UNICEF ’s Community & Lady Health Worker Program UNICEF’s Next Generation, March 2011 UNICEF Pakistan’s Community & Lady Health Worker Program UNICEF’s Next Generation, March 2011

The Threats Facing Pakistani Children and Women Pakistani children face a variety of serious challenges ranging from malnutrition and poor access to education and health facilities to exploitation in the form of child labor. Every year, almost 460,000 Pakistani children under the age of 5 die from preventable causes and nearly one in ten will not see their fifth birthday. Pneumonia and diarrhea are the main killers of young children—13 percent and 11 percent, respectively, and their low status in society can leave them at risk to daily violence at home and in school as well as to organized trafficking and sexual Photo cover exploitation. Girls are particularly vulnerable as conservative attitudes Pakistan: Mir Afzal, 4, his may prevent them attending or finishing school. fractured foot wrapped in a bandage, sits in his Similarly, Pakistani women face unpaved roads in mountainous terrain, sister’s lap in a camp numerous challenges to leading healthy typically via donkey, is dangerous and that has been set up for earthquake survivors and productive lives as they too have a often impossible. comparably low social status. This status, next to Mansehra District Very few women in Pakistan are trained Hospital in the town of as well as discriminatory social norms, in health care and midwifery procedures, Mansehra in NWFP. leaves women vulnerable to sickness, which significantly compromises the © UNICEF/Pirozzi neglect, and violence. For instance, an health and safety of Pakistani women estimated 25,000 Pakistani mothers and infants. Cultural norms often prevent Photo below die every year due to complications of Pakistani women from receiving health pregnancy and childbirth. The absence Pakistan: A health worker care at hospitals staffed exclusively by administers a dose of oral of medical facilities and skilled birth male health personnel. As a result, most polio vaccine to a boy, as attendants in rural villages means maternal deaths in Pakistan occur due other children wait their that pregnant women suffering from turn, in Quetta, capital of to complications that could have been complications must travel from the the southwestern province treated and prevented with the assistance remote corners of the country to the of . © UNICEF/ of a trained female birth attendant and the Bronstein cities for treatment. Travel over the appropriate medical supplies. Women and Children Bear the Brunt of Disasters The number of people displaced by natural disasters and conflict is further exacerbating the health of babies and mothers. Last year, more than 20 million people—one in eight Pakistanis—were affected by severe flooding that took place in July following heavy monsoon rains in the north. Swiftly moving south, the floods engulfed more than one fifth of the country’s landmass swallowing an area the size of the United Kingdom. Over 2,000 people died and over a million homes were destroyed.

2 UNICEF Pakistan’s Community & Lady Health Worker Program The consequences of flooding on UNICEF in Action Pakistan’s poorest and most vulnerable Pakistan’s high maternal and infant AFGHANISTAN are serious. Over 10 million children mortality rates undoubtedly reflect the Islamabad (28 percent of them under five years country’s shortage of trained health

PAKISTAN old) and 3 million women were severely providers. Exacerbating this problem are affected by the flooding last year and pervasive delays in decision making by tens of thousands are still in relief camps uninformed family members, extensive and spontaneous settlements. The 2011 delays in transportation to appropriate monsoon season is looming precariously health facilities, and general delays in near, and as recent as January 2011, parts administering quality health services. of southern Pakistan were still under To overcome these challenges, UNICEF several feet of water. initiated the Community and Lady Health Malnutrition, compounded by the vicious Worker Program. This innovative program circle of contaminated water, lack of creates community awareness about sanitation, and poor hygiene practices, key health issues such as the critical is a major challenge. Some areas of importance of seeking care from health Pakistan, notably Province, where workers and health facilities at the Map flooding was the most severe, are still appropriate time. The program trains Flood-affected areas faced with an increased number of children Pakistani women with the knowledge and shown in red. suffering from severe acute malnutrition. skills necessary to inform families about Sanitation remains virtually non-existent, the health and nutrition interventions that water sources remain damaged or are available for their children. For example, contaminated and people lost not only a UNICEF-trained Lady Health Worker their houses but also essential household will go door-to-door encouraging families items to fetch and store water, resulting in to attend upcoming vaccination drives. an acute shortage of safe drinking water Additionally, Lady Health Workers educate and an increased risk of waterborne disease. pregnant women about antenatal care and ensure that women in their communities

Photo right Pakistan: Rabia (right), from the NGO Islamic Relief, UNICEF’s implementing partner, goes over the items in a UNICEF family hygiene kit with a group of women accompanied by their children in Pakistan- administered . © UNICEFZaidi

3 UNICEF Pakistan’s Community & Lady Health Worker Program receive proper support during their blood-pressure apparatus, thermometers, pregnancies. Each Lady Health Worker is health treatments like oral rehydration salts assigned approximately 100 households and zinc, safe maternal delivery kits, and that have not had prior access to essential other supplies, along with informational health and nutrition services. and educational materials to support outreach. Lady Health Workers also reach out to families displaced by the floodwaters. With The Impact of Your Support the assistance of the Lady Health Workers, The women and children of Pakistan UNICEF has reached over six million people need your support now more than ever. with a combination of safe water supplies Engaging new Community and Lady and water treatment for families. UNICEF Health Workers is an integral part of supports Lady Health Workers as they UNICEF’s plan to scale up many of the distribute millions of water purifying tablets tried and tested health interventions that and messages about proper hygiene to have demonstrated positive results. So avert secondary infections such as cholera far, these dedicated Pakistani community and other diarrheal diseases. workers have had a lasting positive effect on childhood vaccination rates; they have Photo right increased the use of antenatal services; Pakistan: Taslim Kausar, they have increased the provision of iron a lady health worker, measures the arm of an tablets to pregnant women; they have infant with an arm band, increased the frequency of child growth in the village of Basti monitoring; and they have lowered the Nowshera in Layyah rates of childhood diarrhea. District. The red portion of the armband indicates With your support, UNICEF and its local severe acute malnutrition, partners will be able to strengthen existing a life-threatening community and lady health workers and condition. © UNICEF/ Shehzad Noorani identify more young Pakistani girls that As an added benefit, the program can serve as community health workers simultaneously addresses the financial and facilitators as Pakistan prepares for pressures Pakistani people are facing a national scale up. With the necessary due to the loss of income, livestock, training, these girls will eventually be able arable land, and other economic to provide basic—yet lifesaving—packages resources caused by the floodwaters. of health services to communities throughout Pakistan. By providing participating Pakistani women with a salary and training, UNICEF is able UNICEF has an extraordinary level of to make the Community and Lady Health technical expertise that is backed by a Workers program sustainable. Providing network of highly skilled field staff and a salary ensures the retention of trained teams of professionals in public health, health care workers, and also provides a disease prevention, logistics, education, source of income that empowers women and emergency response. UNICEF can call in Pakistan. Through the program, UNICEF on this expertise to maximize the impact of is also able to set up community health your support. For instance, UNCEF’s Next and nutrition committees to turn this Generation’s commitment of $75,000 could newly acquired knowledge into practice. support one of the following components With participation from community of the program: members themselves, the program • Train and support 255 young Pakistani delivers services through training and women serving as Community Health deployment of over 100,000 Lady Health Workers for one year. Workers whom UNICEF equips with

4 UNICEF Pakistan’s Community & Lady Health Worker Program • Provide information, education, and Your gift of $3,000 could provide 435,000 communication packages for 60,000 water purification tablets to make 580,000 Community and Lady Health Workers gallons of clean water. including counseling cards for health Your gift of $5,000 could train and provide education sessions; birth registration health supplies and annual stipends to sheets; and brochures on antenatal 17 young Pakistani women serving as care, birth preparedness, clean delivery Community Health Workers. practices, and essential newborn care. Your gift of $10,000 could purchase over • Provide 4 million chewable de-worming 525,000 chewable de-worming tablets that tablets for distribution to 2 million children Community and Lady Health Workers can twice a year. distribute over the course of two rounds Education and awareness building are of de-worming each year per child. critical components in this campaign, Your support is vital to the expansion of along with greater respect for the rights of this successful program, and at the same women and children. The program fosters time, will empower Pakistani women by women’s participation and empowerment enhancing their skills, knowledge, and in households, communities, places of their social status. You can help these employment and in politics. Additionally, women become true agents of change— it encourages greater involvement of men for themselves and their communities. in maternal and child care. Thank you for your continued interest in Impact of a Gift and concern for the children and women At this time, I hope you will consider of Pakistan. a gift to UNICEF’s Next Generation To make a donation, please visit: Pakistan Project. www.unicefusa.org/projectpakistan Your gift of $1,000 could purchase 40 first or send a check to: aid kits, containing bandages, tape, gloves, (made payable to the U.S. Fund for UNICEF) scissors, a blanket, eye ointment, and disinfectant. U.S. Fund for UNICEF Attn: Casey Rotter Your gift of $2,500 could provide school 125 Maiden Lane, 11th Floor supplies for one year to over 200 children. NY, NY 10038

UNICEF has saved more children’s lives than any number of children under age five dying each day other humanitarian organization in the world. has been cut by one-third. But still, 22,000 children Working in over 150 countries, UNICEF provides die each day from preventable causes. Our mission children with health care, clean water, nutrition, is to do whatever it takes to make that number zero education, emergency relief, and more. The by giving children the essentials for a safe and U.S. Fund for UNICEF U.S. Fund for UNICEF supports UNICEF’s work healthy childhood. For more information, visit 125 Maiden Lane through fundraising, advocacy, and education www.unicefusa.org. New York, NY 10038 in the United States. 1.800.4UNICEF www.unicefusa.org UNICEF is at the forefront of efforts to reduce child mortality worldwide. In just two decades, the Casey Rotter, Next Generation Tel: 212.880.9164 • e-mail: [email protected]

5 UNICEF Pakistan’s Community & Lady Health Worker Program