About 64 percent of the total population of Pakistan is below the age of 30. On the one hand, this youth bulge poses many development challenges, while on the other, it may be seen as an opportunity. If engaged and utilized properly, the youth can serve as catalysts for various development goals. Currently, this young population faces many challenges, one of them being the difficulty faced when seeking correct information and quality services around Sexual and Reproductive Health and Rights (SRHR). The modern contraceptive prevalence rate (mCPR) is currently at a low 28%, with an increase of only 1% in the past five years. Early and closely-spaced pregnancies, as well as a high total fertility rate (3.7 births/women) threaten the health and wellbeing of Pakistani women of reproductive age and their newborns.
To address these challenges, Pathfinder International with the support of the Bill and Melinda Gates Foundation (BMGF) and partners including Aahung, Ipas, Greenstar Social Marketing (GSM), National Committee for Maternal and Neonatal Health (NCMNH), and Shirkat Gah are implementing the Naya Qadam project. This project aims to increase access to Post Pregnancy Family Planning (PPFP), and more specifically Post-Abortion Family planning (PAFP) and Postpartum Family Planning (PPFP) with a focus on young women aged between 15 and 24 years.
Aahung’s previous work on comprehensive sexual and reproductive health in Pakistan has enabled the project team to plan and implement strategies for improving quality Adolescent and Youth Sexual and Reproductive Health and Rights (AYSRHR) services and found that the key access point for young people aged 15 and 24 years are public midlevel service providers (Lady Health Visitors (LHVs) and Community Midwives (CMWs) and private providers.
Unique adolescent sexual and reproductive health needs are often not prioritized by service providers. Moreover, myths and misconceptions held by health care providers (HCPs) as well as provider bias and gender discriminatory practices often result in young people not feeling comfortable in accessing services or being turned away from quality services. Hence, these adolescents and young people prefer to seek inaccurate information from their peers or social media and thus end up practicing unhealthy and unsafe behaviors.
This project aims to work in a total of six districts of Sindh and Punjab- three from Sindh including Karachi, Shaheed Benazirabad and Larkana; and three districts from Punjab including Rawalpindi, Vehari and Okara.
To date Aahung has trained 37 midlevel in-service providers including CMWs, LHVs and district coordinators as Master Trainers on AYSRH with a focus on access to quality information and services to young people including effective counseling skills. Moreover, AYSRH related topics including client-centered approach to adolescent FP, sexual and reproductive rights, , Value Clarification and Attitude Transformation (VCAT), quality of a youth friendly service provider and quality of youth friendly health services were incorporated in the training . These topics were discussed with the mid-level providers to ensure that service providers recognize the importance of these topics as well as their role in providing non-judgmental, unbiased, and quality services to adolescents and young people.
Along with in-service public midlevel providers, Aahung also trained 44 Lady Health Supervisors (LHSs), LHVs, and district coordinators as Master Trainers on AYSRH to ensure that culturally appropriate, correct and complete information is being shared with the community through Lady Health Workers (LHWs). Through these trainings, not only was the knowledge of healthcare providers enhanced, there was a noticeable increase in their level of comfort in discussing AYSRHR issues with their clients.
As a way forward, Aahung shall build capacity of midlevel pre-service providers including Public Health School Instructors and CMW tutors on AYSRHR, which are also a particularly strategic group to work with because they are in contact with future in-service midlevel providers. An added benefit of engaging this group is that these students themselves often fall within the 15 to 24 years age range and can therefore communicate with other young people more effectively.
The term Naya Qadam literally means ‘a new step’ and denotes a positive, fresh start. Through this collaborative effort, each organization’s strength shall be merged to create synergies that will positively affect the health and wellbeing not only of Pakistani women of reproductive age and their newborns, but also their families and communities.