Ramazan 26, 1422

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ISLAMABAD, Dec 11: The Interim Poverty Reduction Strategy, prepared by the finance division and the Planning Commission, suggests that women’s fertility rate in the country, especially in rural areas, should be brought down to provide better health care and education to all.

The fertility rate in Pakistan - five children by a woman - is one of the highest in Asia despite the cut in population growth rate from three per cent per annum to around 2.2 per cent in recent years.

According to the study, the awareness of at least one method of family planning is around 97 per cent, while contraceptive prevalence rate is 28 per cent. Antenatal care is resorted to by only 27 per cent of the women and about 76 per cent deliveries take place at home.

“This situation can best be addressed through mass awareness campaigns and enhanced availability of skilled service providers at a grassroots level,” the paper said. The task will entail training of family health workers (FHWs) as midwives and upgradation of family welfare centres (FWCs) into family development centres.

The population control programme operates through 1,658 FWCs, 131 mobile service units, and 106 reproductive health centres and 12,000 village-based family planning workers (VBFPWs), in the country.

The VBFPWs of the ministry of population and welfare and 43,000 lady health workers (LHWs) of the ministry of health have been unified as one cadre of 55,000 FHWs for the provision of primary health care and health services in rural areas.

According to a new decision incorporated in the I-PRSP, the number of FHWs will be increased to 68,000 over the medium term. These workers will be trained further in a phased manner to provide midwifery services at community level. The programme will be backed by independent media and advocacy campaign for social marketing and NGO involvement.

In view of the universal level of awareness that has already been achieved, emphasis will be focused on creating demand for family planning services through inter-personal communication (IPC) and advocacy. Front line workers will be trained in communication and counselling skills with special reference to the IPC. The opinion leaders — religious leaders, traditional healers etc — will be sensitised through special advocacy campaigns for community involvement in rural health and family planning issues. Special workshops will educate elected councillors about population welfare.

Independent evaluations have also identified areas which need further support. In this respect the main programme strategies include, improvement in the quality of services, expansion of coverage, strengthening of supervision, better management, and strengthening of family planning and reproductive health components of the programme.

There will be an integration of all primary health care services to provide comprehensive health care to the population. In this respect steps will be taken to implement a reproductive health programme and integrate it into the PHC system.

The study also said that in order to eliminate all forms of discrimination against women a permanent commission on the status of women has been set up. The commission has been assigned the task of examining existing policies, programmes, and legislation about women. It has recommended a number of measures for instituting women development and gender equality.

Now a decision has been taken at the federal level to safeguard women’s interests and a national plan of action (NPA) for women has been prepared through a consultative process. The prime focus of this plan is on education, reproductive health, family planning, economic empowerment and domestic violence.

Skill development councils have been established at major districts for providing training in non-traditional skills.

Access to micro credit facilities have been instituted through the First Women Bank and Khushali Bank. Crisis centres have also been set up for victims of domestic violence for medical and legal help.

Child labour, the study said, is another issue where state intervention has become necessary. For this the National Commission for Child Welfare has started a review of existing legislation concerning the child rights and welfare. Amended ordinance on juvenile justice has also been promulgated.

The ministry of social welfare has, through the Pakistan Baitul Maal, established 51 child labour schools where child workers are given suitable education leading to their rehabilitation.