Advocacy for Post Abortion Care Services in Pakistan

A multiphase approach was adopted. In the first phase, Pathfinder conducted provincial workshops with all District Health Managers from Sindh and Punjab provinces and other high-level stakeholders on unsafe abortion and the need for PAC to create a critical mass of advocates and supporters for acceptability and planned implementation. In the second phase Pathfinder facilitated the district health managers to develop District Action Plans for PAC at public sector facilities. The third phase focused on real implementation of two of the district plans, one in each of the provinces as a pilot to inform implementation of the other district plans.

113 District Action Plans for PAC were developed during dissemination workshops held in 2010-11. Pakistan Nursing Council and Lady Health Workers (LHW) Programs of Sindh and Punjab were supported to adapt Pathfinder developed PAC modules for training of health care providers and 90,000 LHWs. Pathfinder trained 90 health care providers, including lady doctor, lady health visitors and family welfare workers, at First Level Care Facilities (FLCF) on comprehensive PAC services and 1,000 LHW on PAC counseling in 2 project districts. The results from base-line and end line surveys held a year apart in project districts showed increase in correct knowledge about the minimum advised interval for pregnancy after miscarriage from 23% to 44%; and an increase in women who sought PAC services from 70% to 95%. With more awareness to prevention of unwanted pregnancies, utilization of LHWs as a source of FP services increased from 42% to 68%