Project Name:
Scaling-up Best Practices in Pakistan to Integrate Family Planning into Maternal, Neonatal and Child Health Services

Country:
Pakistan

Project Location within Country: 
District Shaheed Benazirabad of Sindh Province.

Name of Client:
Dr. Taufeeq Ahmed, Country Representative
Pathfinder International
House # 579, Street 35, Sector E-11/3, Islamabad
Tel: +92-51-2221949, Web: www.pathfind.org

Beneficiar(ies):
Communities, CBOs, NGOs, Government Officials & relevant stakeholders

Start Date (Month/year):
October 2011

Expected Completion Date: 
January, 2012

Name of Senior Staff Involved and Functions Performed:

Dr. Yameen Memon, Chief Executive and Dr. Ghulam Hyder Akhund

• Prepare project document
• Review field instruments
• Impart training to the field staff and Stakeholder workshop
• Supervise field data collection activities
• Monitor project activities
• Facilitate data management
• Coordinate with the client and relevant stakeholders
• Literature review and report production

Description of Project

Pakistan Demographic and Health Survey-PDHS (2006-07), indicates that the contraceptive prevalence rate (CPR) is 22% for modern methods, women on average have one birth in excess of their desired fertility (TFR of 4.1 vs. Wanted TFR of 3.1), and induced abortions are common- approximately 890,000 annually. A large portion of women (34%) experience short birth intervals of less than 24 months in their lifetime reproductive history. Short birth intervals are more common among young women and for low birth order children (2-3 births), which significantly increase health risks for women and their babies. Indeed, 22% of infant deaths occur after short birth intervals, and the neonatal mortality risk is reduced to half simply by enhancing birth intervals to 36 months or more.

The Lady Health Workers (LHWs) Program, a national community outreach program that employs around 100,000 LHWs covering 60% of rural Pakistan, could not fully address the issues of access to FP. The LHWs should reach women at their homes with HTSP messages, providing them with short-acting contraceptives and refer women to facilities for long-acting methods but the program’s impact has been limited and the inefficiencies in the system result in missed opportunities for counseling and referrals.

Thus, it implies that lack of awareness and lack of adequate/matching services are the two main barriers which immediately need be addressed through an appropriate intervention. To increase utilization of Safe Motherhood, FP&RH Services through comprehensive community mobilization and effective supportive supervision and monitoring in the District Shaheed Benazirabad of Sindh. Through the proposed Project, awareness will be raised among the target audience to create demand for Basic EmONC, HTSP and PAC and issue of supply/availability of matching services is also addressed.

Under the proposed Project, the NATPOW will work in one Tehsil in each of the selected Districts. The project will be implemented under three strategic objectives which are:

• Increase Awareness and Promote Positive Family Planning and Reproductive Health Behaviours
• Capacity Building of Health Care Providers on improved service provision for Family Planning and Reproductive Health
• Strengthening of Health Care Systems by improving M&E at all tiers of supervision

Scope of the Study

• Improving clinical and counseling skills of different cadres of Health Care Providers for FP by applying Healthy Timing and Spacing of Pregnancies (HTSP)
• Strengthening clinical and counseling skills of different cadres of Health Care Providers for Post Abortion Care (PAC)
• Project Coordination meeting with District managers at Shaheed Benazirabad
• In consultation with District Health managers at Shaheed Benazirabad preparing the following:
• Training Plan for 30 LHW Trainers in consultation with concerned district officials
• Training Plan for 300 Lady Health Workers in consultation with concerned district officials
• Plan and conduct 4 day training of 30 LHW Trainers including 15 LHS in selected 13 Union Councils of District Shaheed Benazirabad
• Conduct 4 day training of 54 Health Care Providers (WMOs/LHVs/CMWs/FWW) at First Level Care Facilities in selected 13 Union Councils of Shaheed Benazirabad District
• Training of 300 LHWs in selected 13 Union Councils of Shaheed Benazirabad District on HTSP and PAC using the revised Training Manual for LHWs
• Organize and conduct training of 25 Religious Leaders in selected 13 Union Councils of Shaheed Benazirabad District on HTSP
• Organize and conduct training of 25 Secondary School Teachers in selected 13 Union Councils of Shaheed Benazirabad District on HTSP
• Plan and coordinate 300 Female Support Group Meeting by LHWs (one meeting by each trained LHW) in consultation with respective district officials
• Conduct of 300 Female Support Group meeting by LHWs (one meeting by each trained LHW) in selected 13 Union Councils of Shaheed Benazirabad District on HTSP and PAC by 300 trained LHWs
• Plan and coordinate 25 meeting by 25 Religious Leaders at a health facility (BHU and or RHC) with Health Facility Staff including male / female medical officer(s), Lady Health Visitors (LHVs), Community Midwife (CMW), LHS and LHWs, with in the projected time; in consultation with respective district officials
• Conduct of 25 meeting by 25 Religious Leaders at a health facility (BHU and or RHC) with Health Facility Staff including male / female medical officer(s), Lady Health Visitors (LHVs),
• Community Midwife (CMW), LHS and LHWs, in selected 13 Union Councils of Shaheed Benazirabad District on Islam and Family Planning with focus on HTSP
• Plan and coordinate 25 Male Support Group meeting by Community Reformers (A team of 25 Secondary School Teachers and 25 Religious Leaders who will conduct one meeting with in the projected time) in consultation with respective district officials
• Conduct of 25 Male Support Group meeting by Community Reformers (A team of 25 Secondary School Teachers and 25 Religious Leaders who will conduct one meeting with in the projected time) in selected 13 Union Councils of Shaheed Benazirabad District on HTSP

Services Provided

• Minutes of the Project Coordination meeting with District managers at Shaheed Benazirabad
• List of different cadres of health care providers including LHW trainers, LHWs, LHS, WMOs, LHVs, FWW, and CMWs
• Training Plans for training of LHW trainers, LHWs, and HCPs
• Organized Training and report for district LHW trainers
• Organized Training and report for health care providers
• Organized Training and report for 300 LHW
• Organized comprehensive training for 25 Religious Leaders in selected 13 Union Councils of Shaheed Benazirabad District on HTSP
• Organized a comprehensive training for 25 Secondary School Teachers from selected 13 Union Councils of Shaheed Benazirabad District on HTSP
• Conduct 300 Female Support Group Meeting in all selected Union Councils and Report on Female Support Group Meetings by LHWs
• Conduct 25 Religious Leaders meetings at the facility and Report on 25 Meetings by Religious Leaders at Facility
• Conduct 25 Male Support Group Meetings and Report on 25 Male Support Group Meetings by Community Reformers
• Draft and Final Report Developed