With many urban-rural disparities and a drastic imbalance in the health workforce, including insufficient numbers of health workers, nurses, and skilled birth attendants, through the Prime Minister’s Programme for Family Planning and Primary Care, Pakistan created the Lady Health Worker cadre in 1994. Lady Health Workers must be recommended by the community, have at least eight years of schooling, and undergo extensive training. The goal of this program is to equip female health workers with the skills to provide essential primary health services in rural and urban slum communities. External evaluation has shown substantially better health indicators in the population served by Lady Health Workers. In the Punjab province, for example, Lady Health Workers have played a critical role in reducing maternal mortality rates. A 2006 study of the region revealed a drop in maternal mortality from 350 to 250 per 1000,000 live births. Infant mortality also declined from 250 to 79 per 100,000 live births.
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