From awareness to action: improving maternal health literacy in South Punjab
In one of Pakistan’s most underserved regions, a new initiative aims to ensure that families can recognise danger signs and act quickly when complications arise.
8 min read
Kofi Annan understood women’s role in human development. “Children are our future,” said the former UN secretary-general, “and their mothers are its guardians.” Yet every two minutes a woman dies during pregnancy or childbirth worldwide. Many of these deaths—from complications such as postpartum haemorrhage, sepsis and eclampsia—need not be fatal if treated in time. And, although addressing maternal mortality is complex, one intervention has a powerful impact: increased health literacy.
In Pakistan, which has one of the world’s highest rates of maternal, perinatal and neonatal mortality, the challenges facing mothers are especially acute. In addition to an overstretched public health system in which hospitals and clinics are scarce and staff are few, poor roads make emergency care hard to reach. Improving women’s health literacy could ease pressure on the system by helping women to manage their own health and that of their families, and prevent avoidable health problems.
“When it comes to nutrition and what needs to be done when you reach reproductive age or are expecting a child, one of the biggest barriers for mothers in Pakistan is low health literacy.”
Sadaf Malik, head of corporate affairs for Pakistan, Gulf & Near East (GNE) and KSA, Haleon
Yet social and gender-related factors create barriers to women and mothers’ health literacy, says Pernille Ironside, UNICEF’s representative in Pakistan. “Critical information on pregnancy danger signs, nutrition, birth preparedness and postnatal care often doesn't reach women,” she says. This, she adds, is exacerbated by poverty and geographic isolation.
“When it comes to nutrition and what needs to be done when you reach reproductive age or are expecting a child, one of the biggest barriers for mothers in Pakistan is low health literacy,” says Sadaf Malik, head of corporate affairs for Haleon in Pakistan, the Gulf and Near East (GNE), and KSA. When that knowledge is lacking, misinformation can spread, she warns. “Across many rural communities, there remains a strong social stigma around women seeking reproductive or gynaecological care, which often discourages them from visiting a gynaecologist even when needed.”
Lady Health Worker Husna Aziz conducts nutritional screening of a child using a Mid-Upper Arm Circumference (MUAC) tape at the Health House in UC Wang, Rajanpur.
Lady Health Worker Husna Aziz measures the weight of a baby and the mother as part of routine maternal and child health monitoring at the Health House in UC Wang, Rajanpur.
Closing the gap in maternal care
To tackle these problems, UNICEF and Haleon Pakistan launched the Mothers Matter programme in 2024. Focused on Rajanpur, one of the most underserved districts in South Punjab, the initiative provides families with guidance across the maternal health lifecycle—from pregnancy and childbirth to the postnatal period—to help protect the health of mothers and children.
The programme combines the provision of clear information on maternal health risks and mothers’ rights with community engagement led by trusted local health workers, who encourage families to recognise danger signs, plan for emergencies and seek care quickly when complications arise. To improve service delivery, the programme also builds capacity in primary and secondary healthcare facilities. And by linking families to these services, it helps to translate awareness into access and action.
Customisation is also important, says Ms Ironside. “Messaging is tailored to each audience, whether that's mothers, husbands, fathers, mothers-in-law or community influencers,” she explains. “And it's not just about awareness, but also very much about how to take action.” For example, messages promoting pre-birth planning relating to transport, financial and other arrangements might be targeted at family members, while information on safe infant delivery would be designed for mothers themselves.
Lady Health Worker Husna Aziz educates mothers of newborns using a maternal and newborn health flipbook, explaining key health messages including nutrition and danger signs at a health house in UC Wang, Rajanpur.
“These kinds of partnerships can achieve a lot of impact that probably neither of us could deliver on our own.”
Pernille Ironside, UNICEF’s representative in Pakistan
It takes a village
Ms Ironside points out that improving health literacy cannot rely on top-down programmes. Instead, it must become a shared national goal, one that gives communities a voice in shaping clear health information and empowers citizens to make informed decisions. Governments, development organisations, companies and civil-society groups all have a role to play.
Perhaps the most important Mothers Matter partner is the Lady Health Worker (LHW) network. Since 1994, these trusted female health workers have acted as a bridge between healthcare facilities and communities, supporting pregnant women and young mothers, while providing health information.
Recognising their value, Mothers Matter provides additional training for LHWs. By December 2025, the programme had trained 280 in counselling, communication, identification of danger signs and referral practices. Sessions combine lectures and workshops with role-playing, says Ms Malik. “And all of it is done in the local language.”
Supporting this work are several institutional partners. Haleon collaborated with UNICEF on the programme's initial design and provides flexible funding for its delivery, helping to bring information and support directly to communities. It also brings expertise in health literacy and maternal health and nutrition, shaping messaging and educational materials used in training and public awareness campaigns. “The partnership brings together innovation, social purpose and resources,” says Ms Ironside. “These kinds of partnerships can achieve a lot of impact that probably neither of us could deliver on our own.”
Dr Rimsha examines the ultrasound machine used for maternal health assessments at Maryam Nawaz Health Clinic, Kotla Naser, Rajanpur.
UNICEF also works closely with Pakistan’s health authorities to strengthen health systems. “We support the government in the delivery of training, which is a critical component of the programme,” says Ms Ironside. This, she adds, includes training on how to manage maternal and newborn emergencies such as neonatal asphyxia and postpartum haemorrhage.
Mothers Matter is also collaborating with the government to ensure that future communications reflect national health information. These will be delivered across a mix of mass media, digital platforms and community dialogues, using regionally appropriate languages and locally relatable stories.
“Awareness is not optional—it's lifesaving.”
Pernille Ironside, UNICEF’s representative in Pakistan
Tracking impact
Measuring results is essential to understand what works and to shape health policy, says Ms Ironside. Mothers Matter measures a combination of process, outcome and behaviour indicators that include knowledge of maternal health, care-seeking and timely uptake of relevant healthcare services. It also records how many women it reaches through its outreach and communications, and aligns its monitoring with Pakistan’s national health information systems to support national learning and accountability.
Lady Health Worker Husna Aziz provides cord care counselling to a mother during a newborn visit at a health house in UC Wang, Rajanpur.
For example, in the 12 months from October 1st 2024, 120 mothers were saved by timely management of postpartum haemorrhage, while 70,000 mothers and caregivers took part in local counselling sessions on safe delivery, postnatal and newborn healthcare, and guidance on when to seek care. As the Mothers Matter programme continues its work, it expects this impact to grow.
Sometimes, evidence of impact is more personal. “There are amazing stories from the ground as to what could be life-saving actions that are taken, perhaps by a family member who would not have been able to previously, because they just didn't know how,” says Ms Ironside.
For her, the value of health literacy becomes clearest in moments of crisis. “Most maternal deaths are linked to delays in either recognising the danger signs or deciding to seek care,” she says. “So awareness is not optional—it's lifesaving.”
Photographs: UNICEF