Fostering Women Leaders – The Journey of a Female QIT President

Tuesday 10 October 2017

Zarina, 49, is a mother of seven children, and lives in the village Ranjhapur Bariro in district Jacobabad, Sindh. Her husband Nazeer Ahmed is a watchman in a local school.

Zarina is the president of the Quality Improvement Team formed by Save the Children under the Integrated Maternal, Newborn and Child Health (IMNCH) project at Rural Health Centre (RHC) Mirpur Bariro. The QITs were formed to actively engage the local community and serve as a platform between the community and local health facilities to bridge the gap between community expectations, and the actual supply of health services.

Zarina has always been active in social work, especially for her village. She works as a volunteer to support her community with support of different organisations, including the Sindh Rural Support Organisation (SRSO) and now, Save the Children. Due to this exposure, she had a general idea about the dismal state of health provisions in her village.

“Zarina facilitated many women to run small businesses at community level, and SRSO provided small grants worth PKR 470,000 in her village,”says Musarrat, a senior official of SRSO.

Zarina has first-hand experience about the lack of health services of pregnant women and children in her village. Some of her closest friends and female relatives passed away during delivery at home, because they couldn’t afford to go to a hospital or get medicines. Her village is very far from the health facility and the local transport costs about PKR 500 (USD 5 approximately) to reach there. Zarina came to know about Save the Children’s intervention when her neighbour Jameela visited RHC Mirpur Bariro as she was facing some complications during her pregnancy, but had to return without a check-up because there was no ultrasound machine at the facility. When Zarina got to know about Save the Children’s involvement, she visited the facility and came to know that the project team was forming QITs to involve the local community. She also volunteered to become a member of the team.

While Zarina appreciates the focus on repair and renovation of health facilities, she is particularly happy about the inclusion of females, transgender and Persons with Disabilities (PwD) from the community. Sensitising the QITs towards inclusion has been a slow and tedious process – trainings were conducted on gender and disability inclusion, women were counselled and encouraged to speak up and male members were sensitised. When asked if women actively participate in the decision making process within QITs, Zarina said:

“In the beginning, QIT’s male members used to treat us like all men do. The women mostly remained silent, but after our QIT was sensitised on gender inclusion, things changed. We (women) started participating more and sharing our opinions during meetings. This participation has also started reflecting at community level now.”

Zarina is happy to see many positive changes at the facility after the intervention. The facility provides maternal services now, with support of Skilled Birth Attendants deployed by Integrated Health Services (IHS) for both evening and night shifts. The labour room is fully functional and all medicines are provided free of cost. Ramps, accessible bathrooms, railing and wheelchairs have been provided for PwD. The QIT is very active, and it meets on the 12th of every month to do action planning. The fact that a woman is in the lead decision making role at the QIT has also greatly changed the perception of the community towards female participation.

“We, the women, now speak with men at homes. We have started discussing issues at village level, and except a few, the perception of many families in our villages is changing in terms of women participation. See! You (Save the Children, male team member) are a man and sitting inside my home with your fellow colleagues, but earlier, this was not possible. When my husband will come, I will tell him that someone from Save the Children came over to discuss QIT’s issues and he will consider it normal.”

As the QIT’s president, Zarina is working to make the facility even better for the community. She says that the women members of the team have greatly emphasised the need for an ultrasound machine, functional ambulance and provision of electricity in waiting areas. The IMNCH project team is already collaborating with the QIT to fulfil these demands and has also linked the district management with facility management teams for long-term coordination and sustainability. While discussing what changes she would like to see more for women, she emphasised on hygiene promotion. She says:

“The environment where we live in is not clean and people need more sensitisation on the use of latrine. Personal and domestic hygiene needs to be improved further. It would solve a lot of health related problems for people. I also wish that Save the Children would start menstrual hygiene interventions in our community.”