Brief :

The Centre for Global Child Health (C-GCH) at The Hospital for Sick Children (SickKids) in Toronto hosted a high-level delegation on Friday, 9th September 2016 for an overview of ongoing projects of Centre staff in Pakistan and potential for further strategic linkages and impact on policy. Imran Siddiqui-Consul General of Pakistan, Samir Dossal-President of the Canada Pakistan Business Council (CPBC), Dr. Shafiq Qaadri-Member of Provincial Parliament, and Salma Zahid-Member of Parliament graciously attended this briefing.

Dr. Stanley Zlotkin, Chief of the C-GCH, welcomed the guests and presented an overview of C-GCH and its work towards improving child health in resource-poor environments through research, capacity building and knowledge synthesis, translation and advocacy.

Following introduction of the Centre staff in attendance, Dr. Zulfiqar Bhutta, Co-Director C-GCH provided a detailed outline of the status of maternal and child health in Pakistan including current indicators, challenges and essential interventions required to achieve the sustainable development goals. Details of the recently launched Umeed-e-Nau project, a collaboration between the Government of Pakistan, Aga Khan University (AKU) and the Bill and Melinda Gates Foundation with linkages to C-GCH were also shared. Dr. Bhutta underscored the huge potential for influencing public health and policy in Pakistan through the activities of the C-GCH and furthering linkages with the Pakistani origin diaspora in Canada.

Subsequently members of the C-GCH team provided details of key projects being implemented in Pakistan. Dr. Shaun Morris, Clinician Scientist, presented a research initiative underway in Rahim Yar Khan (RYK) through which low-cost, evidence-based kits are being delivered by Lady Health Workers to pregnant women to impact newborn care and survival. The hypothesis is that this intervention will lead to a reduction in neonatal deaths by providing essential evidence-based newborn interventions and education. He also briefed on an ongoing birth cohort research project in the same district.

Jo-Anna Baxter (PhD candidate) briefed the delegation on the Matiari Preconception and Pregnancy Supplementation Trial which will be launched soon in rural Sindh with support from the Canadian Government through the World Food Program and the Bill and Melinda Gates Foundation. The trial aims to assess the impact of life skills development and multiple micronutrient supplementation on multiple health and pregnancy outcomes of adolescent girls and young women in Matiari district. This intervention is being implemented through the Government-employed Lady Health Workers (LHWs) and also involves the education sector with interventions delivered through schools.

Dr. Farhana Zareef presented the role of C-GCH in the Access to Quality Care and Strengthening Health System (AQCESS) Aga Khan Foundation Canada and C-GCH project which intends to strengthen maternal neonatal and child health activities in the Northern Areas of Pakistan through capacity building, operational research, monitoring and evaluation of health facility management and care providers. Engagement of Government tiers and policy makers with orientation visits to health facilities and briefings is also a key component of this intervention with a major role for C-GCH and AKU in monitoring and impact assessment.

Dr. Amira Khan introduced the delegation to the Centre’s e-learning initiatives, namely the SickKids Public Health Nutrition Course a free, online, evidence-based course for health workers in low- and middle-income countries. She informed that the course had 882 users over 93 countries and Pakistan with 117 had the second highest number of users globally. Majority of the users from Pakistan had completed their Master’s degree and were working as project coordinators or public health managers. Most of them were employed in the NGO sector.

Daina Als then provided an overview of C-GCH’s work on collecting data on typhoid trends and risk factors in Pakistan. Pakistan has the 9th highest burden of typhoid globally and the disease kills more than 200,000 people each year all over the world. The available information collected by Centre investigators in collaboration with three leading Centres in Pakistan (AKU, Armed Forces Institute of Pathology and Shaukat Khanum Hospital) suggest that while the burden of typhoid has reduced since the 1990s, rates seem to have plateaued and that drug resistant typhoid poses major risks.

Each presentation was followed by a question answer session. There was detailed feedback from the delegation and discussion at the end of the program. The delegation commended C-GCH on their all-encompassing work on maternal and child health in Pakistan. Further they expressed their desire to facilitate opportunities of collaboration and fostering linkages between Canada and Pakistan in the field of maternal and child health. It was agreed that the Pakistani diaspora in Canada should be engaged by raising awareness of ongoing C-GCH projects in Pakistan to encourage potential support and engagement in on-going efforts. Samir Dossal offered his support in informing and reaching out to the Pakistani community using the CPBC platform and also through linkages with ongoing efforts to link Science & Technology investments in Pakistan.

MP Salma Zahid and MPP Dr. Shafiq Qaadri both agreed that it would be valuable if C-GCH’s work in Pakistan was highlighted to the Canada Pakistan Friendship Groups both in the Federal and Provincial Parliaments. This could be achieved through presentations in Ottawa and Toronto, thus creating an opportunity to focus on the C-GCH links with the Government of Pakistan and the Aga Khan Foundation Canada, Aga Khan Development Network and the Aga Khan University.

The Consul General Pakistan highlighted the need for creating opportunities and mechanisms to re-engage the Canadian government to gain its support for essential developmental issues, as Pakistan is no longer a priority country for development grants in Canada. He encouraged participation from the C-GCH in a planned series of activities in this regards with the Federal government in Ottawa. He assured C-GCH of his fullest support for future partnerships and facilitation of the current work.

Report and photos courtesy Sick Kids