Promotion of early childhood development and the psychosocial well-being of Pakistani children

Partner Institutes
University of Liverpool	Rawalpindi Medical College

Shazia lives in a small community called Mandra in rural Rawalpindi. Pregnant with her second child she, like one in every four women in Pakistan, suffers from perinatal depression. Her first pregnancy had been an extremely trying experience, because no one in the village could understand what was wrong with her. That is to be expected, because mental health receives very little attention and recognition in Pakistan.

This time around, however, Shazia is actually looking forward to the arrival of her baby. That is because she has been receiving a very special visitor for the last couple of months. Manzar Bibi is a lady health worker trained to counsel expectant and new mothers to deal with issues of maternal depression and she has been helping Shazia come to terms with her condition.

Manzar Bibi is one of the many health workers trained under the collaborative project between Rawalpindi Medical College and the University of Liverpool in the UK to promote the psychological well-being of mothers and children. This INSPIRE partnership believes that as positive childhood development is intrinsically linked to the mother’s capacity to provide care, maternal health should be the starting point for such an endeavour.

In Pakistan, an estimated 42% of the population is below the age of 14; yet the area of childhood development has received surprisingly little attention. Most of the current work dealing with issues of childhood development is being carried out in the west, where the cultural, social and intellectual environment is completely different. This project aims to develop culturally relevant research and apply the findings in practical settings, particularly the rural communities of Pakistan.

In order to make their work more accessible, the INSPIRE team of specialists is working to transfer their skills to non-specialists e.g. lady health workers or ordinary primary care physicians, or even volunteers from within the community. Hence, instead of the villagers having to travel long distances, or deal with cultural taboos to consult psychiatrists, trained locals like Manzar Bibi can go to the community themselves.

The partnership is collaborating with a local non-governmental organisation, the Human Development Research Foundation, to set up a rural research centre which trains local personnel in the area of mental health. Two trainings in Pakistan and one in the UK have been conducted and bilateral exchange visits have also taken place to build the capacity of Pakistani researchers. As a next step, the team hopes to improve psychological interventions so that even volunteer workers can deliver them. The team also hopes to work with mothers are children who have been traumatised by natural and manmade disasters in Pakistan.

Lessons learnt:

•   Pakistani institutions possess a tremendous human resource capacity that has great potential to be developed and it can be trained to compete with international institutions at the highest level.
• High-powered research can be carried out in Pakistan and HEIs in the UK can play an important role in this. The fruits of such endeavours will be for all to share.
•  Lady Health Workers in rural Pakistan can play a very important role in providing basic mental health care to mothers and children in villages, for whom there is no other facility to provide such care.

Challenges faced:
There is no challenge that a ‘problem-solving attitude’ cannot overcome. We can go on about the security situation, the inertia of the government, a different work culture; but all these challenges pale into insignificance when you meet the hardworking and perceptive youth, their keenness to learn, the generosity of the people, and the hidden potential of Pakistan.

The impact/benefits of the project:
The project has enabled the team to win an international competitive research grant in collaboration with their UK and regional partners, so that the work in Rawalpindi will continue for the next five years.

Key contacts:

Prof. Atif Rahman, University of Liverpool

Atif.Rahman@liverpool.ac.uk

www.liv.ac.uk

Dr. Fareed Minhas, Rawalpindi Medical College

fareedminhas@hotmail.com

www.rmc.edu.pk