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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

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
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
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
FP in Pakistan: The History

  • FPAP started in 1953

  • GoP programs in 1966

  • Many phases and approaches


Family planning in pakistan
Family Planning in Pakistan

MWRA: 23 million

Source: PDHS 2006-7


Modern methods
Modern Methods

Total Users: 5.1 Million


Services for modern methods
Services for Modern Methods

Total Users: 2.9 Million (12% of MWRA)


Connecting cpr to services
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
Costs of FP in the Public Sector

In PKR

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


Inferences of costs
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
Trends in Services 2006-12

In Millions Women Served


Services by sectors
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
Age when Information Received

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


What does it all mean
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
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