Safe delivery and newborn care practices in Sindh, Pakistan: a community-based investigation of mothers and health workers.

Objective: to determine the prevalence of specific intrapartum practices in Sindh province, Pakistan.

Design: a cross-sectional, questionnaire based study.

Setting: 6 health clinics in Mirpurkhas, Sindh province, rural Pakistan.

Participants: 225 mothers and 82 health workers.

Measurements And Findings: outcome measures were indicators of safe delivery practices and referral following an obstetric complication. Prevalence of unhygienic and unsafe practices in deliveries attended by Traditional Birth Attendants (TBAs) was common. Deliveries by skilled attendants were significantly safer but with some failures in hygienic practices. 29% of women who had experienced an obstetric complication had not received emergency obstetric care.

Conclusions And Implications For Practice: safe delivery practices and newborn care needs to be improved in rural Pakistan. This may be achieved by training health workers and TBAs in safe delivery practices, using safe delivery kits and with an effective referral system.