This blog post was contributed by Faisal Siraj, one of the fifteen Young Champions of Maternal Health chosen by Ashoka and the Maternal Health Task Force at EngenderHealth. This is his final blog post about his experience as a Young Champion, and you can learn more about him, the other Young Champions, and the program here.
I can’t imagine that nine months have almost come to an end and I have to say goodbye to my family organization in Nigeria. This month was very busy as there were a lot of things to do in a very short amount of time. Community awareness sessions went according to the routine and I left all community sessions to the community educators so that they can follow the same route. Today I had lunch at my mentor’s home and then we all went to the beach. It was a memorable day, but at times we were all sad because I am leaving for Pakistan tomorrow.
Before starting the Young Champions Program, I had an initial idea, but it was a baby idea. Now I am confident to say that these nine months nurtured my baby idea very well — it is much more refined, with well-identified goals and effective implementation strategies to overcome challenges. Initially, my idea was to use medical interns in medical colleges to work in the basic health units for training of health providers and community awareness on maternal health. After completing the Young Champions Program, I realize my idea has much more potential than I had anticipated.
Now my idea is to use medical interns (in medical colleges) for two purposes, which in turn will serve two more purposes.
First of all, the interns will create awareness in the communities,specifically among pregnant women, about general health during pregnancy, complications during pregnancies, and the importance of antenatal check ups to either avoid or diagnose early complications. This has the potential to change health seeking behaviors of the individuals. To be more precise, if the community is aware of the importance of monitoring blood pressure during antenatal check ups, they will ask for it. In some health facilities, the health providers don’t bother to tie a blood pressure cuff to the patient. This is happening in Nigeria currently, but after a few sessions with communities, pregnant women now prefer to go to those traditional birth attendants (TBAs) who have a blood pressure apparatus and regularly check their blood pressure during check ups.
Secondly, the medical interns will train TBAs and health workers on standard protocols and proper referrals in the basic health units (first tier of a health system in Pakistan). This has the potential to change the behaviors of health providers in basic health units. Creating awareness has an indirect effect on changing the health providers’ behaviors. As I said before, if a patient asks for a blood pressure check and the health provider is aware of the importance of it, he/she will feel compelled to check it.
These two actions have potential to modify health providing behaviors of future doctors and establish a proper referral system. Future doctors will be treating the communities in their clinics, so if they are aware of the importance of awareness in the communities and standard protocols, our problem is resolved. Providing that there is proper monitoring of the health providers at the basic health units, this structure can establish a proper referral system. As we all know, an active referral system lessens the burden on main hospitals and increases the chances of quality of care.
I have identified a few challenges which have the potential to complicate implementation of my innovation. First of all, for my idea to be effectively implemented, I need full political support. I need to bring the issue of posting medical interns to policymakers, with the goal of government making it mandatory for medical interns to take part in these sessions. Secondly, I need full collaboration from the Ministry of Health; if we want to establish a proper referral system through this innovation, we need a proper way to monitor health providers at the grassroots level. Moreover, full cooperation of the Ministry of Health is the soul of this project, because if they include these postings in the medical curriculum and make them necessary for the final assessment, medical interns will be working hard to fulfill the core aim of this innovation. Lastly, the Public Health Department is equally important because it is the only government body that will be keenly interested to participate to gain an active status in the public health activities in Pakistan.
In the future, I want to pursue my career and exhaust my energies on the innovation I proposed. I need an active platform to start my project. Meanwhile, I am looking for a job in some international organization to gain more experience and keep polishing my skills. Amen.