areas of Sindh. Providing health care in these deprived surroundings has not been an easy task. However, in a short time, the Centre has succeeded in becoming the focal point of reproductive health services for the entire area of Nara and much of the bordering Tharparkar desert.

Nara MCH Centre was established in response to a critical need for maternal care in an area deprived of health care facilities for females.

The Centre is collectively managed by AKU, the local community-based organisation, the district administration and the Red Crescent Society, Khairpur, through a formal contractual agreement. At a time when there is increasing demand for meaningful and effective public-private partnerships, the MCH Centre can be regarded as a pioneer effort. While major funding for the Centre came from the multinational Lasmo Oil Pakistan Limited, the local community donated a two-acre plot of land and created an endowment to contribute towards the operating cost. The Department of Health (DoH), Government of Sindh, has also actively collaborated on this project and a reporting linkage exists between the Centre and DoH.

The MCH Nara has gradually expanded its services from primary health to include general inpatient care, managing complicated deliveries, laboratory, ultrasound and ambulance services. Due to heavy patient load, the Centre now generates sufficient funding to cover its own expenses. However, the task of providing maternal and infant care does not end here. In an area where roads are few and females are not free to move without the consent of their husbands, considerable technical support and resources have been directed by the project towards establishing an effective outreach system for the villages. Two satellite dispensaries run by paramedics and a system of weekly mobile clinics for the desert areas, have been set up to build a sustainable health network around the MCH Centre. In addition, traditional birth attendants in each of the catchment villages have been trained by the project in safe methods for obstetric and neonatal care.

At present, the project is in a transitional phase with day-to-day management being gradually handed over to local NGOs while the scope of continuing technical support and capacity development is being considered for AKU.

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