Introducing client-centered reproductive health services in a Pakistani setting (PDF)
Sathar,Zeba A.; Jain,Anrudh K.; RamaRao,Saumya; ul Haque,Minhaj; Kim,Jacqueline
Studies in Family Planning 36(3): 221-234
Publication date: 2005
Pakistan is a high-fertility country with elevated levels of maternal mortality and unmet need forfamily planning. Limited access to and poor quality of reproductive health services and genderrelatedproblems comprise the major explanations for these poor indicators. The authors designedan intervention to address some of these issues and implemented it on a quasi-experimental basisin Bhalwal Tehsil of the Sargodha district of Punjab. The intervention introduced a client-centeredapproach to providing reproductive health services, including family planning and infant, child,and maternal health care. The intervention consisted of training health-care providers based infixed-location clinics and in communities. It introduced the concept of SAHR (an acronym forsalutation, assessment, help, and reassurance), to inculcate a client-centered approach to care thatacknowledges explicitly and addresses a client's gender and power relations within her family andhousehold. Results of the intervention indicate significant effects on providers' behavior related toSAHR elements. The changes provide demonstrable evidence that the public sector can shift towardclient-centered services in reproductive health care in a challenging setting.