Status: Completed Start Date: Jan 2013 End Date: Dec 2015 Geographic Coverage: District Lodharan and Khanewal in Punjab; District Matiari and Tando M.Khan in Sindh Focus Area: Health SDG Goal: 3 Ensure Healthy Lives and promote well-‐being for all at all ages Implementing Partner: SPO Funding Partner: Packard Foundation
Sexual and Reproduction Health of women in Pakistan does not meet the basic criteria to ensure healthy lives. The country has alarming increase in maternal mortality rate, where women who want to avoid pregnancy are not using safe and effective family planning methods, for reasons ranging from lack of access to information or services to lack of support from their partners or communities. This is a common phenomenon across the developing countries.
In order to contribute to the sustainable Development Goals (previously MDGs), Strengthening Participatory Organization (SPO) in partnership with Packard Foundation implemented a project titled ‘Quality Family Planning and Reproductive Healthcare through Community Mobilization From rhetoric to reality’.
Overarching goal of the project was to ‘To strengthen implementation of and quality of Family Planning (FP) and Reproductive Health (RH) services by establishing a functional community oversight and advocacy mechanism for strengthening the overall management and monitoring mechanisms of Public FP/RH services for improved health and population outcomes’.
Initially The Packard Planning Grant was instrumental in conducting a formative research, which included stakeholder mapping and qualitative data collection from all the four districts.
The stakeholder mapping provided in-depth knowledge about existing Family Planning Reproductive Health (FPRH) services being provided in the target districts and their respective quality. Based on the research study, the project intervention was initiated in five Basic Health Units (BHUs) of the targeted districts. The intermediate results intended were;
Health/FP seeking behaviors among communities in target population.
Establishment and operationalization of robust community based oversight and monitoring mechanisms from basic health facility level to the secondary level.
Carrying out upstream advocacy at the provincial level based on ground realities from the community level for desired policy changes.
Behavior change process requires all stakeholders, including the target communities, to work in coordination to achieve shared objectives. The project engaged with all tiers of community based mobilizers, but specifically with the community itself, considering them to be an important stakeholder, to promote positive health seeking behaviors. A comprehensive model was applied using public sector community based workers, Lady Health Workers and also Community Midwives. Male involvement is necessary to build consensus within the ambits of the families. The project empowered these communities to work as local mobilizers and role models and local champions for their peers thus transmitting knowledge learned to practice.
Communities were involved in the oversight of family planning and reproductive health services through use of existing structures i.e. health committees and linking them up with the district health and population authorities. Monitoring of health services has been a weakest area of Public Sector, so the formed Network Health committees conducted regularly on monthly basis review exercise and used a service quality checklist to identify the gaps and make recommendations. The role of SPO has been that of a facilitator and building local capacities. The linkages developed at district level led to timely corrective actions taken by local authorities based on recommendations compiled by the community.