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UNICEF in Partnership with the Norwegian Government Improves Health Practices and Behaviours in Disadvantaged Communities

© UNICEF/Pakistan/Sami
Nangar and his wife Maryam stand inside their house showing the manual which they use for conducting health and hygiene sessions in their community

By: Fatima Shahryar

UMERKOT DISTRICT, PAKISTAN, January 8, 2014 – Nangar (40) and Maryam (30) are a couple who along with their seven children live in a remote desert village, Ahorifarm in Umerkot District, Sindh, Pakistan. Like others in their community, this family also lacks access to basic health services. Not only that, they also have little knowledge about hygiene practices and their positive impact on community health. 

“We were selected to be the focal family in our village. For the last two years, we have been giving key health messages to our community. It is our mission to improve the health of our people.”

“I have done my intermediate but my wife Maryam cannot read or write. However, she is vocal and confident,” says Nangar.  “We were selected to be the focal family in our village. For the last two years, we have been giving key health messages to our community. It is our mission to improve the health of our people.” 

 A focal family comprises two members of the same family, selected on the basis of education and vocal confidence and trained for six days to impart health and hygiene messages to their community in order to promote positive health behaviours. 

Umerkot is primarily a desert area located near the south eastern border of the country. Due to its distant location, Lady Health Workers (LHWs) programme has not yet reached all areas in Umerkot district. As a result, communities in this area lack health service delivery from skilled health care providers.  Areas not covered by the LHWs are referred to as uncovered area. 

UNICEF under the Norway Pakistan Partnership Initiative (NPPI) is implementing a project to promote positive Mother, Newborn and Child Health (MNCH) services and improved health behaviour through community mobilization in district Umerkot. The Thardeep Rural Development Programme (TRDP), a local Non-governmental organization (NGO) is UNICEF’s partner in implementing this project. 

“Earlier, our women had no concept of hygiene’s impact on health, but now they are well informed and often come back for advice. Through these sessions, families in the village have become like one big family.”

Maryam is a housewife, and other than performing her daily household chores, she also attends to the needs of her seven children. Despite belonging to a minority Hindu community and being unable to read and write, Maryam has learned the health and hygiene messages well. She enjoys the reputation of the woman who ‘knows’ amongst women of her community. 

“I guide them on health related issues including antenatal and postnatal check-ups, exclusive breastfeeding and cleanliness. I also give women deworming tablets and clean delivery kits given to us by UNICEF,” says Maryam. “Earlier, our women had no concept of hygiene’s impact on health, but now they are well informed and often come back for advice. Through these sessions, families in the village have become like one big family.” 


© UNICEF/Pakistan/Sami
Wala (17) conducts a health and hygiene session in her village Ahmad Dars located in a remote desert of Umerkot district, SindhWala (17) conducts a health and hygiene session in her village Ahmad Dars located in a remote desert of Umerkot district, Sindh

A sum of Rupees 5,000 is given to village committee as emergency funds. This committee comprises of senior and trustworthy members selected with advice from the people of the village. The funds can be used in emergency situations such as hiring transport to take a pregnant women to the hospital when she is about to deliver.  In addition, each focal family is also given Rupees 5,000 to invest in an activity to improve the health and hygiene of the people. Maryam and Nangar used these funds to build a model latrine in their house. In a period of two months, 91 out of total 191 households of the community built latrines in their houses too. Amongst them is Kacha Khemo, an 85 year old man who acknowledging the importance of hygiene exclaims, “cleanliness is essential.”

MNCH cannot be improved without social mobilization and health system delivery at community level. The factors jeopardizing maternal and child survival and overall health across the country reinforce the benefits of a continuum of care. This underlines the imperative of delivering essential services and information for mother and children at various stages of pregnancy and child growth. 

Another example of successful community mobilization and behaviour change towards health practices is seen in the neighbouring village Ahmed Dars. The focal family comprising siblings Walah (17) and Gulzar (19), have managed to bring about a positive change in their community where people are now fully conscious about their hygiene level and availing of health services within their access. 

Walah conducts regular health and hygiene sessions in her village while Gulzar works as a tea boy at different roadside hotels but supports his sister over the weekends. They have been doing this for more than 17 months. 

“With regular sessions, I have won the trust of women in my community,” says Walah.  “I advise them on the importance of good health and how to maintain it...

“With regular sessions, I have won the trust of women in my community,” says Walah.  “I advise them on the importance of good health and how to maintain it. I have personally taken a number of women to the nearby hospital where they delivered their babies. I am very proud to have played a part in saving lives of mothers and children, some at very critical time.” 

Change begins to take shape at the roots, and despite being a slow process it always shows the results. The two focal families in villages Ahorifarm and Ahmed Dars are examples of selfless and dedicated work that is bringing about a positive change in attitude and behaviour towards health and hygiene practices amongst the most disadvantaged communities. The NPPI and UNICEF with support from a local organization and the communities are bringing about this positive change in Pakistan.  

 

 

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