title: Strengthening primary health care and family planning services in Pakistan: some critical issues.
abstract: OBJECTIVE
  The Lady Health Workers (LHWs) under the Ministry of Health and the Village-based Family Planning Workers (VBFPWs) under the Ministry of Population Welfare are mandated to bring services to the people and are often the only health care resource available particularly for women. This study was conducted to understand the problems faced by the LHWs and VBFPWs in their routine work.
  
  
  METHODS
  A situational analysis followed by focus group discussions conducted with a cross-section of LHWs and VBFPWs in four districts, one from each province.
  
  
  RESULTS
  Findings reveal that LHWs and VBFPWs are faced with a number of problems that severely limit their effectiveness. Findings suggest that the population/health worker ratios vary considerably from one district to another. Moreover, these two categories of workers differ considerably in terms of level of education, training and skills. There is lack of well-designed client record cards, proper training and backup support, including emergency obstetric care, to cover the range of essential services demanded by the consumers and a lack of information feedback.
  
  
  CONCLUSIONS
  These issues need to be recognized and addressed to further strengthen primary health care and family planning services in the country. The paper presents some of the important findings of the survey and focus group discussions conducted by the Community Health Sciences Department of the Aga Khan University as part of a broader study funded by the United Nations Population Fund. These findings have serious implications for future primary health care and family planning policies in Pakistan.
authors.affiliation: Department of Community Health Sciences, Aga Khan University, Karachi.
authors.forename: A
authors.initials: A
authors.lastname: Islam
authors.forename: F A
authors.initials: FA
authors.lastname: Malik
authors.forename: S
authors.initials: S
authors.lastname: Basaria
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D005193:Family Planning Services / Q000458:organization & administration*; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D009313:National Health Programs; D010154:Pakistan; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation