PPIU-Sindh About Us

Bridge the gap between the community & the static Health Facilities
Bring about community awareness, change in attitude and mobilization for health
Provide promotive, preventive & curative PHC services
Put greater emphasis on Maternal and Child Health services
Expand the availability of Family Planning services in rural/ urban areas
Improve nutritional status of mothers & children
Improve utilization of Health Services
Integrate existing Vertical Health Programmes

To develop the necessary health manpower in support of the Programme by selection, training and deployment of 100,000 LHWs throughout the country

To address the primary health care problems in the community, providing promotive, preventive, curative and appropriate rehabilitative services to which the entire population has effective access

To bring about community participation through creation of awareness, changing of attitudes, organization and mobilization of support

To expand the family planning services availability in urban slums and rural areas of Pakistan

A reduction of IMR from 85 to 55 per 1000 live,
A births reduction of MMR from 400 to 180 per 100,000 live births,
Increase in CPR from 22% to 42% in rural & from 40% to 58% in urban areas
An increase in immunization coverage in children aged 12-35 months fully vaccinated from 45% to 80% in rural areas, and from 64% to above 90% in urban areas by the year 2011 (In liaison with EPI)
Increase TT-5 immunization in CBAs from 12% to 40% increase in the percentage of children being exclusively breastfed till age of 6 months from 18% to 50%
An increase in births assisted by skilled birth attendant from existing 12% to 30% in rural areas and from 43% to 80% in urban areas covered by the Programme
The principal sources for the verification of the Programme’s performance will be the “independent” PIHS and Programme Evaluations and the new MIS

HUMAN RESOURCE INDICATORS

Policy development, National level planning, M&E, Coordination, Resource generation & allocation

The Lady Health Workers’ Programme
Promoting Health and Reducing Poverty by bridging the gap between the Health Services and Communities by providing QUALITY Integrated Health Services to the Doorsteps of our Communities. Launched in 1993-94 as a grass roots community level initiative to; Bridge the gap between the community & the static Health Facilities Bring about community awareness, change in attitude and mobilization for health Provide promotive, preventive & curative PHC services Put greater emphasis on Maternal and Child Health services Expand the availability of Family Planning services in rural/ urban areas Improve nutritional status of mothers & children Improve utilization of Health Services Integrate existing Vertical Health Programmes
Goals of the Programme *(under PC-1 2003-08)*
To develop the necessary health manpower in support of the Programme by selection, training and deployment of 100,000 LHWs throughout the country To address the primary health care problems in the community, providing promotive, preventive, curative and appropriate rehabilitative services to which the entire population has effective access To bring about community participation through creation of awareness, changing of attitudes, organization and mobilization of support To expand the family planning services availability in urban slums and rural areas of Pakistan
Objectives *(under PC-1 2003-08)*
The Programme will contribute to: A reduction of IMR from 85 to 55 per 1000 live, A births reduction of MMR from 400 to 180 per 100,000 live births, Increase in CPR from 22% to 42% in rural & from 40% to 58% in urban areas An increase in immunization coverage in children aged 12-35 months fully vaccinated from 45% to 80% in rural areas, and from 64% to above 90% in urban areas by the year 2011 (In liaison with EPI) Increase TT-5 immunization in CBAs from 12% to 40% increase in the percentage of children being exclusively breastfed till age of 6 months from 18% to 50% An increase in births assisted by skilled birth attendant from existing 12% to 30% in rural areas and from 43% to 80% in urban areas covered by the Programme The principal sources for the verification of the Programme’s performance will be the “independent” PIHS and Programme Evaluations and the new MIS
Targets
HUMAN RESOURCE INDICATORS LHWs = 21,225 LHSs = 1 LHS/25 LHW FAMILY PLANNING INDICATORS CPR in rural areas = 22 to 42% CPR in urban areas = 40 to 58% availability of contraceptives in rural areas up to 70% availability of contraceptives in urban areas up to 80%
Managing NP for FP & PHC – Partnership at Federal, Provincial & District level
Ministry of Health (Federal PIU)	Policy development, National level planning, M&E, Coordination, Resource generation & allocation

Provincial Health, Department (Provincial PIU)/ District Implementation Unit	Distribution of finances/ logistics, Training, Monitoring, Coordination, Hiring/firing of LHWs, supervisors, FPOs, Distribution of stipends and supplies to LHWs, Training of trainers, female supervisors, Coordination with other departments, Supervision

*FLCF/Training Centers*	Selection of LHWs, Training and supervision of LHWs, Management of referrals, Distribution of logistics, Collection and compilation of data

Community/Village	Provision of PHC services by (Health House) LHWs

Current Status (Updated: March 2008)
*Program Coverage*
Total Population of Province Sindh	38507619
Total Population Urban	18521109
Total Population Rural	19986510
(according to census 1998 + annual growth rate)
Urban Population covered by LHWs	5000699 (27%)
Rural Population covered by LHWs	11792041 (59%)
*Trainers*
District Master Trainers	146
Facility Trainers	1545
*Vehicles*
Total No. of Vehicles Received	839
Total No. of Vehicles Functional	839
Lady Health Workers (LHWs)/Lady Health Supervisors (LHSs)
Working LHWs	20576
LHWs Under 03 Months' Training	126
Working LHSs	826

Collaboration with Other Projects / Program
*EPI* LHWs involved in Routine Immunization (Pilot districts are Khairpur, Larkana, Thatta, Karachi (Gaddap). Polio NIDs and SNIDs MNT AFP Surveillance Acute Flaccid Paralysis (AFP) Surveillance District Hyderabad also started in Karachi City District Ghotki, Nawabshah, J.Abad & Larkana UNFPA Assisted Program (7th Country Program) MIS/ GIS District Thatta/ J. Abad *UNICEF (Assisted Project)* Training of LHWs and LHSs in EPI LHWs are trained and involved in WRLH Child Survival & Development IMCI (Karachi, Hyderabad and Sanghar) WHO Basic Development Need (BDN) Project District Dadu Acute Flaccid Paralysis (AFP) Surveillance District Hyderabad also started in Karachi City District Ghotki, Nawabshah, J.Abad & Larkana Integration of PHC Program District Sukkur Vital Horoscope (districts involved are Tharparkar, Badin, Sanghar, M.Khas, Dadu, N.Feroze, Larkana, Khairpur, Shikarpur, J.Abad) IMCI (Nawabshah) *Women Health Project* Districts involved: Badin, Shikarpur, N. Feroze and Umer Kot Reproductive Health Project Districts involved: Larkana, Dadu, Thatta, Tharparkar, Jacobabad, Nawabshah, Khairpur & Ghotki *Aga Khan University* Prenatal Infection in District Hyderabad LBW Project at Hala, Matiari District Hyderabad and Khairpur Client Registered Card (CRC) District Mirpur Khas Zinc Supplementation district Hyderabad Family Planning Association of Pakistan Tubal Ligation and IUCD insertion camps in all districts *PAIMAN* A USAID funded project aiming to increase the status of maternal and neonatal health in Dadu and Sukkur


Achievements of NP for FP & PHC
The NP for FP & PHC has played a significant role in women empowerment by creating job opportunities for >21,000 LHWs and 800 supervisors in the field >30 % of total Population is being covered by LHWs 1800 VBFPWs have been absorbed as LHWs LHWs have been actively involved in EPI activities e.g Polio National Immunization Days (NIDs) - out of 30 million children, about 16 million are immunized by LHWs Maternal & Neonatal Tetanus Elimination Activities in high risk areas of 54 districts (Out of 5 million target women, 4.5 millions were vaccinated by LHWs) Majority of LHWs have been trained in giving EPI vaccines LHWs are involved in Directly Observed Therapy, Short Term (DOTs) LHWs are involved in nutrition activities i.e. promotion of breast feeding, iodised salt, and provision of vitamin A to approx. 16 million children during NIDs LHWs carry out AFP surveillance for detection of polio cases Safe Motherhood activities including promotion of antenatal care, clean delivery practices and post natal care CPR increased to >40% in LHW areas