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Celebrating Independence? – Free the mother

By : Dr Syed Azizur Rab
Dated : 2020

Profile: Dr Syed Azizur Rab is the Chief Executive Officer (CEO) of Greenstar Social Marketing Pakistan Guarantee Limited – the largest social franchise network on Reproductive health in the world and one of the significant contributors to family planning services in Pakistan.

In 1947 a nation is born, free from the long and harsh British rule. Every year on 14th of August this nation that our fore fathers lovingly named “Pakistan” celebrates freedom. However, even today freedom for most is a farfetched dream. Freedom to make individual choices and freedom to have a thriving family is still a privilege and not a right.

The basic unit of nation is a family. Family is the nucleus of civilization and the basic social unit of society. Research clearly shows that the institution of family is first form of community and government and, as Michael Novak said, the first, best and original Department of Health, Education and Welfare. Women are at epicenter of a family. Hence true liberation cannot be achieved without empowering women with information and resources to freely make choices about their life. The overwhelming effects of not empowering women and girls are evident in several development indicators of Pakistan particularly the achievements of key health indicators.

Pakistan is the sixth most populous country in the world with an average annual growth rate of 2.40 and a current population of 207.8 million . With a high total fertility, Pakistan is projected to become the 5th most populous country by the end of the next decade. Approximately 12,000 women die during pregnancy every year – the fourth highest number globally . There are 423,000 child deaths annually and 44% of children suffer from chronic malnutrition . These indicators can only be improved by empowering families and ensuring access to Family Planning services – by giving them choices to envision healthy and thriving family and be able to realize their dream coming true. Family planning is an investment worth doing. It enables women and young people to complete their education, it saves governments money, and it helps entire communities and nations thrive. During London Summit in 2012 each country, including Pakistan, pledged to bring modern contraception within the reach of an additional 120 million women and girls by the year 2020. There are significant opportunities to meet this commitment through realizing the potential of public private partner ships.

Private health facilities are often perceived by users to offer better quality of care and are far more physically accessible for both being numerous and extended hours of services. Despite affordability issues and still largely underutilized, Pakistan’s private sector is playing almost an equal role to the public sector in providing Family Planning services. According to the PDHS 2017-18, the two sectors account for nearly the same shares in women’s reported sources of contraceptives in both high and low income groups. (Pakistan, 2019).

How Governments can leverage from Private Sector to improve access to Choices to women and girls

  • Providing contraceptive commodity support to private sector for social marketing
  • since most women prefer private sector facilities to access services
  • Increasing time of service delivery in public sector family planning clinics
  • Increasing access of young people to family planning services and introducing pre marriage counseling programs
  • Given that the rapid population growth has been declared as a national emergency and in order to encourage investment from new and existing players, sales tax and import duty exemption can be granted on contraceptive commodities.
  • Attract private sector towards contraceptive manufacturing by allowing a fair price and directing the Multinationals to ensure the low price affordable injection as service item while they make profits from researched based new molecules.
  • Choices available to women around the world should be made accessible to Pakistan by giving subsidy to all women on more expensive contraceptives such as implants
  • 7. Already available resources in Government inventory can be distributed effectively through private sector

There is growing realization among Pakistani policymakers, in line with Government’s vision of universal health coverage as in the wider international community, that the capacity of the private sector must also be utilized systematically through formal public–private partnerships (PPPs) to attain FP and other development goals. The policy environment has improved and provinces have recently developed health sector strategies. Following 18th amendment, and the subsequent devolution, the provincial governments have been empowered to plan and deliver integrated services through an essential package of health services, and to work with non-state sector for service delivery. This provincial empowerment needs to trickle down to all key players and contributors like the private sector and eventually to their beneficiaries – the families of Pakistan

There isn’t much to be done, only to put power back where it belongs to – in the hands of people and to free the mother from the cycle of death, disability, disease and disaster and liberate them truly.