Sindh government launches major upgrade to health worker curriculum

By Abdul Qadir Qureshi

(Pakistan News & Features Services)

The Sindh government has approved a major upgrade to the curriculum for lady health supervisors (LHSs) in a move aimed at enhancing the quality of door-to-door preventive healthcare services delivered by lady health workers (LHWs).  

 

The new curriculum, which incorporates the latest treatment guidelines for pneumonia and diarrhoea: two preventable diseases that caused over 670,000 deaths in the country in 2015, was unveiled during a meeting of provincial stakeholders and researchers involved in the Nigraan Plus study at Aga Khan University.

 

The new curriculum includes directives on how LHSs can effectively support and supervise the work of LHWs thereby empowering them to apply the latest knowledge and clinical skills to manage pneumonia and diarrhoea at early stages; when care is the most effective.

“This revised LHS curriculum will now be used for training purposes and it is envisaged that it will ultimately help in better management of childhood diarrhoea and pneumonia. I express my sincere gratitude to representatives of the Sindh Lady Health Worker’s Programme for Family Planning and Primary Healthcare, and the Nigraan Plus team at AKU for their voluntary participation to revise this curriculum. They have made great efforts in reviewing and translating it to Sindhi and in producing the first-ever electronic copy of this curriculum,” the Sindh Lady Health Worker Programme Director, Dr Ghulam Hussain Sheikh, observed.

Nigraan Plus, a community research and management intervention in Mirpurkhas, saw AKU researchers work alongside provincial health officials to investigate the real-world barriers hindering the fight against pneumonia and diarrhoea.

 

One of the components of Nigraan Plus was a knowledge assessment survey of 32 LHSs and 160 LHWs in the district which found that most health workers lacked the minimum knowledge to manage cases of the diseases. It also noted a need to improve the quality of mentorship provided by LHSs to LHWs.

 “Most of the discussion about improvements to health systems revolves around LHWs. This means that LHSs are vastly underutilized. An LHS who effectively mentors 15 to 20 LHWs under his/her guidance can have a massive multiplier effect since every LHW is responsible for 100 households. Our revised curriculum and the policy recommendations flowing from our findings have highlighted cost-effective and simple measures that will help Pakistan achieve targets under Sustainable Development Goal 3 on reducing childhood mortality,” Professor Fauziah Rabbani, the project’s principal investigator, stated.

The researchers and health officials from the Sindh government also discussed a range of relevant findings from research under the ongoing Nigraan Plus project.  

 

Over the first year, community health workers surveyed over 4,000 mothers and caregivers in low income areas of Mirpurkhas. They found that fewer than one in three caregivers were aware of the symptoms of dehydration, a complication associated with diarrhea, while less than four out of ten households surveyed could detect breathing difficulties, a symptom of pneumonia.

A lack of awareness of these symptoms resulted in 70 per cent of families paying to visit a private clinic for treatment even though these health issues could be easily treated at the doorstep by an LHW, members of the Nigraan Plus team noted.

 

The researchers also noted that parents often stopped giving food and drinks to a child suffering from loose motions in order to ‘give the body rest’. This widespread practice often resulted in a worsening of dehydration often requiring hospital care.

 The findings from the study also noted unnecessary delay and expense in the treatment of dehydration. This is because most families went to the market to buy sachets of oral rehydration salts (ORS) even though they could quickly boost their child’s health by making a home-based solution with salt, sugar and water. This delay in providing ORS also raised the likelihood of dehydration worsening to a dangerous level.

Similar misconceptions were also noted in the case of pneumonia with the majority of caregivers viewing signs of respiratory infection as being a ‘mere cough’ meaning that only 12 per cent of respondents provided appropriate antibiotics to their children.

The researchers called on the government to enact the measures in order to protect children from pneumonia and diarrhea like the LHWs should have access to antibiotics, zinc supplements and ORS. This will help them provide essential treatment at home instead of urging caregivers to visit the hospital.

It was also suggested to launch a mass awareness campaign on the importance of home-based rehydration to treat diarrhoea, and the use of antibiotics to tackle pneumonia and expand SMS-based surveillance system so that LHWs can highlight critical cases to their supervisors. Which will enable a follow-up visit to be made within 24 hours.

 

Nigraan Plus is part of the Umeed-e-Nau project that is being implemented by AKU in collaboration with Pakistan’s provincial health ministries with the support of the Bill and Melinda Gates Foundation.

 

Other officials present at the event included Special Secretary (Admin), Department of Health, Sindh, Mr Abdul Waheed Shaikh; Provincial Monitoring Coordinator, Sindh Lady Health Worker Programme for Family Planning and Primary Healthcare, Dr Pir Ghulam Hussain; and District Coordinating Officer, Mirpurkhas, for the Sindh Lady Health Worker Programme for Family Planning and Primary Healthcare, Dr Hamza Ali Panhwar.

Dr Sameen Siddiqi, chair of the Department of Community Health Sciences at AKU, University Provost and Vice-President, Academic, Dr Carl Amrhein, and AKU’s Community Health Sciences faculty Dr Shagufta Perveen, Dr Imran Naeem and Anam Feroz were also present.

Greater value, prestige desired for teachers

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

The misconceptions present in phrases such as those who can’t do, teach and you’re just a teacher are at the heart of Pakistan’s education problems, according to speakers at the Teachers Matter symposium organised by AKU’s Institute for Educational Development (IED).

The symposium brought together 250 policy experts, principals, teacher educators and researchers who noted that the low status of the teaching profession is one of the major issues affecting the recruitment, development and retention of qualified teachers. 

“Teachers are looked down upon even though their work lays the foundations for an educated, prosperous society. The country’s commitments under the sustainable development goals require education stakeholders to attain universal access to primary and secondary education by 2030. You cannot achieve education for all without having teachers for all,” Dr Sarfaroz Niyozov, Director, IED, remarked. 

The speakers at the event noted that many aspiring teachers choose to follow other professions because of concerns over pay and career development. They highlighted the need for school systems to introduce formal career development plans as well as continuing professional development schemes to boost teachers’ subject knowledge, teaching skills and their broader understanding of the profession. These initiatives would keep teachers motivated and participants noted that research shows that it is good for students too.

A study commissioned by UNESCO cites research into how students who are taught by two underperforming teachers in a row, are at risk of never catching up on their peers. 

“An enthusiastic teacher cultivates a love for learning in students which prompts them to apply what they learn in class to the real world. Everyone wants high test scores however the centrality of teachers in ensuring those scores is often ignored. Teachers need to be provided a facilitative environment in which they can prosper and inspire their students,” Dr Sajid Ali, an associate professor at IED, reckoned. 

The speakers at the event recognized that attending a variety of professional development programmes should be mandatory for all teachers and encouraged schools to reward teachers who apply novel techniques and learning methods in the classroom. 

However, speakers also noted that technological advances mean that today’s teachers have a wealth of resources at their fingertips. Teachers must also take charge of their performance by striving to innovate in the classroom and by constantly reflecting on how well students are learning, they added. 

While the participants at the symposium noted that government statistics highlight major shortages in the number of teachers in public schools, they viewed the education system’s failings as being a result of shortcomings in both the quantity and quality of teachers. The poor perception of teaching as an occupation has also had an impact on teachers entering and exiting the profession. 

The speakers noted that many schools suffer from a high turnover with large classes, poor working conditions, low job satisfaction and low salaries relative to other industries being cited as reasons for teachers leaving their jobs. 

“Teachers are agents of change; the conduits of knowledge and education. Yet, the teaching vocation remains one of the most undervalued. The search for and retention of good teachers will continue to be a challenge until we can begin to value those who teach,” Sabrina Dawood, CEO of Dawood Public School, stated. 

The participants at the seminar also pointed to the gap between working conditions in private and state schools. They noted that public sector schools offer much better pay packages and job security than the private sector. 

However, they also pointed out that public sector schools need to improve their mechanisms to hold teachers accountable for their performance. The other speakers at the event included Asim Iftikhar from Aga Khan Education Services Pakistan, Unaiza Ayub from The Citizens Foundation and Sadiqa Salahuddin from the Indus Resource Centre.

Agha Siraj rules out horse trading in senate elections

By Rashid Zia Qureshi
(Pakistan News & Features Services)

“The Pakistan Peoples Party (PPP) would sweep the general elections 2018 throughout the country as the PPP Chairman, Bilawal Bhutto Zardari, has won the hearts of Punjab.”

This was observed by the Speaker of the Sindh Assembly, Agha Siraj Durrani, while talking to media at the residence of elder of All Sindhi-Pathan Nawabshah community, Jan Muhammad Pathan. Durrani contradicted the allegations of horse trading leveled against the PPP, adding that other parties were attempting to pass the impression as if their hands were clean. 

“That who fed whom and how much quantity of grass was given to the horses would be known soon but even if anyone have evidence of horse trading he or she should show it,” he said. 

When asked Imran Khan if would contest from Karachi, Durrani said that it is Imran’s wish to contest general election from any part of the country but the factual position is that he would bag how many votes public would see. 

He said that the PPP has always served the masses due to which public has identified failed politicians who had claimed the demise of the PPP. 

Speaking on the differences having erupted in MQM ranks, he stated that the PPP was neither making profit out of it nor was is the party policy. 

However if any political party faces crisis of such situation then party workers get disappointed and join other parties and this was the reason that others were turning to the PPP. 

Durrani considered it to be the beauty of democracy, insisting that by election and general election have big difference and he was confident to win as the people now desired a change.

Nisar Memon’s An Insight into the Senate launched in Karachi

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

Describing national security of Pakistan as key to our survival and growth, Senator Nisar Memon, a former Federal Minister, called upon everyone to rise to the occasion to work for a common of cause of upholding the dignity of our people, sovereignty of the country and strengthening of the institutions, which he reckoned, were in a state of decay. 

He gave the clarion call while speaking at the second launch of his book "An Insight into the Senate of Pakistan" held at the NJV High School's auditorium in Karachi on March 4. Earlier the first launch of the book had taken place in Islamabad. 

Besides Nisar Memon himself, other speakers on the occasion included former Federal Minister and Senator Javed Jabbar, former Chief Minister and Senator Syed Muzaffar Hussain Shah, Marvi Memon, Chairperson Benazir Income Support Programme, Syed Raghib Shah, former chairman WAPDA, and Tariq Hussain from World Bank. 

Nisar Memon discussed national security at length and dilated upon its various aspects like water, environment, climate change, finance, defence, defence production and social service. In the book, he said, he has also touched upon the present day's most sensitive issue of international peace. 

While bringing the book to conclusion, Nisar Memon asked "can't people the believers in one God, one Prophet, one Book and one Faith be joined on one front against aggression and violation of human rights". 

Nisar Memon, who served the Senate for six years, told his audience that objective of his writing this book was to let the people know about those aspects of the Senate to which it is not possible to them to have access to. 

He said many things which occur in the Senate does not appear in newspapers and, therefore, he thought, to present himself before the people for accountability and what he did when he was in the city, what changes and reforms should be brought. 

He said that when you are elected to the Senate to serve the cause of people for six long years, you have to give the best to the people and they must know what you performed, what you gave and what you learned. 

He said he has discussed all these things in black and white and also to encourage the others to come out and speak about the working of the Senate 

Speaking on the occasion Javed Jabbar facilitated Nisar Memon for writing this book which was long overdue from a parliamentarian about parliament. 

While eulogizing the services of Nisar Memon, he recalled his appreciative role in a non-partisan cabinet, his role in the reformers movement and again in a caretaker government and said he enjoyed excellent opportunities into governments he served with a constructive approach. 

He described his book a genuine attempt aimed at strengthening the institutions and pointed out that Senate is the custodian and rather political custodian of all the four provinces and his book contributes wealth of experiences he gained during his six years of Senatorship. 

He mentioned the book a good combination of remembrance, intelligence and contribution to democracy. 

Senator Syed Muzaffar Shah, who was re-elected as Senator for another six years term only the other day, in his eloquent address marked with fluency, observed that Pakistani politicians are not fond of writing books outlining their experiences as parliamentarians and which the people at large want to know as to how the parliaments work in a parliamentary democracy. 

Senator Shah, who has the presence in as many as 14 committees of the Upper House besides being Chairman of Food and Agriculture Committee and said that Senate is the custodian of rights of the provinces while passing laws. 

He disclosed how he save 1300 acres of prime land in the heart of Islamabad belonging to Pakistan Agriculture Research Council and said the report thereof by highly appreciated by the Supreme Court. 

Referring to clamouring of accusation of horse trading in the Senate election, he stated to have secured highest number of votes without spending a single penny. 

He asserted that parliamentarians should write books and follow the example of Senator Nisar Memon who ventured to do this which only few would do as people want to know how parliament work and how the Senate functions and this book is worth reading for such people. 

Muzaffar Shah was confident that soon the Senate will also have financial authority being the custodian of provinces. 

He paid tributes to Nisar Memon from a Sindhi background and from the corporate sector and said he made a significant role in the political history of Pakistan. 

Marvi Memon in her usual charming style said that to be elected a member of the parliament indeed is an honor as they can make a difference in the political history. 

She said that it was a very special for her to have served the country along with her father Nisar Memon and advised that new generation should learn from his experiences. 

Marvi Memon said that the thoughts cherished by his father as Senator and as Federal Minister were always dedicated to the national causes and one would find it explicitly in his book "Insight into the Senate of Pakistan". 

Tariq Hussain from the World Bank spoke about Nisar Memon's focus on aspect of National Security as highlighted by him in his book, particularly the aspect of water which today is assuming as an alarming issue, particularly with reference to drainage, water logging and salinity. 

He said that the book should encourage the others for improving the effectiveness of our political bodies.

Syed Raghib Shah referred to Nisar Memon's acumen about technical issues and said that although he was Chief Engineer in WAPDA he found Mr Memon more technical than him he would speak in the House Committee on Water issues. 

The present Senators, he said, should pursue all those recommendations and suggestions as provided by Nisar Memon on water as Chairman of Water Committee which were duly recognized by the world bodies.

On the occasion Mr Nisar Memon announced that proceeds of his book would go to the NJV High School where he had remained a student. He congratulated Senator Syed Muzaffar Hussain Shah for having been elected to the Senate for another six years term. 

The launch ceremony concluded with the presentation of copies of the book "Insight into the Senate" to the speakers of the day by Nisar Memon himself.

An Insight into the Senate to be launched on March 4

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

The book titled ‘An Insight into the Senate’ is set to be launched at a ceremony to be held in Karachi on March 4. 

The book has been authored by Senator Nisar A Memon, who has also been a former Federal Minister for Information and Broadcasting. 

The speakers on the occasion would include former Federal Minister. Javed Jabbar, ex-Chief Minister Sindh and Senator Syed Muzaffar Hussain Shah, Rukhsana Zuberi, Tariq Hussain and Raghib Shah. 

It’s in the fitness of things of that the book is being launched in Karachi one day after the Senate elections being held on March 3, as 52 senators will be completing their six-year term on March 11.

In the book, Nisar Memon, who has remained as Senator for six years, gives an insight into the working of the Senate with special reference to National Security which includes various aspects like water, climate, environment and defence. 

 As Senator, he was the Chairperson of the Standing Committee of Senate on Defence and Defence Production and the Parliamentary Committee on Water Resources. 

He was also a member of the Standing Committees of Senate on Foreign Affairs, Finance and Economic Affairs and Housing and Environment Committee. 

The first launch of the book was held in Islamabad and the author has selected Karachi as the second venue for the launch of his book.