Primary and reproductive health care is of paramount importance in the context of the Balochistan province. Nevertheless, the situation of the health sector is the worst as compared with the situation of the rest of the provinces of the Pakistan. It is, particularly, deteriorating in the rural and far-flung areas of the Balochistan, where basic health units (BHUs) exist but are dysfunctional in majority of the cases. In terms of reproductive health care, the situation is more alarming than the situation of the primary health care.
Unfortunately, Balochistan is one of the areas in South Asia, where mother mortality rate (MMR) and infant mortality rate (IMR) are frighteningly higher; more mortalities occur here than elsewhere due to unavailability of reproductive health care at rural level. The scattered population and the long distances from a settlement to a health facility further complicate the worsening situation. Thus, women, children, elderly persons, and other segments of the population are forced to undergo poor health conditions and are compelled to spend an unhealthy life.
Given BRDS’ treatment of the health care is such that it bifurcates it into primary and reproductive. In view of its treatment of the health care, BRDS plans and implements interventions aimed at achieving higher levels of improved primary and reproductive health care, especially in the far-flung, rural areas of the province of the Balochistan.
BRDS’ objective of the health sector is as follows:
“To provide basic and reproductive health services in far-flung and disadvantaged areas of the province with primary emphasis on mother and child care.”
In order to contribute to the above objective, BRDS aims at achieving the following specific objectives:
- To promote equitable distribution of high quality primary and reproductive health system improving basic and rural health centers
- To balance patients’ preferences more towards primary health care through awareness sessions
- To train a large pool of government lady health workers to provide reproductive health care in far-flung and disadvantaged areas to contribute to mother and child care
- To better address health risks related to gender and social factors by involving community institutions through health campaigns
Specific results to be accomplished in the course of BRDS’ projects, which would lead to the achievement of above-outlined specific objectives, which include:
- Framework for increasing primary and reproductive health care resources created
- Mechanisms for equitable distribution of primary and reproductive health care system elaborated
- Quality of health care services improved
- Knowledge and skills of primary and reproductive health care professionals in addressing health risks related to social factors and counteracting communicable diseases improved
In order to tackle the problems identified above and to achieve the objectives defined, it is important to establish a network by the formation of health committees within community institutions.
Health Committees could be very useful in finding the balance between the needs of the patients and the communities and promote effective working mechanisms in the health care systems.
Special focus in the field of health care human resources and professional training shall be put on the role of female paramedical staff in clinical and preventive care.
Expected outcomes of BRDS’ interventions include
- Further evidence for benefits of health care generated, demonstrated and communicated to key stakeholders and communities
- Mechanisms for equitable distribution of high quality health care system
- Primary and reproductive health care personnel trained in methods on lifestyle issues, in community based work, and in reproductive health care
Health officers are recruited and are responsible for liaising with the health department and People’s Primary Health Initiatives (PPHI) and other NGOs that may work in the course of our interventions.
The basic units are run by PPHI in the district. The health officer coordinates with PPHI beforehand to ensure its support during implementation of Multi Sector Plans (MSPs) for health component. The community will identify any BHUs that are not catering for their needs, and provide proposals to BRDS for strengthening of such units. The proposals will be made a part of the MSPs and will collectively be sent to donors for approval and thereby implementation by community institutions (CIs).
Similarly, the health officers in unison with the CIs will target health units in far-flung and disadvantaged areas to equip it with inputs to cater for reproductive health services to mothers and pregnant women. In this scenario, we will coordinate with the health department to arrange for paramedical staff for reproductive health care.
BRDS will conduct baseline surveys for identification of areas, which do not have a health facility within 5 km radius. After identification, CIs and BRDS will jointly plan for a health facility with the support of government and donors, which will be established by the CIs under the supervision and technical support of the BRDS. The community will provide land for the construction of a health center.
BRDS will also sign a term of partnership with the CIs for strengthening or establishing / managing health centers.
Sustainability of Health Interventions
The health department and PPHI will be closely involved in the health interventions. Efforts will be made at the time of preparation of MSPs to ensure their contribution to health facilities.
In turn, these two departments will maintain the health facilities supported from donors’ funds.
Health Management Committees (HMC) will be formed, which will be elected from CI members. HMCs will be accountable to their institutions. The HMCs will be responsible for the post management and operation and maintenance of the health facilities.
Achievement in Basic and Reproductive Health Care
|Repair and renovation of health units
|Provision of equipment, furniture, and medicines to health units
|Development and training of health community resource persons
|Training of male and female beneficiaries in preventive health practices
|Development and training of TBAs at community level
|Training of LHWs in the targeted areas
|Formation of health management committees (HMCs)
|Provision of reproductive health services to women