Strengthening Governance in Health Systems for Reproductive Health and Rights in Pakistan

Pakistan, with the world's sixth largest population, is part of a region that is notorious for its social and gender inequities. As a low-income country, its population has faced numerous economic challenges, especially in the last two decades. These economic hardships have magnified the country's underlying social and gender inequities. Social sectors, including health, are generally the first to suffer under economic woes. Over the past decade, the country's security situation has also spiralled downwards. As a result, Pakistan's health system has suffered and health service delivery has worsened. Those most affected are the vulnerable social groups, including the poor and women. Services catering to women's needs are grossly inadequate. Weaknesses in the Ministry of Health, especially those related to governance, also affect services for women, especially those associated to sexual and reproductive health. This four-year project aims to strengthen health systems governance for reproductive health and rights in Pakistan. The research team will use a three-pronged intervention model to enhance rights by ensuring accountability for government and service providers. Shirkat Gah, the Women's Resource Centre, will lead the project, which aims to build skills and knowledge in the planning and implementation sections of Pakistan's Ministry of Population Welfare, Ministry of Health, and civil society organizations. Using a case study design, the research team will assess the model's viability as a tool to strengthen health systems governance for reproductive health and rights. The project team will also generate tools and recommendations to apply the model in other countries in South Asia. Researchers will conduct the study at the district level with two districts selected in each of the two main provinces of Punjab and Sindh, and one district in each of the two smaller regions of Khyber Pakhtunkhwa and Baluchistan. Project outputs include piloted tools and training modules to: -assess health systems governance for sexual and reproductive health; -evaluate health systems governance for community accountability mechanisms; -generate rights-based evidence; and, -transfer knowledge to civil society organizations.