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Training Sessions for Female on CMST is underway

The provision of medical facilities to rural areas has been a major developmental objective of Pakistan.  The government has undertaken several programs to train and deploy women doctors, lady health visitors, and dispensers in their health facilities in the rural areas of the country. However, district Umerkot in Sindh, similar to many other rural districts in Pakistan, is faced with a severe shortage of human resources in the medical sector. Community World Service Asia is addressing this limitation through implementing effective and affordable interventions so that progress towards SDG Goal 3, on achieving health and well being, is successfully met.

In its third year of implementing a Health Project in Umerkot, with the financial support of Act for Peace (AFP) and PWS&D, this project was initiated after consultation and coordination with the all district health authorities and local communities in Umerkot. Rural Health Centres (RHCs) in three villages of Umerkot have been set up to respond to a broad range of health issues including general hygiene, communicable disease prevention, awareness on safe motherhood and safe deliveries, vaccination for women and children, breastfeeding, family planning and access to safe drinking water.

Six Health Committees, comprising of men and women of the communities have been formed in the villages of Nabisar Road, Hyderfarm and Dhoronaro in Umerkot. These are the villages where each RHC is established. Each of these health committees consists of ten members from each village. An advocacy forum, made of ten health activists, has also been set up at the district level to address emerging health issues and to facilitate the successful functionality of the health centres. These activists represent government line departments, civil society organizations and the local community from the catchment areas of where the health facilities are established. Acknowledging the significance of community engagement, the advocacy forum and its work is seen as a back bone for the success of the project and key to providing sustainability to the health centres.

The training titled, Community Management Skill Trainings (CMST), was designed for members of the village health committees to strengthen their capacities on health issues and clearly define their roles and responsibilities. Health committee members were expected to clearly identify health related problems of their village and establish linkages with line department and prioritize health concerns on their own after taking the training.

Altogether, a series of six, two day trainings on CMST with all the village health committee members. In each of the three locations, separate two day training sessions for men and women were conducted. In addition, a one-day orientation session on Leadership Management Skills Training (LMST) was also conducted for the representatives of each line department, civil society organizations and the local community.  A total of ten participants attended this training.

With enhancing the awareness, skills and capabilities of the participants, the training aimed for the Health committees to better plan and manage their relevant activities and effectively utilize the local resources available to them. It also provided the participants an opportunity to strengthen their abilities to work towards breaking the vicious cycle of poverty and overcome communal health concerns, specifically that of women and children.

The purpose of empowering the health advocacy forums is to facilitate positive change and to see development of new policies that will tackle unmet and emerging health needs at district level.

In total six, two days CMST training sessions were conducted with the village committee members. In each of the three locations, two days training session for men and two days training session for women were conducted. 30 males, 10 each from the three locations and 30 women, 10 each from the three locations participated in the training. Apart from that, a one-day orientation session on Leadership Management Skills Training (LMST) was conducted for the representative of line department, civil society and communities. In total 10 participants attended this training which included one woman and nine male members.

 

The buyer displays embroidery designs and color combination used on wall hangings.

As a small district in interior Sindh, Umerkot has a limited a market space for rural artisans to expand their handicraft business to be able to reach large consumer groups.  To expand this outreach, twelve Sales and Marketing Agents (SMAs) from among the rural artisans in Umerkot, were facilitated with a market exposure visit to Mithi and a two-day Capacity building Training. This exposure opportunity aimed at building artisans’ awareness on new market trends and consumer demands outside of Umerkot district and familiarizing them with product pricing, bargaining with middlemen and customers and creating market linkages that will enable a sustaining business environment for these  women artisans from remote villages of Umerkot.

Buyers at the Mithi marketplace warmly welcomed the SMAs from Umerkot and made them comfortable enough to display their finished products, the materials with which they were produced and prices at the foreign market. The artisans were overwhelmed with joy to see their traditional embroidered and appliquéd products being well-received and valued among buyers in Mithi.

Potential buyers and renown retailers of Mithi, such as, Nathoo Raam Block Printing and Handi Crafts, Mama Handi Crafts, Waswani Handi Crafts and another local entrepreneur, met with the Umerkot artisans and showed them their own products as well to give them an idea of the product cycle, latest market trends and best selling products. These experienced retailers further shared tried and tested, successful, marketing techniques with the artisans to enhance their business circle, networks and advertising skills. This was a new learning for the artisans and they openly welcome it as it would surely help in building their handicraft enterprises.

Most of the handicrafts salesmen in Mithi encouraged the SMAs to invest in producing new products by using locally available raw materials and fabric. One of the local entrepreneurs displayed his new range of products, including purses, handbags and pouches, made from shawls that are easily available in local markets, of different designs at his finishing unit and told them how popular these products were.

During the visit, the SMAs from Umerkot received an order of hundred cushions from a popular Mithi retailer, Loveraj Handicrafts. The artisans dealt with confidence and professionalism with their customer and assured him that the order given would be timely completed, with utmost attention to quality.

I gathered innovative ideas to strengthen and increase the work of rural artisans. We had limited access to buyers before. I am confident that our handicrafts will be sold in the urban markets in good price now.,

expressed Naz Pari, SMA from Village Talo Malo, Umerkot.

Community World Service Asia, with the support of Act for Peace (AfP) has set up three Rural Health Centres (RHC) in in the villages of Nabiser, Dhoronaro and Hyder Farm, located in the Umerkot district of Sindh in Pakistan since 2015. These health centres are run and managed by Community World Service Asia and are supporting more than 100,000 people in the district. The RHCs provide routine OPDs, Reproductive Health Services, Family Planning Services, Health Education Sessions, Antenatal and Postnatal services, and also provide free of cost medication and a full range of preventive health coverage.

The community mobilizers assigned with these RHCS regularly visit and monitor the catchment population to mobilize, organize and increase the awareness of the communities residing in these areas on health issues. They are also delivering health awareness sessions for men and women in their villages and for children in their schools.

Access to well-equipped health facilities is a major issue for most rural communities in Sindh. In order to provide health services nearly at the doorstep of these deprived communities, free medical camps were organized in three different Union Councils in the farther catchment areas of the RHCs. The religious ethnicities of the communities where the medical camps were set up were mainly Hindu and Muslims, belonging to different sects and castes of each religion.

The Medical camps services focused primarily on Mother and Child Care. The first two camps were set up at the Syed Muhammad Memon village and Abdul Majeed Arain village through the 24th and 25th of November, while the third camp was organized at the Daim Nohri village on the 30th November. Apart from delivering free consultations, free medicines were also provided to patients visiting the camps. Acute Respiratory Infection (ARI), Gastritis, Diarrhea, flu and fever were found to be the most common health concerns while diagnosing patients at these camps.

Antenatal cards were also issued to pregnant women visiting the medical camps and were advised to visit their nearby Rural Health Center for further consultation and medication. The lady medical officers at the camps shared key awareness messages on the importance and methods of family planning. Community Mobilizers conducted sessions on Child Spacing, family planning and the importance of check-ups during pregnancy among camp visitors as well.

A focal person from the town committee also visited the medical camp and appreciated the efforts of the health team involved and emphasized on the need to conduct these camps on a monthly basis.

The three villages where the camps were set up were all at a distance of seven to nine kilometres from the district of Umerkot. These areas were identified as the most vulnerable in terms of access to health facilities and frequency of diseases. Most of the community members from these villages are unskilled laborers and farmers who cannot afford expensive medical treatment or travel costs to health centres in the cities.

While my personal achievement is important to me, I believe that true happiness is achieved by serving others. Zareena, 17-year-old gender activist from Umerkot.

The lifestyle and traditions of the people of Ahori Farm (a rural village in Kharor Syed) in Umerkot have remained the same for years. Most of the residents here toil the land on a daily basis in an effort to survive. Through this on-going mundane lifestyle, little thought is given to educating girls or helping them develop as equal and empowered community members of Ahori farm. Many girls here do not go to school and educating girls is widely condoned in the village.

Seventeen-year-old Zareena is a rare exception in this close-knit village of Ahori Farm. She has always been different than the other girls – she spoke out against inequalities and had a fierce inclination towards education and learning new things. With her determination, she completed secondary school, unlike a majority of the girls her age in the village. However, Zareena is now being pinched by the bitter-truth of the society she has been born it – her further education has been put to a stop. Due to cultural and social reasons, her parents have refused the continuation of her further studies.

Only twenty percent of the Ahori farm girls have been allowed to complete their education fully, and sadly, Zareena was not among them. All of her friends, Monika, Roshana, Sonia, and Nadani, have also been prevented from pursuing higher education due to the same reasons. To fulfill their urge to study and as an act of goodwill, Zareena and her friends started giving home tuitions to younger boys and girls in their neighborhood.

In May 2017, a skills development center was set up in Ahori Farm. Many of the girls immediately enrolled for trainings on embroidery and other handicraft skills at the centre but Zareena had no interest in learning those kind of skills and did not join the centre.

Soon after, though, she found out about the gender equality related activities that were part of the same project (Community World Service Asia & YCare). That is what sparked her interest in the project. She was soon contacted and was selected to be trained as a community gender activist in the project. After receiving a couple of sessions of the training, Zareena realized that it was the centuries’ old norms and traditions of their village that had led to suppressing women. These customs had left the women with no determination to progress.

As women, we regularly face situations where we are treated unfairly in life, and yet are not allowed to question this tradition or reality. I had never heard about the term gender discrimination before I took the gender training. In the training, I not only discovered the concept of gender discrimination, but I also learnt how to understand gender inequalities and all its complex dynamics.

Zareena was very apprehensive about her work as a community gender activist when she started it initially at the village level. She knew that the society that she had grown up in would not accept women in such roles of change and influence. However, seventeen-year-old Zareena persevered and decided to take the risk and try changing the old norms of her community by starting from her own home. She tried to talk to her parents about the need and importance of girls’ education and how a change is vital towards the pre-conceived perception set of women in their community. At first, they ignored her, but Zareena’s mother slowly began to understand her, and eventually agreed with her. Sensing the positivity, Zareena was encouraged to further magnify this notion and cause.

With the support of her mother and elder brother, Zareena conducted interactive meetings on Girls Education and Women’s Role in Decision making with targeted households in her village. Many in her village still did not welcome a girl as young as Zareena talking about such unmentionable concerns.

More than a hundred girls still do not attend formal school in Ahori Farm even today. However, Zareena is hopeful that she can convince many parents in the village to allow their daughters to be enrolled in schools. Zareena’s elder brother has assured her that he would establish a girls’ tuition center for free.

The centre has provided me a platform through which I can serve the girls of my village in supporting them to be educated. Recently, from our village, five girls, including myself, have just enrolled into the Government High School and Government Girls Degree College in Umerkot. The parents of the other four girls trust and support my cause. They have faith in me for improving the lifestyle of our people. More than anything, I am grateful to my mother and to Mr. Ramesh Kumar, a member of our Community Gender Activists group, both of whom stood by me, helped and supported me.

According to the project team, many more parents from Zareena’s village are now allowing and encouraging their daughters to attend not only primary but high-schools as well.

DurationJul 01, 2016Jun 30, 2017
LocationThatta & Umerkot Districts, Sindh
Key Activities
  • Two 5-day training on pedagogical techniques and classroom management for 50 teachers
  • Two 5-day Master Teachers’ Trainings for 30 Master Teachers
  • Two three-day refresher training workshops for 50 teachers
  • 30 follow-up visits conducted by Master Trainers
  • Two 3-day civic Education camps for 60 students and 10 teachers
Participants110 including teachers and students

Community world Service Asia’s livelihoods and women empowerment project, supported by YCARE and UKAID, in Umerkot district has initiated its third year this April. The activities under the project aim to empower local women with a sustainable increase in their household income through enhancing their handicrafts skills and connecting them with markets, among the many other components of the project. This year, three hundred new artisans have been selected from nine new villages in Union Council Karroo Syed and Sabo this year.

A six months training was designed in two phases, each of three months, on Skill enhancement and Product Development with the expertise of designers from Indus Valley School of Arts and Architecture (IVS) Karachi.

The designer identified six main stitches for skill development, namely Kacho, Pako, Muko, Chain, Kharak and Hurmuch. During the first three months of the training, stitching and embroidery skills of local artisans’ part of the Women Enterprise Groups (WEGs)[1], were enhanced. The skill building mainly focused on building upon the traditional skills that these women already had but in more accordance to latest fashion trends and market demand, which were lacking in their previous home-made products. These skill enhancement classes were organized by Community liaison officers (CLOs) and mentored by Enterprise Development Officers (EDOs) of Community World Service Asia.

In addition, artisans were also taught the value addition of using the right color combinations, designing and cuts and quality control- all aspects which are pivotal to the urban buyers. For budgeting, pricing and dealing with customers, the artisans were given a three months training on adult Literacy courses which enabled them to read, write and compute during their business dealings.

The determined women from Umerkot are currently practicing their newly acquired skills by working on test products using modern designs and fashionable color schemes. This will particularly allow artisans to improve their quality of work and design which will increase the value and exclusivity of their handmade products.

[1] Women Enterprise Group is group formed of rural artisans, producing hand-made products, in the vocational centers established in various villages of Umerkot.

“My father drank alcohol daily and used to beat my mother,” quietly recounted a 15 years old daughter of Mohan from Haji Chanesar Mari village.

Mohan, father to five sons and two daughter, was a hopeless alcoholic, living with his family in the small but close-knit village of Haji Chanesar Mari in Umerkot. He was a selfish man who only thought of himself and never considered the impacts of his drunkenness on his wife and children. Many evenings, Mohan’s children witnessed their mother, Devi, being beaten by their drunk father. Some evenings, one of the children would become victims of his physical and verbal abuse as well.

As a small, independent farmer, Mohan earned well. Despite his sufficient earnings, Devi, was unable to save any money for the dowry of their daughters or for the purchase of cattle for the family’s nutritional support. All of Mohan’s extra earnings were consumed on alcohol. “He was consuming alcohol of at least PKR 200 regularly,” shared Devi. “At times, when he would be out of money, he would lend money from others to fulfill his alcohol craving.”

“Despite having such a beautiful family, I have mostly thought of myself only throughout my adult life,” shared Mohan himself one day. “I never dream about a better life, education, health or of other facilities for my children.”

Sajan, a gender activist in their village, took a lead to work with families affected by severe alcoholism. He had selected at least five households with whom to start work with. People advised him to consider working on other social issues, realizing the challenges he may face working with alcohol addicts. However, Sajan remained firm in his disposition as he considered alcoholism as one of the root causes of many gender based discriminatory practices and mind sets in their community. “Local alcohol is produced and is easily available from nearby villages,” Sajan pointed the severity of this issue.

Sajan and his colleague decided to train local children to play the role of drug addicts and their family members and demonstrate how one alcoholic would easily ruin a whole family. This drama was performed in Mohan’s house in his very presence. Mohan’s own son performed the role of an alcoholic who drank daily and beat his wife. At the end of the interactive play, a communal issue (alcoholism) was laid in front of the acting village leader in the play to find a resolution, seeking support from other men of the community as well. The alcoholic, played by Mohan’s son, was not even considered in the village decision making as the community saw him as a senseless man who was incapable of supporting himself or his family. “It was a very shameful moment for me that the character played by my son was hated by everyone and was failing everywhere in the community,” Mohan said disappointedly, “I realized that that could become the future of my children if I continue to drink this way.”

The story and performances touched Mohan’s slumbering soul and made him realize the impact of his disgraceful attitude on his family. He promised to quit drinking alcohol. Mohan kept his promise and quit soon after he saw the theater performance. Relinquishing a severe addiction as such as suddenly left Mohan unwell and ill. At this time, Sajan supported Mohan in acquiring medical support in Umerkot city where the doctor strictly advised him not to consume alcohol at all during this time. If he followed his advice, Mohan’s health would be better soon.

It has been month and half since Mohan has consumed a single drop of alcohol. Mohan and his family are very grateful to Sajan for not only helping Mohan leave his addiction but also in re-strengthening the family’s long lost bond. “I have stopped hanging out with friends who drank with me. I wish to become a proud father for my children and a responsible husband to my wife.”

Small efforts can sometimes bring a big change. We should never gauge or underestimate any effort that is made with complete sincerity and dedication; the results may not be seen at once but gradually it may change lives positively.

A stall showcasing antiques and cultural shawls which attracted many people at the festivals.

The Sindh Culture and Tourism Department organized a two-day “Thar and Parker Festival” at the historical Umerkot Fort from the 24th – 25th of March. The various arts and crafts of the culturally rich Thar were put on display on a number of stalls at the vibrant festival. Apparel, rillies, handbags, fancy clutches, jewelry and other handmade crafts were on display and for sale. The entertaining event featured cultural activities such as camel and horse races, folk musical concerts and standing stalls of delicious local food.

The festival was inaugurated by Syed Sardar Ali Shah, Minister of Culture and Tourism in Sindh. “This festival will show the more beautiful facets of our rich desert which has formerly remained hidden as the region has predominantly been known for its natural disasters and subsequent deaths of children,” announced Mr. Shah. He added that such events will bring back harmony and a cultural spirit to the region which has suffered consistently in the past. Dost Mohammad Rahimoon, MPA Sindh, also present at the inauguration ceremony added, “The festival will provide a forum to people to showcase their rich culture and traditions for the entire world to see.”

Local artisans of Umerkot, along with Community World Service Asia staff, participated at the event, showcasing and promoting their handicrafts from Umerkot and Thatta. A range of products including casual apparel, jewelry and other home accessories produced under the brand “Taanka” were exhibited for sale at the festival. A large number of people visited the stall and watched the artisans hand make some of the products “live”. Syed Sardar Shah, also paid visited the Taanka stall and appreciated the quality work of the artisans that stood out among the many stalls at the festival.

Women from near and far villages, attended the event and were very happy to see a large variety of cultural apparels and antiques at the stalls. Families enjoyed tableau and the many music and theatre shows being performed by local communities and theater groups. Folk musician sang and entertained audiences at the festival for hours and received much applause and cheers. The festival ended with sparkling, large fireworks on the second day, lightening the lives of the people of Thar with color, happiness and celebration.

“Daughters have always been preferred in our family, unlike other families in the village. My husband and I have never given priority to our two sons over our two daughters. We love all of them equally,”

said Hurmi, a resident of Haji Chanesar village in Umerkot. Hurmi is the Vice President of the Steering Committee of the village and a gender activist in the area.

“My first child was a daughter. Normally in our community, daughters are considered as burdens and families are not so happy when a girl is born. But the case was different at our home. I am lucky to have a husband who loves daughters more.”

When the skills development center was set up at Haji Chanesar Village, Hurmi helped identify artisans who were most in need of a sustainable livelihood. Later in the project stage, a steering committee was formed for which Hurmi was nominated as Vice President by the unanimous vote of the artisans themselves.

“After the Community Management Skill Training, the Steering Committee was well equipped with knowledge on how to manage communities and resolve their issues and conflicts. As the Vice President, my role was more influential as many expected me to bring change in the rigid traditions we have been following for years.”

“The center brought countless benefits to women and girls in residual and nearby villages. They used to work in the fields in the season of cotton picking. Parents of young girls felt insecure sending their daughters to the fields, as they worked under the scorching sun and the bushes and thorns would tear their clothes or injure them. The center serves as a shadow in their lives. We encouraged the men of our families to send their wives, sisters and daughters to the center without a worry as the environment is safe and secure. Women in our area now work without worrying about traveling long distances while carrying heavy crops on their heads.”

As a dedicated member of the Steering Committee, Hurmi worked actively for the well-being of her fellow villagers. Recognizing her consistent efforts and dedication, Hurmi was selected as a participant of a ToT for Gender Activists.

“When I joined the Gender Group as an activist, my in-laws and neighbors discouraged me saying such activities for women were not part of our culture and it was not right to let women and girls talk so boldly on sensitive issues. My husband on the other hand, supported me strongly. He motivated me to work as a gender activist and change the mind-sets of the people who did not allow their daughters to grow socially and economically,”

reiterated Hurmi with a confident smile.

“When I started working as a gender activist, I realized that the people in these rural communities are still living in a backward world, where caste difference was a firm way of life. One of the reasons for some families to not send their daughters to the skills center was the issue of caste difference. They could not allow their daughters to sit with women belonging to a lower caste than them. They also believed that sending their daughters to the skill building center will bring dishonor to their traditions and cultural values,”

narrated Hurmi disappointedly,

“We conducted gender awareness sessions. We also led sessions to individual households to have a direct impact. Girls in our village started to go to school and early childhood marriages started to decrease.”

“Recently, a 16-year-old girl was getting married in our village. Our gender activist group visited the household and briefed the family about the problems young girls face in early marriages. When the girl’s in-laws (to be) came to schedule the wedding for February 23rd, the father of the 16-year-old refused instantly. The in-laws were furious to see his reaction. The daughter’s family called us to talk to the in-laws and explain the disadvantages of early childhood marriages to them as well. When the in-laws were also enlightened on the subject, they too understood and postponed the marriage to three years later. It is not just about one change in one house. People have started to think over many rigid traditions followed by us for ages as a result of these awareness sessions.”

“There was another instance of a man named Mohan. His wife, Dhai, was very disturbed as Mohan use to drink a lot. He used to waste his earnings on buying alcohol. He did not even spare Dhai’s minimum wage which she earned through stitching and agricultural work. He even hit Dhai when he was drunk. He once hit her with a small axe while he was drunk. He also used to beat his children. We tried to talk to him but he did not listen. So, we went to a doctor to talk about Mohan’s condition. We requested the doctor to scare Mohan by lying to him, stating that his health is weakening. When Mohan fell ill, the doctor came to Mohan and stated that he has cancer. Mohan got so scarred that he stopped consuming alcohol himself. Mohan has not been drinking since three months now. His wife is very relieved as he does not hit her or her children as his mental state has now improved. He does not waste money on drinking now and is more calm and caring towards his family. Yesterday, our steering committee held a meeting with the villagers. At the meeting, Mohan informed us that he has quit smoking as well. His wife is very happy now. Everybody in the village is curious to know how Mohan has changed so much.”

It is important for women to participate proactively for work on gender equality as only women can understand the problems of other women well enough. They will work towards resolving issues in a more realistic and practical manner.

“Women easily communicate their issues to us. I am happy when I help others to live a better life, especially when daughters are treated well. Now that we have been given a chance to live a better life, we must walk forward together to build a progressive society instead of letting each other down. I wish to see an all girls’ educated and equality based society”

Health & Hygiene session in the catchment area of RHC Dhoronaro.

According to the Pakistan Demographic and Health Survey (PDHS), 2012-13, maternal and child death remains a major concern in Pakistan. In the provincial public sector, health services are provided through a tiered referral system of health care facilities; with increasing levels of complexity and coverage from primary, to secondary and tertiary health services. Primary care facilities include Basic Health Units (BHUs), Rural Health Centres (RHCs), Government Rural Dispensaries (GRDs), Mother and Child Health (MCH) Centres and TB centres. Most of these public health facilities lack the provision of a broader range of preventive and curative health services.

Community World Service Asia conducted a baseline survey in first year (2015) of its health project inception in Umerkot and these are the major findings of the study:

  • Very few, small private clinics operational in some villages of the targeted Union Councils. These clinics are not affordable for most of the community members (selected in the sample size) as they have low monthly incomes, with an average of only PKR 8733
  • According to 91.7% of the respondents, there are no antenatal services. 99% of respondents replied that there are no postnatal services. 5% reported the absence of delivery services whereas 96.1% reported the absence of family planning services
  • 100% of respondents replied that there are no women medical officers available at the health facility, whereas, 76.5 % reported the absence of Lady Health Visitors (LHVs) in the health facility. A 99.5% and 81.4% responded positively to the presence of male doctors and Medical Technician (MT) respectively
  • 5% respondents raised the need for a presence of medical staff to improve health services in the area
  • 8% respondents raised the need for provision of essential medicines, whereas 37% believed that the provision of 24 hours emergency services were essential to improve the quality of services
  • 2% of the respondents believed better infrastructure and cleanliness of health facilities were key to further improving the overall health services of the area

What is the project doing?

After analysing the results of the baseline survey, three Rural Health Centres (RHCs) were set up by Community World Service Asia, with the support of Act for Peace. All three of these RHCs are functioning with a focus on delivering primary healthcare services in the district of Umerkot.

The health facilities established, have deployed Female Medical Officers (FMOs), LHVs and Medical Technicians in their centres at Hyderfarm and Nabisar Road along with providing medicines. In RHC Dhoronaro, a lady doctor sits in shifts and rotationally visits the centre as well.

The social mobilizers, under the project, have formed two Health Committees in addition to the existing six committees formed last year. An advocacy forum has also been developed at district level to address emerging health issues. The village Health Committees and advocacy forum consists of eight to ten members including both men and women activists from the community, who are responsible to facilitate and support health services provided under the project. The village Health Committees meet monthly, with facilitation of the community mobilizers, and share their committees’ progress, problems and challenges and plan for the next month. A total of eight village Health Committees and a district health advocacy forum are running actively and meet regularly at the health facility. They conduct joint meetings in the villages on a fortnightly or monthly basis to discuss the pertaining issues regarding health and other community based problems. These meetings are properly documented and shared with the project management team. The discussions of these meetings are recorded for further planning, improvement and implementation of the project activities.

Clinical support is also given at these curative and preventive RHCs with focus to Maternal, Newborn and Child Health (MNCH) services. These services are delivered by women health staff comprising of FMOs and LHVs along with two medical technicians and one male and one female social mobilizers. The main focus of the services is on reproductive health of women of childbearing age.

Recognizing maternal, neonatal and child health care as a major component of the health services, the project team provides antenatal and postnatal assistance to local women.  Complicated cases are referred to the secondary level health care facilities in the area. The MNCH services at the RHC focus on continuum of care including family planning, pre-pregnancy, pregnancy, labour and childbirth, postpartum, newborn care, and child health and support high-impact, evidence-based interventions that saves lives.

Health education sessions are being conducted for men, women and children at the health facilities, in the surrounding villages of each RHC and at schools. Major topics on health education, such as Personal Hygiene, Family Planning, Reproductive Health, Hepatitis, HIV/AIDS awareness, Importance of Breastfeeding and Safe Drinking Water, with emphasis to prevalence of the disease, have been included in the IEC materials developed for building the knowledge of the communities.  Through general OPD, patients are treated and facilitated along with being provided necessary medicines.

The project team assessed the nutritional status of women and children under five, of all the three RHCs, through analysing their medical history, physical examination, and height to weight balance and various other parameters. The patients are then referred accordingly to different NGOs, providing nutritional care, based in the district. More complicated cases are referred to District Headquarter Hospitals of Umerkot and Mirpurkhas. Counselling sessions to malnourished, lactating and pregnant women are also provided. Children under the age of five are facilitated with de-worming medicines and family planning services are being provided to women by LHVs across the three healthcare facilities. The LHVs brief the women from these communities on the importance and benefits of family planning and the various, free of cost methods available for family planning at the health facilities.

What have we achieved so far?

The availability of services such as primary care, behavioural health, emergency, and public health services are a basic human right which must be provided to all. The project has worked towards providing this basic right and has achieved the following so far:

  • 12,156 community members provided with curative and preventive healthcare services
  • 11,307 individual have participated in health education sessions
  • 2,414 women provided with antenatal and postnatal services
  • 868 individuals have availed family planning services
  • 5,426 women and children were assessed for nutritional balance
  • 42 baby deliveries conducted at the health facilities
  • 25 delivery kits were provided to women as per criteria
  • Participation in seven coordination meetings with line departments, other NGOs and civil society organizations working at district level.

Community World Service Asia is implementing the project through its own staff, including two lady doctors, three LHVs, two Medical Technicians, two community mobilizers and a manager located in Umerkot. They are implementing the project with equally involving the Health Committees and District Advocacy Forum. The health team continues to maintain regular dialogue with the government line departments at the Federal, Provincial and District levels to ensure the efficacy and implementation of the program. Regular coordination meetings are held between key, district stakeholders including NGOs and civil society organizations.