CARE International in Pakistan
about care

Women and Reproductive Health Initiative (WARHI) - Supporting Access for Family Planning and Post Abortion Care Services in Emergencies (SAF-PAC I)

In recent years, Pakistan has had to face man-made and natural disasters worsening the health status of the women in humanitarian situations. Unprecedented flooding in July 2010 affected more than 20 million people, many of whom remain displaced even today. In this scenario, women became the most vulnerable segment of population. The inadequate security made them susceptible to reproductive health problems and further challenged their access to available services.

This emergency context intensified the issues of limited availability and uptake of family planning methods. Responding to these challenges, CARE Pakistan targeted one of the hardest hit districts from the flooding and launched the Supporting Access for Family Planning and Post Abortion Care Services in Emergencies (SAF-PAC) project, locally called WARHI (Women and Reproductive Health Initiative).

WARHI aimed to reduce both unintended pregnancies and deaths from unsafe abortion during emergencies. The initiative achieved these overarching goals by fulfilling two strategic objectives: improving coverage, quality and equity of reproductive health services in emergencies; and increasing CARE’s organizational leadership and capacity to support and sustain these services. The project allowed CARE to integrate these essential services into its response to acute and protracted emergencies in Pakistan.

Objectives

  • Increase number of new acceptors of temporary modern FP methods and acceptors of long-term and permanent methods from 1603 to 2004
  • Increase the proportion of FP acceptors who accept long-term and permanent methods for IUCD , implants, tubal ligation and vasectomy from 33% to 45%
  • Increase the number of PAC clients by 40% from baseline of 186 in the target health facilities
  • Increase the proportion of PAC clients treated in an approved facility for PAC services that leave the facility with a modern FP method to at least 60% of all PAC clients
  • Ensure that at least 80% of service providers meet knowledge and competency standards, by training status
  • Ensure that 80% of clients are satisfied with FP and PAC services
  • Ensure that essential clinical equipment and supplies (including contraceptives) are always available at each facility covered by the project each year of the project
  • Increase the number of new users of modern contraceptive methods;
  • Ensure all women who come to the health facility experiencing complications from abortion receive Post Abortion Care(PAC) services;
  • Increase the proportion of PAC clients who accept a modern family planning method and who are provided a long-acting method;
  • Ensure that each health facility supported by the project (in all, two hospitals and fourteen health centers) has the necessary supplies, medicines, and equipment to provide Family Planning(FP) and Post Abortion Care(PAC)
  • Ensure that 80 percent of trained providers achieve high performance standards and provide on average at least one PAC service and at least eight FP consultations per month; and
  • Increased use of management information data for programmatic decision-making

Outcomes

  • Improved service provision with coordination and support of government systems and services
  • Reduced maternal morbidity and mortality by improving access to family planning and PAC services in flood affected populations in South Punjab
  • Provision of accurate information about RH services through trained community outreach workers.
  • The number of new acceptors of temporary modern FP methods and acceptors of long-term and permanent methods increased markedly above the planned target.
  • The proportion of FP acceptors who accepted long-term and permanent methods remained closer to the baseline level of 33%; however, there was substantial gain in absolute numbers.
  • The number of PAC clients increased three folds more than the actual target.
  • The results of the exit poll interviews demonstrate that more than 80% clients were satisfied with the quality of service provision including audiovisual privacy, positive attitude and responsiveness of health care providers.
  • Uninterrupted supply of essential clinical equipment and other materials including contraceptives is a major achievement of this project.

Time frame: June 2011 - December 2012

Location: District Muzaffargarh, Punjab

Donor: CARE USA

Budget: USD 2,031,185

Cost: USD 1,927,550

Implementing Partner: Rahnuma Family Planning Association of Pakistan (FPAP) and Ministry of Health (MoH) Government of Pakistan (GoP)

Beneficiaries: 80,000