Family planning: Smartest investment for achieving the Sustainable Developments Goals for Pakistan

Wazir, Muhammad Asif; Alazar, Yilma Melkamu; Kadirov, Bakhtior

doi:10.31235/osf.io/b3uvx

Cited by 9 publications

(9 citation statements)

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“…The project cost USD 4.02 per household reached, USD 9.95 per user served, and USD 5.21 per CYP, all well below any comparable costs in the public sector Pakistan, including that for the lady health workers [ 4 , 28 ], and much below regional costs [ 29 , 30 ]. The program owes its low costs to working with the community women, many of whom were working for the first time.…”

Section: Discussionmentioning

confidence: 99%

Community‐Driven Family Planning in Urban Slums: Results from Rawalpindi, Pakistan

Khan¹,

Ahmad²,

Najam³

et al. 2023

BioMed Research International

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Background. Pakistan’s contraceptive prevalence rate (CPR) has remained static (less than 1% annual increase since 2006) due to several demand and supply issues. The Akhter Hameed Khan Foundation implemented a community-driven, demand-generation intervention with complementary supply side family planning (FP) services in a large urban informal settlement in Rawalpindi, Pakistan. Methods. The intervention recruited local women as outreach workers called Aapis (sisters), who conducted household outreach and provided counseling, contraceptives, and referrals. Program data were used to guide in-program corrections, identify the most willing to use married women of reproductive age (MWRA), and target specific geographic locations. The evaluation compared results from two surveys. The baseline survey included 1485 MWRA while the endline included 1560 MWRA that were sampled using the same methodology. A logit model was used with survey weights and clustered standard errors, to estimate the odds of using a contraceptive method. Results. CPR in Dhok Hassu increased from 33% at the baseline to 44% at endline. Long-acting reversible contraceptives (LARCs) usage increased from 1% at baseline to 4% at endline. Increase in CPR is correlated with increasing number of children and education of MWRA and is the highest between the ages of 25 and 39 and for working women. Qualitative evaluation of the intervention provided lessons about in-program corrections using data and empowerment of the female outreach workers and MWRA. Conclusion. The Aapis Initiative is a unique community-based demand-supply side intervention that successfully increased modern contraceptive prevalence rate (mCPR) by economically engaging the women from within the community as outreach workers and enabling healthcare providers to establish a sustainable ecosystem for increasing knowledge and access to family planning services.

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Section: Discussionmentioning

confidence: 99%

Community‐Driven Family Planning in Urban Slums: Results from Rawalpindi, Pakistan

Khan¹,

Ahmad²,

Najam³

et al. 2023

BioMed Research International

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“…It is the world’s fifth most populous country, and its current population growth rate of 2.4% sets it on a path where its population will increase from the current 208 to 310 million by 2050 [ 5 , 6 ]. This will profoundly impact Pakistan’s socioeconomic status and environment, and affect its ability to achieve its Sustainable Development Goals (SDGs), especially SDG 3 (good health and well-being) [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Raising the contraceptive prevalence rate to 50% by 2025 in Pakistan: an analysis of number of users and service delivery channels

Abdullah¹,

Bilal²,

Khan³

et al. 2023

Health Res Policy Sys

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Background Pakistan is the fifth most populous country in the world, with a population that is growing at 2.4% annually. Despite considerable political will, including a national commitment that was endorsed by the president to raise the contraceptive prevalence rate (CPR) to 50% by 2025, it has stagnated at around 30–35%. Much of the dialogue on raising CPR is hypothetical and revolves around percentage point change rather than an actual number of women that must be served. Methods The Demographic and Health Survey 2017–18 (DHS 2017–18) provides information about the channels through which users receive family planning (FP) services and disaggregates this information at the provincial level. Proportions of users from each of these channels were multiplied by the Pakistan Census-2017 populations to arrive at the number of users. These users were compared with the total FP users and the number of women that had used any FP service in the past 12 months. Linear estimations of population were applied to calculate population numbers in 2025. Results The national target of 50% CPR by 2025 translates to a population of 20.02 million users. Currently, 11.26 million married women of reproductive age (MWRA) use any method, 8.22 million use a modern method and 4.94 million received this service in the past 12 months. Of these, 2.7 million did so from social marketing outlets, 0.76 million from public sector outreach through lady health workers (LHWs), 0.55 million from private sector and 0.88 million from public sector facilities. However, arriving at the CPR target means expanding annual service delivery from 4.94 to 13.7 million users. Since social marketing and LHW outreach may have become saturated, only public and private health facilities are the likely channels for such an expansion. Conclusions We demonstrate triangulation of the survey data with the census data as a simple policy analysis tool that can help decision-makers estimate the quantum of services they must provide. Such an analysis also allows an understanding of the utilization patterns of each of these channels. In Pakistan’s context, underutilization of funds and existing facilities suggests that increased funding or more providers will likely not be helpful. The policy changes that will likely be most effective include adding outreach to support existing public and private sector facilities while ensuring that procurement of commodities is prioritized.

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“…From the current 208 to 310million its population will rise by 2050 as can be foreseen by its existing growth rate of population (2.4 %) [4]. This will have an intense impact on socio-economic standing and Pakistan's environment and will influence its reliability to accomplish its Sustainable Development Goals, specifically SDG-3 (Good health and well-being) [5]. Pakistan's demographic requirements are clearly out of balance now [6].…”

Section: Introductionmentioning

confidence: 99%

Comparison and Analytical Impact of Various Methods of Contraception on Liver Profile of Females of Sindh Province

Shah¹,

Warsi²,

Laghari³

2023

PJMHS

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Objective: To Compare and Analyze the impact of different methods of contraception on liver Profile of females of Sindh province. Study setting: This is a comparative cross-sectional study that was done at Liaquat university of medical and health sciences Jamshoro, at center 'A' of reproductive health services. Methodology: 300 participants from Hyderabad Sindh were selected. Females aged 20 to 40 years and those on an individual method of contraception were selected.300 females were selected for this study. Among them, 138 ( 46.0%) were residents of rural Sindh whereas162(54.0%) belonged tour ban Sindh. Consent from participants both verbal and written was taken. A structured questionnaire was filled out for demographic characteristics following detailed history. Blood Sampling was done for liver function test. Results: The results showed that present users of contraceptives generally had significantly greater liver parameters biliru bin, gamma GT, SGPT, and Alkaline phosphates compared to non-users ( p-value= <0.05). Bilirubin level was considerably greater among women who were using the contraceptive methods DMPA injection (0.72±0.24), Jadelle (0.54±0.26), IUCD (0.44±0.18) than the corresponding values for nonusers (0.43±0.194) [control 0.43±0.194 vs DMPA injection(0.72±0.24)vsJadelle(0.54±0.26)vsIUCD(0.44±0.18),P-value=<0.05)]. Gama GT level was considerably greater among women who were using the contraceptive methods Jadelle (20.36±11.97), Oral (14.00±3.2) than the corresponding values for non users (15.42±7.36)[control 15.42±7.36 Jadelle (20.36±11.97) vs Oral (14.00±3.2) Oral (14.00±3.2) P-value = <0.05)]. SGPT level was considerably greater among women who were using the contraceptive methods DMPA injection (32.68±18.37), Jadelle (31.34±14.13), IUCD (29.66±14.62), Tubal ligation (18.00±0.00) than the corresponding values for nonusers (25.39±14.59) [control25.39±14.59 vs injection (32.68±18.37) vs Jadelle (31.34±14.13) vs IUCD (29.66±14.62), Tubal ligation (18.00±0.00) P-value = < 0.05)]. Alkaline Phosphatase level was considerably greater among women who were using the contraceptive methods DMPA injection (114.65±48.19),Jadelle (99.28±38.076),IUCD(101.74±42.23)Oral(78.89±21.70)TubalLigation(62.50±2.12)Condom (94.62±25.67) than the corresponding values for nonusers (131.51±59.04) [control131.51±59.04 vs DMPA injection (114.65±48.19) vs Jadelle (99.28±38.076) vs IUCD(101.74±42.23),Oral(78.89±21.70)Tuballigation (62.50±2.12)Condom(94.62±25.67)P-value= < 0.05)]. Conclusion: The impact on the liver of different contraceptive methods was compared and analyzed in the population of Sindh. Keywords: DMPA (depot- medroxy progester one acetate), Implant, Oral Pills, IUCD (intrauterine contraceptive device), tuballigation.

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Family planning: Smartest investment for achieving the Sustainable Developments Goals for Pakistan

Cited by 9 publications

References 0 publications

Community‐Driven Family Planning in Urban Slums: Results from Rawalpindi, Pakistan

Community‐Driven Family Planning in Urban Slums: Results from Rawalpindi, Pakistan

Raising the contraceptive prevalence rate to 50% by 2025 in Pakistan: an analysis of number of users and service delivery channels

Comparison and Analytical Impact of Various Methods of Contraception on Liver Profile of Females of Sindh Province

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