The Pakistani Lady Health Worker Program: Providing Care to Underserved Populations
In response to urban-rural healthcare disparities and inadequacies in the health workforce, including insufficient numbers of health workers, nurses, paramedics and skilled birth attendants, Pakistan created the Lady Health Worker Program in 1994. The programme equips female health workers with the skills to provide essential primary health services in rural and urban slum communities. The Lady Health Workers are each responsible for an average of 1,000 people in the communities where they themselves live. In order to become a Lady Health Worker in Pakistan, a woman needs at least 8 years of schooling, must be recommended by her community, and undergoes extensive training. Every health worker in the program is assigned to a specific government health facility where they receive training, a small subsistence allowance, and medical supplies. The Lady Health Worker Programme is supervised by provincial and district coordinators who conduct quarterly review meetings and provide analytical feedback on health records from Lady Health Workers.
External evaluation has shown substantially better health indicators in the population served by Lady Health Workers when compared to the general population. A 2006 study of in the Punjab province documented that Lady Health Workers contributed to a drop in maternal mortality from 350 to 250 per 100,000 live births, and a decline in infant mortality from 250 to 79 per 100,000 live births.