Date of Award

11-1-2024

Degree Type

Thesis

Degree Name

Master of Science in Nursing (MScN)

First Advisor

Dr. Rafat Jan

Second Advisor

Ms. Kiran Mubeen

Third Advisor

Mr. Ihsan Ullah

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: In South Waziristan, Pakistan, maternal, neonatal, and child health (MNCH) services are often hindered by limited healthcare access, socio-economic constraints, and geographical challenges. Understanding the utilization patterns and outcomes of MNCH services in this underserved region is critical for informing policy and improving health outcomes for mothers and children.
Purpose: This study aims to examine the utilization of MNCH services in South Waziristan and assess the outcomes related to antenatal care, birth outcomes, referral practices, and complications from 2019 to 2023.
Method: A retrospective chart review was conducted using data extracted from the District Health Information System (DHIS) and local health facilities. Patient records were analyzed to determine trends in antenatal visits, birth outcomes, referral rates, and maternal and neonatal complications within the specified period. Descriptive and inferential statistics were used to identify patterns and correlations among key indicators.
Findings: Antenatal care visits have shown notable changes over the years, with ANC 1 visits increasing from 13% (6,021 visits) in 2019 to 26% (12,042 visits) in 2023. Similarly, ANC 2 visits rose from 16% (3,212 visits) in 2019 to 27% (5,592 visits) in 2023. ANC 3 visits fluctuated between 17% and 26%, peaking at 4,360 visits in 2023. However, there were no recorded ANC 4 visits, indicating a significant gap in full antenatal care. In terms of birth outcomes, the live birth rate was 17.79 per 1,000 Births, while the stillbirth rate stood at 27.34 per 1,000 deliveries. The maternal mortality ratio was recorded at 1,132.79 per 100,000 live births, with an abortion rate of 10.58 per 1,000 pregnant women. Referrals primarily went to District Headquarters (DHQ) facilities, with fewer cases directed to Rural Health Centers (RHCs) and Tehsil Headquarters (THQ). The most common reasons for referrals included antepartum hemorrhage, high blood pressure, and prolonged labor. Postnatal visits showed fluctuations over the years, peaking at 33% in 2022 but dropping to just 4% in 2023. Newborn referrals mainly went to DHQ facilities for complications, which saw significant declines in cases over the years.
Conclusion: The study highlights significant gaps in MNCH service utilization in South Waziristan, emphasizing the need for enhanced healthcare access, improved referral systems, and targeted community outreach. Strengthening MNCH services could positively impact maternal and child health outcomes in South Waziristan, providing a foundation for healthcare reforms in similar underserved regions. kindly provide 6 keywords from above abstract

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1

Last Page

110

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