Family planning in pakistan what we know what we must do
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Family Planning in Pakistan: What we know, what we must do. Dr. Adnan A. Khan Research and Development Solutions. The Evidence to Policy and Action Grant Initiative. USAID Small Grant (2011) to RADS Partners – Punjab and Sindh DOH and PWDs

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Family Planning in Pakistan: What we know, what we must do

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Family Planning in Pakistan: What we know, what we must do

Dr. Adnan A. Khan

Research and Development Solutions


The Evidence to Policy and Action Grant Initiative

  • USAID Small Grant (2011) to RADS

  • Partners – Punjab and Sindh DOH and PWDs

  • Areas – Family Planning and Immunization in the context of MNH

  • Purpose - Institutionalize information generation and use and actions


What is RADS doing

  • Analysis- existing datasets, LHW, EPI data (Punjab and Sindh)

  • Research on models of services

  • Working with DoH/PWD to understand their programmatic data and connect to program improvements

  • Informed Advocacy to Politicians, communities

  • Work with donors to address their information needs/efficiency


FP in Pakistan: The History

  • FPAP started in 1953

  • GoP programs in 1966

  • Many phases and approaches


Family Planning in Pakistan

MWRA: 23 million

Source: PDHS 2006-7


Modern Methods

Total Users: 5.1 Million


Services for Modern Methods

Total Users: 2.9 Million (12% of MWRA)


Connecting CPR to Services

CPR

30% of MWRA

7.1 Million Users

Modern Methods

22% of MWRA

5.1 Million Users

Services

12% of MWRA

2.9 Million Users


Costs of FP in the Public Sector

In PKR

Regional Costs: PKR 240-400 (USD 4-6)/ CYP


Inferences of Costs

  • Pakistan public sector costs are 4 fold higher than regional costs (USD 4-5/CYP)

  • 4% of costs in public sector are for commodities

  • If regional efficiency was to be achieved, public sector FP funding alone can allow >80% CPR


Trends in Services 2006-12

In Millions Women Served


Services by Sectors

Public

1 M,

33%

Private

1.9 M

67%

2.9 million (12%) of MWRA receive FP services per year


Age when Information Received

Source: Khan et al, Study of Information Processing by Young Women. RAF/ DFID 2012-13


What does it all mean

  • Overall CPR has increased at <1% per annum

  • 12-14% of MWRA receive FP services each year

  • Government services only account for 33% of all services or around 1 million women.

  • Nearly half of couples buy FP supplies from stores. Markets serve ~50%. These are poorly understood

  • Despite investments and programs, the number of users has not increased above secular trends

  • Young women are a major potential user group that is largely being ignored


Lessons

  • While supply side programming is useful, demand must be created

  • Spacing messages must be incorporated into common narrative

  • Address Young women – soon to be married, newly married

  • Government programs must be held accountable to the investments that go into them. This may mean that unless they produce results, facilities and sections of programs may be closed down

  • Markets for FP are crucial, better understanding and used


Thank You


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