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Community midwife training in Pakistan Team members discussing strategies

Technical Resource Facility, Pakistan

We managed the Technical Resource Facility (TRF) which provided support to Pakistan government over six years to improve maternal, newborn and child health by building capacity in areas including health policy and strategy, service delivery and procurement.

Community midwife visit in Pakistan
Pakistan's health systems
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Pakistan's health systems A community midwife carries out a health check.

Building sustained capabilities in the country's health system, the TRF has been instrumental in the effective implementation of policies and programmes to improve people’s access to quality health care services, especially the poor and marginalised.

Key facts

  • Our health experts managed the TRF, which was established in 2009.
  • The £19.27M project is funded by the UK’s Department of International Development and Australian Department for Foreign Affairs and Trade.
  • TRF supports provincial governments and administrations across Pakistan. Its main hub is in Islamabad with offices in Lahore, Peshawar, Karachi and Quetta.

Challenges

In Pakistan around 17,000 women have been dying each year from complications in pregnancy and childbirth. Each year 400,000 have been children dying before the age of five. Many of these deaths are largely preventable with provision of and access to appropriate healthcare. Following a constitutional amendment in Pakistan in 2010, provincial governments assumed responsibility for planning and delivering health services, although health departments faced serious challenges in charting a clear and comprehensive approach to delivering services and in mobilising resources for the health sector.

Solution

We worked with government to identify key challenges and solutions in the health sector and prioritise these into detailed technical assistance work plans. We procured and managed technical assistance, ensuring that efforts are geared towards problem solving and focused on sustainable results. Through close collaboration with government counterparts we also helped build capacity to enable government to procure and manage its own health sector technical assistance in the future.

Value and benefits

The technical assistance approach we used allows for a flexible and targeted response to health needs in Pakistan delivering specific expertise where required. The permanent team of health specialists provides oversight and ensures that a progressive, sustained process is maintained.

  • Over 125 technical assistance assignments, either completed or ongoing, resulting in the adoption of major recommendations by provincial government.
  • TRF’s work on the development of health sector strategies for the provinces has enabled government and donors to align their priorities for health.
  • We assessed the quality of training of community midwives resulting in an upgrade of the curriculum and recommendations for improving clinical skills.
  • Our work on analysis of the provincial budget data has allowed government and donors to prioritise their budgetary allocation, identify gaps in allocation and develop expenditures over the medium and longer term.
  • Work on developing infection control guidelines has resulted in pilot programmes to improve infection control practice in public health facilities.
  • Through a communication and advocacy strategy we are raising the profile of health within Pakistan, focusing on the needs of women and newborn children.

Our health work in Pakistan will continue in Punjab and Khyber Pakhtunkhwa through a new project, TRF+, which will run until 2018 and focus on reproductive, maternal and newborn health and nutrition.

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