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'Only systems thinking can improve family planning program in Pakistan': A descriptive qualitative study
Saira Zafar1, Babar Tasneem Shaikh1
1Health Systems & Policy Department, Health Services Academy, Islamabad, Pakistan.
International Journal of Health Policy and Management
|December 10, 2014
Summary
Pakistan's Family Planning (FP) program faces challenges due to slow fertility decline and stagnant contraceptive prevalence. Strengthening all WHO health system building blocks is crucial for achieving demographic targets and improving FP services.
Area of Science:
- Public Health
- Health Systems Strengthening
- Reproductive Health
Background:
- Pakistan's Family Planning (FP) program has struggled to meet targets, resulting in slow fertility decline and rapid population growth.
- Key challenges include a stagnant contraceptive prevalence rate and high unmet need for FP services.
- A holistic approach is needed to address gaps in health system components like service delivery, governance, and financing.
Purpose of the Study:
- To explore health system factors contributing to the underperformance of Pakistan's FP program.
- To identify challenges and perspectives from various stakeholders involved in FP initiatives.
Main Methods:
- A descriptive qualitative study employing 23 in-depth interviews.
- Inclusion of provincial representatives from Population Welfare and Health departments, donor agencies, and NGOs.
- Manual content analysis to identify themes and nodes related to health system performance.
Main Results:
- FP program performance is unsatisfactory, failing to achieve desired outcomes.
- Inadequate government prioritization has hampered the program's progress.
- Issues identified across all health system areas, including governance, funding, HR, and information systems, impede success.
Conclusions:
- Strengthening all interconnected WHO health system building blocks is essential for achieving demographic targets.
- A comprehensive approach to health system strengthening will enable the delivery of equitable and responsive FP services.
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