Situation Analysis: It is estimated that 33% women in Pakistan have an ‘unmet need’ for contraceptives and RH services which translates into an alarming MMR of 300-700 per 100,000 live births. There is a disparity between knowledge about and actual use of modern contraception methods - although 95% of women are aware of modern methods of contraception, use is limited to 28% of women aged 15-49 (UNFPA, GOP 2002).

With the HIV/AIDS pandemic, the need to provide an integrated package of SRH services, first seen in the early 1990s and endorsed at the ICPD, has become more urgent than ever.

In addition to providing services to the target groups, the need exists for an ongoing dialogue with national policy makers to sensitise them to the need for provision of quality RH services and the development and proper implementation of appropriate policies.

Key Challenges:

• Social, cultural, economic and physical barriers to access are still strong in Pakistan.
• Weak networking between public and private sectors limits access.
• Insufficient resources are allocated to SRH leading to inadequate capacity (including infrastructure and technical competence) to meet the vast unmet need.

Strategic Direction: FPAP will improve access of SRHR for women and men by reducing socio-cultural barriers that impede access to essential services.

Goal:  All people, particularly the poor, marginalized, the socially excluded and the underserved are able to exercise their rights to make informed choices about their sexual & reproductive health, have access to quality SRH information, sexuality education & high quality services including family planning.

Objectives:

• To reduce socio cultural barriers and improve access to SRH information, education and services by men and women in FPAP operational areas.
• To improve access to SRH information and affordable, acceptable and quality services to poor and marginalized men, women and young people.

Activities to Achieve Objective 1:

To reduce socio cultural barriers and improve access to SRH information, education and services by men and women in FPAP operational areas.

• Conduct baseline survey (KABP) to measure socio-cultural barriers which impede access;
• Identify areas to conduct BCC;
• Develop and implement group specific BCC activities;
• Hold dialogue with opinion leaders at community level;
• Solicit support from political/ opinion leaders, service providers, governmental and non governmental institutions at national, provincial and the grassroots level;
• Hold consultation dialogues with financial institutions to link-up micro credit facilities with improving access to SRH services;
• Involve men as partners in SRH programmes;
• Conduct indicative research to asses reduction in socio-cultural barriers;

Activities to Achieve Objective 2:

To improve access to SRH information and affordable, acceptable and quality services to poor and marginalized men, women including young people.

• Provide RH, FP (including contraceptive surgery) and life span services to men and women, especially young couples, through mobile and static outlets as well as collaborative and referral network;
• Develop and disseminate IEC material;
• Establish new and strengthen existing- collaborative and referral networks;
• Strengthen Quality of Care protocol;
• Hold regular Focus Group Discussions and exit interviews;
• Provide Emergency Contraceptive (ECP) on selected outlets;
• Develop technical and managerial capacity of the staff and volunteers for improved services to poor and marginalized men, women and young people
• Mobilise resources for improved services to poor and marginalized men, women and young people.

Outcomes and Indicators: