LAHORE: After failing to achieve millennium development goals (MDGs) regarding reduction of maternal mortality rate and child mortality up to five years, the Punjab government has introduced Mother Neonatal Child Health (MNCH), a referral system for better management of obstetric complications from primary healthcare to tertiary care hospitals across the province. According to Pakistan Demographic Household Survey 2012-13, more than half of births (52 percent) take place at homes while the remaining take place in a health facility. Unskilled birth attendants handle more than 41 percent of births in Punjab, the report added. Newborn care was essential to reduce neonatal problems and deaths, but 54 percent of newborns do not receive postnatal checkup in Pakistan. There are 74 deaths against 1,000 births, excluding the under-five mortality rate that is 89 deaths per 1,000 births. It accentuates that one in every 14 Pakistani children die before his/her first birthday, while one in every 11 die before fifth birthday. The report stated that in Punjab alone, the neonatal mortality is from 58 to 63 deaths per 1,000 births while under-five mortality has reached 105 deaths per 1,000 live births. These records highlight that one in every 13 children born in the province is barely able to survive till the age of one. The report also pronounced that 227 women out of 100,000 are dying in the province with complication of pregnancy or during delivery. Punjab has failed to achieve the target of reducing maternal and newborn deaths set under MDGs. A letter, written to executive district officers (Health) and medical superintendent (MS) of DHQs, stressed on hospitals’ teaching programmes. “The government’s Specialised Healthcare and Medical Education (SHE&ME) Department has launched MNCH referral coordinators (MRC), a programme that is aimed at better management of the referrals of obstetric complications from 24/7 basic health units, rural health centers, tehsil headquarter hospitals, district headquarter hospitals and teaching hospitals,” the letter stated. The MNCH referral coordinators were appointed and equipped with smartphones, so that they could perform functions that include staying informed about resources availability in all THQs and DHQs in their concerned districts. A well-informed source privy to this development told Daily Times that the integrated MNCH and nutrition district coordinator would be made the ‘focal person’ to manage the MRC programme. He would intercede with the EDO (Health) and MS of THQs, DHQs and teaching hospitals to nominate persons for MRC hospitals, and then forward the nominations to the IRMNCH and Nutrition Programme Punjab. A deputy medical superintendent (DMS) from each hospital maybe nominated for each shift as an MRC coordinator. He said that the coordinators receiving calls from 24/7 BHU and RHC regarding referral requests would then inform the staff seeking guidance on how to manage complications. In addition, if a referral is required, coordinator would arrange for an ambulance for patient pick up, and would have to receive referral patient at the hospital and ensure doctor, staff, and medicine availability for prompt treatment.