Bringing About a Behavioural Change in Providers to Meet the Reproductive Health Needs of Clients

The international conference on population and development held in Cairo in 1994 has became a historical turning point in the way population policies and programmes are perceived and sexual and reproductive health services are conceptualised and delivered. Inherent in the ICPD plan of action is the concept of care that recommends providing a range of reproductive health services to both men and women, that are safe and effective, and that satisfy clients, needs and wants. Clients are far more likely to use services that are of high quality. Achieving quality care requires complying with high technical and ethical standards (such as freedom of choice, informed consent, and freedom from coercion and abuse) and providing services at costs that are affordable to both clients and health care system. The most common barriers to quality are negative provider attitudes or behaviours, poor interactions between clients and providers, a lack of essential drugs and supplies in facilities, and delays in referrals to other necessary services. Pakistan has among the worst reproductive health indicators in the developing world. It has lagged behind many of its neighbours in terms of its social indicators. Access to health and educational facilities, especially in the rural areas has remained outstandingly weak. Maternal and infant mortality rates are unacceptably high at above 500 per 100,000 and 80 per 1000 births, respectively. Malnutrition, anaemia and reproductive tract infections are widely prevalent in women.