In District Upper Dir in Khyber Pakhtunkhwa, deaths from severe bleeding after childbirth remained a major concern, even though these deaths are largely preventable with timely, appropriate care. Frontline health workers also had limited access to specialist support. AMAN’s intervention brought practical training in postpartum haemorrhage management, including balloon tamponade, together with online consultations with senior gynaecologists, giving providers both the skills to respond and a way to seek specialist guidance when difficult cases arose.
Dr. Khalid, District Health Officer, reported that deaths from postpartum haemorrhage had reduced following the training, particularly training on balloon tamponade. He also noted that online consultations with senior gynaecologists had strengthened the capabilities of Lady Health Visitors in antenatal and postnatal care.
The changes were designed to continue beyond the project period. The WhatsApp support group and online consultations provided an ongoing channel for senior obstetricians and residents to offer supportive supervision and mentorship to providers in remote facilities, extending specialist support beyond what was available locally.
During the implementation period, no maternal death was reported from the 10 intervention sites. The experience demonstrates how strengthening frontline skills alongside access to specialist guidance can help build a health system better equipped to respond to maternal emergencies, particularly where specialist care is far away.