Perinatal Death Surveillance and Response: A Secondary Analysis of Nepal’s Efforts

This paper presents Nepal’s experience regarding perinatal death surveillance and the country’s response in reducing preventable perinatal deaths. In developing this paper, evidence of perinatal mortality in Nepal is brought from secondary sources, mainly the assessment report of Maternal and Perinatal Death Surveillance and Response (MPDSR) system. As of 2019, this initiative has been implemented in 77 hospitals across Nepal. Challenges and barriers in implementing the MPDSR system need to be brought to attention, as the system is being scaled up to 110 hospitals. Data from the Perinatal Death Review revealed that 72% of the maternal deaths occurred during the post-partum period, due to (i) post-partum haemorrhage, (ii) hypertensive disorder, (iii) pregnancy-related infections, and (iv) non-obstetric causes. In 70% of the cases such deaths could have been prevented. Majority of perinatal deaths, at 71%, were stillbirths, mainly due to low child weight of less than 2500 grams. In conclusion, there is urgent need for the national guidelines for MPDSR system to be amended, additional and continued training provision to the health workforce, improvement in the coordination and feedback mechanism, and strengthening of the information management system

Exploring Barriers Inhibiting the Effectiveness of Leadership in Public Sector Organizations in Khyber Pakhtunkhwa, Pakistan

Research shows that besides other factors success and failure of an organization mainly depends on the effectiveness of its leadership. Effective leadership is one of the potential sources of management development, sustained competitive advantage and organizational performance. The importance of leadership is testimony to the fact that organizational leadership has long been the focus of research in western countries including the United Kingdom (UK), Germany, France, New Zealand and America but indigenous studies regarding leadership effectiveness in various developing countries including Pakistan is not very extensive. This is the reason that research regarding organizational leadership has not received enough attention in Pakistan. The current rapid deteriorations in public sector organizations in KP shows that one of the dominant factors is lack of effective leadership in public sector organizations. There are certain cultural, social and political factors that influence the effectiveness of leadership but so far, no comprehensive study has been carried out on the above mentioned situation that could explore barriers inhibiting the effectiveness of leadership in the context of Khyber Pakhtunkhwa, Pakistan. Therefore, this research study was conducted to explore barriers inhibiting the effectiveness of leadership in public sector organizations in KP. In order to address central research questions of the study, qualitative mode of enquiry was adopted by using interpretivist paradigm. A purposive sampling approach was used to select those public sector organizations that are playing fundamental role in socio economic development of KP such as agriculture, education and health. For data collection, a sample of thirty (n=30) employees was drawn from selected public sector organizations. Semi-structured interview and observation were used as data collection tools. Thematic analysis was used for data analysis. The findings of the study reveal that there is leadership crisis in public sector organizations. Organizational leaders are deficient with leadership qualities such as relevant knowledge and experience, poor communication skills, inappropriate leadership style, lack of honesty and integrity and lack of leadership focus. Leadership crisis is due to various barriers that have impeded the effectiveness of organizational leadership such as lack of proper training and development, undue political interference, lack of adequate finances, traditional bureaucratic culture, cultural and social obligations, policy issues, corruption and lack of accountability. In order to overcome these barriers, this study gives a number of recommendations ranging from availability of adequate financial resources to the provision of proper training and development to organizational executives, attitudinal changes of bureaucrats and developing culture of accountability. This research contributes to a growing body of knowledge by providing indepth knowledge and information about the barriers creating hurdles for organizational leaders in KP, Pakistan. The findings of the study are helpful for policy makers in enhancing their understanding to specifically focus on those factors that can improve the effectiveness of organizational leadership. This will foster leadership capacity of organizational executives that will further create a more conducive environment for the effectiveness of public sector organizations.