Pakistan
Pakistan has the 6th largest population in the world with the second largest Muslim population. The country has experienced political volatility for decades. However, of greater concern is the backdrop of violence and insecurity that prevails. The rise in terrorist acts and increasing Taliban control in the northern parts of the country has resulted in the largest internal displacement of people ever. Pakistan has also had to contend with enormous natural disasters, the greatest of which was the 2005 earthquake in the Northern areas and Kashmir, in which more than 82,000 people were killed. In 2010 Pakistan saw a devastating flood. Approximately one-fifth of Pakistan's total land area was underwater and about 20 million people were affected, mostly by destruction of property, livelihood and infrastructure, with a death toll of close to 2,000.
Pakistan has one of largest gender disparities in the world. The 2009 Global Gender Gap report ranked Pakistan as number 132 of 134 countries in their ability to divide resources equitably between genders. This contributes to the low bargaining power and literacy rates among females. Even if women have certain rights, they often cannot enforce them. Females also face a high degree of violence both within and outside the home and a judicial system that often does not deliver swift and accurate justice.
Reproductive Health
With a birthrate of 4.1, Pakistan’s already large population is growing rapidly. The majority of the population is of reproductive age, or soon will be, forecasting a future of increased population growth.
On the positive side, Pakistan’s Population Policy has promoted reproductive health since 1998. The Ministry of Health pioneered the Lady Health Workers program, which delivers primary health services, including family planning, to the doorsteps of women in both urban and rural settings. Pakistan is also a signatory to international women’s rights charters. In 2011 the Ministries of Health and Population were devolved to Provincial control. The results of this restructuring remain to be seen.
Despite positive policies, reproductive health conditions remain abysmally poor. Equity remains one of the greatest concerns as the marginalized populations, the poorest of the poor and rural women, continue to have little access to reproductive health services and information. Maternal mortality, a high unmet need for family planning and youth reproductive health issues remain critical concerns for Pakistan.
United Action
In this scenario it is essential that leadership development takes place across sectors—from within communities and districts, to local and national level organizations, right up to the policy makers and national leaders. It is also critical that this leadership be united in its sense of collective responsibility and action.
The LDM program in Pakistan built a strong network of more than 170 Leadership Fellows who, through their collective identity, are strongly linked and networked for collective action. Program activities to promote this networking included provincial chapter meetings, an active national list serve, national meetings of Leadership Fellows, and Fellows working together on critical thematic issues.
In 2007, Leadership Fellows collaborated with members of the Pakistan Reproductive Health Network (PRHN) to review and respond to the Ministry of Youth Affairs’ draft for a youth policy. While members of both networks advocated for greater inclusion of reproductive health strategies for youth, other Leadership Fellows held focus groups with youth and communicated findings to the Ministry. Leadership Fellows in organizations such as the World Population Foundation (WPF), and United Nations Population Fund (UNFPA), continued advocating with the youth ministry, and today the youth policy of Pakistan includes reproductive health, in the form of life skills, as one of the responses for youth in Pakistan.
Fellows with an interest in Islam and reproductive health collaborated to support to the development of a manual on Islam and reproductive health, aimed at the concerns of health service providers to clarify what religion has to say regarding family planning, abortion, and other aspects of reproductive health. Many of these Fellows were provided the opportunity to participate in study tours to Egypt and Malaysia to increase their understanding of the subject. The manual developed and piloted by the Institute of Public Health where two leadership fellows are based, is now ready for further dissemination.
Fellows have also played an active role in the disasters that Pakistan has faced. Fellows came together across Provinces to provide support to displaced persons, both refugees as well as victims of the earthquake and flood. The support ranged from fundraising, running mobile camps, providing food and medicines, as well as responding to specific reproductive health and hygiene needs.
Sustainability
To build sustainable resources for leadership development in Pakistan; the LDM program partnered with two institutions with large scale outreach (The Ministry of Population Welfare and The Pakistan Reproductive Health Network (PRHN)) to develop a team of leadership development trainers. This team committed to rolling out trainings within their institutions to strengthen leadership concepts and skills for reproductive health. In 2009 and 2010, more than 16 trainings were conducted by the new trainers for a broad range of constituents including government district health care workers, youth, NGO leaders, and community leaders. These secondary trainings were supported with funds leveraged outside the LDM program.
LDM also worked closely with other in-country leadership programs to promote mutual exchange of learning and support. This took place through The Leadership Learning Group (LLG), a forum initiated by LDM in partnership with the Packard Foundation, in which representatives from leadership programs continue to meet quarterly to share program updates and discuss issues of common interest.
In response to an overwhelming demand for the LDM network and program to continue, a call for expression of interest was also requested from select organizations that would be interested to take over the management of the LDM program. In 2011, a partnership between ProServe and Management Development Institute (MDi) was selected under the leadership of Yasmin Zaidi to continue with the LDM Program in Pakistan.
Sources:
- The World Bank (2009)
- Population Reference Bureau (2009)