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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. 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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  1. Family Planning in Pakistan: What we know, what we must do Dr. Adnan A. Khan Research and Development Solutions

  2. 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

  3. 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

  4. FP in Pakistan: The History • FPAP started in 1953 • GoP programs in 1966 • Many phases and approaches

  5. Family Planning in Pakistan MWRA: 23 million Source: PDHS 2006-7

  6. Modern Methods Total Users: 5.1 Million

  7. Services for Modern Methods Total Users: 2.9 Million (12% of MWRA)

  8. 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

  9. Costs of FP in the Public Sector In PKR Regional Costs: PKR 240-400 (USD 4-6)/ CYP

  10. 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

  11. Trends in Services 2006-12 In Millions Women Served

  12. Services by Sectors Public 1 M, 33% Private 1.9 M 67% 2.9 million (12%) of MWRA receive FP services per year

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

  14. 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

  15. 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

  16. Thank You

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