INTRODUCTION PROCESS

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INTRODUCTION PROCESS

• WHRAP- Arrow partnership
• MDG- expanding the agenda movement
• National Policy Dialogue
• Regional Policy Dialogue
• Provincial Policy Consultation Meetings

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Mr.Abdullah Khan Sumbul

• Punjab Devolved Social Services Programme
• 200 million intervention 65 for health, 18 for
  water supply and sanitation and 17 for
  education.
• Focus is on attainment of MDGs
• Challenges
• Limited capacity of local governments
• Lack of systems to collect relevant and credible
  information.
• Must have independent monitoring of the social
  service delivery sector
• Medical education system skewed

3
Kazi Afaque Hussain(Secretary, Population Welfare
Dept)

• Components of MoPW
• Family welfare centers.
• Rep health service centers. Run by lady doctors.
• Mobile Service Units. Provide services at the
  door step.
• Male mobilizers. Currently have 300 in Punjab,
  plan to have about 1500 by the end of the year.
• Challenges
• MoPW has been shuffled b/w provincial and federal
  governments
• Budget controlled by federal, orders given my
  provincial govt
• Have a lot of funds for seminars, advocacy etc,
  but no people to do that
• Solutions
• Public- Private Partnerships
• Must get recognition of the importance of SRH at
  the highest levels.

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Recommendations made by participants

• Must focus on education and awareness in the
  rural areas
• Sex education should be introduced
• Focus on monitoring
• The Ulema have the biggest influence on the
  population. Hence we can not ignore them. Need to
  find ways to involve them in population issues.
• Find strategies to integrate HIV into PHC level

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Social Determinants of Health

• Health influenced by many factors in the
  environment
• Community based studies to see difference in
  priorities of households with less burden of
  disease than those with more.
• Economic status
• Water and sanitation
• Unable to access health facility
• Tribal conflict
• Lack of female staff
• Law order situation
• Gender disparities
• Need to address health holistically

6
Media perspective

• Media extremely powerful tool to effect people
• None of the projects that have media components
  dont use them
• Should use media to encourage public-private
  partnerships
• Private media is very open give money to
  private channels to make programmes on important
  issues that PTV can not.
• Case studies can be used to make dramas, talk
  shows, etc.
• Doesnt work with one off programmes. Need to
  constantly reinforce
• Media can be used to touch people personally.

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Consumer Perspective

• Challenges
• Inequitable health and social sector systems
• Disparities at household level
• Case of Tobacco Control and how it has an effect
  on all the MDGs
• MDGs do not support economic growth models
• Recommendations
• Strengthen PHC
• MDG indicators need to have systems approach.

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Service Provider Perspective

• Challenges
• Collective effort lacking bringing together
  various stakeholders to work for the same cause.
• MDGs place most responsibility on health care
  providers and they have no knowledge of MDGs.
• Project on SRHR Of 3000 only 3 medical
  students knew
• Recommendations
• Need to raise awareness on rights, MDGs, and
  SRHR amongst health care providers
• Increase discourse on sexual and reproductive
  rights
• Broaden perspectives and instill a sense of
  responsibility amongst todays generation of
  health care providers.
• Special responsibility on family physicians and
  gynecologists
• Strengthen health systems
• Include SRHR into curriculum

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Youth Perspective

• Challenges
• No information on SRH available to the curious
  youth
• Media misinforming the youth on SRH
• Stigma attached to discussing these issues.
• If even want to discuss, there is no one
  available to talk to
• Recommendations
• Provide accurate information on SRH to youth
• Provide platforms for discussion and raising
  awareness on SRHR with young people.

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• MoH perspective
• Door-to-door services
• Free emergency services
• Free ambulance services 1122
• Govt offers doctors double salary to go to rural
  areas but not working
• Board for child protection
• Need to look at the vulnerable populations such
  as street children as well.

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Recommendations by Participants

• Need to have proper and more centralized
  information channels.
• Epidemic of HIV has reached second stage
  sitting on a volcano, must act fast now!
• Public wants to learn dont demonize or
  scandalize issues of SRHR.
• Need to educate the religious leaders
• Look at countries that are making progress, such
  as Indonesia and Brazil and use them as models of
  practice
• Should include an indicator for assessing what
  percent of population has information on HIV/AIDS
• Participants endorse the resolution on
• Universal Access to Reproductive Health
  Services