Family planning (FP) in Pakistan faces a variety of challenges due to cultural, socio-economic and political factors, as well as myths, misconceptions and religious beliefs. The Pakistani health system itself also faces multiple challenges, including limited staff capacity and skills regarding FP, understaffing and commodity security.
Since January 2023, the Basic Health Unit-214 RB in Faisalabad has been implementing high-impact interventions with support from The Challenge Initiative (TCI). The health facility in-charge there, Dr. Faiqa Yasmeen, is a TCI-trained master coach specializing in postpartum family planning (PPFP). TCI has also been supporting local government and facility staff in implementing interventions such as family health days (FHDs), whole site orientations (WSOs), and on-the-Job training.
Dr. Faiqa took a special interest in implementing these interventions with the technical support of the TCI City Manager and mobilized relevant facility staff and resources to help ensure the availability of FP commodities on designated FHDs. TCI, in consultation with district health leadership, ensured the presence of trained service providers, equipment, commodities, and supplies at a facility during FHDs.
Implementing well-planned and well-organized FHDs on a regular basis has started to show positive signs. Facility data shows that the number of family planning clients doubled. The facility that served an average of 82 clients per month prior to TCI engagement (Jun–Dec 2023) now serves an average of 151 FP clients since TCI implementation began.
Noticing the dramatic increase in the FP clients, Dr. Faiqa said:
TCI’s team regularly visits and follows up with Lady Health Supervisor (LHS) and Lady Health Workers (LHWs) for mobilizing the community. Resultantly, the scaling up of the services and shift in family planning uptake, in such a small facility, is tremendous. We made special requests and arrangements to ensure the availability of LARC and other contraceptives in order to avoid any shortages on FHDs.”
The Lady Health Supervisor (LHS), Samana Kazmi, added:
At the basic health facility, it is expected that general OPD (outpatient department) clients will regularly visit the facility, but having family planning-focused FHDs, with availability of all commodities, has increased the trust of the community and demand for FP as well. During FHDs, we decorate the facility by placing balloons, colorful banner, and standees with information that creates a festive air, which attracts the community and is something unusual for the community.”
Facility staff are encouraged by the increasing family planning numbers, the facility is catering to FP clients on non-FHD days due to the increase demand of FP services among the community. The system of commodity supply is increasingly evolving, where the stock levels are regularly monitored to ensure service continuity. Health facility connectivity with the district health office and vice versa has also improved because of regular coordination by the TCI team.