dr. adnan a. khan research and development solutions
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Dr. Adnan A. KhanDr. Adnan A. Khan
Research and Development Research and Development SolutionsSolutions
USAID Small Grant (2011) to RADS Partners – Punjab and Sindh DOH and PWDs Areas – Family Planning and Immunization in the
context of MNH Purpose - Institutionalize information generation
and use and actions
The Evidence to Policy and Action Grant Initiative
Analysis- existing datasets, LHW, EPI data
(Punjab and Sindh) Research on models of services Working with DoH/PWD to understand their
programmatic data and connect to program improvements
Informed Advocacy to Politicians, communities
Work with donors to address their information needs/efficiency
What is RADS doing
FPAP started in 1953 GoP programs in 1966 Many phases and approaches
FP in Pakistan: The History
Family Planning in Pakistan
Source: PDHS 2006-7 MWRA: 23 million
Modern Methods
Total Users: 5.1 Million
Services for Modern Methods
Total Users: 2.9 Million Total Users: 2.9 Million (12% of (12% of MWRA)MWRA)
Connecting CPR to ServicesCPR
30% of MWRA7.1 Million
UsersModern Methods
22% of MWRA5.1 Million
Users Services
12% of MWRA2.9 Million
Users
Costs of FP in the Public Sector
Per Women served
CYP
MoH 826 671 - BHUs 661 391 - LHWs 887 728MoPW 4,347 1,032
Total for MoH and MoPW
2,414(USD 40)
937(USD 16)In PKR
Regional Costs: PKR 240-400 (USD 4-6)/ CYP
Inferences of Costs
Pakistan public sector costs are 4 fold higher than regional costs (USD 4-5/CYP)
4% of costs in public sector are for commodities
If regional efficiency was to be achieved, public sector FP funding alone can allow >80% CPR
Trends in Services 2006-12
In M
illion
s W
om
en
S
erv
ed
Services by Sectors
Private
1.9 M67%
Public 1 M,33%
2.9 million (12%) of MWRA receive FP services per year
Age when Information Received
JhelumPak
PattanTime Lag(in years)
RH/Puberty 13 120-3
months
Menstruation 14 130-3
monthsMarriage 23 23 2Child bearing 25 31 5-10Birthing options 27 32 5-12
Family Planning
29 40 9-20
Source: Khan et al, Study of Information Processing by Young Women. RAF/ DFID 2012-13
Overall CPR has increased at <1% per annum
12-14% of MWRA receive FP services each year
Government services only account for 33% of all services or around 1 million women.
Nearly half of couples buy FP supplies from stores. Markets serve ~50%. These are poorly understood
Despite investments and programs, the number of users has not increased above secular trends
Young women are a major potential user group that is largely being ignored
What does it all mean
While supply side programming is useful, demand must be created
Spacing messages must be incorporated into common narrative
Address Young women – soon to be married, newly married
Government programs must be held accountable to the investments that go into them. This may mean that unless they produce results, facilities and sections of programs may be closed down
Markets for FP are crucial, better understanding and used
Lessons
Thank You
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