Malika Zohra, 35 years old, lives in Danyore – a village in Gilgit District-15 km away from the central city of Gilgit. Malika is a Community Midwife (CMW), identified and trained under the Access to Quality Care through Extending and Strengthening Health Systems project (AQCESS) project, funded by Global Affairs Canada. Malika is the only earning member of her family; her husband relies on odd jobs, and has no regular source of income. Beside her technical capacity, she depends mainly on the agriculture and livestock. Together they have four sons, all of whom are enrolled in the local school going. Malika’s mother-in-law also lives with them. Besides working as a CMW, Malika is also responsible for doing the household chores, and tending to the crops and livestock.

Through the Project’s lifecycle she has undergone intensive trainings under the social franchising model. She has received training on Healthy Timing and Spacing of Pregnancy (HTSP), essential maternal and neonatal care, reproductive health care, interpersonal communication and business management. Moreover, to provide Malika with hands-on experience with delivering of essential Maternal and Newborn Child Health (MNCH) services, she was deployed to the Aga Khan Medical Centre, Gilgit for a clinical observership for twenty days, at the end of which she gained in-depth understanding of the latest protocols for lifesaving maternal and child care.

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Opened in 2016, the Aga Khan Medical Centre, Gilgit is one of 60+ Aga Khan health centres operating in Northern Pakistan. Malika Zohra was deployed there for clinical observation for 20 days, at the end of which she gained in-depth understanding of the latest protocols for lifesaving maternal and child care.

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AKDN / Christopher Wilton-Steer

Through the support of AQCESS in terms of capacity building, medicines and supplies, Malika Zohra is not only providing quality health care in the door steps but has improved her income through the charging mechanism introduced by the social franchising model. She is earning around PKR 12,000 a month by providing medicine and service, including Antenatal Care (ANC), Postnatal Care (PNC), general care and deliveries. 

In February 2018 Malika was provided with a smart phone with the Nighedasht application pre-installed on it. Nighedasht was designed and developed by AKDN Digital Health Resource Centre in collaboration with the Aga Khan Health Services, Pakistan.  It aims to improve the quality, coverage and access to MNCH services by digitising antenatal care, the delivery process and postnatal care; strengthening the referral system between CMWs and gynaecologists; and building capacity of CMWs through educational videos. 

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Malika Zohra filing a patient's report through the Nighedasht application. The Nighedasht application digitizes information about antenatal care, delivery and postnatal care services provided by CMWs.

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AKDN / Hooran Pari

Malika was provided training for integrating the application into her work routine. She uses it mainly for reporting key information and data about the health of pregnant women, mothers and newborns. The application is also used to track antenatal and postnatal visits. Malika also uses Nighedaasht to learn more about certain medical procedures and complicated cases.

Says Malika: "Before I started using the Nighedaasht app, I had to update data (of women and newborns) manually, which was quite time consuming. I can now do it through the application, which saves time. The other useful feature of this application is the expert advice which I can seek, [like] help from a gynaecologist in emergencies."