Pakistan Reproductive Health and Family Planning Survey 2000-01

[sibgakhan]

Pakistan Reproductive Health and Family Planning Survey 2000-01

plz visit:

http://www.mopw.gov.pk/nips/ch1.htm

[Muskan Ghuman]

Salam,

Thanx Sibga for the link...


Regards,
Muskan

[free thinker]

Question-1 When was the Population Welfare Programme started in Pakistan?

Answer 1953, the Family Planning Association of Pakistan (Non-Government Organization) In 1953, the Family Planning Association of Pakistan (Non-Government Organization) initiated few clinics provide family planning services.

Question-2 When was the Population Welfare Programme started in the public sector?

Answer: During the second plan period (1960-65) the Population Welfare Programme was started by the Ministry of Health but the programme could not show progress. Hence an independent Family Planning Council was created in 1965 to run the programme independently.

Question-3 What were the Population Crude Birth Rate and Death Rate when programme was launched on large scale in 1965?

Answer: The annual crude birth rate was around 45 per thousand and death rate was around about 18 per thousand and net growth rate was 2.7% per annum. Annual crude birth rate was around 45 per thousand and death rate was around about 18 per thousand and net growth rate was 2.7% per annum.

Question-4 The Pakistan Population Welfare Program is one of the oldest in the world but has not yielded progress when compared to other countries like Bangladesh and Indonesia.

Answer: During the past decade though the programme enjoyed full political support and commitment, yet it lacked backing from the community. The community based approach could not be fully materialized due to religious, social and cultural norms of the society. Low literacy rate particularly among women folk, happens to be another major impediment in the way of programme success. The past decade though the programme enjoyed full political support and commitment, yet it lacked backing from the community. The community based approach could not be fully materialized due to religious, social and cultural norms of the society. Low literacy rate particularly among women folk, happens to be another major impediment in the way of programme success.

Question-5 What are the Ninth Five Year Plan objectives of the current Population Welfare Programme?

Answer :The current Population Welfare Programme 1998-2003 aims at reducing Growth Rate from 2.4% to 1.9%, Total Fertility Rate from 5.2% to 4.2% and to increase Contraceptive Prevalence Rate from 24.4% to 40.3%.

Question-6 What is the awareness level of contraceptives and unmet need of Pakistan Population Welfare Programme?

Answer: The awareness of any contraceptive method is about 94% and unmet needs are about 38%, according to Pakistan Fertility and Family Planning Survey (PFFPS) 1996-97.

Question-7 The Population Welfare Programme in Pakistan has covered span of more than 30 years but has not achieved the desired level of CPR. How much more period is required to reach the replacement level of fertility?

Answer: Keeping in view the prevailing trend low literacy level and Socio-cultural and religious norms, the Population Welfare Programme would take at least 2 decades to reach the replacement level of fertility.

Question-8 What are the programme's new strategy for physical programme coverage with special attention to rural areas?

Answer: Some of the major strategies being pursued by the programme with special attention to rural areas are:
Expansion of family planning services in the rural areas through village based family planning workers;
Mobile service units for covering the far flung villages having no access to family planning services;
Expansion in service delivery through family welfare centres and reproductive health service centres in the public and private sectors for provision of contraceptive surgery;
Effective and increased involvement of all health outlets in the public and private sectors by providing training/refresher courses, basic equipment, IEC material, sign boards and regular supply of contraceptives to paramedics;
Introduction of family planning and MCH services in Federally Administered Tribal Areas (FATA) adjoining the NWFP through their health infrastructure;
Reinforcement of family planning and Mother and Child Health services in the Azad State of Jammu and Kashmir (AJK) and the Northern Areas;
Encouragement and support to non-governmental organizations (NGOs) for undertaking innovative and cost-effective service delivery to cover specific urban and semi-urban areas like slums, katchi-abadis, labour colonies, etc.;
Involvement of registered medical practitioners, hakeems, homeopaths, traditional birth attendants, private clinics and hospitals for dispensation of family planning services through their infrastructure by way of training, orientation, contraceptive supplies, information, education and communication (IEC) material and signboards;
Acceleration of training and orientation programmes for programme personnel, employees of other departments who are providing health services at different outlets and community based groups;
Intensification of motivational campaign through television, radio, films, print material and press media with the involvement of the private sector expertise. Special emphasis is being placed on participatory and inter-personal communication. Attractive publicity boards, hoardings, neon-signs, bus panels with appropriate messages are being installed at airports, railway stations, hospitals, bus stands and other prominent places. All service outlets of the programme in public and private sectors are being made visible by fixing direction boards. Seminars, conferences, group meetings, walks, meet-the-press sessions are being organized at the federal, provincial and grass root levels. Population education component is being filtered through formal and non-formal school system with the involvement of the Ministry of Education. Similarly, presentation on demographic facts and figures have been initiated for college & university students in the country as well as at all the national institutions.


Question-9 What is the progress of the ICPD plan of action to which Pakistan is signatory?

Answer: The new direction is the shift from the focus on fertility towards a comprehensive approach integrating family planning with reproductive health and also addressing wider range of concerns, especially economic status, education and gender equity and equality. One of the major achievements of the Cairo Conference has been the recognition of the need to empower women, both as a highly important end in itself and as a key to improving the quality of life for everyone. It also emphasizes that men have a key role to play in bringing about gender equity and equality, in fostering women's full participation in development and in improving women's reproductive health.

Goals are set out in three related areas: expanded access to education, particularly for girls; reduced mortality rates; and increased access to quality reproductive health services, including family planning. The International Conference on Population and Development (ICPD) Programme of Action urges all countries to make reproductive health care and family planning accessible through primary health care system to all individuals of appropriate ages no later than 2015.

Question-10 What types of contraceptives method are more popular in Pakistan?
Answer: As per Pakistan Fertility and Family Planning Survey (PFFPS) in 1996-97 female sterilization is more popular clinical method followed by condom and IUD.

Question-11 When was last population census held in Pakistan?
Answer :The last population census was held in March, 1998 after a span of 17 years. The population at that time was 130.579 million of which 32.5% people were living in urban areas and the sex ratio was 108.1%. The average household size stood at 6.6.

Question-12 What steps have been taken to introduce Subject of population at college and university levels?
Answer: At the school level lessons have been introduced in the curriculum to project the consequences of high population growth rate. At the university level population subjects are being taught in length wherein benefits of small family are being highlighted.

Question-13 What is the role of media in propagating small family norm?
Answer: The electronic & print media is playing important role for communication and propagation of advantages and importance of small family norms. According to Pakistan Fertility and Family Planning Survey 94% married women of reproductive age (15-49 years) have the knowledge of at least one contraceptive method.

Question-14 What is the impact of population on environment?
Answer: Population increase has not only brought an environmental degradation, it has also ushered in shortage of safe drinking water, diminishing forest resources, climate change due to depletion of ozone layer. Other forms of environmental pollution are marine pollution, noise pollution, depletion of land resources etc. Besides these, environmental pollution has also damaged the beauty and serenity of nature. Almost half of the world population is urbanized because of which traffic problems have multiplied, land erosion, and solid waste disposal are the major civic problems these days. Other major salient features are: -
During the past 25 years, cultivable land has increased by 27 percent compared to 98 percent increase in the population, resulting in reduced individual land holdings in Pakistan have reduced in area.
The urban population will double in the next 20 years at its current 3.5% growth rate.&nb?;
Each year, deforestation occurs at the rate of 2.5 percent.
Since only 50% of our population has sewerage facility, the other 50% churns out wastes damaging the environment and causing a lot of diseases.
The increase in the number of motor vehicles, each year, is 4.5 percent. Almost 70% of our vehicles have outlived their life span and emit unburnt dangerous gases in atmosphere. In fact, the total number of vehicles in Pakistan emits more noxious fumes in the air as compared to all vehicles in the US.
The industrial and residential areas have merged causing health hazards for the population.
Excessive use of Polyethylene bags is another serious environmental hazard.


Question-15 What is the status of women in Pakistan?
Answer: Twenty three per cent of our children do not attend schools at all;&nb?;&nb?; and majority of them is girls.
There are 108 men compared to 100 women in Pakistan.
Currently, the number of children not attending schools range between 18 to 20 million. Most of these children are girls.
Literacy rate among females is 35 per cent.
There are 30% less academic institutions for girls as compared to boys.
Only 24% of our females have access to health facilities.
The Maternal Mortality Ratio (MMR) in developing countries is 35 per thousand, which is very high compared to the developed countries.
Almost 28,000 women die annually during and after childbirth in Pakistan.
Only 29% of women get antenatal care in Pakistan.
Total Fertility Rate (TFR) in Pakistan is 4.7.
The percentage of women in the labour force is twenty four.
Although more than half of agricultural rural labour consists of women, their contribution is taken as "invisible and negligible,"
In times of war, famine, and other national emergencies, women suffer more than men.
Thirty nine per cent of women in Pakistan do not want to conceive after three children. Limited access (60% coverage of the programme) to reproductive health facilities make them victim of repeated pregnancies.


Question-16 What is the role of NGOs in the Population Welfare Programme of Pakistan?

Answer :Non-Government Organizations (NGOs) started working in Pakistan for education and social welfare soon after independence of Pakistan in 1947. A NGO pioneered the population welfare programme in Pakistan in the early 1950s. However, it was in 1980s that the NGOs took upon themselves to work in an organized manner. The NGOs sought cooperation from the Government and various donors for their programmes of social development.
The Government of Pakistan seeks active cooperation with NGOs in the areas of family planning and reproductive health through the Ministry of Population Welfare, and the National Trust for Population Welfare (NATPOW). One example of cooperation between NGOs and the Government is sharing the responsibility of meeting national population sector targets. NGOs use initiative, creativity, and take innovative steps because of their size and limited commitment, they can create "models" for replication. NGOs have contributed significantly in promoting the cause of the population program in the country. The contribution of NGOs to community development carries special significance.
Some 264 NGOs with 479 outlets, operating through out the country, have been registered with National Trust for Population Welfare (NATPOW).


Question-17 What is the role of Private Sector in the Population Welfare Programme of Pakistan?
Answer :The Private Sector is involved in the Programme through Social Marketing (SM) activities with the aim of making Family Planning (FP) information and services available more widely at reduced rates. Currently SM. Projects are funded by KFW (Development Bank of Germany) and Department for International Development (DFID) U.K. The Projects are executed outside Public Sector Development Programme (PSDP) by Social Marketing Pakistan, by adopting independent logo of "Green Star" The other Project is executed by Key Social Marketing by using an independent logo of "key" The range of activities of SM includes advertisement/Promotional campaign, training of doctors, paramedic & chemists as well as dispensation of Contraceptives through a commercial distribution network of over 58000 distribution/service points.

Question-18 What steps have been taken regarding awareness of Human Immuno-deficiency Virus (HIV) / Acquired Immune Deficiency Syndrome (AIDS), Sexually Transmitted Diseases (STDS), Reproductive Tract Infections (RTIs) ?
Answer: A comprehensive awareness strategy has been developed and implemented through mass media, hot-line telephone message, NGOs support district networking and imparting AIDS education to the key influential persons. As a result of awareness raising campaign, the knowledge about AIDS, which stood at almost zero in 1991-92, has now leaped to 96 per cent.
Broad policies for the essential screening of blood before transfusion have been adopted for control of transmission of diseases like AIDS, hepatitis B and C, malaria, and syphilis. These steps include preparation of legislation bill for mandatory screening of blood both in private and public sector, development of national guidelines and standard operating procedures on blood transfusion, and imparting training on different issues of safe blood transfusion.


Question-19 How high population growth rate has affected sustainable development in Pakistan?
Answer :The population profile in Pakistan reveals that in order to achieve sustainable development, empowerment of women, effective use of resources, efficient family planning, and popularization of small family norm are imperative.
Each year, 3.02 million persons add to the population of Pakistan.
With current growth rate of 2.2 percent, Pakistan's population will double in next 32 years.
High Total Fertility Rate (4.7) and lower literacy rate (35%) among females are major obstacles to sustainable development.
Fifty percent of Pakistan's population is forced to live in one-room houses.
Over one third of women, with three children in Pakistan, do not look forward to another pregnancy. Nevertheless, they get pregnant because they do not have access to reproductive health facilities.
Low per capita income (US$ 443).
Forests in Pakistan occupy only 4% of the total area.
Pakistan is an agricultural country but per capita arable land is shrinking due to higher pressure on land. In 1951-52, per capita agricultural holding was 1.1 acres due to higher pressure on land which reduced to 0.5 acres in 1977.
Slowdown in population growth rate, wider coverage of reproductive health services, education of women, and effective steps to eradicate poverty are prerequisites for sustainable development in Pakistan.


Question-20 What are the beliefs and practices about breastfeeding in Pakistani Women.
Answer According to Pakistan Fertility and Family Planning Survey (PFFPS) 1996-97, the majority of ever married women in Pakistan (57%), think that during the period of breastfeeding, the chance of becoming pregnant decreases while only 8% think opposite to it. The breastfeeding practice is quite encouraging as the&nb?; Pakistan Fertility and Family Planning Survey (PFFPS) 1996-97 result show that only 4% of women never breastfeed their children, while rest (96%) start breastfeeding in 24 hours and above since birth of baby.

Question-21 What services are offered at Family Welfare Centres?
Answer While the main function of Family Welfare Centres is provision of Family Planning/Reproductive Health Services, some other services are offered as well. These are;
Maternal and child health services including antenatal and post natal care and;
Treatment of minor ailment like cold, cough, influenza, minor gastrointestinal upset etc.


Question-22 What Family Planning/Reproductive Health services are offered?
Answer All non-surgical contraceptives available in the Government Programme are available at the Family Welfare Centre. These include Condoms, Oral Pills, Injections and the Intra Uterine Contraceptive Device.&nb?; The programme offers contraceptive surgery as well in which there is permanent sterilization and a temporary surgical procedure called Norplant. In permanent sterilization there are male and female procedures viz vasectomy and Bilateral Tubal Ligation. For these services the Family Welfare Centre refer cases to the Reproductive Health Services Centres where a doctor trained in surgical procedures offers these services.

The Family Welfare Centre staff is trained in counseling techniques and they help clients make a free and informed choice regarding the choice of the contraceptive they wish to use. In addition, Family Welfare Centres offer Reproductive Health services as well, like counseling and management of Sexually Transmitted Infections, issues pertaining to menarche, menopause etc.


Question-23 Do the Family Welfare Centres have medicines?
Answer Yes, there are a few medicines for minor and simple ailments only.

Question-24 Is Contraceptive Surgery undertaken at Family Welfare Centre?
Answer No, surgery is not performed at Family Welfare Centres.&nb?; However, there is a very strong referral system for referring Contraceptive Surgery clients to Reproductive Health services Centres, located in hospitals where both male and female procedure is performed.

Question-25 Do Family Welfare Centres provide treatment and management of Acquired Immuno Deficiency Syndrome (AIDS)?
Answer

Question-26 What contraceptives are available at Family Welfare Centre?
Answer Please refer to Question No.2 of FAQs about Programme.

Question-27 Do these contraceptives have any side effects?
Answer Yes, all contraceptives have side effects. However, these are usually not serious. Our staff is fully trained and competent in dealing with these side effects. They also have all the necessary medicines to treat or deal with these side effects and do everything to make the client comfortable and ensure a good quality of life.

Question-28 Can anything be done for a woman who is a few days overdue?
Answer No, by the time a period is missed, it is too late to institute any form of contraception and we advise the woman to go with the pregnancy.

Question-29 Are there any post coital contraceptives?
Answer Yes, heavy doses of the Oral Pills act as post coital or emergency contraceptives. 2 pills within 72 hours and 2 pills 12 hours later usually prevent a pregnancy. Tablet Postinor (not available in the Government's Programme) can also be used within 72 hours for the same purpose.

Insertion of an Intra Uterine Contraceptive Device within 5 days of an unprotected intercourse also acts as an emergency contraceptive. However, it must be noted that the 5-day time limit must not be exceeded.

Question-30 What is an Intra Uterine Contraceptive Device?
Answer An Intra Uterine Contraceptive Device is a small device, which is inserted by a trained Doctor, Nurse or Paramedic into the uterus of a woman to prevent a pregnancy. There are different kinds of Intra Uterine Contraceptive Devices available and the one in the programme is called Copper-T 380-A and it is effective for 10 years.

Question-31 Are there any services available for men?
Answer The services available are:
Family Planning Information & Counselling;
Provision of condoms;
Referral for Vasectomy;
Counselling and referral for management of reproductive health related problems of adolescents;
Prevention and management of Reproductive Tract Infections/ Sexually Transmitted Diseases and Human Immuno Deficiency Virus(HIV)/Acquired Immuno Deficiency Syndrome (AIDS);
Counselling and referral for management of infertility;
In the rural area, a cadre of community based worker called the Male Mobilizers is present. These Workers are in place to address male issues and to sensitize the male members of the community to Family Planning/Reproductive Health issues.