Comment by Riaz Haq on December 22, 2021 at 5:10pm

In Pakistan’s remote areas, midwives ensure care beyond safe birth

https://reliefweb.int/report/pakistan/pakistan-s-remote-areas-midwi...

During the pandemic, 24-year-old Seema moved to Koohi Goth, an urban slum on the outskirts of Pakistan’s largest city, to be closer to her parents.

She had three daughters, the youngest of whom died as a newborn because of the lack of neonatal services in her former neighbourhood of Karachi City, a few miles from the Rehri Goth, coupled with limited prenatal care to address pregnancy complications.

Now she is pregnant again, but this time, she started visiting the midwifery-led care unit at the Koohi Goth Hospital, where she receives regular checkups for free.

A need to improve care

Reproductive, maternal, neonatal, and child health indicators remain poor in Pakistan. Early childbearing and lack of awareness put women at life-threatening risks. In remote areas, health facilities are scarce and births are mostly attended by unskilled midwives, further exacerbating the risk of maternal and child mortality. According to the 2019 Pakistan Maternal Mortality Survey, the maternal mortality rate is 186 deaths per 100,000 live births. (The number is higher in rural areas versus urban areas.)

As other hospitals shut down given COVID-19 restrictions, Koohi Goth Hospital’s doors stayed open to a rising number of visitors. Every day, almost 500 women visit the facility’s outpatient department and on average, five babies are safely delivered. “Hundreds of women visit the facility every day. I sometimes feel tired but these women need us,” says Noor, the facility’s senior midwife whose patients include Seema. “When we help them, we forget our pain.”

The midwives here come from the most underserved communities across Pakistan, including Sindh, Gligit-Balistan and Khyber Pakhtunkhwa. UNFPA provides refresher training as well as Internet-based courses to enhance and expand their skills. UNFPA then works with local governments to deploy them to remote areas to staff Basic Health Units, the main way people access primary health care.

UNFPA is also working with Pakistan National Forum for Women’s Health, a pioneer in midwifery services and obstetric fistula prevention and treatment, to establish three more midwifery-led care units within hospitals in Sindh province. Midwives in these units handle low-risk pregnancies, provide family planning counselling and conduct antenatal and postnatal check-ups, referring more complicated cases to obstetricians/gynaecologists.

**Counselling for contraceptives **

Neelum is a midwife at Keti Bandar, a remote fishermen village at the old harbour in Thatta district, 150 kilometres away from Karachi. Family planning counselling, information and services “are essential and lifesaving, considering the high fertility trends in the coastal communities and short birth spacing, which many times leads to pregnancy complications,” she said.

When patients tell the midwives that their husbands and mothers-in-law pressure them not to use contraception, the midwives invite the husbands to learn about the consequences of repeated pregnancies. “Now, the use of long-acting reversible contraceptives is increasing,” said Neelum, who also makes house calls. “We are also introducing male contraceptives in the communities.”

There is a huge need to develop a cadre of midwives to ensure that women in remote communities receive care and services. UNFPA, with the support of Johnson & Johnson and other partners, is working with federal and provincial health authorities to raise the level of midwifery education and services in Pakistan.

Seema, who gave birth at 17 to her first daughter at home, said, “My mother-in-law prays for my life because a mother’s life is important for little children.”

Comment by Riaz Haq on February 23, 2022 at 9:27am

Javed Hassan
@javedhassan
Superb initiative of school meals program for 23000 students of 100 Public primary schools of Islamabad by Fed Min of Education under
@Shafqat_Mahmood
. The program will help in ensuring significant reduction in dropouts and improved learning .

https://twitter.com/javedhassan/status/1496424187300356100?s=20&...

-------------------

“The ‘School Meal Program’ improved the attendance, health, and retention of students in schools where the program has already been initiated,” the (Punjab) minister said.

He said that the schools under this program have seen a 33 percent increase in attendance, and a 77 percent improvement in students’ health, and their BMI levels.


https://propakistani.pk/2022/02/04/punjab-govt-launches-free-lunch-...

Comment by Riaz Haq on April 13, 2022 at 10:13am

Senator Dr Sania Nishtar
@SaniaNishtar
Anonymized data from the #Ehsaas Registry is being made public. This is a gold mine for researchers and globally, a stellar example of #DataDemocratisation. 3/3
https://bit.ly/3LZEnuZ

https://twitter.com/SaniaNishtar/status/1514183448109498370?s=20&am...

Ehsaas, the Pakistan-Tehreek-e-Insaf government-run social safety net, achieved a historical landmark of completing the Ehsaas Survey for 34 million households in Pakistan.

This is South Asia’s first digital door-to-door ‘census-like’ survey, with multiple digital safeguards to hedge against abuse, said Dr Sania Nishtar, former special assistant to PM and Chairperson Benazir Income Support Program (BISP).

Senator Dr Sania Nishtar today shared an informational video on the Ehsaas National Socio-Economic Registry (NSER) as she stepped down, highlighting an important component of Ehsaas that was completed but not yet publicly released.


On Twitter, she wrote, “Our Government achieved the historical landmark of completing the Ehsaas Survey for 34 Mn households. This is South Asia’s first digital door-to-door ‘census-like’ survey, with multiple digital safeguards to hedge against abuse”.


She further added “Ehsaas’ Registry enabled the govt to target Ehsaas’ social benefits effectively, target subsidies, and respond to shocks. Here are some insights from the survey across multiple dimensions and unique attributes of the registry. Anonymized Data from the Ehsaas Registry is being made public. This is a gold mine for researchers and globally a stellar example of #DataDemocratisation”.

Ehsaas achieved a historical landmark earlier this year to conclude the nationwide door-to-door NSER survey for more than 34 million households. The NSER survey is an all-encompassing survey designed to assess the socioeconomic status of the household and ascertain their poverty score through Proxy Means Testing (0 – 100). The survey has 43 unique variables and covers demographic, socio-economic, education, health, and asset profiles of the household.


The Ehsaas Registry is unique and important for its own reasons. It was not just Pakistan’s but also South Asia’s first digital and census-like door-to-door survey. Multiple digital safeguards, logical checks, and 3rd party validation and profiling were conducted to hedge against the risk and ensure data credibility. And through its credible and reliable database, it became a key enabler in decision making for all Ehsaas programs and facilitated making evidence-based and impartial decisions on the basis of need and merit.

To promote transparency and encourage data sharing, Ehsaas has made selective data from the NSER registry public. The video shares key insights across four key dimensions including Household coverage, Socio-economic analysis, Education analysis, and Health and Disability analysis. A dynamic PowerBI-based dashboard has also been developed and can be accessed here:

Comment by Riaz Haq on April 26, 2022 at 6:52pm

Modest progress on SDGs
Khaleeq Kiani

https://www.dawn.com/news/1686708


Pakistan’s first Sustainable Develop­ment Goals (SDGs) Status Report (2021) is out and the country’s overall progress on SDGs is modest.

“Overall, Pakistan’s SDGs (composite) index score has increased from 53.11 in 2015 to 63.49 in 2020 i.e. 19.5 per cent up from the baseline of 2015,” according to Dr Shabnam Sarfraz, member of Social Sector and Devolution of the Ministry of Planning, Development and Special Initiatives.

In summary, the status report finds a considerable decline in extreme poverty, improvement in access to energy, increased industrial activities, reduction in maternal mortality, improvement in undernourishment, food insecurity, wash and housing, and climate action.

There are many areas identified by the report that need urgent collective attention such as education, children out of school, the proportion of youth not in education, employment and training, provision of decent work environment, implementation of climatic adaptation etc.

Since 2015, the Government of Pakistan has not published a consolidated report that presents the country’s progress on SDGs indicators viz-a-viz their baseline values. The report captures the existing data availability gap and compares the baseline 2014-2015 with values of the most recent available data on 133 SDG indicators.

The report says that Pakistan’s progress on SDG-1 — poverty reduction has been steady. Poverty has been on the decline between the period 2014-15 and 2018-19 with 9.3 million people lifted out of poverty away from the national poverty line. Similarly, Pakistan witnessed a significant decline in the proportion of the population affected by disasters.

In a drive towards zero hunger as espoused by SDG-2, undernourishment declined by 4.2pc from 20.2pc to 16pc from 2015 to 2019. Also, a moderate achievement was made through the reduction of stunting by 7pc and wasting by 4pc during 2013-18 among children under five years of age.

Improvements are seen in health outcomes for mothers by reducing anaemia among pregnant women by 16.5pc in seven years during 2011-18. There was a one per cent decrease in the agricultural area under productive and sustainable agriculture, from 39pc to 38pc, over four years during 2015-2019.

On good health and well-being under SDG-3, Pakistan has shown reasonable progress by improving most of the basic health indicators. The number of mothers dying during pregnancy and live births reduced by 32.6pc during 2007-2019. Births attended by skilled health personnel increased by 10pc in five years during 2013-18. National vaccination coverage improved by 11.5pc in five years between 2013 and 2018.

Concerning education achievements (SDG-4), the country’s progress has been dismal. The primary completion rate has stagnated at 67pc in five years during 2015-20. Similarly, the gender gap (SDG-5) of 9pc between the primary completion rate of males and females has also persisted in this period. The lower secondary completion rate has marginally increased from 50pc to 59pc during 2015-20. The national literacy rate stagnated at 60pc in five years during 2015-20, which is alarming and worrying.

More girls were enrolled in schools improving the gender parity in net enrolment at primary, middle and Matric levels during 2015-19. Large deficiencies and disparities persist in the provision of basic services to schools across the country.

Access to clean water and sanitation has also shown improvements at the national and provincial levels over time under SDG-6. Improved source of drinking water is available to 94pc of the country’s population. Access to drinking water in Balochistan has increased by 17pc in 5 years during 2015-20. The population having access to unshared toilets and handwashing facilities is 68pc and 54pc respectively, as per Pakistan Social and Living Standards Measurement Survey (PSLM) 2019-20.

Comment by Riaz Haq on April 26, 2022 at 6:53pm

Modest progress on SDGs
Khaleeq Kiani

https://www.dawn.com/news/1686708


Pakistan’s first Sustainable Develop­ment Goals (SDGs) Status Report (2021) is out and the country’s overall progress on SDGs is modest.


On SDG-7, Pakistan’s commitment to the environment is shown by an increase in the share of renewable energy by more than four times between 2015 to 2019. The reliance on clean fuel (cooking) increased to 47pc in the period during 2018-19, from 41.3pc in 2014-15 at the national level. An increase of 3pc was recorded in 2019- 20 with 96pc of the population having access to electricity as compared to 93pc in 2014-15.

On SDG-8 ensuring decent work and economic growth, the economy experienced a slowdown with an annual growth rate of real GDP per capita declining to -3.36pc in the fiscal year 2019-20 from 2.04pc in 2014-15. Similarly, almost one-third of the total youth (30pc) in the age group (15-24 years) was not obtaining education, employment or training at the national level over the four year period of 2015-19 (SDGs indicator 8.6.1). Within the country, the highest instance of this category of youth was in Khyber Pakhtunkhwa, 38pc. The children aged 10-14 years engaged in work slightly reduced by over 2pc to 6.47pc from 8.64pc during 2015-19, at the national level.

Some progress was made on the SDG-9: industry, innovation and infrastructure targets. With the availability of new data from PSLM the baseline value is established with 88pc of the rural population living within two kilometres of an all-season road. The proportion of small-scale industries in total industry value added increased to 10.50pc in 2019-20 from 8.40pc in 2014-15, despite the overall negative effects of Covid-19 in 2019-20. The proportion of the mobile phone-owning population increased by 1pc in two years, from 45pc to 46pc between 2018-20.

A slight dent was made by the reduction of income inequality by 2pc in 2016-2019 for SDG-10. A small decline of 7pc in the proportion of the urban population living in slums, informal settlements or inadequate housing also occurred during 2014-2018 from 45pc to 38pc for SDG-11. Pakistan remains committed to addressing the problem of hazardous waste and to compliance with the Basel Convention as required under SDG-12 concerning sustainable consumption and production. Regarding SDG-13 on climate action, greenhouse gas emissions were 375.03 million tonnes in 2016, a 2.5pc increase from 2015.

Relating to the SDG-14: Life below Water, Pakistan has maintained the proportion of fish stocks at 30pc within biologically sustainable levels for the five years between 2015-20. Despite the growing population and rapid urbanisation pressures, Pakistan’s forest area as a proportion of total land remained unchanged at around 5pc in five years between 2015-2020 which is one of the targets of SDG-15: Life on Land.

On SDG-16: Peace, Justice and Strong Institutions; in terms of counting the uncounted, birth registration of children under 5 years showed an improvement by 8.2pc in five years between 2013-18. Under SDG-17 developing partnerships for achieving SDGs showed significant improvement in its journey towards digital transformation as the fixed internet broadband subscriptions per 100 inhabitants increased by 20pc in three years during 2017-20.

Comment by Riaz Haq on April 28, 2022 at 4:27pm

SDG Rankings Report 2021:


https://dashboards.sdgindex.org/rankings

Central African Republic 38.27 165

Nigeria 48.93 160

Haiti 51.35 150

Uganda 53.15 140

Rwanda 57.58 130

Pakistan score 57.72 rank 129

India 60.07 120

Bangladesh 63.45 109

Nepal 66.52 96

Sri Lanka 68.10 87

Bhutan 69.98 75

China 62.07 57

Russia 73.75 46

US 76.01 32

UK 79.97 17

Finland 85.90 1

Comment by Riaz Haq on May 12, 2022 at 12:52pm

Sindh to Finally Get #Rescue 1122 After Almost Two Decades. #PPP gov't in #Sindh has procured 288 new #ambulances and a loan of $70 million from the #WorldBank to launch the service. #Punjab launched it in 2004 in #Musharraf era. #Pakistan #emergency https://propakistani.pk/2022/05/10/sindh-to-finally-get-rescue-1122...

After noticing its effectiveness in Punjab, the Sindh government has decided to launch the Rescue 1122 emergency response service. The Punjab government launched this service in 2004, giving it an 18-year-headstart over Sindh.

According to a media report, the government has procured 288 new ambulances and a loan of $70 million from the World Bank to launch the service.

Sources say that authorities will deliver new ambulances to the health department soon. They added that Provincial Disaster Management Authority (PDMA) will begin work on the mobilization of Rescue 1122 next week.

Sources further stated that the ambulance service will work under Aman Foundation, while the fire brigade will operate under the Local Government and Community Development (LG&CD) department of Sindh.

The government will set up Rescue 1122’s regional offices in all divisional headquarters and will continue to use PDMA’s machinery and staff to diffuse emergency situations.


Rescue 1122 will have five offices in Karachi. Also, the Sindh government will likely integrate the service with 10,000 cameras at 2,000 locations across the mega-city as a part of its latest Safe City project.

Comment by Riaz Haq on May 19, 2022 at 6:57am

‘Pakistan SDGs Status Report 2021’ presents Pakistan’s progress on the SDGs using national and provincial data. The first of its kind, the status report, published by the Federal SDGs Support Unit at the Ministry of Planning Development and Special Initiatives, Pakistan, highlights the country’s progress on SDG indicators vis-à-vis their 2014-2015 baseline values. The report presents data on 133 SDG indicators with their corresponding latest values. Overall, the report assesses Pakistan’s progress on the SDGs as “modest.”


http://sdg.iisd.org/commentary/guest-articles/measuring-progress-th...

https://www.sdgpakistan.pk/uploads/pub/Pak_SDGs_Status_Report_2021.pdf

Pakistan’s progress on SDG 1 (no poverty) is steady. Poverty consistently declined in the period from 2014-2015 until 2018-2019, with 9.3 million people lifted out of poverty, based on the national poverty line. Similarly, Pakistan witnessed a significant decline in the proportion of the population affected by disasters. In a drive towards zero hunger (SDG 2), undernourishment declined by 4.2% from 20.2% in 2015 to 16% in 2019.

Pakistan shows modest progress in the basic health indicators of SDG 3 (good health and well-being). The number of mothers dying during pregnancy and in child birth reduced by 32.6% from 2007 to 2019. Births attended by skilled health personnel increased by 10% in the five years from 2013 to 2018. National vaccination coverage improved by 11.5% in the period from 2013-2018.

The country’s progress on achieving quality education (SDG 4), however, is dismal. The primary school completion rate stagnated at 67% in the five years from 2015-2020. The national literacy rate remained at 60% in the same period.

On gender equality (SDG 5), Pakistan shows progress on several fronts. The proportion of women in managerial positions (SDG indicator 5.5.2) nearly doubled between 2015 (2.7%) and 2019 (4.53%). Physical violence reduced by 5.3% from 18% in 2012-2013 to 13.6% in 2017-2018 nationwide. Khyber Pakhtunkhwa and Balochistan, which had previously recorded the highest rates of physical violence against women (31%), saw numbers decline from 2013-2018 to 23.4% and 34.6%, respectively.

Access to clean water and sanitation (SDG 6) also shows improvements at the national and provincial levels. Improved sources of drinking water are available to 94% of the country’s population. Access to improved drinking water in Balochistan increased by 17% from 2015-2020.

Pakistan’s commitment to the environment is evidenced by an increase in the share of renewable energy (SDG 7) by more than four times between 2015 and 2019. Reliance on clean fuel for cooking nationwide increased to 47% in the period from 2018-2019, from the floor of 41.3% in 2014-2015.

Progress on SDG 8 (decent work and economic growth) indicators is slow. The economy experienced a slowdown, with an annual growth rate of real GDP per capita declining to -3.36% in the fiscal year 2019-2020, from 2.04% in 2014-2015. Some progress was made on the SDG 9 (industry, innovation and infrastructure) targets. The proportion of small-scale industries in total industry value added increased to 10.5% in 2019-2020, from 8.4% in 2014-2015, despite the overall negative effects of COVID-19 in 2019-2020.

A slight dent was made in the reduction of income inequality – a 2% drop from 2016-2019, contributing to SDG 10 (reduced inequalities). A decline of 7% in the proportion of the urban population living in slums, informal settlements or inadequate housing (SDG 11 on sustainable cities and communities) also occurred, from 45% in 2014 to 38% in 2018.

Comment by Riaz Haq on May 19, 2022 at 6:58am

‘Pakistan SDGs Status Report 2021’ presents Pakistan’s progress on the SDGs using national and provincial data. The first of its kind, the status report, published by the Federal SDGs Support Unit at the Ministry of Planning Development and Special Initiatives, Pakistan, highlights the country’s progress on SDG indicators vis-à-vis their 2014-2015 baseline values. The report presents data on 133 SDG indicators with their corresponding latest values. Overall, the report assesses Pakistan’s progress on the SDGs as “modest.”


http://sdg.iisd.org/commentary/guest-articles/measuring-progress-th...

https://www.sdgpakistan.pk/uploads/pub/Pak_SDGs_Status_Report_2021.pdf


Pakistan remains committed to addressing the problem of hazardous waste and achieving compliance with the Basel Convention as required under SDG 12 (responsible consumption and production). However, Pakistan’s contribution to SDG 13 (climate action) is minimal. The country has adopted and implemented national disaster risk reduction (DRR) strategies in line with the Sendai Framework on DRR, with the 2020 index score of 0.8, an improvement on 2018 when it was 0.4. However, greenhouse gas (GHG) emissions grew by 375.03 million tons in 2016, a 2.5% increase from 2015.

With respect to SDG 14 (life below water), Pakistan maintained the proportion of fish stocks within biologically sustainable levels at 30% between 2015 and 2020. Despite the growing population and rapid urbanization, Pakistan’s forest area as a proportion of total land – one of the targets of SDG 15 (life on land) – remained unchanged, at around 5% from 2015-2020.

Regarding SDG 16 (peace, justice and strong institutions), birth registration of children under five showed an improvement of 8.2% from 2013-2018. Pakistan is showing significant improvement on SDG 17 (partnerships for the Goals) on its journey towards digital transformation. Fixed internet broadband subscriptions per 100 inhabitants increased by 20% in the three years from 2017-2020.

Pakistan’s 2021 SDG status report visualizes the country’s progress through a nationally computed index by the SDGs Section and Federal SDGs Unit of the Ministry of Planning, Development and Special Initiatives. Pakistan’s SDG index was developed on the basis of national data sources collated from authentic and reliable sources.

Comment by Riaz Haq on May 22, 2022 at 5:09pm

Pakistan’s generational shift
By Dr Ayesha RazzaqueMay 22, 2022

https://www.thenews.com.pk/print/959718-pakistan-s-generational-shift

In this generation only 18.7 per cent of rural women are without an education, down from 75.5 per cent from their mothers’ generation. Nearly 50 per cent have an education ranging from a primary to secondary education, up from just 20 per cent in the previous generation. A stunning 22.9 per cent have a higher secondary or above education, up from an almost nothing 0.3 per cent in their previous generation.


---------------

Last year saw the publication of ‘Womansplaining – Navigating Activism, Politics and Modernity in Pakistan,’ a book edited by Federal Minister Sherry Rehman to which I was able to contribute a chapter. It connected education with women’s rights and argued that indigenous movements like the Aurat March should focus on education as a core part of their agenda.

Detractors of Pakistan’s women’s rights movement have been taking potshots at it by claiming that the issues it raises are not the issues of ‘real’ (read: rural) women. Put aside for a minute the fact that Pakistan’s rural population now accounts for 62 per cent, down from 72 per cent in 1980, and is on a steady decline. While the numbers may differ, and women’s power to negotiate may differ, rural and urban women share basic challenges and better education can yield similar opportunities and improvements in life circumstances.

Indigenous progressive and women’s rights movements have adopted the cause of education as an agenda item but should make it front and center, specifically K-12 education for girls in rural areas. New data further substantiates that connection with numbers. Education up to the higher secondary level, just the education that rural schools offer today, is the enabler that brings increased women’s labour force participation, delayed first marriage, lower rates of consanguinity, increased income, increased spousal income, and is a contributing factor to greater freedom of movement and communication – all positives.

Studies exploring the relationships between levels of education and life circumstances around the world are plentiful and capture the situation at a point and place in time. The Learning and Educational Achievements in Pakistan Schools (LEAPS) programme is qualitatively different because it already spans a period of almost two decades. The LEAPS programme has been tracking lower- and middle-income households in 120 randomly selected villages across three districts in rural Punjab since 2003. It has been revisiting them since then, most recently for the sixth time in 2018, roughly once every three years. That makes it one of the largest and longest panels of households in lower- and middle-income countries. This study is also unique as it looks at return on investment in education beyond an individual’s income and looks into the possible spillover into life circumstances and quality-of-life which is especially interesting for those interested in women empowerment and feminist movements.

In this latest round it surveyed 2006 women now aged 20-30. All these women were from the same 120 birth villages and have been tracked to their marital homes within or outside the village if they have married, migrated or moved for any other reason. Preliminary descriptive results of the long-running LEAPS study tell interesting stories. The headline finding of LEAPS investigators is that Pakistan is in the midst of a ‘generational shift’ where, for the first time in its education history, we have a ‘critical mass of moderately educated women’.



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Existing plans, at least in the domain of education, remain unguided by some of the very excellent evidence that is available. Meanwhile, the Planning Commission is organizing a ‘Turnaround Pakistan’ conference perhaps as early as May 28 to conduct national consultations. Whether a hurriedly thrown together conference can change the way business is done remains to be seen.

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