With a 17% literacy rate, where are the lady health workers going to come from?

Contraception helps women space their pregnancies and lowers the mortality rate.

KARACHI:

The push to try and make healthcare available to more and more Pakistanis continues. Part of this picture are lady health workers who are supposed to reach out to women and children at their doorstep.

But there is a shortage of these staffers, experts pointed out at a national workshop on Wednesday. “There are about 90,000 lady health workers in Pakistan,” said the Sindh population welfare secretary, Mumtaz Ali Shah. “These health workers are selected by organisations on the basis of their educational standards which is rather impractical as the literacy rate in rural areas is 17%.”

This shortage of staff is problematic as only one-fifth of the population can benefit from public health facilities - lady health workers are meant to help fill this gap. “So far the situation does not look very promising,” said HANDS chairman Prof. Ghaffar Billo.

Pakistan’s Maternal Mortality Rate is 276 out of 100,000 live births and the Infant Mortality Rate is 76 out of 100,000 live births. Only about one-third of couples use contraception. And 37% of all married people don’t have family planning. Just half of the country is covered by the National Programme of Primary Health Care of LHWs.

Dr Yasmeen Sabeeh Qazi of the David & Lucile Packard Foundation elaborated on the state of health and birth spacing services in LHWs. One of the best ways to stop mothers and babies from dying is to use contraception. The closer the pregnancies the more a woman’s health is put at risk. Thus, there is great potential for an impact on maternal, newborn, infant and child health in Pakistan as 67% of non-first births are spaced less then 36 months apart.

Sixteen per cent of women in the country are bearing children while they are between the ages 15 and 19 years. Also, conversely, 35% of currently married women are older than 34 years of age, 37% of infants under six months of age are breast fed and modern contraceptive use is low at 21.7% overall.

There have been some successes. NGOs Marvi in Sindh coupled a trained birth attendant with a community health worker to increase the use of contraceptives by 12%, save the lives of 5,000 mothers at pregnancy and increase family planning awareness, according to Dr Khalid Pervez.

According to Hashim Khan, the Balochistan rural support programme trained community health workers as midwives in a pilot project in 2010. The Bunyad foundation which was formed in 1994 has eastablished 117 community learning centres in 11 districts of the Punjab.



Published in The Express Tribune, July 28^th, 2011.