Pakistan’s health system compromises of public and private sectors, and profit and not-for-profit service provision. Currently 80% of Pakistan’s health services are administered by the private sector compromising of multiplicity of service providers, which includes clinics, hospitals, and traditional health workers such as midwives, lady health workers, and homeopathic doctors or Hakeems. The health care delivery system in Pakistan is systematized through preventive, curative, and rehabilitative services. The general quality and reach of health services in Pakistan, specifically affordable health care, is very weak, with the poor suffering the most. According to WHO (World Health Organization), 2015 statistics, the number of physicians per 1000 population is 10. Leaving a huge gap in provision of health services to be filled by alternative health care providers.
The situation in Southern Punjab is worse off compared to Central Punjab, where these services are scarcer, and of poorer quality. To provide relief to the poor community of Southern Punjab, particularly D.G. Khan, CSC has taken many initiatives in health.
CSC was part of the PAIMAN health initiative funded by USAID, and implemented by John Snow Inc. and partners. Through the implementation of the project, CSC improved the maternal and neonatal health behavior of targeted rural communities. Furthermore, trainings on Antenatal, Perinatal, post natal, and immunization improved the understanding of health professionals, Traditional Birth Attendees (TBAs), mothers, and male community members. Awareness sessions were conducted with schoolteachers and students on Mother and Newborn Health (MNH) Issues, engaging students to encourage their families to practice healthy habits related to MNH. Among other interventions targeted towards behavioral change, and overall improvement of health facilities, CSC set up Medical Camps, blood registries, and formed Emergency Obstetric Care Committees for sustainability of its interventions in the area.
Another project, Pakistan Safe Drinking and Hygiene Promotion Project , funded by Abt. Associates, promoted clean and hygienic practices among the residence of D.G. Khan, and created easy access to safe and clean drinking water. To inspire communities to adapt hygienic practices, students and teachers were engaged in numerous activities, as agents of change, so that they would stimulate a change in their communities. 15 schools were selected from D.G. Khan where workshops on hygiene practices, causes of diarrhea, and benefits of drinking and using clean water on health and environment were discussed. Basic hygiene products were distributed in schools like soups as well as informative posters, pamphlets, and stickers to students of the school.
Pakistan sustained high Mother Mortality Rate of 178 per 100,000 live births and the under-five child mortality rate of around 49 deaths per 1,000 live births during the last a decade or so. After the success of PAIMAN, CSC launched another project, improving the Reproductive Health & Rights of Marginalized and Underserved Communities, which focused on improving healthy reproductive behaviors, and rights of marginalized communities, specifically of women and youth, in 14 union councils of D.G. Khan. Under this project, CSC improved healthy reproductive behaviors through formation of support groups. These support groups were trained in correct reproductive practices and were encouraged to share their training with others from the community. The project included training of Traditional Birth Attendees (TBAs), more popular with community members in these areas compared to hospital delieveries, on safe delivery, post and pre natal checkups of mothers, and other issues related to safe pregnancy.
Move Forward to Regain Prosperous Lives Phase I
This project aimed at improving the lives of 1,000 flood effected household’s incumbents and 20,000 people (particularly women, children, and infants) of worst flood affected union councils of D.G. Khan and Rajanpur through Improvement in Health, Economic Revival and Social Protection. Under this project, CSC established community clinics and mobile medical camps at deprived union councils of D.G. Khan and Rajanpur where 27,540 beneficiaries received health services. 360 pregnant women improved their health status through access to health facilities and balance nutrition through the project. 1724 community members received gender sensitization workshops on gender awareness and elimination of Violence Against Women (VAW). We provided asset transfers for establishment of shops/businesses to 55 women which increased their income from 6000-8000 per month. 200 families were provided with seeds and fertilizers for improving crop yield and increased income from Rs. 53,000 to 79,000 per crop. Technical sessions were provided to 700 farmers and trainings on enterprise and technical income generation were given to 270 women. Better economic opportunities for women, and improved education and health facilities were provided to children through project activities. 1700 participants attended training sessions on Disaster Risk Reduction (DRR.) for better preparation of against future calamities. Furthermore, livestock management training was provided to 700 farmers and provided two goats to 313 families for cattle farming which helped families in earning revenue.
Move Forward to Regain Prosperous Lives Phase II
The objective of this project was to work in flood affected areas of D.G. Khan for rehabilitation of flood victims, in addition to Socio-economic empowerment of women, develop strong corporations between farmers, encourage modern techniques of cultivation and livestock management, Youth Economic Development initiatives, and improve health conditions. Through this project 50 landless women benefited from Landless Women scheme, which resulted in an average saving of Rs. 49,000/- to 53,000/- per woman. A total of 16 skill development trainings were provided to 438 women. We organized 27 women right sessions, which included sessions with 57 religious scholars, resulting in the participation of 1,137 males and females who benefited and learned from these sessions. A farmer’s cooperative of 10 farmers was formed from 20 villages, who conducted 80 agro and non-agro based trainings for 1500 participants. 569 farmers learned from 22 technical support sessions conducted in collaboration with District Agriculture Department on modern techniques of cultivation, land preparation, seeding, and pest control. Two batches of 36 Community Volunteers were trained to provide health care and treatment to livestock in two union councils. In order to improve the health conditions, 29,852 patients received Reproductive Health facilities through two static community clinics, and Mobile Service Units. 100 Traditional Birth Attendees attended 21 sessions on topics related to safe delivery of child. 946 participants through 34 sessions on health and hygiene learned about hygiene practises, safe drinking water, birth spacing, safe delivery, danger signs, etc . 41 youth members from targeted union councils attended courses on mobile repairing and general electrician in collaboration with Government Technical Training Institute and received mobile repair kits.
English Access Micro Scholarship Program
The English Access Micro Scholarship program funded by US Consulate started in July 2011 and completed in June 2014. The objective of this project was to provide a foundation of English language skills and civic values to students of non-elite schools between the ages of 14-18. In this program, students of 5 government schools of D. G. Khan were engaged in after-school classes and intensive summer programs. Lectures and workshops were conducted for enhancing English linguistics of participating students and civic values were disseminated through classroom and outdoor activities. A total of 583 students benefitted from this project, developing working level proficiency of English language and strengthened civic values. Selected teachers and students received international exposure of US and Turkey through cultural exchange programme.
Prime Minister Interest Free Loan
In 2013, the Prime Minister of Pakistan committed to bringing productive microfinance loans to the doorsteps of the economically marginalized so that they could set-up microenterprises to enhance their incomes and improve their living standards. As a result of this commitment, the Government of Pakistan announced the Prime Minister’s Interest Free Loan (PMIFL) Scheme worth Rs. 3.5 Billion to support productive microenterprise activities for the poor in rural and urban areas of Pakistan. This scheme provided interest-free microfinance loans for marginalized communities, especially women. Micro loans of up to PKR 50,000 are being distributed to men and women for establishing and expanding their enterprises.
The scheme is an important part of CEIP’s poverty graduation model, and prepares clients for conventional microfinance. CEIP has successfully implemented the scheme in 10 Union Councils of Dera Ghazi Khan, and has served more than 18,000 clients. The PMIFL Scheme has proved to be an ideal integration with CEIP’s existing interventions targeting livelihood development in the District under the Move Forward to Regain Prosperous Lives (MFRPL) project, which ended in 2016. Under MFPL project, CEIP has mobilized, organized, and trained communities on various employability avenues through viable micro-enterprises development interventions.