2011 International Conference on Family Planning
29 November–2 December 2011
"Overview and lessons learned"
Ali Mohammed Mir
In Pakistan, statistics clearly outline issues related to access to services. Though the fertility transition began in the early 1990s, there are persistent high levels of population growth at 2% per annum and a stagnating contraceptive prevalence rate (CPR) with just below 4 children per woman, coupled with high unmet need for family planning especially among poor and rural women. A lack of public acceptability of family planning, which is seen by many as an infringement of their social values, further complicates access. The FALAH project is a 5-year USAID-funded project mandated to support high quality birth spacing services in Pakistan. To enhance acceptability for family planning/birth spacing, FALAH introduced the birth spacing saves lives paradigm, and involved the health sector, to enhance access and address the social and cultural barriers associated with unmet need.
FALAH mobilized communities through mass media and innovatively used interpersonal communication through door-to-door visits, neighborhood and group meetings, and interactive theatres to empower married women and their husbands through information exchange on side effects and contraceptive choices. To improve quality of services FALAH has developed national standards and pre-service curricula for all levels of providers and designed trainings to health providers to become more client-centered and responsive to clients’ reproductive health needs. The project has also expanded contraceptive choice and encouraged the private sector through innovative approaches such as use of volunteers to expand services to rural areas. Through ensuring the use of the contraceptive logistic system, FALAH has contributed to improving the availability of contraceptives at the facility level. Regular and extensive monitoring by the lead partner, Population Council, along with follow ups and validation visits ensure that the activities are taking place as planned and quality is being maintained.
Through community mobilization activities, FALAH has reached over 7,570,700 married men and women in the project districts. Over 24,300 male and female health providers have received service trainings. At this time, FALAH has delivered over 7,480,800 years of couple years protection (CYP).
A multipronged approach that addresses both client sensibilities and improves quality of care can ensure uptake of family planning services in conservative societies. The impact of these services is being estimated through population-based surveys in more than 20 health districts.
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