Seminar on Women's Health Issues

"In Pakistan, three women die and 40 are permanently disabled during childbirth every hour," said Dr. Talat Rizvi, consultant to UNICEF, at the seminar "Adapting the Training Modules (ATM) for Pakistan", organised by the Department of Community Health Sciences (CHS) in May 2003.

Pakistan, as well as much of the region, faces numerous challenges in the field of community health. The critical ones include how to make health service providers more sensitive to the health needs of women, and making women more aware of their rights and responsibilities to seek appropriate health care. To address these issues, UNDP, World Bank and WHO jointly developed two training manuals. The first manual, "Health Workers for Change", suggests ways of making health care providers more sensitive to the health needs of women, and the second, "Towards the Healthy Women's Counselling Guide", assists women in effectively communicating their health needs. These training manuals have already been successfully utilised in both African and Latin American countries.

The seminar aimed at bridging the gap between health providers and the community, by disseminating the findings of a study jointly undertaken by CHS; Aga Khan Health Service, Pakistan; Health and Nutrition Development Society; and the Marie Stopes Society. The study sought to adapt the two training manuals to the Pakistani context, providing tools to facilitate a process of empowerment for women to address their own health needs.

Participants of the Seminar on "Adapting the Training Modules for Pakistan", organised by the Department of Community Health Sciences in May 2003.

Dr. Farhat Abbas, Acting Dean, Medical College, AKU, spoke on the poor social status of women in Pakistan, citing the latest UNDP report, where Pakistan ranked 135th out of the 174 countries in the gender-related Development Index. He said that gender disparity prevented women from seeking adequate health care for themselves. This, he added, led to a comparatively poorer health status of women in the country. Members of those communities where the manual was tested also shared their experiences, as did the partner NGOs.  Dr. Masood Kadir, Acting Chair of CHS, described the study as a prime example of how such private-public partnerships could strengthen health service delivery systems in Pakistan. Dr. Fauziah Rabbani, Head of Health Systems Division, CHS, said, "This is a first step towards initiating a process of empowering women to address their health needs.”

The investigation in Pakistan provided many insights on gender inequalities and their effect on women's health. Women were perceived as caretakers of the household while men were the breadwinners. Women were eager to learn more about reproductive health and nutrition. However, their prime, and usually inadequate, source of information remained their husbands and mothers-in-law. Women were also generally dissatisfied with health care services due to their poor quality, high cost and the often non-caring attitude of health care providers. On the other hand, health providers identified lack of adequate management, gender sensitisation training, and inadequate incentives as main impediments to providing quality care. In response to these findings, it was suggested that health care providers reflect on their practices and overcome shortcomings, to improve the quality of medical care.

The approach followed in Pakistan is documented separately in the manual "Initiating Women's Empowerment for Health", and moves a step further to facilitate the process of reflection and analysis amongst community members, related to women's health and empowerment. It also provides strong evidence that the adapted manuals can strengthen the health care system in Pakistan. The areas in focus are provider-client relationships, problem-solving abilities and better informed health seeking behaviour on the part of the client.