Reproductive Health & Rights

Young people in Pakistan face a range of serious reproductive health, psychological and identity issues. These reproductive health problems do not only have an immediate impact on the lives and well-being of young people, but also contribute to long term pattern of poverty, dependency and poor socio economic development. In the recognition of the extent of adolescent health problems UNFPA in partnership with ACT initiated an effort to address young people’s needs for reproductive health information, counseling and training.
60 young leaders from 30 youth led organizations were trained on RHR. A cadre of 16 Master Trainers from KP, AJK and ICT trained by imparting 10 days residential TOT at Islamabad. Young Leaders Annual Plans developed for advocating RHR in their circle of influence. The comprehensive TOT training was followed by series of cascade trainings delivered by master trainers. The master trainers as well as trainees of the cascade training events committed to carry out orientation on RHR in their respective institutions, organizations, and target populations subject to availability of resources.

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RHR for Transgenders

With the technical & financial support from UNFPA, ACT International has implemented Training on Reproductive Health & Rights (RHR). The purpose of this training is to create and strengthen the group of young trainers that could later work as master trainers to build the capacity of the youth and others in their communities on Reproductive health. The training was based upon innovative training methodologies for RHR to understand technical terms more effectively. 

For this purpose, a handbook on RHR, as a reference document, has been developed and also translated into Urdu for a better understanding of all the participants. Along with this handbook, a training manual has been prepared to guide young trainers to work as independent trainers. These master trainers in the future will further train young people through a cascade training model. A cadre of 16 master trainers from three districts of South Punjab i.e. Bahawalpur, D.G. Khan and Multan have been trained on Reproductive health by imparting 10 days of ToT in Multan. These master trainers pledge to further execute the orientation on RHR in their respective circles.

THE CONTEXT

 The catastrophic monsoon rains & flash floods in August 2022 caused large scale destructions across five provinces in Pakistan. 

• 80 districts have now been declared ‘calamity hit’ – 31 in Baluchistan, 23 in Sindh, 17 in KP, six in GB and three in Punjab
• More than 33 million people have been affected due to floods, 300 people lost their lives while over 5,000 suffered injuries
• Approximately 16 million children have been affected, while more than three million children are at risk of malnutrition and diseases
• Over 650,000 pregnant women and girls are affected, 73,000 of pregnant women are expected to deliver in the next month
• Over 1 million houses have been damaged, out of which, 436,000 house have been completely destroyed
• 2 million acres of agricultural land affected and 2,000 km road destroyed
• More than 800,000 livestock have been lost
• More than 1,000 health facilities have been fully or partially destroyed in Sindh province and 198 in Baluchistan province

RESPONSE BY ACT

 ACT, with its partner Kaar-I-Kher, is on the ground and providing following services to the flood affected families in Punjab, Sindh and Baluchistan Provinces.

• Cooked Food (two time a day)
• Clean Drinking water
• Food Packages (monthly dry ration)
• Temporary Shelter (Tents and Tarpaulins)
• Mosquito Nets
• Non-Food Items (Clothes, Shoes,
• Healthcare Services (Medical Camps)

 ACT is also working with local communities to assess the needs of families, especially the women, children and persons with disabilities (PWD). This data will help ACT to review its ongoing interventions and design more appropriate projects for early recovery and resettlement of the affected populations.

 THE CHANGING CONTEXT

IMMEDIATE AND LONG-TERM NEEDS OF FLOOD AFFECTED FAMILIES

According to the reports, received from ACT field team, a large area in Sindh, Punjab and Baluchistan is still under water. This not only has restricted the access of people but may also cause various diseases in coming days. The already affected people are at risk of various health problems, especially Malaria, Dengue, Malnutrition and water borne diseases. Therefore, necessary actions must be taken to protect the affected people from other complications.

Moreover, most of the organizations are focusing on food supply, temporary shelters, bottled water and other means of assistance, while the affected people need to be provided shelters before winter. The health facilities need to be rehabilitated and livelihood support to be provided so they can start their normal life again.

ACT has launched appeal for the assistance of homeless and helpless flood affected populations of Punjab, Sindh and Baluchistan. This campaign will go on till early recovery and resettlement of the flood affected people.

ACT needs your support; join us by sending your donations for flood affected families.

Social Mobilization & Communication Outreach Awareness for Covid-19 Prevention RCCE-EPI-AJK

In December 2019, a novel coronavirus disease COVID-19 emerged and rapidly spread around the world causing a surge in fatalities, especially among people with co-morbidities. The World-Health Organization (WHO) declared a global COVID-19 pandemic on 11 March 2020. Since then, over 85 Million people had been infected globally and over 373,000 had died as of 31st
December, 2020.
Furthermore, it is devastating for developing countries like Pakistan due to the weak healthcare infrastructure and social protection systems where local economy is already under tremendous stress due to un-employment, high-inflation and high debt to GDP ratio.
A model of the global impact of COVID-19 predicts that many more could become infected and require hospital care,with devastating health and socioeconomic impacts. The Ministry of Health(MOH) anticipated the pandemic to spread quickly before peaking in the second quarter of 2020 but a second or third wave was possible as the country considers loosening restrictions later in the year and restarting economic activity.
The Social Mobilization and Community outreach project influenced the targeted audience from different walks of life by engaging community activists and creating awareness amongst community about prevention of Covid-19. The project developed their knowledge on the pandemic and triggered their attitude to practice at the local level to comply with Covid-19 protocols and SOPs.
At the same time the social mobilization efforts also created a critical mass of local Community Activist known as “Change Agents” to minimize the knowledge gap of relatively underprivileged communities. In parallel to community engagement the project also prepared the state institutions responsive toward communities as duty bearer with multiple activities carried by EPI-RCCE team directly.

Snow Emergency Response

AJK is among the regions where the highest level of malnutrition prevails, affecting people of all ages particularly the women and children. This situation is linked mainly with the reasons of food insecurity, recurrent floods and manifestation of the menace of extremism in the country.
It is further aggravated by certain socio-cultural factors those include poor health and feeding practices, poor health seeking attitudes and lack of awareness and education among communities at lar ge.
The project focused on providing basic food items to the affected families of the 04 union councils of Tehsil Sharda. During the screening process, beneficiaries of all categories were identified: under the WFP assisted emergency response through food distribution, families were provided food items at their nearest possible access point.
The Snow Emergency Response project addressed all the affected families of the area. The identification/registration of beneficiaries/families was carried out using assessment/screening by engaging the team of outreach workers along with the support of local community representatives and line departments. The beneficiary targeted families was 12410, severely affected families for the project period of 01 month.
Field Coordinators along with the distribution teams conducted meetings, door to door visit for screening/ registration of families. To substantiate the overall outreach strategy, a joint human resource pool was utilized by involving the LHWs, LHVs, Community Elders (heads, imam masjid, generalist and teachers etc) and filed teams of ACT mobilized the beneficiaries and ensured their participation during the project. The strategy enabled the organization to optimize its resources for higher outreach coverage.
It was ensured that special cases (patients with disabilities, chronic diseases, un-attended children and women) received food items at their door steps. Record of all families who received the services was maintained on screening/assessment registers and assessment forms. 
At the start of the project Filed distribution teams lead by Field coordinator mapped out the population in order to prepare appropriate and realistic geographical distribution points and coverage plans. They screened and identified families and registered them in their respective villages. Basic information regarding the project criteria, methodology was given to all the families to create smooth environment for food distribution in a manner to avoid any bottlenecks. Tokens were issued to all the registered families to ensure they get the required food on given time, date and place. Similarly, to maximize the coverage and minimize the rate of default cases, regular and rigorous monitoring and follow up strategy was adopted by filed monitoring teams.

GBV Prevention through Social Mobilization

ACT has always considered GBV as a key challenge for women’s rights in Pakistan and resolved to challenge Gender Based Violence at all levels through conventional and innovative approaches. ACT has adopted various techniques such as community mobilization, policy advocacy, men engagement and media utilization for challenging the GBV. ACT envisaged a social mobilization campaign against GBV in six districts of KP in 2016 which could empower the women to fight against violence, involve men to become partners and stakeholders in campaigning, engage media and conduct policy advocacy.
As a result, ACT validated and identified the specific problems pertaining to prevention of GBV by using the secondary source information as well as carried out baseline assessment survey in the proposed districts of KP. The core gaps related to the problems of GBV prevention included creation of demand at community level about GBV responsiveness, existing knowledge attitude and practices on GBV, existing pattern of disseminating information and creating awareness and voices of constituencies related to response services.
ACT identified two major challenges in terms of dealing with GBV in the region:

• Lack of education, knowledge, information, pro practices amongst community (men, women, boys, girls) and society at large about GBV prevention;
• Lack of voices and non-existence of constituencies at community and institutional level about the prevention of GBV and its effective responsiveness/accountability at public and private service providers’ side.

As a result, a strong advocacy based campaign was planned at the community, administration and civil society level along with engagement of local media. It addressed these key problems by mitigating/addressing the identified causes through meaningful engagement of communities and all relevant stakeholders.

The project has been able to achieve the following objectives:

• Organized and mobilized communities (24,000 community members in 30 villages) upon GBV related issues in targeted areas in order to promote reduced tolerance towards GBV
• Formulated 120 communities based Gender Ambassador Team-(GAT) to increase their knowledge upon GBV related legislation, referral mechanism and role of other service providers.
• Imparted skills among 1200 Gender Ambassador Team-(GAT) members for designing and implementing awareness raising campaigns and 120 action plans (each group to complete one action plan)for the prevention of GBV related issues.
• Made committee members aware of their roles and responsibilities related to reporting and advocating GBV related issues
• Increased awareness among communities pertaining to GBV response services and GBV related rights
• Improved linkages among community, stakeholders (lmam-e-masjid, teachers, community elders, lawyers, journalists etc.) and GBV service providers
• Ensured active reporting and emphasizing upon GBV related laws and their implementation by District level Stakeholders (media, bar council and local government bodies)

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Early Recovery Programme for TDPs

A huge number of civilian population, approximately 3 million people, were displaced as a result of a major military operation in Khyber Pakhtunkhwa (KP) province and Khyber Pakhtunkhwa Tribal Districts – KPTO (Previously known as FATA) of the country to root out the local pockets of militants in 2009. The offensive led to significant damage to physical infrastructure and services while creating a large population of Temporarily Displaced Persons (TOPs) who lost their homes and livelihoods.
In 2015, the FATA Secretariat developed a comprehensive Sustainable Return and Rehabilitation Strategy. The strategy encouraged establishing an enabling environment for the voluntary return of the TOP families. As a result, the Government requested the World Bank’s support in strengthening the early recovery of TOP returnees, for all the affected areas of KPTO, to provide the returnees with a predictable and regular flow of income over the re-settlement period to cover basic needs before livelihoods are restored as well as child health wellness grant linked with the attendance of health awareness session.
Complementing the initiatives being implemented by the Government of Pakistan, the World Bank proposed to strengthen the recovery efforts of the government for all recently affected areas of KPTO through an emergency early recovery project having the following components:
i. Early Recovery Grant (ERG): A one-time resettlement grant of Rs. 35,000 to be provided to the families for returning to their homes. The grant covers basic transportation and immediate subsistence needs of the families. It will be directly administered and the upfront payments are made by the government through FATA Secretariat (FOMA is the focal body).
ii. Livelihood Support Grant (LSG) – These are Unconditional Cash Transfers (UCT) amounting to Rs. 4,000 per month, provided to support immediate safety net recovery support for a period of 4 months. These LSGs shall cover basic and subsistence needs of the families after they return to their homes, to ensure consumption smoothing and provision of support for the affected beneficiaries, till they are able to restore their livelihoods.
iii. Child Wellness Grant (CWG) – These are Conditional Cash Transfers (CCT) linked to a comprehensive child wellness package, to encourage long-term improvements in children’s health and support overall human development outcomes for the affected region.
iv. Technical Assistance: Support for the development of Emergency Cash Transfer delivery mechanism for TOPs and non-TOPs belonging to the affected region.

ACT was engaged in the process for beneficiary mobilization, outreach and communication activities with an overreaching goal of supporting and facilitating the design and implementation of the project. Thus, ACT follows a multi-layered approach to engage stakeholders effectively.
Firstly, the social mobilization process ensures that eligible households are identified, stakeholders consulted and mobilized to avail the grants and CWP and grassroots level interventions are supported to facilitate their access to services. Secondly, the Project supports an effective communication campaign. This is fundamental to engage and educate beneficiaries and also for ensuring long term sustainability in behavioral change. A standardized outreach model for the ass is put in place and this model includes awareness sessions for beneficiary communications to ultimately help the project to deliver more efficiently by improving the two-way flow of communication and information for both the LSG and CWG components.
ACT supports the overall program through mobilizing beneficiaries and enhancing awareness of the program amongst the stakeholders. It creates a larger understanding of the program amongst audience in KPTD, influence beneficiaries to visit the ass as per schedule and ensure their multiple visits to the ass as well as inform policy makers about the program.

Strengthening Electoral and Legislative Processes (SELP)

ACT has always endeavored towards improving the democratic system in the country by ensuring strengthening of the electoral and legislative process, and along with it creating awareness on these processes amongst the general public. ACT’s engagement with youth under various project and programmes has always ensured this aspect of strengthening democratic processes.
ACT has engaged 1.6 million women in 32 districts across Pakistan under Waseela-e-Taleem programme of BISP. This engagement provided ACT with a detailed awareness of the local, cultural context and contributed to the formation of 50,000 BISP Beneficiary Committees to uplift women’s voice for redressal of their problems as well as participation in committees to discuss social, economic and other related issues.

On the basis of this experience, SELP was envisaged under Citizens Voice Project (CVP) focusing following activities:

• Volunteer citizens are organized to advocate for and actively facilitate women to acquire CNICs, register as voters, and vote on Election Day.
• Media/journalists write/broadcast about, advocate for, and are actively engaged in support for women to acquire CNICs, register as voters, and vote on Election Day.
• Influential local stakeholders (religious leaders, elders, leaders of local CSOs, and other local community leaders or “influential”) advocate for and are actively engaged in support of women to acquire CNICs, register as voters, and vote on Election Day
• Coordination mechanisms with relevant state institutions (such as local ECP and NADRA offices and local administration) are activated in support of women to acquire CNICs and register as voters.
• Political party leaders (and candidates) advocate for and are actively engaged in support for women to acquire CNICs, register as voters, and vote on Election Day.

The project was able to successfully deliver the envisaged objectives and engage men, women, youth and the general public in a participatory manner while contributing to strong information and awareness on the electoral processes, understanding on norms, rules and legislations as well as the right of women to participate in electoral activities. As a result of this project, the following results were sorted out:

• 50 volunteers from target communities were organized who actively facilitated women to acquire CNICs, register as voters, and vote on Election Day.
• Eight FM radio programs were broadcasted that advocated for women’s CNIC and voter registration, and provided knowledge to 25000 women to acquire CNICs, register as voters and vote on Election Day.
• Community leaders have provided increased support for women to acquire CNICs, register as voters, and vote on Election Day
• 10 officials from NADRA and district registration office were trained in social mobilization and gender mainstreaming to equip them with skills that could enable them in supporting women to acquire CNICs and register as voters.
• 1 0 political party leaders and workers were mobilized who have ensured their support for women to acquire CNICs, register as voters and vote on the Election Day

Creating Awareness and Demand for Birth Registration

The Local Government and Rural Development Department (LGRDD) of KPTD is facing numerous challenges with regards to its capacity in dealing with many issues alongside the temporarily displaced persons, security problems and developmental activities. A need was felt with regards to department’s capacity in dealing with the ‘Birth Registration’ issue where the communities lack awareness on the purpose, benefits or processes of birth registration.
In order to strengthen the institutional capacity of the Local Government and Rural Development Department of FATA for the implementation of “Birth Registration Initiative,” a 6 months’ knowledge-creation and demand-generation activity was designed and carried out in partnership with UNICEF and the MIDAS Communication in Bara, Khyber Agency. The assignment ensured to address the challenges of forced marriages, child labor, employment in hazardous industries, and recruitment by armed groups, illegal adoption and trafficking. The birth registration is also expected to help the beneficiaries to claim inheritance rights, social benefits and citizenship rights. The intervention is a step towards social welfare plan for the beneficiary families and their newborn children.
The intervention ensured effective communication, beneficiary outreach and mobilization strategy satisfying the core objectives of the project. It was expected to reach 250,307 beneficiaries through this assignment, while achieving the ultimate objective of child rights protection.

The project involves following activities to achieve this result:

• Identification and mapping of potential facilitators, prevailing social norms, all vulnerable children, and alternative care institutions in Bara Khyber Agency.
• Design and development of training and IEC material including production and placement.
• Engagement with local communities and stakeholders for the effective promotion of the right of the child to a legal identity through birth registration.

Further, ACT started with forming consensus among relevant stakeholders for registration of children who had not yet been registered with local government department to legitimize their identity. The list of notables/influential of the area was derived in consultation with the office of Assistant Political Agent. With the help of local notables, the relevant stakeholders like LHWs, Nikah Khwans, Maliks and elders were involved in Focus Group Discussions (FGDs) to mobilize the communities. The practice helped to identify media habits and other locally suitable mode of communication for media strategy.
Moreover, a media campaign was also planned in order to outreach all communities in the area. It focused on demand generation at the community level which ultimately lead to increased birth registrations. A total of 1554 men and 525 women had been mobilized to receive education for birth registration in Bara, Khyber Agency.

Youth Mentoring project through Community Centre Platform

ACT has always taken youth as a cross-cutting theme for all its activities and engaged young people across the country in various activities. However, ACT has adopted varying approaches of mentoring and youth development in order to guide and support the vulnerable young people.
“Youth Mentoring Program through Community Center Platform” was UNDP funded project and implemented in Union Council Musazai Sharif of District D.I Khan, KP. The project aimed at providing opportunities to the local youth by awareness raising, capacity building, knowledge transformation, mentorship and setting up their link with already established community centers by UNDP.
The project was initiated with the identification of active youth members from the selected community through primary data sources and initial dialogues were organized with the selected representatives for the formation of youth groups. Keeping in view the gender ratio and local context, 15 youth groups were formed (10 Male and 5 Female) from targeted villages of UC Musazai. These groups were given delivered extensive trainings on leadership, life skills, conflict resolution, and entrepreneurship through mentors who had been identified after meetings with community elders, specialists and renowned professionals. The mentors adopted different types of mentoring approaches to mentor youth groups at community centers.

The main goal of Youth Mentoring Program was to identify and address all the key challenges faced by the youth of local community.

Key Accomplishments

• Conducted a perceptual exercise to understand the already developed perceptions and prepared mentoring activities accordingly.
• Detailed plan was devised outlining the typology of mentoring activities through personal or technological interactions.
• Detailed design of activities that map individual, group, and team mentoring interactions.
• Developed an effective entry criterion for selecting youth into the mentorship program.
• Increased community engagement, volunteerism, and deepening of leadership potential and skills in youth.
• Formation of Fifteen (15) Youth Groups in targeted communities who are now actively linked with UNDP resource centers and initiating community level activities at their own.
• Eight (8) trainings had been conducted on different thematic area for the selected youth, who are now capacitated upon computer literacy, leadership, conflict resolution, life skills etc.
• Five (5) Social Action Projects (SAP’s) had been designed and implemented by the youth groups in their respective communities. And most importantly, youth of the adjacent communities are replicating the same actions at their own villages.

Gender Equity Fund

Gender-based violence is a pervasive and general issue affecting all socio-economic and cultural groups throughout the country which instils a great toll on both individuals and society at large. As compared to the cosmopolitan cities of Pakistan the issue prevalence is much high in cultures where male domination is still followed religiously and is considered as an unquestionable domain. Out of such clans “Pakhtoons are highlighted the most for controlling and confining their women in the name of honour and religion while depriving them even from the basic necessities of life.
Considering KP (Pukhtoon hub) and the prevalence of GBV in the area inferred from different secondary and primary data sources; ACT in collaboration with Caritas initiated a social mobilization intervention along with advocacy efforts to reduce tolerance of general community towards GBV in three districts – Mardan, Swabi and Nowshera. The organization along with sensitizing the general community also upgraded the intervention by establishing a toll free GBV helpline – BOLO at Directorate of Social Welfare Department Peshawar. Consequently now in the extended phase of the same program ACT established Mobile Crisis Unit based in Social Welfare Department Peshawar that has linked with BOLO helpline and other relevant government and non-government service providers in the Province. The mobile crisis unit is responsible for providing immediate response in case of any GBV related issue in Peshawar and nearby vicinity. The setup is initially run in a test phase for a period of two years and after its proper evaluation and success rate, its services will also be further expanded to other districts of KP.

A National level Conference of 2 days was organized for Community Activists related to CGBV engaged with relevant partners of Caritas from Sindh and KP. Key objectives of the conference included exchange of learning, appreciation and recognizing determination of CA’s; present successes and deliberate on challenges and provide exposure to CA’s. The summit contributed in defining innovative ideas and strategies for public and private sector for reducing tolerance against GBV in society at large. CA’s shared their experiences; the initiatives taken by them at different levels; the networking process and their success stories. This national summit deliberated the situation and its multi-dimensional purpose for GBV programing and the challenges faced for response services for the survivors.
The national summit concluded with national recommendations for Public and Private sector for reducing tolerance against GBV and reinforcing the agenda of reducing tolerance against GBV by integrating and synergizing the GBV programme by the support of Donors; Government; relevant stakeholders; CSO’s and NGO’s.
As per the design of MCU; handing over to the Social Welfare Department for reinforcement in terms of strengthening the coordination, integration and to avoid duplication of efforts related to service providers working in the outreach. Furthermore, improved robust referral mechanism, capacity building of government staff and service providers was achieved. Linking the support service of women desks in police station with centralized Bolo helpline to manage CGBV cases effectively. Women desks in police stations are supported by equipping them (tangible support and trainings) to be able to deal with CGBV survivors with high degree of proficiency. In this context proposed MCU handing over ceremony at Peshawar was carried out in which many government and non-government departments and officials of line department were also present.
Mobile Crisis Unit based in Social Welfare Department Peshawar is linked with BOLO helpline as main contact point, with a referral support linkage with district hospitals, shelter homes, rescue 15 and other relevant government and non-government response service providers in the KP Province. At the inception and roll out stage of Mobile Crisis Unit services it was proposed that all relevant stakeholders will be oriented about the functions as well as TORs of MCU and their specific role as relevant stakeholders. Therefore, consultative workshop for GBV relevant stakeholder on response and operation modality of the MCU was conducted. All relevant stake holders were present and they were also requested to share their suggestions for betterment of MCU. Ombudsperson of KP province also shared that she will be highly honored to assist on any case if need arises.

4S Festival – World Enviromental Day

ACT International, has organized a mega “Festival 4S: Save Environment, Save Planet, Save Life & Save future in Muzaffarabad, the capital city of Azad Jammu and Kashmir on June 5 and June 6, 2013. Environmental Protection Agency (EPA-AJK) and Environmental Conservation Organization (ECO) were the partner organizations. The walk organized with the collaboration of the partner organization was arranged on June 5, which was largely attended by all segments of the society, cabinet ministers, concerned departments, schoolchildren, youth and general public that started from the center of the city and culminated at famous Jalalabad Park. With an aim to further the goals of Nektaina’s project ‘Education 4 Sustainability’ ACT International organized a big festival titled “Festival 4S” which was a well-attended event and largely represented by the concerned departments/ ministries as well as private sector.

Students of schools/colleges/universities from public sector and private systems, community elders, parents/teachers thronged the festival. All stakeholders including ministries, civil society representatives and educational institutions displayed their stall by presenting the models related to the theme of the event. ACT international displayed a video house playing documentaries related to environment. A printed pledge was also signed by the visitors assuring their commitment to save the environment which was collected by ACT International. Furthermore, ACT International displayed a 100-meter mural and the participants signed showing their commitment to save environment. In addition to this, a live theater on environment and a seminar was also the integral part of the event. ACT International’s Chief Executive Officer Mubashar Nabi, gave a detailed briefing on the Festival 4s, its impact and the plan to reach the environmental goals. On the conclusion of the festival, prizes were distributed among the participating organizations, schools and the officials for organizing the festival. AJK Senior Minister Chaudhry Yasin, the Chief Guest, AJK Minister for Forest and UN Country Director distributed the prizes.

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