The Basic Health Unit (BHU) in Baloch Goth – located in the heart of an urban slum in Karachi, Pakistan – was in deplorable condition because of a lack of maintenance. With dysfunctional rooms, no toilets and clothes strung about, the facility’s appearance did not convey confidence in the services it was designed to provide (i.e., primary health care and family planning). Family planning services had also been subpar for years.

A Lady Health Visitor (LHV) was appointed to jumpstart the provision of short- and long-term contraceptives, deliveries, postpartum family planning (PPFP) and post-abortion family planning (PAFP) services, as well as antenatal care. The newly trained LHV assumed the role of a guardian angel within the rundown facility and began engaging the community to generate demand for the facility’s services.

After The Challenge Initiative (TCI) started implementing facility-based Family Health Days in Baloch Goth, client volume improved but primarily for short-term methods. After an analysis revealed that the healthcare provider needed basic skills and knowledge about long-term reversible contraceptives, TCI’s family planning Focal Person from District West, Dr. Huma Tabassum, provided the training. But the facility still lacked privacy as it did not have a separate procedure room to provide intrauterine contraceptive device (IUCD) services.

TCI also advocated with the leadership to designate Lady (Community) Health Workers working in the vicinity to conduct exclusive demand generation for family planning to create awareness and improve client volume. But the waiting area at the facility was the only room where clients were counseled and provided with services. To respond to demand for long-term methods, the facility staff creatively split the available space with curtains and screens as a makeshift arrangement to offer long-term services in private.

The encouraging response from the staff and community led the district health team, with support from TCI, to conduct a Facility Makeover at the BHU in Baloch Goth. The facility was renovated according to guidance provided in TCI University. Rooms were repainted, procedure rooms were re-arranged to provide family planning services with privacy and confidentiality, water stations were installed, bathrooms were fixed and the waiting area was expanded to accommodate more people. In addition, through joint advocacy from the health district health team and TCI, a commodities shortage was fixed and a gynecologist was appointed to help ensure high-quality services.

The madeover facility was inaugurated in June 2023 by Government leadership, including Member of National Assembly Dr. Shahida Rehmani (MNA Pakistan Peoples Party) and the District Health Officer, Dr. Salman Shaikh. Dr. Rehmani commended the collaborative efforts of the Department of Health and TCI and expressed her appreciation for their dedication to improving healthcare infrastructure and family planning services:

 The facility makeover activity will positively impact the primary care and family planning services linked with mother and child health and well-being of the people of Baloch Goth.”

Dr. Shaikh also expressed gratitude for the concerted efforts to transform BHU Baloch Goth into a modern, well-equipped healthcare facility, saying:

 I am an eyewitness of the transformation of this facility from being dormant to now a fully functional health center where people, especially women, can come to acquire Family Planning and Family Health Solutions. I am grateful to TCI Pakistan for their evidence-based high-impact interventions and continuous technical support to the Government of Sindh.”

The facility makeover at BHU Baloch Goth is a testament to the collective commitment towards providing quality healthcare and family planning services to the community. It is the result of a joint vision of the Sindh government, the Department of Health and TCI in Pakistan to create a nurturing and accessible healthcare environment for family planning services.

Ever since TCI began supporting the BHU in Baloch Goth, family planning clients have increased from an average of 10-15 a month to 150-200 per month. The facility is now the go-to health center for women seeking family planning, as well as maternal and child health services.