By Arfa Masihuddin

Rakhshanda is a resident of interior Sindh, Pakistan. Her house is nothing like ours; there are no fancy carpets or electrical appliances to make her life easy, and the amount of money that we spend in a restaurant on one meal is what she saves up for two months to buy a few necessities. With three young kids, her twenty-two-year-old body does not have the energy to carry her fourth child. Complicated previous pregnancies and a home-birth have ensured that her current pregnancy demands even more attention and care.

In the absence of a proper hospital equipped with necessary services, obstetric emergencies—particularly in the rural areas— are often overlooked.Thus, many women like Rakhshanda suffer.In a patriarchal society where women and their wellbeing are unapologetically ignored, female reproductive health takes a backseat—amplified by limited access to female doctors.

So, how can we empower Pakistani women and ensure their right to health?

Currently constituting a network of 24 E-Health Hubs across Pakistan and serving millions of patients through its digital healthcare services, Sehat Kahani seeks to create an all-female health provider network to ensure quality healthcare solutions for communities where affordable healthcare is still out of reach Working to revolutionize reproductive healthcare in Pakistan and female doctors to continue working despite societal pressures, Sehat Kahani has influenced the livelihoods and wellbeing of women and girls throughout Pakistan.

In collaboration with DFID,IDEO.org, and the Amplify programme, Sehat Kahani launched a project in August 2018 focused on providing effective antenatal healthcare at its E-Health clinics by tackling the main problems keeping the women from availing the services. With a human-centred approach, the project comprised of aesthetic improvement of the clinics, provision of incentives like reimbursement of travel cost, free ultrasound tests, and offering gifts like a baby-kit and a ration-kit to women who completed the minimum requirement of 4 antenatal visits. In prototyping different strategies for patient retention, Sehat Kahani discovered which interventions were most patient-friendly and would yield the best results.

Today, 26% of the women residing in rural Pakistan have access to antenatal healthcare and 38% are still delivering at home. As a result, a high maternal and neonatal mortality rate threaten the lives of many. In light of this, Sehat Kahani took up an innovative approach to target young pregnant women who are unable to reach E-Health clinics and encourage them to register for and avail the antenatal services being offered there. Sehat Kahani adopted a collective problem-solving method as compared to solving them individually. Using medical and non-medical incentives, they reached out to the local community by educating them on the importance of at least 4 antenatal visits while also improving the patient and caregiver experience at the Sehat Kahani clinics.

Our first target intervention was community outreach. Community mobilizers make personal visits door to door to explain the importance of antenatal car.. In 2018, with the help of around 2 mobilizers in each of the 4 communities, a total of around 1100 women registered—improving the antenatal healthcare engagement by almost 40%.

“The Sehat Kahani team came to our neighbourhood. They showed us on their big mobile phones how the clinic looked and the doctors who worked there and explained why it’s important for me to visit the doctor regularly, ” says Samina, who is now regular with her antenatal visits.

Through Amplify funding, the Sehat Kahani clinics were able to offer a variety of patient incentives to understand what would primarily draw patients to these facilities. Free ultrasound services have proven to be a huge incentive to patients. Pareeshay Bibi of KP was particularly happy with the free ultrasound service provided at the E-Health clinic. “Earlier, there were no ultrasound services available here. Out of the four free services offered by the clinic, I chose to get the ultrasound! I can see my baby before it is even born! It’s magical!”

In addition to community outreach and incentives, a knowledge-base in reproductive health and antenatal care is essential for women’s wellbeing. Both online presentations and educational sessions with acclaimed gynaecologists educated women and their families on the importance of antenatal care and debunked pregnancy-related myths.

“I always thought that I have to eat double the amount of food during my pregnancy but through this session, I learnt that eating a balanced diet is more important,” said Gul Bibi, a resident of KP.

Happy, healthy women make happy, healthy mothers who raise happy, healthy kids. The results on a graph sheet projecting the achieved targets are more than that; they are symbolic of the cherubic smiles of healthy newborns and the joyous contentment on the faces of their parents. With successful collaborative projects like Amplify, Sehat Kahani hopes to continue carrying this beacon of health and expedite these services for the welfare of the community at large by effectively addressing the issues at the core.

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