Issue: Reproductive health/community health
Started in 1994, the Pakistan Lady Health Workers programme (LHWP) is a major public sector initiative to provide reproductive healthcare to women in Pakistan. It employs almost 100,000 women as community health workers who address women’s reproductive healthcare needs by providing information, basic services and access to further care. The programme has had substantial positive impacts on family planning, antenatal care, neo-natal check-ups and immunisation rates in the communities it serves (42-44).
It has also had significant effects on the lives of the health workers. They receive training, are knowledgeable and gain respect, earn an income, and have become more visible and mobile within their communities. An evaluation has shown that the women are more empowered: they have greater say in intra-household decision-making, including family planning and health-seeking behaviour.
Starting in 2002, LHWs and their supporters have made headlines by organizing protests, demonstrations, and sit-ins. According to Ayesha Khan, “These protests have coalesced into the beginning of a movement, based around issues like delayed and insufficient salaries, regularization of service as government employees, reimbursement of travel expenses, perceived exploitation, and cases of harassment.” The LHWs have scored major victories in their advocacy efforts. After campaigning for three years, the prime minister approved the regularization of their service in early 2013 (43).