PAKISTAN’S pre-eminent community health outreach programme — the Lady Health Worker (LHW) Programme — has been around for 30 years. As we celebrate this pearl jubilee anniversary, it behoves policymakers to sort through research and evidence collected over time to assess success and failure so as to fix what is broken.

Here are some recent statistics on the state of healthcare in this country. According to Unicef data, every year more than 350,000 of the 6.3 million babies born, die in infancy. Six out of every 100 children die in the country before they complete their fifth year. Health ministry demographic surveys show that around 15,000 women die annually while giving birth. Pakistan faces a nutrition emergency with stunting a key cause of concern that affects over 40 per cent of children. The Bureau of Statistics figures place population growth rate at a high 2.4pc with a stagnating contraceptive prevalence rate of 34pc. Infectious diseases, maternal health and undernutrition comprise around half of the national burden of disease.

The LHW programme was designed to tackle a specific set of issues, which required direct access to women in households. The system of healthcare provision in the 1980s halted at the Basic Health Unit which was failing a majority of rural communities, due to difficulty of access. The programme sought to focus on reproductive, maternal, neonatal and child health and included the provision of basic services as well as referring community members to the nearest public health facilities (especially for........

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