Population

Pakistan with its 199.71 millions in 2015 stands the 6th most populous country of the world @ 1.92% per annum growth and Sindh has 46 million population of country being the second largest province. Growth rate of Sindh is estimated at 2.98% per annum per census 1998. PDHS 2012-13 shows that the CPR of Sindh 30%. This position depicts that Sindh province has to increase multifold investment and efforts to improve the situation.

In order to achieve the target of 45% CPR, the Population Welfare Department, Sindh has planned to conduct twice a week Family Health Days (FHDs) to address unmet need by providing Family Planning Services in remote areas from where Married Women of Reproductive Age (MWRA) have least access to FP services. Currently one FHD is conducted every week in one of the taluka of each district. These FHD are arranged either at Family Welfare Centre (FWCs), Mobile Service Unit (MSU) or Reproductive Health Service “A” Centre (RHS “A”). Under Accelerated Action Plan, the FP services need to be enhanced, therefore CPR will be increased which in turn will improve mother and child health and reduce stunting and malnutrition. The unmet need of the rural population in remote areas of Sindh who have least access to the service delivery outlets will be addressed by conducting Family Health Days. It is an ongoing activity of Population Welfare Department, Sindh. On release of funds from Government of Sindh under AAP for stunting and Malnutrition the number of FHDs will be doubled in 19 districts from 4 – 8/ month in one district.

Population Welfare Department, Sindh is emphasizing on Long Acting Reversible Contraceptives (LARCs) e.g. Intrauterine Contraceptive Device (IUCDs) and Implants, especially Post Partum Family Planning (PPFP). The Lady Health Workers, who are working at household level, are in close contact with the MWRA and they exactly know the family size, newly-wed couples and the birth record of the children, so these LHWs can act as catalyst in motivating and referring the eligible clients to the nearest FWCs, MSUs, RHS “A” centres, BHUs, and RHCs they can also bring the clients to the FHDs.

To make these FHDs successful by improving the clientele, the original role of LHWs for Family Planning and Primary Health Care, needs to be revived. Presently LHWs are providing short acting contraceptives only, to Married Women of Reproductive Age (MWRA). To increase CPR, awareness of masses needs to be created for Long Acting Reversible Contraceptive (LARCs) i.e. IUCD & Implants, the LHWs will be trained in Client Centred FP (CCFP) counselling and will then start referring implants and IUCDs clients which will improve mother and child health and their nutritional status.

Sectoral link to malnutrition and stunting

Rapidly growing Population of Pakistan in general and specifically of Sindh, is a great challenge. The high fertility rate of 3.9 per Married Women of Reproductive Age (MWRA) leads to poor health of Mother as well as Child, the poor woman who herself is malnourished and under-age conceives at too short interval again giving birth to a premature or under-weight baby, as a result of which malnutrition gets worsened so Population Welfare Department, Sindh wants to improve the accessibility of FP services to the poor and needy clients by promoting Healthy Timing and Spacing of Pregnancy (HTSP) and addressing the unmet need.

Goal:

To contribute in enhancing Contraceptive Prevalence Rate (CPR) from 30% to 45% by 2020
To reduce unmet need for Family Planning from 21 to 14%

Objectives:

Strengthening existing services
Functional Integration with Department of Health, PPHI and MNCH
Capacity building of staff of all stakeholders which will expand service delivery