Pakistan

With funding from UNFPA, Jhpiego supports the development of an integrated model of family planning (FP) services and counseling in primary health care at 18 targeted facilities in Islamabad and two in Karachi. Jhpiego is working to improve quality of care by building the capacity of health workers, strengthening facilities and community engagement by training outreach workers, and involving males and youth to integrate FP services into current maternal, newborn and child health services. In Karachi, a community engagement strategy for the facilities includes use of male mobilizers. In addition, Jhpiego and UNFPA are supporting postpartum family planning (PPFP) strategies by training Master Trainers on PPFP and by supporting task shifting/sharing through capacity building of Lady Health Workers to provide first dose of intramuscular DMPA injections in Islamabad, including hard-to-reach areas such as Gilgit Baltistan and Azad Jammu and Kashmir.

Moving Integrated, Quality Maternal, Newborn and Child Health and Family Planning and Reproductive Health Services to Scale (MOMENTUM) is a suite of projects, funded by the U.S. Agency for International Development, that aims to accelerate reductions in maternal, newborn and child mortality and morbidity in high-burden countries by increasing host country commitment and capacity to provide high-quality, integrated health care. Each of the projects has a specific focus area; together they provide a comprehensive, flexible package of support for countries as they overcome context-specific health challenges towards sustainable development. The six-year, Jhpiego-led MOMENTUM Country and Global Leadership project focuses on: 1) providing targeted technical and capacity development assistance to our missions, partner countries and local organizations; and 2) contributing to global technical leadership and policy dialogue for improved maternal, newborn and child health, voluntary family planning and reproductive health outcomes. Jhpiego’s sub-partners under this project are: Save the Children, Johns Hopkins University International Vaccine Access Center, Quicksand, Matchboxology, BAO Systems, Avenir Health, McKinsey and Company, PACT, Institute for Healthcare Improvement, Christian Connections for International Health and Ubora Quality Institute. In Pakistan, the program is implementing proven high-impact interventions in districts of Kohat and Hangu in Khyber Pakhtunkhwa province to improve incorporation of postpartum family planning services in the Department of Health and Population Welfare Department health services, and to build local capacity for data management, consolidation and use.

This Gavi-funded project, operational in Pakistan and Togo, seeks to expand immunization coverage through increased male engagement. Under this award,  Jhpiego is reviewing current global evidence, building consensus among national immunization stakeholders, testing select male engagement strategies to improve men’s role in caregiving and increase immunization uptake and exploring how tested male engagement strategies can strengthen gender equitable attitudes and/or roles. Jhpiego is also examining whether and how male engagement approaches can increase rates of immunization and analyzing the cost-effectiveness and efficiency of male engagement strategies relative to current immunization demand creation strategies. Findings of this work will be widely disseminated to ensure understanding and uptake of findings by government stakeholders, immunization program design specialists among implementation partners, and Gavi secretariat and Alliance partners. These findings will also inform the development of three tools—a framework; a theory of change; and a monitoring, evaluation and learning plan—that will be used in the design and development of country-specific interventions in Togo and Pakistan for engaging male caregivers to improve immunization outcomes for children.

This initiative is a collaborative effort involving Jhpiego, the Federal Directorate of Immunization and the Provincial Expanded Programme on Immunization in Sindh. This project aims to extend vaccination services to previously unvaccinated segments of the population in the underserved union councils of District Keemari and West Karachi. A comprehensive coverage assessment was carried out to pinpoint areas with unvaccinated individuals within selected union councils of Songal and Itehad Town. These areas were selected due to the high percentage of underserved populations in these areas. Extensive capacity-building sessions and workshops were organized for health care professionals and local communities which significantly helped foster a stronger foundation for the vaccination drive. Engagement of local leaders and organizations played a pivotal role in ensuring proficient field monitoring and achieving high vaccination rates, with 19,868 vaccinations administered in Phase 1 and 20,666 in Phase 2—a commendable 94% coverage rate in both rounds. Despite formidable challenges–including security concerns, lack of government infrastructure for immunization, absence of outreach sites in scattered unregistered population clusters, vaccine hesitancy and refusals for COVID-19 vaccinations and considerable distances between facilities—the Jhpiego team persevered and managed to vaccinate a substantial portion of the target population, which also includes undocumented local residents, illegal residents, and mobile populations. The project serves as a model for reaching unreached and vulnerable populations, underscoring the importance of local organizations, the identification and engagement of local influencers and religious leaders, as well as a profound understanding and respect for local customs and cultures. These elements proved essential for effectively reaching the community, regardless of sociocultural background, gender, or ethnicity.