CARE International in Pakistan
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Sexual and Reproductive Health - Maa aur Maamta kay Liye ik Naveed (MUMKIN)

MUMKIN project was designed to contribute towards reducing poverty in the framework of sustainable development by addressing the Millennium Development Goals (MDGs), particularly MDG 5 ‘Improving Maternal Health’. CARE wished to achieve the overall objective of addressing sexual and reproductive health (SRH) needs and rights, raising awareness about SRH issues, improving access to quality SRH services, and ensuring safe practice among women, youth and men. The focus was on meeting the needs of the poor and marginalized segments, particularly women and youth. The attempt was to advance the role of women and increase their perspective in delivery and monitoring of SRH services. Emphasis was placed on building the capacities of public and traditional health workers to effectively address SRH issues and improve utilization SRH facilities and services. By promoting SRH rights and improving governance and accountability in the SRH sector, community involvement and ownership was optimized making the SRH service delivery compatible to local needs and sensitivities. Community capacity to actively engage in health system management and demand quality SRH services was strengthened. Community awareness/sensitization was a major part of this project, to enhance public understanding of SRH and to increase demand and use of SRH services.

Objectives

  • Restore and equip nine village dispensaries (the lowest level of primary health care in Pakistan) and one tehsil (sub-district) hospital
  • Provide Infrastructural support in the local health facilities
  • Train medical staff in essential SRH rights and services at the targeted health facilities as well as Traditional Birth Attendants (TBAs).
  • Provide essential telecommunication equipment to local dispensaries and THQ to establish an efficient referral system between the villages and district-level health facilities; including SRH Helpline at the THQ
  • Establish transport linkages between the dispensaries and the Tehsil Head Quarter Hospital (THQ) e.g. provide vehicle for transporting emergency cases
  • Conduct 19 mobile SRH camps across the target villages
  • Create Community Health Committees at District and Union Council level; train them in management of health facilities and services at district and local level , develop Health Improvement plans for them, hold quarterly coordination meetings between them
  • Hold sensitization trainings for local and district government representatives in SRH issues
  • Train Community Change Agents in interactive communication skills to raise awareness on SRH
  • Train school teachers to discuss SRH issues in schools and counselors to provide support
  • Develop Behavior Change Communication (BCC) materials and disseminate in target areas to sensitize women, youth and parents towards SRH

Outcomes

  • Awareness of the target community on SRH issues was raised. Information, Education and Communication (IEC) material on SRH issues was designed and developed in the local language, Sindhi, which helped greatly in maximizing outreach.
  • Traditional birth attendants (TBAs) were trained or provided refresher courses and now use clean delivery kits after completion of their training.
  • Efficient and timely SRH services were provided through government facilities and mobile camps to a higher number of beneficiaries than had been targeted.
  • Women were empowered to increase their participation in Health Management Committees (HMC) and health-related decision-making.
  • Management of health facilities improved due to enhanced coordination with local government authorities through HMCs.
  • Sustainability of the effort was ensured through successful advocacy with the district government and provincial health department.
  • Emphasis on quality SHR services and introduction of a referral system helped strengthen overall health service delivery, which effected a marked reduction in maternal and infant mortality in the target area.
  • Provision of quality family planning (FP) products and services fulfilled a large unmet demand and led to an increase in the number of FP users in the target area.
  • The capacity of community change agents was built for mobilizing behavior change.

Time frame: February 2009 to July 2011

Location: Kambar Shahdadkot District, Upper Sindh

Donor: European Commission

Budget: EUR 466,642

Cost: EUR 394,681

Implementing Partner: Takhleeq Foundation (TF), Health and Nutrition Development Society (HANDS)

Beneficiaries: 50,000