Program & Service Delivery
Pakistan will engage with provinces to implement the Minister’s directive to provide birth spacing services in health facilities at all levels. Contraceptive services will be included in the essential service package of two provinces in 2012, with the others following in 2013.
Pakistan commits to making FP a priority for over 100,000 LHWs, who cover 70% of rural areas. They will strengthen LHW quality of care by regularizing their employment status, providing training, and reinforcing referral links between LHWs, community midwives, and nearby facilities. Pakistan will strengthen supply chain management, training and communication campaigns. A modern state of the art storage tracking system at the Central Contraceptive Warehouse in Karachi has been installed.
Pakistan is working to scale up access through public-private partnerships and contracting-out mechanisms, and to scale up work with religious and community leaders and men to promote the benefits of birth spacing. There will also be efforts to increase the focus on men in communications messages, mobilization activities, and services (through the increased availability of vasectomy services and condom distribution).
The provinces are planning other initiatives, such as:
- Strengthening procurement and logistic systems for timely, regular and uninterrupted availability of contraceptives at all public service delivery points;
- Improving the technical and communication skills of service providers for better service quality; and
- Placing greater emphasis on communication for generating more demand, raising awareness, and changing behavior.
Annual public spending for family planning services for 2011-2012 was US $151 million. Pakistan will increase this to $197.7 million in 2012-2013, with further increases annually to ensure universal access by 2020.
The private sector share is $40.8 million. Greenstar Social Marketing, Family Planning Association Pakistan, and Marie Stopes International provide the main share of private sector family planning services.
2011-2012 spending on family planning was $1.21 per capita (public sector share: $0.84; private sector share: $0.37). In 2012-2013, the public sector share will increase to $1.07 per capital (total: $1.55 per capita). The goal is to reach $2.50 per capita by 2020.
Contraceptive requirements for both Government and Greenstar social marketing are covered by USAID until 2014. Subsequently, the government will need to import approximately $13 million worth of contraceptives yearly. This number will increase to $35 million annually by 2020, as we reach CPR 55 percent. The 2013-2020 resource gap for contraceptive commodities is $186 million.
The provinces are currently developing medium term budgetary frameworks, aligned with health sector strategy, to ensure financing of programs including family planning. The next step is to have a specified line item for family planning in their health budgets. Provinces will raise additional resources to increase access to quality services by training staff in client centered services and ensuring the availability of contraceptive supplies.
Policy & Political
Pakistan commits to strengthening the National Task Force/National Population Commission on Population and Development to achieve policy consensus and program improvement for FP across provinces. The Task Force/Commission will also coordinate with the provinces to agree on specific service delivery targets that could be monitored periodically. Federal financing will be aligned with the achievement of these targets.
Post 18th Amendment provinces and Special Areas governments will develop health sector strategies for 2012-2020 containing interventions for promotion of FP, and will also regularly monitor the CPR. The National Population Policy 2010 will act as an umbrella as provinces develop their own population policies, prioritizing the centrality of population within their health and development plans.
In addition, cross party support for population issues will be ensured by the Parliamentary Group on Population and Development, to influence political party agendas before the next elections.
The MDG Parliamentary committee is currently ensuring accurate monitoring of MDG targets through independent data collected by Pakistan Bureau of Statistics.
Pakistan plans to achieve universal access to RH by 2020, and to raise CPR to 55% by 2020.