Public Health
How granular data helped improve skilled birth attendance in Punjab, Pakistan
by By Fenton Whelan, Will Anderson & Akif Malik
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Leveraging existing monitoring systems to rapidly collect useful data for governments.

Risks of childbirth

Childbirth is inherently a risky moment. A complication that can lead to the death of the child or mother develops in around 15% of deliveries. These complications are well understood, and there are clear treatment protocols. In a good hospital, the risk of maternal death is close to zero. But at home in a village, far from the nearest road, the chances of obtaining care in time to ensure the survival of both mother and child are severely compromised.




Data systems need to record to right data

Prior to 2014, Punjab lacked the data to identify shortcomings in the system. The government knew, for instance, that people in rural areas were less likely to be able to access healthcare, but they did not know exactly which people and in which areas. For the Government to rapidly and improve skilled birth attendance (SBA) coverage, they required a system capable of delivering detailed information on coverage across Punjab.

In 2014, vaccinators in Punjab were already using a mobile reporting system which captured their location every time they vaccinated a child. Rather than creating an entirely new system, Punjab was able to leverage the power of the vaccinator tracking app to collect useful information on care at the time of delivery. A simple adjustment asked vaccinators to collect an additional data point; while vaccinating a child, the vaccinator would ask the mother whether or not the child was born in the presence of a skilled birth attendant. This data was recorded along with the location of the child.

Data systems need to present the data in meaningful ways

This information provided the Government with a close to live picture of skilled birth attendance. In turn, this helped officials to make better decisions. For example, officials used the information to determine where to:

  • Build new health facilities ready and able to safely deliver babies

  • Change existing facilities to provide 24/7 delivery services

  • Station dedicated maternal and child health ambulances to improve access to facilities   




Using this data system to make better decisions contributed to the rapid improvements in SBA, especially in rural and remote communities. By 2018, 360,000 additional children were being born each year with medical care in the first moments of life.


About the Authors

Fenton Whelan founded Acasus, he has more than a decade of experience in public health and education development. Fenton leads the Acasus support in Pakistan. Will Anderson is the lead researcher for public-sector projects at Acasus. Akif Malik is a management consultant and strategy development professional, who has experience across private equity, building products and healthcare.

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