Investing in the health of future populations through a youth-focused programme.

OBJECTIVE: This paper describes different approaches and results of the holistic integrated model of Rahnuma Family Planning Association of Pakistan (R-FPAP). The model seeks to provide sexual and reproductive health (SRH) services to adolescents and young people based on their rights as opposed to simply on their needs. METHODS: Combined methodical efforts were performed by the organization for the provision of SRH services to adolescents and young people including youth-friendly services at clinics, outreach interventions, youth empowerment, and advocating for youth sexual and reproductive health rights (SRHR). Service delivery statistics available in the organization from 2007-2011 were utilized for estimating the results of these efforts. RESULTS: An increase of 157.5% in the total number of SRH services received by adolescent and young clients aged 10-24 years was observed during a span of five years. About 310.8% more human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and reproductive tract infection (RTI)/sexually transmitted infection (STI)-related services were received by the clients of the same age group. The integration of different methodical efforts helped in reaching one of every 100 adolescents and young people in Pakistan aged 10-24 years during 2011, which was an increase from four of every 1,000 adolescents and young people of the same age bracket served in year 2007. CONCLUSION: The unmet need of the SRH rights of adolescents and youth, especially underserved young clients, can be addressed comprehensively through rights-based integrated approaches by providing clinical services, involving them through outreach initiatives, advocating for their SRHR, and facilitating them by establishing conducive environments for the promulgation of supportive laws and policies.

Birth preparedness and the role of the private sector: a community survey.

OBJECTIVES: To assess the birth preparedness and utilisation of services in an urban union council where only the private sector provided any healthcare. METHODS: Descriptive study design was adopted which had two components: 1) a cross-sectional community survey on birth preparedness and utilisation of services and 2) a provider survey with census of all eligible healthcare facilities. Door to door survey was conducted by visiting every tenth household. All allopathic healthcare facilities in the selected union council were visited for collecting information about the available services and amenities. RESULTS: Knowledge regarding danger signs during pregnancy and delivery was low. Sixty four percent women received some antenatal care while 45% deliveries were conducted at home. Among those having to seek emergency care during pregnancy, delivery or postpartum, 39% approached a health facility. Lack of preparation in terms of transport was reported in 83% cases. Two of the health facilities had a skilled birth attendant while four provided antenatal care services. Health education was provided by four; deliveries were conducted at one; while family planning services were provided by five facilities. CONCLUSION: Women and their families are not sensitised to prepare for safe deliveries. There is a need to improve the essential maternal and newborn health care services at the health facilities. The role of private health sector towards improving MNH; especially birth preparedness in the country needs to be explored at a larger level.