Saleem participating in a hands-on training for Jadelle Insertion.
In Pakistan’s Karachi West district, The Challenge Initiative (TCI) is advancing a groundbreaking approach to male involvement in family planning service delivery. Under the leadership of Dr. Shazia Baloach, Additional District Health Officer (Preventive), and Dr. Huma Tabassum, TCI’s focal person, the district has begun training male healthcare providers to insert Jadelle – a long-acting contraceptive implant typically provided by female practitioners.
This game-changing initiative began unexpectedly. When the nominated female doctor from Mansoor Nagar, Orangi Town, was unable to attend a Postpartum Family Planning (PPFP) training due to an emergency, staff nurse Mr. Saleem was sent as a substitute.
Orangi Town, one of Asia’s largest informal settlements, presents unique challenges to healthcare delivery. Yet Saleem’s participation proved to be a turning point. Not only did he excel during the training, but upon returning to his facility, he performed over 50 successful Jadelle insertions – significantly advancing family planning access in the district.
Dr. Baloach reflected on the importance of inclusive service delivery:
As doctors, we treat patients without any bias toward male or female genders; similarly, there should be no bias in family planning services.”
Recognizing the promise of this unexpected success, Drs. Baloach and Tabassum moved quickly to build on it, nominating additional male doctors for PPFP training. The results were swift and encouraging, capturing attention across Karachi West and inspiring neighboring districts to adopt a similar approach.
Karachi West’s newly trained providers now regularly host Family Health Days (FHDs), offering family planning services directly at their facilities. These events illustrate how strategic leadership, strong communication, and system-wide collaboration can accelerate service delivery improvements.
However, this effort to increase the number of male family planning service providers has faced challenges. For example, a new Medical Superintendent temporarily barred Saleem from continuing family planning services. In response, the district’s family planning focal person reached out to the District Health Officer and Assistant District Health Officer, who swiftly intervened to reinstate Saleem’s role – reinforcing the importance of leadership support in sustaining innovative service models.
Dr. Tabassum emphasized the broader impact:
Saleem attending a PPFP capacity-building session in Karachi West.
Male mobilization plays a crucial role in improving family planning services, providing valuable support and feedback within the community. This initiative was also extended to households through male involvement.”
The experience in Karachi West demonstrates the power of adaptive leadership, the value of seizing unexpected opportunities, and the potential of male engagement to strengthen health systems. It also underscores the critical importance of collaboration between district leadership and healthcare providers to overcome barriers and sustain progress. TCI’s efforts in Karachi West offer a replicable model for other regions aiming to expand access to family planning services through inclusive, gender-sensitive approaches.
Special thanks to Dr Lajpat Kessani, DHO West, and Dr. Sadaf Bano, DDHO, DHIS & MIS West, for their contributions to this article.
