Overcoming Barriers in Reproductive Health

Transcription

1 1 Our World - Report Overcoming Barriers in Reproductive Health Islamabad March 08, 2011 Introduction: The first - FGD of David & Lucile Packard Foundation funded project Women Leadership in RH and Development brand named as - Our World and implemented by LEAD Pakistan LP was held on March 08, 2011 at the LEAD house, F-7 Markaz Islamabad. This FGD carried a symbolic vision of being held on the International Women Day. The title of the FGD was Overcoming Barriers in Reproductive Health. It was attended by a multi sectoral group of public health specialists, media journalist, government official, INGO, researcher, civil society, academia, Packard grantees and donor organization. The worthy participants included representatives from Ministry of Health, Ministry of Women development, FPAP-Rahnuma, Shifa college of Medicine, USAID, Marie Stopes Society MSS, Kavish, Heart file, SACHET, Islamabad Dateline and Research & Development Solutions. Dr. Nabeela Ali, Chief of Party COP, USAID TOUH facilitated the FGD and was assisted and supported by the Project Director OW, Asif Jah. The discussion was very well focused, interactive and thought provoking. It did generate substantial forward thinking and formed a basis to move the project ahead in a more focused manner. Dr. Nabeela s moderation and facilitation was highly professional, to the point and interesting. Objectives: LEAD Pakistan hopes to raise the profile of Reproductive Health (RH) within the broader social development sector and advocate greater attention to meeting reproductive health goals by using its experience and expertise in cultivating leaders on the one hand; and its passion for improving RH status on the other by creating leaders in the field of reproductive health. The main thrust of this initiative is that it seeks to create a cross-sectoral network of women of renown and influence as cause ambassadors for improving Pakistan s Reproductive Health Status. The major objectives of this FGD were: 1. To seek inputs and insights of multi sectoral group of professionals on the role of women leaders and means of engaging them in overcoming barriers in reproductive health. 2. To identify gaps preventing the conflicts from being solved. 3. Some questions that the focus group discussion aimed to address included the identification and classification of barriers to RH, the role of the women leaders in addressing these barriers, how they can fulfill their role and the prerequisites needed to assert their role. Process: The proceedings were divided into three parts; orientation session, experts opinion about the area of focus and focus group discussion on barriers in reproductive health. This was followed by a Q & A session. A detailed workshop agenda is given at the end of the report. The orientation session began with an introduction of LEAD Pakistan. This was followed by a briefing by Asif Jah, Project Director, on the project Our World, its objectives, outcomes, the

2 2 reproductive health network including the three proposed issue-specific caucuses and the purpose of the focus group. He presented an overview of the project and elaborated on the objectives and expected outcomes of the focus group discussion. After this, the participants introduced themselves. Dr. Nabeela Ali, Chief of Party, JSI, chaired, facilitated and moderated the discussion group. The participants shared their point of view about barriers in reproductive health existing in the country and the role and mandate of concerned stakeholders. Discussion: Dr. Nabeela Ali gave a detail presentation on barriers in RH and road blocks in achieving MDGs 4 & 5. Following were the major thrust of the presentation. 1. Political and social barriers a. Extra ordinary events like earthquakes and flood etc. b. Determinants of maternal and child mortality in Pakistan including female education, poverty and socio cultural etc. 2. Programmatic barriers and their progress on following a. PDHS and MGDs 4 & 5. b. MDGs for Maternal Mortality c. MDGs for Infant Mortality d. Resource allocation 3. Programmatic challenges a. Scaling up best practices. b. 8.7 Million women of reproductive age till 2015 in Pakistan 4. Health System barriers a. Human Resource in terms of their skills, education and availability b. Centralization and Decentralization process in Pakistan caused instability, this also effects international funding. c. Unreliable HMIS/DHIS at various levels. d. Governance issues including poor performance, political interference, lack of ownership and financial instability etc. 5. Political and Private Sector a. Models and innovation like Benazir Income Support Program - BISP and Peoples Primary Health Care Initiative - PPHI is not enough. b. Confidence of people in private sectors in many times higher than the public sector but neglected. 6. Research and Policy Gaps a. Need of focused targeted researches b. Policy formulation should be Research based.

3 3 During the following further points were raised/ recommended by the participants: In governance, there is no accountability for poor performance and high political interference. This in turn, affects the developments and creates barriers in the reproductive health related issues. Focused targeted research necessary to understand the determinants of maternal and newborn mortality. The process of public policy engagement by the RH network seeks to assess the capacity gap, stakeholders mapping and analysis and identity priority issues. Creation of a strong network of leaders and engaging with policy makers. People should be sensitized about reproductive health issues and there should be a greater focus on public policy engagement. The proposed composition of the caucus and the possible members from government, civil society, corporate, performing arts, academia/universities, media, law, Packard partner, donor agency and LEAD Pakistan would be included. The mechanism for engaging women from the community and any NGO workers, civil society members which will be involved at the grassroots level, a point raised by Dr. Saba. Zehra Kamal from Cavish stressed on the need to identify the focus of public policy engagement. The focus should include the policy level as well as the community level. Other issues such as RH in early marriages need to be highlighted. Dr. Nabeela Ali mentioned that some aspects of health sector may get prioritized and we need to identify areas which really matter. Social, cultural and political dimensions of health sector need to be discussed as well. Asif Jah, Project Manager, pointed out the geographical areas focused will be in Punjab and Sind provinces. Emphasis on programmatic challenges including issues of coverage and access to health services. Asif Jah also recommended that women empowerment is an issue which needs to be dealt in detail and also in terms of economic empowerment The participants also stressed on the role that parliamentarians can play such as Dr. Fehmida Mirza. There are quite a few female parliamentary members who should be contacted and the policy issues should be discussed with them. Political parties should include the issue of reproductive health and their proposals in the mandates. Allocation of resources needs to be identified as well as the budget allocation. The resource allocation especially in health, education, sports and youth affairs should also be focused on. There is a big discrimination between boys and girls. So there should be emphasis on targeted female education, lack of funding from the federal government. Both the federal and provincial governments should be involved for overcoming barriers to reproductive health. This is where the leaders can come in and focus. The provincial policy makers need to be engaged for resource allocation. A donor conference needs to be arranged to sensitize them and tell them to put their money in serious effort.

4 4 Women leaders can play a crucial role in mobilizing the community. Names of renowned educationists also discussed such as Bella Raza, Amina, Yasmin Rashid, Nafeesa shah and others from the Fatima Jinnah University. Proper mapping needs to be done and the root cause has to be identified and addressed. People in the community need to be involved through education, employment opportunities. E-learning programs, DVD s and policy briefs should also be made to engage the community. There is a dire need to understand the local geographical issues. A communication leadership plan should be established for building a social pressure group. Role of Raza Rabbani commission and role of media and youth was also discussed. Another dimension related to reproductive rights such as inter-sectoral involvement from health and education should also be included. Dr. Nabeela Ali suggested that the participants of the focus group should Asif Jah and Haseeb Kiani with more suggestions and feedback, if any. List of Participants: S. No. Name Designation Organization Contact Number/ 1 Dr. Nabeela Ali Chief of Party JSI-INGO Dr. Samina Mohsin Khan Assistant Director General - Health Ministry of Health Dr. Sumaida Anwar National M & E/QA Officer Ministry of Women Development drsumaida@natp ow.org.pk 4 Dr. Ayesha Khan Senior Researcher Research & Development Solutions 5 Ms. Zehra Kamal Community Consultant ayesha@khans.or g,ayakhan@gmail.c om Kavish , zehrakamal77@g mail.com 6 Dr. Noreen Saba Waheed Senior Instructor Shifa Hospital, College of Medicine , Saba4444@hotm ail.com 7 Mr. Munir Ahmed Media Journalist Islamabad ,

5 5 8 Dr. Nasira Malik Medical Superintendent Dateline zameenzaad@gm ail.com FPAP- Rahnumna , mnnsyed@gmail. com, drnasira@fpapak. org, 9 Dr. Saba Amjad Manager Operations Heart file , saba@heartfile.or g 10 Dr. Shuaib Khan Director, Health Systems USAID shuaib@jsi.org.pk 11 Dr. Zaib Project Director RHIA SACHET SACHET, Pakistan ; zeibhunzai@gmai l.com; 12 Mr. Maroof Awan Project Coordinator SACHET , Maroof88@gmail. com 13 Dr. Tariq Majid Resident Consultant Marie Stopes Society 14 Ms. Hina Batool Gardezi 230 A, St 4, F- 10/3, Islamabad tmchz@yahoo,.co m Research Officer NATPOW , Hina.gardezi@gm ail.com 15 Dr. Hamid Shahzad Senior Instructor Shifa Hospital, College of Medicine , hamidshehzad@h otmail.com 16 Dr. Suleman Qazi Chief Technical Advisor LEAD Suleman.qazi@g mail.com

6 6 AGENDA March 08, 2011 Venue: Time: Lead House F-7 Markaz, Islamabad :45 pm 04:00 pm Activity Arrival and Registration Recitation from the Holy Quran Welcome Note and Introduction Setting the frame work Discussion Vote of Thanks by LEAD Pakistan Hi Tea Time 1:45 pm 2:00 pm 2:05 pm 2:15 pm 2:30 pm 3:45 pm 4:00 pm