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Ministry of

Population Welfare
Yearbook 2009-10

Message
Rising population growth poses a serious threat to a countrys social progress, economic stability,
health, environment, law and order, and food security. According to most experts, it is the biggest
obstacle to the socioeconomic development of the people in the developing world.
Pakistan is the sixth most populous country in the world and the fourth most populous country in
Asia. The countrys population has increased from 34.0 million in 1951 to 173.5 million in 2010.
Due to increasing realization of the need for family planning, total fertility and population growth
rates have started to decline globally.
Arresting population growth is one of the top priorities of the present government, since this will
help in attaining a balance between the countrys resources and population, leading to sustainable
socioeconomic development. If the current population growth rate of 2.05% does not slow down,
Pakistans population would double in the next 34 years. Furthermore, over one-third of
Pakistans population is aged below 15 years and it would be entering the reproductive age in the
near future.
The Population Welfare Programme of the Ministry of Population Welfare (MoPW) aims at
improving the quality of peoples life by enabling couples to decide the number of and spacing
between their children, and by providing them the information and the means to do so. Since its
inception, the Programme has been focusing on family planning under the umbrella of
reproductive health as a development intervention; otherwise, the demographic scenario of
Pakistan would have not been so encouraging.
Although a fertility transition has set in, there is still an unmet need of 25% for family planning in
Pakistan. Addressing this issue requires collective efforts by the MoPW and its partners,
including the Ministry and Departments of Health, civil society and the private sector.
I hope that the users of the MoPWs Yearbook 2009-10 would be able to better understand the
demographic scenario of Pakistan, as well as know about the efforts put in by the Ministry in
collaboration with its partners.
I would like to reiterate that the MoPW alone cannot meet the challenges posed by accelerating
population growth; this requires support and cooperation of other ministries and departments,
non-governmental and civil society organizations, and the private sector.
Finally, I want to put on record my appreciation for the efforts and hard work put in by the
MoPWs staff in compiling this Yearbook.
(Dr. Firdous Ashiq Awan)
Federal Minister for Population Welfare

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Preface
I am pleased to present the MoPWs Yearbook 2009-10, prepared in pursuance of Sub-Rule(2) of
the Rules of Business, 1973. The document encompasses the mandate, functions, activities and
achievements of the Ministry, besides presenting an overview of the new Population Policy, the
next five-year development plan, and future strategies and initiatives.
I hope that the users of the Yearbook 2009-10 would be able to learn about the important role the
MoPW is playing in the field of population and development. The Ministry aims at ensuring
universal coverage of family planning and reproductive health with the help of its partners.
Although the Ministry has had modest success in reducing the population growth rate in Pakistan,
a fertility decline has set in, which will hopefully help us in achieving our goals.
I am convinced that, with the collaboration and active support of its partners, the MoPW will
soon achieve replacement level fertility, leading Pakistan towards the ultimate goal of population
stabilization.
(Shaukat Hayat Durrani)
Secretary, Ministry of Population Welfare

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Contents
PART I
Chapter 1
A. Mandate of MoPW as Per Rules of Business, 1973

B. Organogram/Organizational Chart of MoPW

C. Functions of Different Wings of MoPW

Chapter 2
Overview of Population Welfare Programme and Implementing Agencies

Chapter 3
Autonomous Bodies of MoPW

Chapter 4
Draft Pakistan Population Policy, 2010

PART II
Chapter 5
Service Delivery
A. Service Outlets of Population Welfare Programme (Public)
I. Family Welfare Centres
II. Reproductive Health Services-A Centres
III. Mobile Service Units

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15
17

B. Service Outlets of Population Welfare Programme (PPP)


I. Reproductive Health Services-B Centres
II. Public-Private Partnership

20
20

Chapter 6
Other Activities
A. Training Institutes
I. Clinical Training
II. Non-Clinical Training

21
22

B. Communication and Advocacy

24

C. Population Education

29

D. Contraceptive Commodity Security (Procurement and Performance)

30

E. International Cooperation

33

F. Monitoring and Supervision

38

G. Research and Evaluation


I. National Research Institute of Fertility Care
II. National Institute of Population Studies

39
39

H. Special Initiatives

41

I.

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PSDP Allocation and Utilization

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PART I

Chapter 1
A. Mandate of MoPW as Per Rules of Business, 1973
1(i).
(ii).

Develop policies for implementing the Population Welfare Programme in the


country.
Monitor population activities and evaluate the Programme.

2.

Deal and make agreements with other countries and international organizations in
matters related to the Programme.

3(i).
(ii).

Collect, maintain and analyze demographic and population statistics.


Acquire, store and dispatch supplies for the Programme.

4(i).

Manage information and educational services for the furtherance of Programme


objectives.
Conduct training in the field of population planning.

(ii).
5.

Formulate the policy governing the manufacture, use and quality control of
contraceptives under the Programme.

6.

Conduct research on different aspects of the Programme, such as clinical, social and
demographic.

7.

Promote population planning activities through public sector agencies and


institutions, hakims, non-governmental organizations (NGOs), etc

8.

Oversee matters related to the National Trust for Population Welfare (NATPOW) and
the National Institute of Population Studies (NIPS).

9.

Coordinate with other Ministries and Departments for systematic introduction of


population education, and financial and regulatory incentives and disincentives
favouring population planning.

B. Organogram/Organizational Chart of MoPW

Minister
Secretary
Autonomous Bodies
NIPS

Additional Secretary

Chief F&A Officer


SO (F&A)

NATPOW

Joint Secretary

Director General
Technical Wing

Director General
Programme Wing

Director General
M&S Wing

Director General
PPP Wing

Director General
Planning Wing

Director (FM)

Director (FWC)

Director (CS)

Director (PM)

Director

Director (FA)

Deputy Secretary
Admn-I

Director (RHS)

Director (PE)

Director (PME)

Director

Director
(Planning)

Deputy Secretary
Admn-II

Director (TC)

Director
(Training)

Director
(SS&DP)

Director (PPP)

Director (CT)

PWTIs (Lahore
and Karachi)

Director
(CW&S)

Director
(NRIFC)

C. Functions of Different Wings of MoPW


Planning Wing

Review the Population Policy and facilitate the process of its formulation, as well as that
of other population-related strategies.

Translate the Policy into federal and provincial projects and schemes under the
Population Welfare Programme.

Procure funding for Programme projects from national and international sources.

Finalize the Annual Work Plan of the MoPWs PC-Is (both Federal Activity and
Provincial Programmes).

Conduct strategic monitoring to facilitate effective implementation of the MoPWs PC-Is.

Serve as the secretariat for the National Commission for Population Welfare (NCPW)
and the Social Sector Coordination Committee (SSCC).

Technical Wing

Form policy to execute the technical component of the Population Welfare Programme.

Implement, monitor and evaluate the clinical training component of the Programme being
executed through the MoPWs 13 Regional Training Institutes (RTIs).

Design and conduct training programmes for medics and paramedics working in the
public sector, the private sector and NGOs.

Prepare standard operating procedures (SOPs), guidelines and protocols for the service
delivery infrastructure of the Programme.

Oversee the Provincial Population Welfare Departments (PWDs) for ensuring quality at
service delivery outlets.

Monitor implementation of the clinical training component of the Programme in the


provinces to ensure that they are in line with the Population Policy.

Provide guidance to the National Research Institute of Fertility Care (NRIFC) in


implementing the latest contraceptive Technology.

Implement service delivery and training activities in Islamabad Capital Territory (lCT)
under the Programme.

Coordinate with the health sector for rendering quality family planning/reproductive
health (FP/RH) services.

Coordinate with international agencies and development partners for implementation of


donor-funded projects.

Serve as focal point for the South Asian Association for Regional Cooperation (SAARC);
womens development; regional economic cooperation; the Gender Responsive
Budgeting Initiative (GRBI); the Peoples Primary Healthcare Initiative (PPHI); the
Family Advancement of Life and Health (FALAH) Project; the Pakistan Initiative for
Mothers and Newborns (PAIMAN); etc.

Provide resource persons for the College of Physicians and Surgeons Pakistan, Health
Services Academy, Pakistan Civil Services Academy, Aga Khan University, etc.

Administration Wing
The Administration Wing consists of two Administrative Units and the Directorate of Financial
Management with clearly defined functions. The two Administrative Units are responsible for
recruitments, promotions, disciplinary matters, legal issues, stores, office security, National
Assembly and Senate matters, inter-provincial meetings on the Population Welfare Programme
and coordination between different Programme units. The Directorate of Financial Management
is responsible for preparing budget proposals related to development/non-development financial
allocations and revised estimates for the Programme; ensuring timely releases of funds to
Programme units and monitoring their utilization; observing financial discipline; obtaining
expenditure statements from the PWDs and other Programme units; maintaining proper record;
submitting financial statements to the government and donor agencies; attending to audit
objections; preparing pension/gratuity claims; and coordinating with the Finance Division/
Departments of Finance and the Accountant General Pakistan Revenues (AGPR).

Monitoring and Statistics (M&S) Wing

Manage contraceptives for Population Welfare Programme and non-Programme service


outlets.

Store and supply contraceptive commodities.

Conduct field monitoring of Programme activities.

Ensure inter-provincial coordination for Programme activities.

Maintain contraceptive data bank and issue performance statistics report.

Public-Private Partnership (PPP) Wing

Build a sustainable partnership with public, private and corporate sectors for providing
quality FP/RH services.

Legislate for mandatory provision of FP/RH services in the corporate sector, and by
medics, paramedics, hakims and homeopaths.

Bring all public and private sector initiatives under the umbrella of PPP.

Steer, monitor and facilitate all PPP initiatives being carried out through the nationwide
network of NATPOW.

Facilitate government and donor assistance for PPPs.

Programme Wing

Guide and supervise preparation of communication, advocacy and media policy/strategy


for the Population Welfare Programme.

Plan, execute and monitor advocacy activities and awareness campaigns through the print
and electronic media, and interpersonal communication.

Guide and monitor the Production and Printing Unit, Lahore.

Supervise preparation of the training policy and annual plans, and their implementation
through the MoPWs Regional and Population Welfare Training Institutes.

Facilitate inter-sectoral linkages for highlighting population as a crosscutting theme.

Manage, supervise and monitor all Directorates and Training Institutes of the MoPW.

Chapter 2
Overview of Population Welfare
Programme and Implementing Agencies
The Population Welfare Programme (hereby referred to as the Programme) is an ongoing social
development endeavour operating within the framework of the Population Policy of Pakistan,
2002. Recognizing that Pakistan has the highest population growth rate among the six most
populous countries of the world, the Programme aims at encouraging voluntary adoption of small
family norms in the country. In fact, Pakistan makes the third highest annual net addition to the
global population after India and China. The countrys high fertility rate remains a major
contributor to this situation since the mortality rate has been fairly stable over the years.
Anticipating the far reaching implications of high population growth rate for Pakistans
socioeconomic development, the then policymakers introduced family planning on a limited scale
in the First Five-Year National Development Plan (1955-1960). The related services were
provided through voluntary organizations. In the Second Five-Year Plan (1960-1965), however,
family planning services were dispensed through the health infrastructure. Family planning
gained priority in the Third Five-Year Plan (1965-1970), when an independent setup was
established for managing and executing the Programme.
The Programme witnessed a positive change and received sustained political support from 1988
to 2002. There was consistency and continuity in the operations during these years, with the
stakeholders in the public sector, the private sector (particularly social marketing companies) and
civil society playing an important role in achieving positive results. Both the budgetary allocation
for the Programme and its coverage increased, along with the expansion of and a wider role for
the social marketing sector. The private providers and retailers involved in the distribution and
dispensation of products under independent logos were enlisted, and promotional campaigns and
a whole range of follow-up communication activities were undertaken in the field.
As a result, Pakistan was referred to be entering the fertility transition phase, with contraceptive
prevalence rate (CPR) gradually rising and total fertility and population growth rates gradually
falling. However, there remained a wide gap between awareness level and CPR, and the unmet
need for family planning ranged around 33%.
The Programme has passed through different phases in terms of administrative and financial
setup. Before 2002, it had a federalized status. In February 2000, a committee was setup to review
the Programme and its interface with the health sector. The recommendations of the committee
were presented to the then Chief Executive of Pakistan on 6 April 2001 and were approved
accordingly.
In view of these recommendations, the Federal Government transferred the Programme to the
Provincial Governments along with assets, liabilities, and administrative and financial controls
through a handing over note. The latter were required to take over the Programme and start
funding it from their budgets starting 2006, but this has not yet happened. The transit
arrangements have resulted in a number of issues in terms of planning, monitoring and financial
management.
After the announcement of the 7th National Finance Commission (NFC) Award, the Executive
Committee of the National Economic Council (ECNEC) decided on 16 January 2010 that the

Population Welfare Departments (PWDs) should assume their responsibility and the Provincial
Governments should now starting providing funds for the Programme as per their commitment.
The last Five-Year Population Welfare Programme (2003-2008) set the ultimate goal of
population stabilization as a development priority to attain sustainable socioeconomic
development. There was an increasing realization of the crosscutting effect of the population
factor on the socioeconomic canvas during this period. The Programme was accorded high
priority in the overall development framework and in the Poverty Reduction Strategy Paper
(PRSP). The commitment was sustained with allocation of additional resources through the
Public Sector Development Programme (PSDP) for implementing Programme activities.

Implementing Agencies
The Population Welfare Programme is executed through the following implementing agencies:
1. Population Welfare Department, Punjab.
2. Population Welfare Department, Sindh.
3. Population Welfare Department, Khyber Pakhtunkhwa.
4. Population Welfare Department, Balochistan.
5. Population Welfare Programme, Azad Jammu and Kashmir (AJK).
6. Population Welfare Programme, Federally-Administered Tribal Areas (FATA).
7. Population Welfare Programme, Gilgit-Baltistan.
8. Population Welfare Programme, Islamabad Capital Territory (ICT).

Chapter 3
Autonomous Bodies of MoPW
National Institute of Population Studies
The National Institute of Population Studies (NIPS) is a research organization engaged in
carrying out interdisciplinary research in the field of population and development; conducting
evaluation and impact studies of the Population Welfare Programme; and developing human
resource. Data generated by NIPS are used in formulating population planning strategies.

National Trust for Population Welfare


The National Trust for Population Welfare (NATPOW) is an autonomous, not-for-profit
organization established in 1994 under the umbrella of the Ministry of Population Welfare
(MoPW). It is mandated to develop partnerships between the government and the donors, NGOs
and the private sector. NATPOW provides technical and financial assistance to its affiliated
NGOs, numbering 600, for improving the reproductive health status of women and men, as well
as mother and child health (MCH), with special emphasis on community mobilization and
participation, advocacy and awareness raising, capacity building/human resource development
(HRD), and FP/RH service delivery, so as to meaningfully contribute to the implementation of
the Population Policy. NATPOWs health interventions are merged with education and poverty
alleviation, as well as crosscutting interventions of HRD and research; monitoring and evaluation;
and information, education and communication (IEC). The need for specialized services provided
by NATPOW has been felt in public and private sector organizations aiming at developing their
capacity to achieve the Millennium Development Goals (MDGs).

National Commission for Population Welfare


The Population Welfare Programme was de-federalized in 2002, and all administrative and fiscal
powers were transferred from the Federal Government to the Provincial Governments. During
operationalization of the Programme under the new arrangement, many issues cropped up. To
oversee and review performance of the Federal and Provincial Governments, NGOs and the
private sector, the National Commission for Population Welfare (NCPW) was set up under the
chairmanship of the Prime Minister of Pakistan on 20 September 2005. The NCPW comprises 24
permanent and nine guest members. Its first meeting was held on 1 July 2006 and the decisions
taken have been implemented. No further meeting of the Commission has so far been convened.
The NCPWs terms of reference (ToRs) are to:

Formulate policies for the implementation of the Population Welfare Programme.

Hold annual review of these policies in the light of actual functioning of the Programme
and the realization of its objectives.

Muster political, financial and administrative support for the Programme.

Promote and encourage partnerships between all the actors involved in population
planning activities.

Build consensus on directions for population in general and for the MoPW in particular.

Ensure effective coordination between the Federal and Provincial Governments for the
attainment of Programme objectives.

Chapter 4
Draft Pakistan Population Policy, 2010
The Draft Pakistan Population Policy, 2010 (hereby referred to as the Policy 2010) places the
population factor at the centre stage of national development planning. It recognizes
reproductive health as a critical component of sustainable socioeconomic development having
strong linkages with the governments poverty reduction strategies. The Policy 2010 repositions
family planning as a health initiative, with a focus on MCH, by making family planning services
a vital component of the essential services package.
Within this holistic perspective, and in the wake of emerging demographic realities, the Policy
2010 re-emphasizes timely completion of fertility transition for stabilizing the population and
reaping the demographic dividend. Infused with this spirit, it is expected that the Policy 2010
would contribute meaningfully to the implementation of the Programme of Action of the
International Conference on Population Development (ICPD) and the achievement of the MDGs,
particularly reducing the maternal mortality ratio by two-thirds by 2015.

Vision
The Policy 2010 would promote a prosperous, healthy and skilled society where every pregnancy
is planned; every child is nurtured and cared for; and every citizen is provided with choices to
improve the quality of his or her life.

Goals
The Policy 2010 seeks to:

Accelerate the completion of fertility transition for achieving population stabilization.

Enhance human development for capitalizing on the unique opportunities offered by the
emerging demographic scenario in the form of demographic dividend.

Increase pregnancy spacing for improving the health of women and children.

Objectives
The short-term objectives of the Policy 2010 are to:

Make available family planning services to the remotest areas of the country by 2015.

Reduce the unmet need for family planning from the current 25% to 20% by 2015.

Reduce the total fertility rate (TFR) from the current 3.6 births to 3.2 births per woman
by 2015.

Ensure contraceptive commodity security for all public and private sector outlets by
2015.

Improve maternal health by encouraging pregnancy spacing of more than 36 months,


reducing the incidence of first birth among those mothers aged below 18 and
discouraging the trend of mothers giving birth after age 34 and above, thus contributing
to the achievement of the MDGs 4 and 5.

The long-term objectives of the Policy 2010 are to:

Attain replacement level fertility by 2030.

Achieve universal access to family planning services by 2030.

Reduce the unmet need for family planning from the current 25% to 5% by 2030.

Increase the contraceptive prevalence rate (CPR) from the current 30% to 60% by 2030.

Principles
The principles of the Policy 2010 are based on the Programme of Action of the ICPD, the MDGs
and the Karachi Declaration, 2009. These are to:

Promote reproductive health as an entitlement, based on voluntary and informed choice.

Address the population issue within national laws and development priorities, while
considering the social and cultural norms.

Ensure active, responsible and accountable participation by all the stakeholders.

Promote programmatic interventions on the basis of scientific evidence.

Assumptions
The Policy 2010 is based on the following assumptions:

Sustained political commitment at the federal and provincial level.

Full ownership of the Programme by the Provincial Governments by 2015 and


programmatic interventions by them to reduce the unmet need for family planning.

Enhanced resource availability for the Programme under the NFC Award.

Mandatory provision of family planning services by the Health Departments and


adoption of family planning as an essential health intervention by the Ministry of Health.

Centre staging of the population factor in national development planning for reaping the
demographic dividend.

Broad-based multi-sectoral support.

Strategies
The Policy 2010 lays strong emphasis on reshaping the unprecedented demographic dividend, as
envisaged by the Planning Commissions Vision 2030 document. This necessitates adopting
human development policies that can help transform the young population into a skilled
workforce It situates reproductive health and family planning within the context of overall
economic and social development, thus creating linkages with other developmental concerns,
such as increasing the provision and outreach of primary and secondary education, empowering
women and creating employment opportunities for the people.
The Policy 2010 also stresses putting in place an effective reproductive health programme that
ensures continuation in and speeding up of the fertility transition process. It, therefore, attaches
special importance to achieving universal access to FP/RH information and services. The Policy
2010 recognizes that achieving fertility transition is a collective responsibility of all potential
providers in the public, private and NGO sector, and provides for involving all the stakeholders in
achieving the stated goals and objectives through the adoption of the following strategies:

a. Mainstreaming Population in Development Planning


A population policy impacts all spheres of socioeconomic life. It is evident from the interlinkages between population and development that demographic trends are, on the one hand,
determinants of socioeconomic development and, on the other, are determined by it. Broad-based
sectoral and inter-sectoral support is, thus, critical to realizing the goals of the Policy 2010. This
includes building strong linkages between population and other social sector areas.
Female education, in particular, is vital for achieving fertility transition. This is evident from the
fact that the lack of emphasis on female education in Pakistan in the past has adversely affected
the pace of fertility transition. Similarly, limited female employment has not allowed the country
to accrue the benefits of womens positive association with fertility transition. Adequate
investment in young people so that they could develop marketable skills has also remained an
unattended area in Pakistan, limiting the youths productive involvement in the society.
In addition, rapid urbanization is putting an unprecedented pressure on the policymakers to cater
to the growing need for services and amenities. The projected urbanization growth over the next
two decades encompasses massive internal migration patterns and necessitates innovative
population redistribution policies, such as building new towns and industrial zones. To address
these issues, the institutions of the Programme would be strengthened, and all the stakeholders
would be brought on one platform for reviewing the Programme and monitoring the progress
made on goals and objectives. This would help evolve an integrated service delivery strategy to
achieve synergy and facilitate reaping of the demographic dividend.
b. Advocacy and Demand Generation
The Programme has achieved a universal level of awareness, but there still exists a wide gap in
the knowledge (of at least one method) and practice of family planning. The communication
approach has to take this into consideration, and develop evidence-based, audience-specific and
vibrant campaign to bring about necessary changes in attitudes and behaviour. The promotion of
pregnancy spacing perspective of reproductive health needs special communication initiatives
that emphasize its positive impact on maternal and child health.
Pregnancy spacing is also in line with religious precepts and, thus, it provides a strong framework
to solicit support of the religious community. The media with its fast growing role in
disseminating information, building public opinion and shaping societal behaviour would be
used to play a vital role in projecting and promoting voluntary adoption of small family norms
and responsible parenthood. A strategy would also be devised to bring about positive changes in
attitudes and behaviour towards the use of male contraceptives.
c. Enhancing Access to and Improving Quality of FP/RH Services
The Programmes service delivery network of 3,416 centres (2,853 Family Welfare Centres, 271
Reproductive Health Service Centres and 292 Mobile Service Units) hardly covers 35.0 million
people or slightly over 20% of the countrys population. The goal of achieving universal access to
FP/RH services by 2030 and reaching out to the remotest areas of the country by 2015 cannot be
realized through the efforts of the Ministry of Population Welfare (MoPW) alone; it calls for
collective resolve and efforts by all the stakeholders.
The Policy 2010, therefore, emphasizes filling the critical gap in access to FP/RH services
through upgrading, expanding and integrating service outlets managed by different stakeholders:
the Ministry and Departments of Population Welfare, the Ministry and Departments of Health,
the Planning and Development Division, the Ministry of Finance, provincial line departments
(PLDs), social marketing companies (SMCs), private sector health professionals, population
experts, NGOs and civil society organizations (CSOs).

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d. Contraceptive Commodity Security


Ensuring commodity security to cater to national needs for at least five years and uninterrupted
availability of a complete range of contraceptives at affordable prices at all facilities is the lifeline
of family planning services. In view of the projected increase in contraceptive uptake, additional
contraceptive requirements are anticipated in coming years. Both commodity security and supply
chain management system would be improved to avoid overstocking and stock outs at any level
and any time.
e. Training and Human Resource Development
One of the major responsibilities of the MoPW under the Policy 2010 would be to implement the
Programme professionally, so as to keep pace with other stakeholders and maintain national
service standards while providing FP/RH services. This would require professional human
resource to carry out a wide range of specialized functions. The Policy 2010, therefore, focuses
on HRD in line with the emerging role of the Ministry and Departments of Population Welfare
vis--vis other stakeholders.
Managerial inefficiency and low quality of care and services are often cited as the major reasons
for ineffective implementation of the Programme. However, they are not the cause; rather, they
are an outcome of the cause: lack of capacity. For capacity building, the Programme has two
Population Welfare Training Institutes (PWTIs) in Karachi and Lahore and 13 Regional Training
Institutes (RTIs) across the country, but the outcome leaves a lot to be desired. Measures ranging
from revamping these institutes to revisiting their supervisory structure and control mechanisms
are, therefore, a prerequisite for bringing about a positive change in the situation.
f. Research and Evaluation
Drawing on research on different aspects of reproductive health, family planning and fertility
transition, the Policy 2010 recommends an evidence-based approach for the Programme. It also
encourages institutionalization of research on family planning and reproductive health to enhance
the knowledge base for improved policies and programmes. Future research would focus on how
fertility transition could be accelerated in the shortest possible time.
Research on improving access to services and addressing socio-cultural barriers would also be
carried out to improve implementation of the Programme. Similarly, clinical and biomedical
research would also be conducted to introduce new family planning methods. Furthermore,
research on social mobilization, male involvement and innovative communications would be
promoted.
g. Public-Private Partnership
Extending support to public-private partnership (PPP) initiatives is critical to expanding FP/RH
services, both horizontally and vertically. The Policy 2010 envisages replacing the existing focus
of the Programme on the private sector with an innovative approach, so that collaboration could
be enhanced in those areas where family planning and reproductive health services are required.
The approach would focus on extending outreach to rural areas and deepening efforts in urban
slums.
It would bring into its fold public sector organizations, corporate bodies, industrial concerns,
private medical practitioners, NGOs/CSOs. Furthermore, the community-based service delivery
model partnering with the community for setting up village-based service facilities would be
adopted. Efforts would also be made to enlarge the social marketing network so as to encourage
healthy competition. The vast social network of Rural Support Programmes (RSPs) and other
NGOs/CSOs would also be involved in social mobilization.

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h. Monitoring
The Policy 2010 emphasises adopting a joint monitoring framework to ensure effective
implementation by all the stakeholders. It envisages adopting the results-based monitoring (RBM)
mechanism to ensure that processes and outputs contribute to the achievement of clearly stated
objectives. This approach would shift the focus of monitoring from outputs (number of
contraceptives distributed, number of clients contacted and recruited, etc.) to outcomes (increase
in the CPR, etc.). Laying emphasis on outcomes is also important for the MoPW to engage the
stakeholders and build partnerships to achieve shared objectives.
The monitoring framework would specify the indicators of input, service delivery process and
output, which would be observed, reviewed and followed up regularly at the tehsil, district and
division level. Monitoring by the Provincial Population Welfare Departments (PWDs) would
largely be a review of the monitoring efforts at the tehsil and district level. As a step towards
activating the verification tool, the PWDs would send their monitoring reports to the MoPW.
These reports would be analyzed in regular review sessions on Programme implementation at the
national level. The monitoring process, in order to be result-oriented, would also institutionalize
the capacity to track and concurrently follow up the progress made in important aspects of the
Programme. Since the operational monitoring would rest with the PWDs, the MoPW would
maintain supportive linkages with them, as well as enhance their professional capacity and skills.

Implementation Plan
After the introduction of the 18th Constitutional Amendment, the Programme has been transferred
to the Provincial Governments; however, policy formulation and execution continue to be federal
subjects, so that continuity and consistency could be ensured in national policies. This is needed
to have an interface with United Nations agencies; to forge bilateral and multilateral agreements;
and to coordinate with international development partners. But this also entails restructuring of
the MoPW, and redefining its role vis--vis the PWDs, the Ministry of Health, the Planning and
Development Division, the Finance Division, other social sector ministries, NGOs/CSOs and the
private sector.
Considering the crosscutting nature of the population issue, participation of all the stakeholders in
implementation of the Policy 2010 would be encouraged and supported. In addition, necessary
mechanisms and institutional arrangements would be put in place to seek the support of elected
representatives and local leaders, opinion makers, religious scholars and organized communities
for efficient and effective implementation of the Policy 2010. Furthermore, academic and
research institutions would be involved in monitoring the progress made by the Policy 2010.
The implementation of the Policy 2010 would rest with the Provincial Governments, who would
collaborate with line departments, public and private sector organizations, and NGOs/CSOs in
such a way that conforms to both social values and national and provincial development
priorities. With the announcement of the 7th NFC Award, the Provincial Governments have
access to additional resources; therefore, it is expected that they would assume full ownership of
the Programme at the earliest.

Legal Framework
The Population Welfare Planning Programme (Appointment and Termination of Services)
Ordinance, 1981 regularized the services of Programme personnel through the Federal Public
Service Commission and the Departmental Selection Committee. The Transfer of Population
Welfare Programme (Field Activities) Ordinance, 1983 de-federalized the Programme by

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transferring its field activities to the Provincial Governments. Importantly, institutional


arrangements for the Programme attained the status of an independent ministry on 12 June 1990.
After an extensive review, the Programme was again de-federalized through the Population
Welfare Programme Ordinance, 2001, and all administrative and fiscal powers were transferred
from the Federal Government to the Provincial Governments. Resultantly, the administrative and
financial control over the service delivery infrastructure (including Family Welfare Centres,
Reproductive Health Services-A Centres and Mobile Service Units) was transferred to the PWDs.
The institutions of the MoPW NIPS, the NATPOW and the NCPW have been established
through executive resolutions and need to be provided a legal cover. Partnerships with the private
sector are also without any formal legal cover, which creates uncertainty among Programme
personnel and partners. Therefore, there is a need to develop a legal framework to strengthen and
support PPP initiatives.

International Cooperation
Pakistan is a signatory to the Programme of Action of the ICPD, as well as committed to
achieving the MDGs. The Policy 2010, therefore, encompasses not only national development
priorities but also international obligations. The MoPW envisages expanding the scope of its
activities in accordance with the recommendations of the ICPD. Precisely against this backdrop,
the Policy 2010 focuses on developing bi-lateral relations, especially with other Muslim and
South Asian countries, and forging linkages with international development agencies, particularly
for sharing best practices and seeking technical support.
The Policy 2010 seeks enhanced financial and technical cooperation from the international
community, anticipating that it would understand and appreciate the population and reproductive
health situation of Pakistan, and its implications within and beyond boundaries. It also urges the
international community to fulfil its obligations under the ICPD and the development partners to
realize their commitments with Pakistan.

13

PART II

14

Chapter 5
Service Delivery
A. Service Outlets of Population Welfare Programme (Public)
I. Family Welfare Centres
Family Welfare Centres (FWCs) are the cornerstone of Pakistans Population Welfare
Programme. They constitute the most extensive institutional network in the country for promoting
and delivering family planning services in both urban and rural areas. An FWC may operate in a
rented building or in any basic health unit (BHU)/rural health centre (RHC) where two separate
rooms are available.
As a static facility, it serves a population of about 7,000; while operating through its satellite
clinics and outreach facilities, an FWC covers a population of about 12,000. The scope of work of
the FWCs includes providing family planning and mother and child health (MCH) services, and
treating minor ailments. Post-ICPD, their scope has been expanded to include several components
of reproductive health such as safe motherhood, infant health care, and management of
reproductive tract infections (RTIs)/sexually-transmitted infections (STIs) and HIV/AIDS.
Each FWC has a staff of five: one family welfare worker/counsellor, family welfare assistant
(male), family welfare assistant (female), female attendant and guard each. Of the 2,853 FWCs of
the MoPW, as of 30 June 2010, 1,500 are located in Punjab; 590 in Sindh; 422 in Khyber
Pakhtunkhwa; 170 in Balochistan; 55 in AJK; 50 in FATA; 37 in Gilgit-Baltistan; and 29 in ICT.
No expansion of the FWCs could be undertaken during 2009-10 because of financial constraints,
since the Population Welfare Programme was implemented on anticipatory approval.

Functions
The FWCs perform the following functions:

Provide family planning information, counselling and services for all methods except
implants and contraceptive surgery; MCH services through static facilities and satellite
clinics; and infant health care, including nutritional advice, growth monitoring and
treatment of common ailments.

Conduct regular educational sessions through Mohalla Sangats to create awareness about
small family norms, female literacy, human rights and gender equality; and orientation
sessions for elected women representatives on topics such as family planning, population
and development, gender equality, and status of women in Islam.

Make available contraceptives, medicines and other supplies; and maintain equipment in
good condition.

Refer cases of family planning, infertility, HIV/AIDS and contraceptive surgery/implants


to appropriate facilities.

II. Reproductive Health Services-A Centres


Reproductive health services (RHS), one of the major clinical components of the Population
Welfare Programme, are provided through RHS-A Centres and RHS-B Centres. The RHS-A
Centres are hospital-based service delivery units established under the Programme. They provide

15

the full range of services identified in the National RHS Package, including contraceptive surgery
facilities for women and men, with safe and effective backup medical support and long-term
client follow-up; MCH services; prevention and management of RTIs/STIs and HIV/AIDS;
counselling and referral for adolescents/youth; management of reproductive health problems of
the elderly women, referral for mens problems; clients education for early detection of cancer in
breast and uterus; and couple counselling and referral for treatment of infertility.
The RHS-A Centres play a vital role in raising awareness about public health, personal hygiene,
nutrition and breastfeeding during reproductive age, and preventive gynae/obstetric facilities. It is
expected that they would contribute to reduction in fertility. Furthermore, these Centres provide
treatment for minor/general aliments, particularly to women and children. Of the 182 RHS-A
Centres of the MoPW, as of 30 June 2010, 63 are located in Punjab; 60 in Sindh; 24 in Khyber
Pakhtunkhwa; 15 in AJK; 10 in Balochistan; 4 in FATA; and 3 each in Gilgit-Baltistan and ICT.

Functions
The RHS-A Centres perform the following functions:

Provide motivation and counselling to family planning clients along with a full range of
contraceptive services, with special emphasis on contraceptive surgery for both women
and men.

Deal with cases related to the management of RTIs/STIs, as well as provide MCH
services.

Arrange extension camps with operation theatre facilities at Tehsil Headquarters (THQ)
hospitals/RHCs for providing contraceptive services, including contraceptive surgery.

Enhance male participation by creating awareness about FP/RH issues, with special focus
on providing vasectomy services, preferably no-scalpel vasectomy (NSV).

Impart training to male doctors of the MoPW, the Ministry of Health and NGOs in
vasectomy procedures.

RHS-A Training Centres


The 15 RHS-A Centres located in teaching hospitals with the highest contraceptive surgery
performance have been upgraded to RHS-A Training Centres, including three RHS-A Master
Training Centres, for ensuring availability of trained medics/paramedics to provide quality RHS
under the Programme. To achieve this end, the RHS-A Training Centres have been provided with
additional staff and logistics. They perform the following functions:

Provide basic/refresher training to Programme/non-Programme doctors from NGOs,


target group institutions (TGIs) and provincial line departments (PLDs), in contraceptive
surgical techniques, counselling, interpersonal communication, implant insertion/removal
techniques and asepsis; and for enabling them to provide comprehensive RHS, to identify
difficult surgical cases and deal with them, to assess and diagnose abnormal gynae/
obstetric problems, and to diagnose/manage infertility cases.

Provide basic/fresher training to Programme/non-Programme paramedics in operation


theatre management and other techniques with emphasis on asepsis/infection prevention.

Develop training curricula, strategy, methodology and annual plan for the
abovementioned activities and undertake them after approval of the MoPW.

Organize family planning and health education programmes at educational institutions


and PLDs.

16

Hold orientation workshops for medics and paramedics of all categories to update their
knowledge about what is available for the clients in the way of contraceptive services.

Provide on-the-job technical monitoring and supervision for strengthening the


institutional setup of RHS-A Centres and for improving service delivery.

Undertake four supervisory visits of three-day duration each every year. During these
visits to be undertaken by the Monitoring Officers of all the 15 RHS-A Training Centres,
a minimum of 4 RHS-A Centres will be covered for technical guidance and support.

Mens Advisory Centres


To address reproductive health needs of men, the Population Welfare Programme has redesignated its NSV Centres as NSV/Mens Advisory Centres (MACs) and it envisages expanding
their number in the near future. At MACs, reproductive health advice and services for male
adolescents and men are provided by male doctors/surgeons of the Ministry and Provincial
Departments of Population Welfare.

Institutional Reimbursement Cost for Contraceptive Surgery Cases


The RHS Centres receive an institutional reimbursement cost (IRC) for contraceptive surgery
cases performed by them. The payment is made to the surgeon/gynaecologist for backup support,
medical superintendent of the hospital for supervision, operation theatre staff, referrer and client,
as well as spent on physical facilities, including medicines, linen, bandages and condoms for
post-vasectomy clients.
Currently, static RHS-A Centres receive an IRC of Rs. 1,060 for each case of tubectomy
performed by them; extension camps of RHS-A Centres receive Rs. 1,100; static RHS-B Centres
receive Rs. 1,400; and extension camps of RHS-B Centres receive Rs. 1,550. However, the IRC
payment for each case of casectomy is Rs. 1,550, whether it is performed at static RHS-A or
RHS-B Centres or their extension camps. Of the total reported contraceptive surgery cases, 5%
and 10% cases are validated before making IRC payments to the RHS-A and RHS-B Centres,
respectively.

III. Mobile Service Units


Mobile Service Units (MSUs) are the flagship of the Population Welfare Programme, since they
provide a package of quality FP/RH services to the people of those remote villages and hamlets
where no other health facilities exist. The MSUs operate from specially-designed vehicles which
carry within them all the facilities of a mini clinic, ensuring complete privacy for simple
gynaecological procedures. Moreover, they carry tents that can be unfolded to make rooms for
outpatients and staff.
The idea behind MSUs is to provide health facilities, particularly RHS, to the people of rural
areas in such a way that each village or community is visited on a rotational basis at least once a
month. For this, the MSUs organize two to three camps each week at different places and return
after one month to every village.
The component of MSUs was initiated during the 7th Five-Year Plan to increase the availability of
family planning services in underserved and un-served areas. Each MSU provides services to a
population of around 30,000 (about 5,000 couples) in 15-20 villages. On average, an MSU holds
10-12 camps each month to offer family planning/MCH services to the people of remote areas.
Of the 292 MSUs of the MoPW, as of 30 June 2010, 117 are stationed in Punjab; 72 in Sindh; 55
in Balochistan; 30 in Khyber Pakhtunkhwa; 7 in AJK and FATA each; 3 in Gilgit-Baltistan; and 1

17

in ICT. Each MSU has one woman medical officer and three support staff: one family welfare
counsellor, driver and female attendant each.
A training manual on specified/identified modules such as planning, supervision and
monitoring; community participation and ownership; skill development; follow-up system;
financial procedures; quality of care; logistic management along with a guide was also
developed.

Functions
The MSUs perform the following functions:

Make family planning information and services accessible in underserved/un-served rural


communities.

Reduce the unmet need for family planning by making services more accessible,
particularly the clinical methods such as intrauterine devices (IUDs) and injectables.

Provide reproductive health, including curative, services to women.

Facilitate the work of male mobilizers regarding the enhancement of mens role and
responsibilities.

Muster local support for the Programme through interaction with elected representatives
and other opinion leaders, and promote better understanding and need for reproductive
health care.

Quality of Care
The Programme has achieved international accreditation ISO 9001:2008 Certification for Quality
Services for selected Service Delivery Points (SDPs). Based on the experience gained from the
above process, various checklists have been designed whereby quality of care is ensured through
standardization and optimization of reproductive health facilities. The following SDPs and
Managerial Offices of the Ministry and Departments of Population Welfare have received ISO
accreditation/certification:

RHS Directorate, MoPW, Islamabad.

District Population Welfare Office (DPWO), Islamabad.

RHS-A Centre, Federal Government Services Hospital, Islamabad.

FWC, Noor Pur Shahan, Islamabad.

DPWO, Chakwal.

MSU, Talagang, Chakwal.

DPWO, Jhelum.

RHS-A Centre, Jhelum.

FWC, Dina-I, Jhelum.

MSU, Sohawa, Jhelum.

External Surveillance Audit


The external surveillance audit of Year 2009 for ISO Certified Outlets of the Programme was
conducted by external auditors from United Registrar of Systems Ltd. from 20-22 August 2009.

18

The Management Representative Office addressed the discrepancies raised in the audit report by
amending the relevant procedures, and the same was circulated to respective SDPs and
Managerial Offices for compliance. Moreover, the respective SDPs and Managerial Offices
strictly observed the opportunities for improvement (OFIs) and potential non-conformities
(PNCs) mentioned in the report.

Internal Audit
The internal audit of ISO Certified Outlets of the Programme was conducted in June 2009 and
January 2010. The major/minor PNCs, observations and OFIs were identified and corrective
preventive actions (CPAs) were initiated accordingly. The same was also conveyed to respective
SDPs and Managerial Offices of ICT and Chakwal District for compliance.

Calibration of Equipment for ISO Certified Outlets


In 2010, the calibration of the following equipment for ISO Certified Outlets of ICT and Chakwal
District was done through Era Lab, Lahore.

Weighing Machine (Adult and Baby).

Thermometer.

Pressure Gauge.

Hygrometer.

BP Apparatus (Mercury).

Special Initiatives of Federal Minister for Population Welfare


Two projects titled Establishment of Two Safe Mother Homes and Establishment of Eight
Multipurpose Service Centres were launched on pilot basis during 2009-10 as special initiatives
of the Federal Minister for Population Welfare. The first project is being implemented in Larkana
and Sialkot with a budget of Rs. 33.0 million; while the second in Badin, Bajaur Agency,
Islamabad, Loralai, Nowshera, Sialkot and Skardu with a budget of Rs. 39.7 million. The Director
(FWCs) has been given the additional charge of Project Director for both the projects since the
Directorate of FWCs is handling them. The spadework on the projects, such as recruitment of
staff and procurement of goods, has already been done and they will be inaugurated soon.

19

B. Service Outlets of Population Welfare Programme (PPP)


I. Reproductive Health Services-B Centres
Well-established hospitals and clinics with fully-equipped operating facilities (operation theatre
facilities, beds for admission, post-operative care, sterilization and emergency resuscitation
equipment, etc.) and trained workforce (gynaecologist/surgeon/doctor trained in MiniLaparotomy techniques, no-scalpel vasectomy (NSV) and occupational therapy, as well as
qualified ward staff), which are interested in performing contraceptive surgery, are enlisted with
the Population Welfare Programme as RHS-B Centres. These include District and Tehsil
Headquarters hospitals of provincial line departments (PLDs) and the Health Departments,
surgical centres of NGOs, private hospitals, etc. Of the 113 RHS-B Centres of the MoPW, as of
30 June 2010, 54 are located in Punjab; 38 in Sindh; 8 in Khyber Pakhtunkhwa; 4 in Balochistan;
8 in ICT; and 1 in Gilgit-Baltistan.

II. Public-Private Partnership


The public-private partnership (PPP) component of the Population Welfare Programme envisages
focusing on those men and women in the reproductive age group, numbering about 47.0 million,
who remained untapped in the past. This objective will be achieved by evolving a sustainable and
mutually win-win partnership with public-private sector organizations (PPSOs), with a view to
meeting the unmet needs of these men and women, and motivating them to adopt best practices in
reproductive health and family planning as part of responsible parenthood/rationalized family
norms and structures.
In Pakistans context, PPP interventions have a vast potential due to the large workforce
employed in the public, private and corporate sector, as well as community-based, nongovernmental and civil society organizations. The MoPW envisages reaching out to this
workforce for raising awareness, inducing motivation and extending FP/RH services. For this
purpose, both public and private sector organizations are approached, especially through
chambers of commerce and industries, labour unions, traders associations, etc.
The focus of this collaboration is on providing comprehensive FP/RH information and services
through the social and physical infrastructure of respective organizations. The approach is to
integrate FP/RH component into their setup, though some input may be required to equip
Programme outlets for providing these services. This input reflects a symbolic partnership, and
encourages PPSOs to carry forward the activities for having a healthy workforce, responsible
parenthood and enlightened citizenship. The main indicators of this initiative are the number of
organizations approached, orientation sessions held, doctors and paramedics trained, and health
outlets activated for FP/RH services.
With a view to bring the public and private sector on board for supplementing the efforts of the
MoPW in providing FP/RH services, 10 sensitization seminars were organized during 2009-10.
As a result, 204 memoranda of understanding (MoUs) were signed by the partners with the
Ministry, with a pledge to support the Programme. Moreover, 140 FWCs/RHC-B Centres/FP
Counters have been established since 2006 on the premises of PPSOs. In addition, 478
medics/paramedics from private and public sectors were imparted training on Population and
Development. The MoPW also held meetings with seven Chambers of Commerce and Industries
(AJK, Islamabad, Karachi, Quetta, Rawalpindi, Sialkot and Tribal Areas), wherein the former
agreed to continue their efforts for achieving Programme objectives.

20

Chapter 6
Other Activities
A. Training Institutes
I. Clinical Training
Clinical training is the key activity aimed at providing quality reproductive health services (RHS)
to the community by developing human resource for the service delivery centres of the
Population Welfare Programme, the Ministry and Departments of Health, PLDs, and other nongovernmental and private sector organizations throughout the country. Thirteen Regional
Training Institutes (RTIs) across Pakistan train personnel for delivering health care services to the
general public.
The RTIs provide skill-based training in Reproductive Health and Family Planning for all
categories of health care providers: doctors, medical students, nurses, student nurses, lady health
visitors and other paramedics. In addition to HRD, the RTIs also undertake activities focused on
raising the awareness level of hakims, homeopaths, community health workers, teachers and
college students.
The Directorate of Clinical Training is responsible for all activities held at the RTIs, as well as
building institutional capacity; developing training curricula; preparing textbooks and other
training material, such as audio-visual aids; conducting examinations for certification of
competence as service providers; assessing and improving quality of training; and ensuring
proper and timely implementation of the clinical training programme through the RTIs.
The Directorate is also the focal point for coordination with the Population Welfare Departments
(PWDs) of Punjab, Sindh, Khyber Pakhtunkhwa and Balochistan, as well as AJK, FATA and
Gilgit-Baltistan; the Population Welfare Training Institutes (PWTIs) in Karachi and Lahore, the
Health Departments, NGOs, social sector institutions, public sector health organizations and nonProgramme health outlets regarding training of their staff (both medics and paramedics) in family
planning and reproductive health.
To meet the increasing need for trained workforce, RTIs are also being established at Khuzdar
and Sialkot, and they will be fully functional by 2011. Establishing new RTIs is in line with the
government policy of womens empowerment. This will also help in creating opportunities for
women, achieving the Millennium Development Goals (MDGs) and alleviating poverty.
Moreover, the new RTIs would empower women to attain skills and be economically productive
for themselves and their families, besides meeting the Programme objectives of reducing high
population growth rate and unmet need for contraceptives, and promoting health of the
population.
The RTIs over the years have grown into excellent training centres for all categories of FP/RH
service providers, not only from the PWDs, but also from the Health Departments, the Pakistan
Army, autonomous bodies, NGOs and the private sector. They are using standardized training
curricula and modern teaching methods, backed up by a comprehensive evaluation system.

Activities
A wide range of training activities were undertaken during 2009-10, as shown in the table and
text below:

21

Sr. No. Activity


1.
2.
3.
4.
5.

Basic Training Course for Family Welfare


Workers (24 months)
Advance Training for FTOs, ASTs and
Family Welfare Counsellors (3-5 months)
Pre-Service Training for Family Welfare
Assistants (3 weeks)
Refresher Training for Paramedics (1-2 and
4 weeks)
Miscellaneous Training and Orientation for
Non-Programme Personnel (1 and 2 days)
Total

Target

Achieved

300

284

40

284

80

136

240

262

4,700

2,660

5,360

3,626

A 14-Day Crash Training Programme in Contraceptive Surgery was conducted for


registered medical practitioners (RMPs). A total of 101 RMPs were trained in MiniLaparotomy techniques through the Programme, for which financial assistance was
provided by the United Nations Population Fund (UNFPA) under Annual Work Plan
2009.

The Second Training of Trainers (ToT) on Client-Centred Family Planning ServicesAdvance under the Family Advancement of Life and Health (FALAH) Project was held
from 29 July-7 August 2009 in Islamabad. Women medical officers (WMOs) of six RHSA Centres from Punjab, Sindh and Balochistan attended the ToT.

Competency-Based IUCD Training was conducted under the FALAH Project from 1722 August 2009 at the RTI/RHS-A Centre, Aabpara, Islamabad. A total of 10 medics and
paramedics attended the training.

A Training Programme on Sharing of Technical Updates on Mini-Laparotomy


Procedures was conducted under the FALAH Project at three RHS-A Master Training
Centres: Lady Wellington Hospital, Lahore; Jinnah Postgraduate Medical Centre,
Karachi; and Nishtar Hospital, Multan. A total of 33 participants from the Population
Welfare and Health Departments attended the programme.

A Training Programme on Updates on NSV Training and Service Provision was


organized under the FALAH Project from 1-3 April 2010 at the NSV Centre, Faisalabad.
Three doctors and paramedics each from the PWDs attended the programme.

The curriculum of family welfare assistant (female) was prepared in Urdu to make
service providers proficient and capable of delivering quality health services. This was
done in consultation with senior officials of the MoPW and other sister organizations and
in collaboration with UNFPA.

World Population Day activities such as walks, quizzes, sports events and seminars were
organized at all the RTIs on 11 July 2009.

II. Non-Clinical Training


The MoPW has two Population Welfare Training Institutes (PWTIs) in Lahore and Karachi for
imparting training to Programme and non-Programme personnel on Population and
Development and other related issues. The following activities were undertaken by the PWTIs
during 2009-10:

22

Programme Personnel
Sr. No. Activity

Participants

Duration

No. Held

1.

Training of Trainers Workshop

Faculty of PWTIs/RTIs

10 days

17

2.

Workshop on Financial and Office


Management
Training Course on Financial
Management
Basic Training Course

Population Welfare
Officers/WMOs
Accountants/Assistant
Accountants
Family Welfare Assistants
(Male)
Drivers

1 week

55

2 weeks

32

2 weeks
(in batches)
4 days
(2 batches)
2 days

100

3.
4.
5.
6.
7.

Course on Skills in Driving and


Personality Development
Workshop on Revision of Curriculum BS-17&18 Officers
for Initial Service Training
Initial Service Training

BS-17&18 Officers

8.

National Workshop on Supervision


and Monitoring

District/Tehsil Population
Welfare Officers (TPWOs)

9.

Course on Managerial Leadership

BS-17&18 Officers

10.

Training Course on Interpersonal


Communication Skills

Family Welfare Assistants


(Female)

11.

Course on Computing Skills

12.

4 weeks
(2 batches)
1 week

158
17
62
27

1 week

31

1 week
(in batches)

250

Stenographers

1 week

39

Course on Contraceptive Logistic


System

Storekeepers/Upper
Division Clerks

1 week

57

13.

Pre-Service Training

Social Mobilizers

6 weeks

161

14.

Training Course on Office


Management

Administration Officers/
Superintendents

1 week

26

4 days

31

1 week

27

15.
16.

Training Course on Office Security Naib Qasids


Course on Communication and
Advocacy

Female Welfare
Counsellors/Workers
Total

1,090

Non-Programme Personnel
Sr. No. Title of Seminar

Participants

Duration

No. Held

2 days/1 day

1,086

1.

Safe Motherhood

Religious Scholars

2.

Safe Motherhood

Factories/Industries Staff

1 day

113

3.

Safe Motherhood

PLDs/NBDs/NGOs

2 days

116

4.

Population and Development

Media

1 day

86

5.

Population and Development

TGIs/NBDs

2 days

266

6.

Population and Development

Male and Female Ulemas

2 days

304

7.

Population and Development

District and Tehsil Nazims

I day

40

8.

Population and Development

NGOs/CSOs

1 day

88

Total

2,099

23

B. Communication and Advocacy


The Directorate of Communication Strategy is mandated to develop and implement media
campaign to promote small family norms and bring about attitudinal change in the masses. A
comprehensive promotional campaign was launched during 2009-10 through the print and
electronic media with a special focus on advocacy for population welfare to achieve the goal of
population stabilization. The messages of the media campaign were blended into educational and
recreational TV and radio programmes sponsored by the Ministry of Population Welfare
(MoPW). Moreover, seminars, workshops, meet-the-press sessions, and orientation programmes
for community, youth and policymakers were organized. Also, advertisements and articles were
published in the press to disseminate information about family planning and reproductive health.

Promotional Campaign
The promotional campaign through the print and electronic media addressed various family
planning and population issues, such as population and development, implications of rapid
population growth, birth spacing, breastfeeding, female literacy, male involvement, removal of
misconceptions regarding side-effects of family planning methods, image enhancement of family
planning workers, early marriage, etc. The details of related activities undertaken during 2009-10
are given in the following table and text:
Sr. No. Activity

Target

Achieved

Percentage

1,000

1,618

162

1.

TV Advertisement

2.

TV Programme

20

20

100

3.

Radio Spot

800

1,155

144

4.

Radio Programme

104

68

65

5.

Press Advertisement

400

598

150

6.

IEC Material

300,000

222,500

74

7.

Conference/Workshop/Seminar/Meeting

200

a. Enter-Educate Programme Aabadi Nama


This ongoing programme is broadcast every Tuesday through the Pakistan Broadcasting
Corporation (PBC) network. A total of 34 programmes of Abadi Nama were telecast during
2009-10. This enter-educate programme includes various segments on population-related news,
issues, information and activities. A special segment of the programme has been assigned to the
involvement of parliamentarians and coverage of population-related news in their constituencies/
areas.
b. Online Family Clinic through FM Radio
This programme of 25-30 minutes duration was aired on rotational basis from different FM radio
stations during 2009-2010. The host of Online Family Clinic was a medical doctor who
responded to the live calls of audiences. The programme focused on use and side-effects of
family planning methods, mother and child health (MCH), male involvement, age at marriage,
service outlets, general health problems, etc.
c. Other Activities
Four thematic songs on population issues were produced in regional languages, and
aired on complementary basis from terrestrial and satellite channels.

24

Palna, a 90-minute tele-film, was produced to address the family planning and
reproductive health issues of newly-wed couples.

A close circuit television (CCTV) campaign was launched through major railway
stations and trains, Daewoo terminals and buses, and Passport Office, Lahore.

Coverage of the launching ceremony of UNFPAs State of World Population 2009


report was arranged through the print and electronic media.

The Pakistan Electronic Media Regulatory Authority (PEMRA) was approached for
airing of population-related messages on complementary basis through satellite
channels as their corporate responsibility.

World Population Day 2009


The following activities were undertaken in connection with the World Population Day (WPD)
on 11 July 2009:
a. Pre-Event Press Conference
A pre-event press conference was arranged in the Media Centre of the Press Information
Department (PID) on the eve of the WPD 2009 to highlight population issues. The Federal
Minister for Population Welfare briefed the media about the importance of the World Population
Day and the programme chalked out by the MoPW in this connection.
b. Curtain Raiser
A curtain raiser was telecast on 10 July 2009 on PTV, PTV News and ATV. Moreover, special
messages were aired on various satellite channels on the eve of the WPD 2009.
c. National Population Convention
A National Population Convention was held on 11 July 2009 at the Prime Ministers Secretariat,
Islamabad. The event was chaired by the Prime Minister of Pakistan and attended by a large
number of federal and provincial ministers, diplomats, parliamentarians, civil servants,
journalists, and representatives of national and international organizations in the public and
private sector.
d. Coverage in Electronic Media
PTV, the national channel, gave special coverage to the WPD 2009 in its Khabarnama besides
airing hourly bulletins on 11 July. Exclusive programmes on family planning and population
issues were telecast on different TV channels Maizban Pakistan on PTV News, News
Morning on PTV Home, Rise and Shine (Khawateen Programme) on PTV and Morning with
Farah on ATV to name just a few in connection with the WPD 2009. Parliamentarians,
celebrities and experts in the field of population were invited to these programmes as guests.
Similar programmes were also broadcast from different FM radio stations. Moreover, TV
channels gave appropriate coverage to the National Population Convention.
e. Coverage in Print Media
Special promotional advertisements were published in 18 national and regional dailies for
imparting awareness to the general public regarding the WPD 2009. Exclusive reports and
supplements were also published in selected leading newspapers. Messages of the President,
Prime Minister, Federal Minister for Population Welfare, Secretary to the MoPW and UNFPA
Country Director were also published in selected leading newspapers to highlight the importance
of the WPD 2009.

25

f. Special Issue of Aabadi Nama


A special issue of Aabadi Nama was published on the occasion of the WPD 2009 and
distributed among the participants of the National Population Convention, as well as
parliamentarians, district nazims, college/university libraries, NGOs and other stakeholders. The
special issue included messages of the President, Prime Minister, Federal Minister for Population
Welfare, Secretary to the MoPW and UNFPA Country Director on the occasion of the WPD
2009. Moreover, it included special articles, reports, editorials and interviews on the theme of the
WPD 2009.

Involving Ulema in Family Planning Activities


The following activities were organized during 2009-10 to enhance the involvement of ulema
(religious scholars) in the Population Welfare Programme:
a. National Ulema Seminar
A National Ulema Seminar was held on 2 July 2009. The Directorate of Communication Strategy
arranged its coverage through the print and electronic media and more than 100 journalists
attended the event. At the end of the seminar, they interviewed the Federal Minister for
Population Welfare, Secretary to the MoPW and selected religious scholars for their news reports.
A positive hype about the event was created through news reports on TV and radio and in the
press.
b. Seminars on Role Of Religious Leaders in Population Welfare Programme
These seminars were held in the six cities of Abbottabad, Karachi, Lahore, Muzaffarabad,
Peshawar and Quetta; and chaired by the Federal Minister for Population Welfare. Their main
objective was to share the activities of the Programme and seek opinion of the religious leaders
regarding their role in its implementation. About 700 local religious leaders and khateebs,
including women, participated in the seminars, during which in-depth group discussions were
held on topics such as role of religious leaders in advancing the goal of family wellbeing, role of
gender from Islamic perspective, socio-cultural barriers to family planning, remedial measures in
promoting MCH, etc.
c. Seminar on Interfaith Harmony and Role of Religious Leaders for Promoting Mother
and Child Health in Population Welfare Programme
This one-day seminar, held on 24 December 2009 in Sialkot, was inaugurated by the Federal
Minister for Population Welfare. The main objective of the seminar on Interfaith Harmony and
Role of Religious Leaders for Promoting Mother and Child Health in Population Welfare
Programme was to share the activities of the Programme and seek opinion of the religious
leaders regarding their role in its implementation.
d. Finalization of Manual for Orientation of Religious Leaders
The MoPW is implementing a project titled Mobilizing Religious Leaders for RH/FP in
Pakistan with the technical and financial assistance of the United States Agency for International
Development (USAID) since July 2009. The former is being provided by a consultant under the
Extended Service Delivery (ESD) arrangement. A consultative meeting of the Curriculum
Advisory Group was held on 30 April 2010 to evolve consensus on the compendium of the
Manual for Orientation of Religious Leaders. The Training Sub-Group held its first meeting
from 8-10 May 2010. Senior officials of the MoPW also participated in the meeting aimed at
reviewing the generic ESD Manual in the light of the Curriculum Advisory Groups directions.
The relevant material was selected from the revised compendium and inserted at appropriate
places in the Manual.

26

e. Master Training Workshop on Mobilizing Religious Leaders for RH/FP in Pakistan


A Master Training Workshop was conducted from 3-8 June 2010 on the Mobilizing Religious
Leaders for RH/FP in Pakistan Project. 18 master trainers, associated with the PWTIs as
instructors, attended the workshop. The Provincial Focal Persons were also engaged in helping
them understand their role as coordinators between the MoPW and the district management.
Female trainers from the RTIs were also asked to join the workshop in the light of their role in
evolving training module for family welfare workers (FWWs) for their pre-service and in-service
training. The master trainers will represent the core trainers associated with the PWTIs, and will
provide orientation to trainers selected form 26 FALAH Project-focused districts through
Training of Trainers (ToT). Subsequently, the district-level trainers will provide orientation to
community-level religious leaders, including imams, khateebs and nikah khwans.

Production and Printing Unit


The MoPW maintains a Production and Printing Unit in Lahore since 1962, which caters to its
needs by printing professional, motivational, clinical and informational materials. It is an inhouse economical printing facility where assignments are executed irrespective of time
constraints. The Production and Printing Unit undertakes assignments for the MoPW, as well as
the Population Welfare Departments of Punjab, Sindh, Khyber Pakhtunkhwa and Balochistan. In
addition, the Unit also facilitates the printing matters of AJK, NIPS and other allied units of the
Ministry. The achievements of the Production and Printing Unit, managed by the Directorate of
Communication Strategy, during 2009-10 are given in the following table:
Quantity Printed

IEC Material
Booklets, Leaflets, Handbills, Posters, Flip Charts, Books,
Brochures, Flyers, Stickers, etc.
Newsletter
Aabadi Nama
Office Stationery
DO Pads, Letterheads, Visiting Cards, File Covers,
Envelopes, etc.
Forms and Registers
Registers, Forms, CRC Cards, Users Slips, Bin Cards, etc.
Total

MoPW, Islamabad

PWD, Punjab

159,900

4,070,000

30,000

32,225

11,100

233,225

4,070,000

Seminar on Population and Development Issues for AJK Parliamentarians


A one-day seminar on Population and Development Issues was organized for parliamentarians
and elected representatives from AJK on 23 November 2009 in Muzaffarabad. A comprehensive
presentation was made on Implications of Population Growth and Response Strategy during the
seminar, which was chaired by the Prime Minister of Azad Jammu and Kashmir. The participants
included members of the AJK Legislative Assembly, secretaries of line departments and
representatives of NGOs.

Production and Dissemination of IEC material


A large quantity of IEC material, including booklets, brochures and handbills highlighting family
planning services/methods, was produced and disseminated during 2009-10. The fatwa in favour
of family planning was also disseminated to all the parliamentarians to gain their support.

27

Media Coverage
Media coverage was arranged for the following events during 2009-10:

National Assembly Standing Committee Meeting.

Visit of the Federal Minister for Population Welfare to India.

Meetings of the Federal Minister for Population Welfare with donor agencies.

Essay and Slogan Writing Competition


In order to involve the youth and general public in population issues and highlight the
implications of high population growth rate, a National Essay and Slogan Writing Competition
was organized. The competition was announced through the national press. 298 entries were
received in the category of slogan writing, while 393 entries in the category of essay writing. The
same were assessed by a committee and cash prizes were awarded to the winners in both the
categories.

Monthly Newsletter Abadi Nama


The MoPWs quarterly newsletter Aabadi Nama was published regularly during 2009-10; and
disseminated among the Provincial Population Welfare Departments (PWDs), other ministries
and departments, colleges, universities, media persons, libraries, MNAs, Senators, district nazims
and other stakeholders. Aabadi Nama highlights special events organized by the MoPW and
PWDs, besides publishing interviews of experts in the field of population and development.

28

C. Population Education
The Directorate of Population Education has evolved a new strategy to focus on youth, the major
cohort in the population pyramid. This programmatic shift from family planning to reproductive
health rights and issues of adolescents will ensure quality of life and care. The new paradigm,
instead of talking about numbers as a population education modality, encompasses spacing,
responsible parenthood, health education and family as a unit in a holistic approach to population
and development issues.
As part of the Youth Sensitization Programme and orientation/education of different categories of
target audience under the population education component, a series of workshops/seminars was
organized. Moreover, Presentation Skills Development Workshops were organized to enhance
the capacity of newly-inducted officers in the Programme at the provincial level. The summary of
the activities undertaken during 2009-10 is given in the following table:
Sr. No Activities Undertaken
1.
2.
3.

4.
5.

Presentations on Population and Development in


Colleges and other Educational Institutions
2-Day Teacher Sensitization Workshops on
Population Issues
4-Day Presentation Skills Development
Workshops for Field Officers of the Provincial
Population Welfare Departments
2-Day Orientation Workshops on Population Issues
for Religious Scholars
Focus Group Meetings to finalize projects to be
launched by the Ministry of Youth Affairs

Venue
Faisalabad, Gujranwala, Islamabad, Mirpur,
Muzaffarabad, Peshawar, Rawalpindi
Faisalabad, Gujranwala, Lahore, Mirpur,
Muzaffarabad, Peshawar
Lahore, Peshawar

Gujranwala
Ministry of Youth Affairs, Islamabad

New Initiatives
To meet the socioeconomic challenges faced by Pakistan, it is vital to sensitize all segments of
the society on population issues, especially opinion leaders like teachers and religious scholars.
The population as a demonstrator of all the developmental indicators and a cross-cutting issue
was highlighted at different for a by the Directorate of Population Education. However, the focus
on youth, especially students and young teachers in productive and reproductive age groups, is
the main thrust of the population education component of the Programme. In this connection, the
MoPWs plan is to sensitize both students and young teachers on population issues. In the first
phase, the Ministry plans to establish seven Population Education Information Resource Centres
(PEIRCs) in public sector universities, one in each province and AJK and ICT. These Centres
will be a major step towards sensitizing the countrys youth on the issue of population and
development.
Moreover, a number of meetings were convened with the Curriculum Wing of the Ministry of
Education to discuss recommendations on already proposed eight themes related to population
and development issues, with a view to sensitizing school students of class 9 and 10 and college
students of class 11 to 12. In addition, the Directorate of Population Education was also involved
in the vetting of the Education and Youth Policies from the population and development point of
view. For the first time in its history, the Directorate was involved not only in finalizing the
Government of Pakistan (GoP)-UNFPA related Annual Work Plan (AWP)-2010 of the Ministries
of Education and Youth Affairs, but also got one of its activities the establishment of seven
PEIRCs incorporated in the AWP-2010 of the Ministry of Education.

29

D. Contraceptive Commodity Security (Procurement and


Performance)
Annual Contraceptives Requirement
The annual contraceptives requirement for the Ministry of Population Welfare (MoPW) was
approved to the tune of Rs. 150.000 million, against the allocation of Rs. 150.000 million for
2009-10. As per the pro-forma invoice provided by UNFPA, funds of Rs. 146.000 million in
foreign exchange were transferred to UNFPA through the Ministry of Finance/AGPR/State Bank
of Pakistan. Besides, oral pills (235,000 cycles) worth Rs. 3.995 million were procured locally
from M/s. ZAFA Pharmaceutical Karachi through open competitive process by issuing tender in
the press. The details of the contraceptives procured through UNFPA during 2009-10 out of GoP
budget (Rs. 146.000 million equivalent to $1.7 million) is given in the following table:
Sr. No. Contraceptive

Quantity Procured

1.

Oral Pill EC (Boxes)

120,000

2.

Oral Pills COC (Cycles, locally procured)

235,000

3.

CU-375 (Sets)

350,000

4.

CUT-380-A (Sets)

400,000

5.

NET-EN (Ampoules)

670,000

6.

Syringes (Pieces)

670,000

7.

DMPA (Vials)

240,000

Central Warehouse and Supplies, Karachi


The Directorate of Central Warehouse and Supplies (CW&S), Karachi is an important part of the
Population Welfare Programme. It is responsible for storage and smooth supplies of
contraceptives to Programme units and non-Programme family planning service delivery outlets.
There will be no family planning programme if contraceptives are not available in services
delivery outlets. That is why the Directorate of CW&S plays a vital role in the entire Programme
by ensuring continued availability of contraceptives to Programme and non-Programme outlets.
During 2009-10, direct supply from CW&S, Karachi to Peoples Primary Healthcare Initiative
(PPHI) district managers was introduced. Moreover, with the technical and financial support of
USAIDs DELIVER and CRISP Projects, rehabilitation work of the CW&S, Karachi
construction of a new Administration Block, expansion of the existing store and introduction of a
pallet-racking system is currently in progress and will hopefully be completed during 2010-11.
The physical verification of the CW&S, Karachi was carried out from 29-31 March 2010. After
approval of the report, follow-up action is in process for implementation of the recommendations.

National Contraceptives Procurement Manual


The DELIVER Project is also facilitating the development of a National Contraceptives
Procurement Manual as a tool for MoPW/Ministry of Health personnel. The Manual addresses
the key phases of the procurement cycle, from procurement planning and issuing invitations to
bid evaluation, supplier selection and contract award and management. It will also provide stepby-step instructions for desk officers and other hands-on procurement staff who are tasked with
the responsibility of procuring quality contraceptives. The National Contraceptives Procurement
Manual will also ensure compliance with the Public Procurement Rules 2004.

30

The draft Manual is an outcome of active interventions by the officers of the MoPW/Ministry of
Health, as well as other key stakeholders such as the Central Drug Laboratory, Drug Control
Authority, Mother and Neonatal Child Health (MNCH) Programme, National Aids Control
Programme, Public Procurement Regulatory Authority (PPRA), United Nations Population Fund
(UNFPA), United States Agency for International Development (USAID) and Department for
International Development (DFID). The Manual is almost ready for government approval.

Commodity Support from UNFPA And USAID


UNFPA and USAID have donated contraceptives to the MoPW. UNFPAs consignments have
been received, while the majority of USAID consignments are yet in the pipeline. The details are
given in the following table:
($ in Million)
Donor

Allocation

Received

In Pipeline

USAID

2.947

1.095

1.852

UNFPA

2.130

2.130

Total

5.077

3.225

1.852

Logistic Management Information System


The DELIVER Project is providing technical assistance to develop a logistic management
information system (LMIS) for improving quantification, forecasting and inventory management
of contraceptives. Once this LMIS is in place, all necessary data will be accessible by a click
from top to the service provider-level.

Contraceptives Receipt and Dispatch


During 2009-10, 1,816 consignments of various contraceptives were received, got cleared from
the Customs and stored in the warehouse. Of these consignments, 1,117 belonged to DPWOs, 346
to RHS-A Centres, 196 to EDOs, 51 to RTIs/NRIFC, 36 to AJK, 31 to the PPHI, 20 to NGOs and
19 to TGIs/Gilgit-Baltistan.
Sr. No. Name of Contraceptive

Units

Quantity

1.

Rubber Condoms

Pieces

48,960,000

2.

Oral Pills

M/cycle

3,764,093

3.

Norgestril (Overette) PoP

M/cycle

119,978

4.

Postinor-2

Box into 2 tabs

120,000

5.

Copper T (380-A)

Pieces

467,056

6.

Multiload cu-375

Pieces

260,300

7.

Norigest Injection

Amps

1,200

8.

Megestron/Depo Injection

Vials

901,000

9.

Disposable Syringe with Needles

Pieces

1,500,000

10.

Implanon (one single rod implant)

Sets

900

During 2009-10, consignments of various contraceptives were dispatched to Programme and nonProgramme service delivery outlets. The details are given in the following table:

31

Sr. No. Name of Contraceptive

Units

Quantity

1.

Rubber Condoms

Pieces

41,364,808

2.

Oral Pills

M/cycle

3,223,123

3.

Norgestril (Overette) PoP

M/cycle

119,978

4.

Exlution Tablets

M/cycle

68,817

5.

Postinor-2

Box into 2 tabs

48,887

6.

Copper T (380-A)

Pieces

662,887

7.

Multiload cu-375

Pieces

96,508

8.

Norigest Injection

Amps

1,336,905

9.

Megestron/Depo Injection

Vials

905,182

10.

Disposable Syringe with Needles

Pieces

2,201,179

11.

Implanon (one single rod implant)

Sets

2,171

In addition, the Directorate of CW&S, Karachi received various contraceptives for the National
Programme for Family Planning and Primary Health Care, Ministry of Health, and provided
storage facilities in the warehouse. Later, the same were dispatched to the Provincial Programme
Implementation Units of the Ministry of Health throughout Pakistan. The details of receipt and
dispatch of the contraceptives belonging to the Ministry of Health that were stored by the CW&S,
Karachi during 2009-10 are given in the following table:
Sr. No. Name of Contraceptive

Receipt

Dispatch

1.

Rubber Condoms

5,066,884

10,544,976

2.

Oral Pills (M/cycles)

3,455,500

3.

Depo Provera Injections (Vials)

75,500

75,500

4.

Disposable Syringes with Needles (Pieces)

75,500

75,500

In addition, the Directorate of CW&S, Karachi received 734 cartons of Rubber Condoms for the
National Aids Control Programme (NACP) and provided storage facilities in the warehouse.

Development of National Contraceptive Procurement Table


With the technical assistance of the DELIVER Project, a National Contraceptive Procurement
Table for 2010-11, 2011-12 and 2012-13 has been prepared on the basis of logistic data, which
include contraceptive requirement for the Population Welfare Programme and other stakeholders.

Outstanding Sale Proceeds


The monitoring exercise on district-specific basis has started to clear off the outstanding sale
proceeds from the concerned District Population Welfare Offices (DPWOs).

32

E.

International Cooperation

United Nations Population Fund (UNFPA)


The Ministry of Population Welfare (MoPW), in consultation with the stakeholder, including the
line ministries/departments, finalized the GoP-UNFPA 7th Country Programme in January 2004
for five years duration (2004-2008) with a total cost of $34.9 million. It was extended twice; the
first extension was approved by the UNFPA/UNDP Executive Board during the meeting held in
Geneva in June 2008. The Programme was later extended until 2012. The purpose of these
extensions was to implement the One Programme under the One UN pilot exercise in Pakistan
(2008-2012), and to synchronize the United Nations programme cycle with the national MediumTerm Development Framework (2005-2010).
The goal of the UNFPA Country Programme is to contribute to the improvement of reproductive
health status of Pakistan leading towards population stabilization and sustainable human
development, with focus on reducing fertility and improving maternal health. The allocation
under the Annual Work Plan (AWP) is for the Ministries of Population Welfare, Health,
Education and Women Development, as well as the Statistics Division, so that they can address
RH/FP issues following a multi-sectoral approach. In the MoPW, four Director Generals/Project
Directors are responsible for implementing the AWP at the federal, provincial and district level.
The UNFPA Country Programme focuses on 10 districts: Chaghi, Chakwal, Jacobabad, Kohat,
Kotli, Muzaffarabad, Mansehra, Muzaffargarh, Qila Saifullah and Thatta. For implementation of
the Programme, the MoPW and other line ministries Health, Education, Women Development
and Youth Affairs, as well as the Statistics Division sign their AWP with UNFPA every year.
Annual Work Plan 2010: The Annual Work Plan for 2010 amounting to $ 2.75 million was
signed between UNFPA and the MoPW on 10 February 2010. The funds will be used for
implementing reproductive health and family planning throughout Pakistan. The AWP is in line
with the MDGs and ICPD objectives. The major activities of the AWP 2010 include:

Training.

Integrated primary health care/reproductive health/family planning services through


Mobile Service Units in remote areas.

Advocacy and community awareness.

Improved management system for programme delivery.

Support to demographic and population studies, and support for public private sector
organizations (PPSO) working on population and development issues.

Procurement of contraceptives for social marketing in Pakistan.

2. United States Agency for International Development (USAID)


USAID is currently supporting in contraceptive commodity security through its DELIVER and
CRISP Projects.
DELIVER Project: The project, running from August 2009 to September 2011, is providing
financial and technical support to Pakistan in the field of forecasting, international procurement of
contraceptives, computerization of warehouse, logistic management information system (LMIS)
and contraceptive commodity security. Under the DELIVER Project, USAID is providing $10.3
million support for commodity supplies for the MoPW, Ministry of Health and Greenstar Social
Marketing-Pakistan. Of this amount, the share of the MoPW is $2.9 million, while that of the

33

Ministry of Health and Greenstar Social Marketing-Pakistan is $6.2 million and $1.2 million,
respectively. The MoPW has received contraceptives worth $1.095 million and contraceptive
worth $1.85 million are in the pipeline under the DELIVER Project, which is also providing
technical support amounting to $3.0 million for forecasting, the Contraceptive Procurement
Manual, LMIS and computerization, including pallet-racking of CW&S, Karachi.
CRISP Project: The project is providing financial and technical support for expansion and
rehabilitation of Central Warehouse and Supplies (CW&S), Karachi. Currently, rehabilitation
work (flooring, ventilation, electrification and painting) of existing storage facility and foundation
work of the Administration Block is being undertaken. The estimated cost of the CRISP Project,
which would be completed by July 2011, is $2.5 million.
Pakistan Demographic and Health Survey (2011-2012): USAID has agreed to provide financial
and technical assistance to the National Institute of Population Studies (NIPS) to conduct the next
Pakistan Demographic and Health Survey (PDHS) 2011-2012.
In addition to these projects, USAID is also providing funds to Pakistani NGOs for undertaking
activities around family planning and reproductive health issues. The details are as follows:
Family Advancement of Life and Health: This five-year project, with a budget of $60 million, is
being implemented in 26 districts across the country. The implementing consortium is led by the
Population Council, a US-based research organization. The ToRs of the Family Advancement of
Life and Health (FALAH) Project are to increase demand for and practice of birth spacing;
increase access to quality of family planning services in the public sector; increase the coverage
and quality of family planning services in the private sector; and increase the coverage of social
marketing of contraceptives and provide support to the commercial sector for marketing of
contraceptives to strengthen contraceptive security. The MoPW is one of the implementing
partners of the FALAH Project. The DG (Technical) is the focal person from the MoPW
regarding formulation and implementation of the Project.
Pakistan Initiative for Mothers and Newborns: This six-year project is designed to reduce
maternal, neonatal and child mortality in Pakistan by making sure women have access to skilled
birth attendants during childbirth and throughout the postpartum period. The Pakistan Initiative
for Mothers and Newborns (PAIMAN) is working at the national, provincial and district level to
strengthen the capacity of public and private health care providers and to improve the health care
system infrastructure. PAIMAN has developed a community-based approach that provides a
continuum of care to mothers, newborns and children through supportive linkages from home
health care to hospital-based care. PAIMANs key partners are the Ministry of Health, the
Ministry of Population Welfare, Provincial and District Health/Population Departments and the
private sector. The PAIMAN consortium is led by John Snow Inc. (JSI), a US-based international
public health organization.
Proposals for Future USAID Assistance: A series of meetings were held at the MoPW and
Finance Division to discuss and prioritize project proposals for USAID support. In this
connection, the Ministry has forwarded six concept papers for USAID funding. These concept
papers were discussed during the last Pak-US strategic dialogue in New York. US authorities
showed their interest in four of the six proposals, costing $180.00 million. These include: (1)
Enhancing Outreach to FP/RH Services through Community Partnership: Family Health Homes
at Village Level (pilot project for two years costing $120.00 million, as against total project cost
of $331.76 million for five years); (2) Community Mobilization through Imams and Khateebs at
Village Level (pilot project for two years costing $28.00 million, as against total project cost of

34

$70.00 million for two years); (3) Research and Training through NIPS, NRIFC, RTIs and
PWTIs (the total project cost is $12.00 million for five years); and (4) Public-Private Partnership
for Universal Access to FP/RH Services (the total project cost is $20.00 million for five years).

3. Partners in Population and Development (PPD)


The Partners in Population and Development (PPD) PPD is an inter-governmental alliance of 25
developing countries: Bangladesh, Benin, China, Colombia, Egypt, Ethiopia, India, Indonesia,
Pakistan, Jordan, Mexico, Gambia, Morocco, Ghana, Tunisia, Yemen, Nigeria, Kenya, Mali,
Thailand, Vietnam, Senegal, South Africa, Uganda and Zimbabwe. The PPD was established
during the International Conference on Population and Development (ICPD), held in Cairo in
1994, with the specific purpose of promoting and improving the transfer of knowledge/expertise
and skills in population and reproductive health through South-South collaboration. Pakistan
joined the PPD, whose headquarters is located in Dhaka, Bangladesh, in 1997.
Members of the PPD believe that by sharing their expertise, they can transform reproductive
health goals outlined in the ICPD into reality. Partners Board, comprising senior officials or
ministers for Family Planning/Population Programme of each member country, is the governing
body of the PPD and its meeting is held annually. The Federal Minister for Population Welfare is
on the Partners Board from Pakistan. This year, the Partners Board meeting will be held in
Indonesia from 25-28 October 2010.
The MoPW is facing an acute shortage of demographers; however, being a member of the PPD, it
is offered one or two slots every year for attending the one-year General Diploma Course in
Demography at Cairo Demographic Centre, Egypt. Nine officers of the Ministry or Provincial
Departments of Population Welfare have so far attended the course, while two are currently
enrolled. Being a member of the PPD, the GoP does not have to bear any expenses in this regard.
However, UNFPA shares the expenses incurred on this course.
The MoPW organized three media workshops in 2004, 2006 and 2009 in Islamabad on the
request of the PPD for creating awareness about its activities. These workshops were attended by
parliamentarians, senior government officials, legal experts, and national and international print
and electronic media, besides representatives of UN agencies, international development partners,
diplomatic missions, professional bodies and NGOs/CSOs,. The Executive Director of the PPD
also attended these workshops.

4. Development Bank of Germany (KfW)


Social marketing was introduced in Pakistan in 1985-86 with the financial assistance of USAID.
KfW (Kreditanstalt fr Wiederaufbau or Development Bank of Germany) entered the field in
January 1995 to sustain condom distribution through a five-year agreement (1995-1999) with a
grant assistance of DM30 million. The assistance provided by KfW covered procurement of
commodities like contraceptives, advertisement/promotional campaign, training, research,
management, monitoring and consultancy.
For enhancing and expanding the Social Marketing Programme, particularly in the North-West
Frontier Province or NWFP (now Khyber Pakhtunkhwa), an MoU was signed between the GoP
and KfW in September 2006. Under the MoU, KfW agreed to provide Euros 6.1 million for the
Social Marketing Programme for three years (2006-09) under the project titled Improved
Reproductive Health Services in NWFP. The project ended in 2009.
Recently, KfW has made a fresh commitment through the External Affairs Division (EAD) to
provide an amount of Euro 8.00 million for Social Marketing Programme under the project titled
Improved Reproductive Health Services in NWFP from 2010-12.

35

5. Visits Abroad
The details of visits/trainings abroad undertaken by officers of MoPW during the year 2009-2010
are given in the following table:
Sr. No. Name and Designation
1.

2.

3.

4.

5.

6.

Event (Venue)

Dates

Funding Source

SAARC Parliamentarians
Conference on Advocacy to
Achieve Universal Access to
Reproductive Health Services
and Commodities Security
(Kathmandu, Nepal)
Dr. Sairah Adnan, Medical
Training Programme on
Officer/Senior Instructor, RTI, HIV/AIDS Prevention and
Abbottabad
Care for Children and
Vulnerable Young People
(Bangkok, Thailand)

28-30 July
2009

UNFPA

Mr. Abdul Ghaffar Khan,


Director General (Projects),
MoPW

16-17 Sept
2009

UNFPA

27-30 Sept
2009

USAID

17-20 Oct
2009

PPD

Dr. Firdous Ashiq Awan,


Federal Minister for
Population Welfare; and Dr.
Mumtaz Esker, Director
General (Technical), MoPW

Asia-Pacific High-Level
Forum on ICPD @15:
Accelerating Progress
Towards ICPD and the
Millennium Development
Goals (Bangkok, Thailand)
Dr. Mumtaz Esker, Director WHO Regional Workshop on
General (Technical), MoPW the Implementation of Best
Practices in Family Planning
(Amman, Jordan)
Dr. Firdous Ashiq Awan,
14th Annual Board Meeting
Federal Minister for
of Partners in Population and
Population Welfare; Major (r). Development (PPD) and 5th
Haroon Rashid, Additional
Asia Pacific Conference on
Secretary, MoPW; and Mr.
Sexual and Reproductive
Hammad Shamimi, Director Health and Rights (Beijing,
(FA), MoPW
China)
Mr. Dilshad Ahmad, Deputy
Secretary, MoPW; Ms. Tanvir
Kiyani, Director, MoPW;
Syed Muhammad Saleem,
Deputy Director, MoPW; Dr.
Asma Rana, Principal, RTI,
Lahore; Mr. Abdul Sattar,
DPWO, Naushki; Dr. Shama
Khawaja, Principal, RTI,
Islamabad; Dr. Mehjabeen
Shah, Medical Officer, RHSA Centre, Hyderabad; Mr.
Akramullah Baig, Project
Director, NA; Dr. Naila
Akhtar, Chief Medical
Officer, RHS-A Master
Training Centre, Lahore; and
Mr. Abdul Waheed, Director,
MoPW, Islamabad

24 Aug-4 Sept Royal Thai


2009
Government

Observational Study Tour on 10-18 Nov


FP/RH Quality of Care
2009
Programme, organized by the
National Population and
Family Planning Commission
of China

UNFPA

36

Sr. No. Name and Designation


7.

Mr. Nayyar Agha, Secretary,


MoPW

8.

Dr. Firdous Ashiq Awan,


Federal Minister for
Population Welfare
Mr. Nayyar Agha, Secretary,
MoPW; and Mr. Abdul
Ghaffar Khan, Director
General (Projects), MoPW

9.

10.

Dr. Badaruddin Abbasi,


Director (TC), MoPW

11.

Dr. Firdous Ashiq Awan,


Minister for Population
Welfare, Islamabad

12.

Mr. Shaukat Hayat Durrani,


Secretary, MoPW

Event (Venue)

Dates

United Nations High-Level


1-3 Dec 2009
Conference on South-South
Cooperation (Nairobi,
Kenya)
Study Visit to Syria to learn 3-7 Dec 2009
about success stories and best
practices in the field of RH/FP
Study Visit to the US, the UK 26 Jan-4 Feb
and Germany to ensure
2010
commodity security for
Greenstar Social MarketingPakistan
2nd USAID-WHO Technical 6-11 March
Meeting on Reconvening
2010
Bangkok 2007-2010: Progress
Made and Lessons Learned in
Scaling-Up FP/MNCH Best
Practices in the Asia and
Middle East Region
(Bangkok, Thailand)
Study Visit to India to observe 15-2 April
best practices, success stories 2010.
and experiences for sharing
knowledge in the area of
RH/FP and to replicate the
same in Pakistan, which
would help in reducing
population growth and fertility
rates and increasing
contraceptive prevalence rate
43rd Session of the
12-18 April
Commission on Population
2010
and Development (New York,
USA)

Funding Source
UNFPA/PPD

Greenstar Social
MarketingPakistan

USAID

UNFPA

UNFPA

37

F. Monitoring and Supervision


Monitoring of Population Welfare Programme activities in the field is an important management
tool to ensure smooth implementation of policies and decision-making, and is thus a regular
activity of the MoPW. The performance of each Programme component is gauged through
performance indicators. The key input indicators include workforce, availability of reproductive
health commodities, capacity building activities, availability of equipment and furniture, and
funding; while the key output indicators include family planning services, antenatal/prenatal/
MCH services, coverage, quality of care, counselling techniques, registration of eligible couples
and client satisfaction. The monitoring is undertaken through:

Analysis of periodic reports received from the field.

Field visits the to service delivery outlets.

Review sessions at regular intervals.

Experience-sharing workshops with the service providers and other stakeholders.

Field Visits
During 2009-10, monitoring teams of the MoPW visited 14 districts in four provinces: Attock,
Chakwal, Okara, Pakpattan and Rawalpindi in Punjab; Karachi (East), Khairpur, Mtiari, Sukkur,
Thatta and Umarkot in Sindh; Gilgit and Diamir in Gilgit-Baltistan; and Pishin in Balochistan.
Their observations were conveyed to the concerned provinces, so that they could improve
performance, as well as the MoPW.

Workshops on Field Monitoring


Monitoring of Population Welfare Programme activities is also done at the provincial and district
level. In order to enhance the capacity of district monitoring officers, two-day training workshops
were conducted for Deputy DPWOs (Tech) and TPWOs in Hyderabad, Muzaffarabad, Peshawar,
Quetta and Sukkur. The focus of the workshops was on the use of tools and indicators during
field monitoring. Fields visit were also arranged for the participants to practically apply these
tools and indicators.

38

G. Research and Evaluation


I. National Research Institute of Fertility Care
The following studies were undertaken by the National Research Institute of Fertility Care
(NRIFC) during 2009-10:
1. Increasing Access to Emergency Contraceptive Pills through Family Welfare Workers
and Community Women Volunteers.
2. Post-Operative Menstrual Changes in Mini-Laparotomy Cases.
3. Impact of Strengthening of Counselling Skills of Service Providers and Enhancing
Quality of Care of Service Outlets.
4. Comparative Study of Norigest and Megesterone to Determine Bleeding Pattern and
Acceptability.
5. Role of Leptin in Infertile Males.
6. Pre-Introductory Clinical Trial of Latest Intra-Uterine Device Yuangong 220.
7. Condom Brands Available in Pakistan: Quality and Client Satisfaction.

Research Advisory Committee Meeting


A meeting of the Research Advisory Committee (RAC) was held at the NRIFC, Karachi to
discuss new research proposals. Representatives of the Ministry of Population Welfare (MoPW),
the Provincial Welfare Department (PWD) Sindh and other research institutes attended the
meeting and approved the following research proposals:
1. Using Innovative IT Approaches for Improvement of Family Planning/Mother and Child
Health (MCH) Services in Pilot Districts.
2. Assessing Burden of STIs/RTIs in MoPW and Ministry of Health Facilities/Outlets in
Selected Districts.
3. Knowledge, Attitude and Practices of Fishermen Community of Rehri Goth, Karachi
regarding Family Planning.
4. Causes of Male Fertility in Our Society.

II. National Institute of Population Studies


The following activities were undertaken by the National Institute of Population Sciences (NIPS)
during 2009-10:

Research Projects
1. Performance Evaluation of Male Mobilizers.
2. Baseline Household Survey of District Chitral.
3. Evolution of Media Campaign of the Population Welfare Programme.
4. Gilgit-Baltistan Demographic and Health Survey.
5. District Population and Development Profile.
6. End-line Survey of the Pakistan Initiative for Mothers and Newborns (PAIMAN).

39

Research Papers
The following research papers were presented by NIPS at the Tenth Annual Population
Conference, organized by the Population Association of Pakistan in 2010.
1. Unintended Pregnancy and Antenatal Care in Pakistan.
2. Maternal Mortality.
3. The Delay in Decision-Making Process and Maternal Mortality.
4. Knowledge of Tuberculosis and its Correlates among Ever Married Women in Pakistan.
5. Media Messages Persuading Couples to Use Contraceptives: An Analysis in the
Backdrop of Socioeconomic Factors.
6. Effects of Birth Interval and Birth Size on Child Survival in Pakistan.
7. Demographic, Social and Economic Factors Influencing the Treatment-Seeking from
Health Facilities for Acute Respiratory Diseases among Pakistani Children: an Insight
into the Pakistan Demographic and Health Survey (PDHS) 2006-07.
8. Correlates of Women Mortality in Pakistan.
9. Prevalence of Traditional Contraceptive Methods in Pakistan.

Other Activities
1. Translation of key findings of the PDHS 2006-07 into Urdu.
2. Revival of news brief.
3. Research studies on Grey Areas/Weaknesses of the Performance Evaluation of Male
Mobilizers and Population Growth and its Implications.
4. Launching of the website.
5. Automation of the library.
6. Training of FCPS/MPH students of Wah Medical College.

Activities in Progress
1. Evaluation of the Regional Training Institutes (RTIs); and contraceptive surgery cases
performed at and family planning services offered by the RHS-B Centres.
2. Pilot study on Islam and Family Planning: Perceptions and Practices in Sialkot and
Chakwal Districts.
3. Study on Existing Status of Population Education at Pre-Service Level in Pakistan.
4. Azad Jammu and Kashmir (AJK) Demographic and Health Survey 2010-11.

Activities Proposed
1. Study on State of Population in Pakistan.
2. Five in-depth research papers on PDHS 2006-07 data.
3. Bi-annual research journal.
4. Evaluation and assessment of quality of care of the Family Welfare Centres (FWCs).
5. Study on Community Response to Deployment of Midwives.

40

H. Special Initiatives
PC-Is of Population Welfare Programme
The PC-Is of the Population Welfare Programme (2010-15) were considered by the Central
Development Working Party (CDWP) on 17 September 2009, wherein it was decided, inter alia,
that a Technical Committee would be set up to review and make pragmatic recommendations
about the future course of the Programme for its effective implementation. A Technical
Committee was set up accordingly by the Planning Commission under the chairpersonship of
Special Advisor to Prime Minister on Social Sector Ms. Shehnaz Wazir Ali.
The first meeting of the Technical Committee was held on 15 March 2010 at the MoPW. The
Committee made recommendations on the Programme and constituted a Core Group
comprising Mr. Muzaffar Mahmood Qureshi (Former Federal Secretary), Dr Zeba A. Sathar
(Country Representative, Population Council), Prof. Dr. Mohammad Nizamuddin (Vice
Chancellor, University of Gujrat) and Mr. Amanullah Khan (Former Senior Chief, Planning
Commission) to ensure that these recommendations were truly reflected in the PC-Is of the
Programme (2010-15).
The last meeting of the Technical Committee was held on 3 May 2010 under the chairpersonship
of Ms. Shahnaz Wazir Ali. The meeting endorsed the PC-Is of the Programme (2010-15) for
submission to the Planning Commission, for seeking approval of the competent forum (CDWP or
ECNEC). The list of PC-Is submitted to the Planning Commission is given in the following table:
Sr. No. Scheme/Project

Cost (Rs. in Million)

1.

Federal Activity

5,580.505

2.

National Institute of Population Studies

300.000

3.

National Trust for Population and Welfare

825.000

4.

Population Welfare Programme, Punjab

18,745.605

5.

Population Welfare Programme, Sindh

12,546.016

6.

Population Welfare Programme, Khyber Pakhtunkhwa

5,946.458

7.

Population Welfare Programme, Balochistan

5,208.098

8.

Population Welfare Programme, Azad Jammu and Kashmir

1116.498

9.

Population Welfare Programme, Gilgit-Baltistan

663.103

10.

Population Welfare Programme, Federally Administered Tribal Areas

997.254

11.

Population Welfare Programme, Islamabad Capital Territory

378.904

Presentation on Population Welfare Programme to Federal Cabinet


A presentation on the Population Welfare Programme was made to the Federal Cabinet on 24
February 2010. In response, the Cabinet decided that the National Commission for Population
Welfare (NCPW), headed by the Prime Minister, shall hold an early meeting, taking on-board the
Provincial Chief Ministers, to address the issues related to the Programme. Accordingly, a
summary was moved to the Prime Minister for convening meeting of the NCPW. The meeting
was first scheduled on 21 June, but then postponed until 5 July. The Draft Pakistan Population
Policy 2010 was to be placed in the NCPWs meeting for its endorsement before submission to
the Federal Cabinet for approval. Since the processing of the Policy is under question in the wake
of the 18th Constitutional Amendment, the meeting has been temporarily postponed.

41

New Website of MoPW


In order to make use of the IT for spreading its message among the general public and attracting
other stakeholders, including international donors, the Federal Minister for Population Welfare
ordered for the development of a new dynamic website of the MoPW. It was decided that the
existing website be replaced with a new multi-faceted website. After fulfilling the codal
formalities, the contract for developing new website of the MoPW was awarded to M/s Avenier
Technologies (Pvt.) Ltd.

Public Sector Development Programme (2010-11)


The Public Sector Development Programme (PSDP) proposals for 2010-11 received from all
Wing Chiefs of the MoPW, its allied units and the Provincial Population Welfare Departments
(including AJK, FATA and Gilgit-Baltistan) were compiled and sent to the Planning and
Development Division. The meeting of the Annual Plan Coordination Committee (APCC) on the
PSDP (2010-11) was held 21 May 2010 with the Deputy Chairman of the Planning Commission
in the chair, while the meeting of the National Economic Council (NEC) for the PSDP 2010-11
was held on 28 May 2010. For 2010-11, the PSDP amounting to Rs. 4115.546 million was
approved for the Population Welfare Programme.

De-Federalization of Population Welfare Programme


A meeting, co-chaired by the Federal Ministers for Population Welfare and Finance, on defederalization of the Population Welfare Programme was held on 19 February 2010. Provincial
Ministers and Secretaries of Population Welfare, Planning and Finance also attended the meeting,
besides the Deputy Chairman of the Planning Commission and the Secretary, Finance Division.
The purpose of the meeting was to seek response of the Provincial Governments on the defederalization of the Programme. The Finance Minister said that the Federal Government would
continue to fund the Programme for the next five years.

42

I.

PSDP Allocation and Utilization

The Public Sector Development Programme (PSDP) allocation, release and expenditure of the
Population Welfare Programme during 2009-10 are given in the following table:
(Rs. in Million)
Utilization

Sr. No. Name of the Project

Allocation

Release

1.

Federal Setup

630.000

423.574

425.561

2.

Federal Projects (AJK, FATA, GilgitBaltistan, ICT)

444.189

234.436

240.043

3.

PWP-Punjab

1,600.000

1,231.400

1,576.855

4.

PWP-Sindh

1,290.000

741.500

895.565

5.

PWP-Khyber Pakhtunkhwa

606.707

413.268

503.801

6.

PWP-Balochistan

500.000

320.000

348.952

7.

New Projects

200.000

61.024

54.443

5,270.896

3,425.202

*4,045.220

Total

* The excess amount was utilized by the provinces out of the unspent balance of previous years withheld by
the concerned Finance Departments.

43

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