Provincial Government Partners. Health Department Government of Sindh Education & Literacy Department Government of Sindh

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Health Department Education & Literacy Department Door-to-door Services by Aman CHWs About 8.3% MWRA were aware of the services of CHWs; of these, about 79% reported household visit(s) by CHWs. Sharing of information by CHWs were on the benefits of family planning (86%) and methods of family planning (78%). Figure-16: Awareness about Aman Community Health Workers (n = 1781) A small number of MWRAs reported CHWs sharing about side effects of family planning, their remedies and about the referral facilities in Korangi Town. Figure-17: Discussion about Family Planning SUKH INITIATIVE Midline Assessment 17 Conclusions / Recommendations The use of modern methods of contraceptive has increased at all the stations of Korangi Town. However, still a large proportion of family planning users practice traditional methods. Among modern methods, condom is the most commonly used method; it is advised to promote other more effective methods. Knowledge imparted on side effects is low; trainings on counseling and management of side effects is advised for CHWs and other providers. Field Station 6 needs more efforts in improving the contraceptive use; it is advised to identify the barriers and their solutions. CHWs of Field Station 6 need trainings and monitoring as community services provided by them are at the lowest as compared to other field stations of Korangi Town. Fact Sheet Sukh Initiative is a multi-donor funded family planning and reproductive health project of Aman Health Care Services, implemented through a consortium of local and international organizations in collaboration with provincial government departments. The project aims to increase modern contraceptive prevalence rate by percentage points in the one million underserved peri-urban population of Karachi city, Sindh, Pakistan Korangi Town Malir Provincial Government Partners Korangi Landhi Bin Qasim Population Welfare Department Project Partners AMAN COMMUNITY HEALTH PROGRAM

KORANGI TOWN FACT SHEET, MIDLINE ASSESSMENT 17 The Sukh Initiative emerged out of commitments made at the London Summit held in July 12. It is a partnership between three private foundations, the Aman Foundation, the Bill & Melinda Gates Foundation and the David and Lucile Packard Foundation. Sukh Initiative is a six-year program (13-19), with goal of increasing the use of modern contraceptives by percentage points amongst.8 million underserved and.2 million LHW covered peri-urban population of Karachi city of Sindh, Pakistan. Sukh Initiative is committed to provide FP related information, counseling, supplies, referrals and quality services to women of reproductive age residing in selected communities. The Initiative has the support of seven national and international consortium partners, of which five are supporting implementation, one strategic communication and one measurement. Sukh Initiative is being implemented in four towns of Karachi, namely Korangi, Landhi, Bin Qasim and Malir. For administrative purposes, Sukh Initiative established field stations in the catchment area, each covering a population of, approximately. Of these, field stations 4, 6 & 7 are located in Korangi. Korangi Town field stations have a current catchment population of 386,716 with 79,698 households and 64,2 married women of reproductive age (MWRA). A total of 89 community health workers (CHWs) are deputed in Korangi Town for door to-door visits; 19 at field station 4, at field station, at field station 6, and at field station 7. A random sample of 1781 MWRA proportionate to population size of each station was interviewed for the midline assessment, 17. Reproductive Health Characteristics About 49% women have 4 or more About 41% women chose private health facility for their last delivery. About 16% women adopted any contraceptive method between 48 hours to 42 days of post-partum period. Figure-4: of MWRA according to Number of Living Children (n = 14) Condom was the preferred method of contraception (44.8%) for post-partum family planning and for post-abortion family planning (6.8%). Majority of women who had miscarriage/abortion visited private facility for post-abortion care (6.%). Figure-7: Post-partum Family Planning Method Mix (n = 418) Current Contraceptive Use At midline survey, the mcpr in Korangi Town is 41.6%, which has increased from baseline figure of 34.%. Field station 6 has the lowest mcpr of 37.7%. Commonly used methods were condom and female sterilization. Figure-: Ever and Current Use of any Modern Method Most of the contraceptive users were Punjabi speaking and in the age group of 34 years having four Private facilities (46.4%) were the main source of contraceptive supplies. Figure-13: Contraceptive Method Mix by Major Spoken Languages (n = 1781) Socio-demographic Characteristics The median age of MWRA was years (IQR 26 3) and about 47% were in between -29 years of age. About 73% women had some form of formal education, with 41.1% having secondary and higher level of education. Urdu is the most commonly spoken language. Figure-2: Education Status of MWRA (n = 1781) Figure-: Place of Last Delivery (n = 963) Figure-8: Type of Health Facility Visited for Post-abortion Care (n = 133) Figure-11: Current Use of Contraceptive Methods (n = 1781) Figure-14: Contraceptive Method Mix by Parity (n = 19) Figure-1: Age Distribution of MWRA (n = 1781) Figure-3: Major Languages spoken (n = 1781) Figure-6: Post-partum Family Planning Use (n = 948) Figure-9: Post-abortion Contraceptive Method Use (n = 7) Figure-12: Contraceptive Method Mix by Age Groups (n = 1781) Figure-: Source of Obtaining Contraceptive Method Last Time (n = 718)

Health Department Education & Literacy Department Door-to-door Services by Aman CHWs About 91% MWRA were aware of CHWs services, of these, 87% reported household visit by CHWs. Sharing of information by CHWs were on benefits of FP (91.%) and methods of Figure-16: Awareness about Aman Community Health Workers (n = 7) FP (8.7%). Less number of MWRAs reported CHWs sharing about side effects of FP, their remedies and about the referral facilities in Malir town. Figure-17: Discussion about Family Planning SUKH INITIATIVE Midline Assessment 17 Conclusions / Recommendations The use of modern methods of contraceptive has increased in Malir Town. However, still a large proportion of family planning users practice traditional methods. Among modern methods, condom is the most commonly used method; it is advised to promote other more effective methods. Knowledge imparted on side effects is low; trainings on counseling and management of side effects is advised for CHWs and other providers. Fact Sheet Sukh Initiative is a multi-donor funded family planning and reproductive health project of Aman Health Care Services, implemented through a consortium of local and international organizations in collaboration with provincial government departments. The project aims to increase modern contraceptive prevalence rate by percentage points in the one million underserved peri-urban population of Karachi city, Sindh, Pakistan Malir Town Malir Provincial Government Partners Korangi Landhi Bin Qasim Population Welfare Department Project Partners AMAN COMMUNITY HEALTH PROGRAM

MALIR TOWN FACT SHEET, MIDLINE ASSESSMENT 17 The Sukh Initiative emerged out of commitments made at the London Summit held in July 12. It is a partnership between three private foundations, the Aman Foundation, the Bill & Melinda Gates Foundation and the David and Lucile Packard Foundation. Sukh Initiative is a six-year program (13-19), with goal of increasing the use of modern contraceptives by percentage points amongst.8 million underserved and.2 million LHW covered peri-urban population of Karachi city of Sindh, Pakistan. Sukh Initiative is committed to provide FP related information, counseling, supplies, referrals and quality services to women of reproductive age residing in selected communities. The Initiative has the support of seven national and international consortium partners, of which five are supporting implementation, one strategic communication and one measurement. Sukh Initiative is being implemented in four towns of Karachi, namely Korangi, Landhi, Bin Qasim and Malir. For administrative purposes, Sukh Initiative established field stations in the catchment area, each covering a population of, approximately. Of these, field station is located in Malir Town. Malir Town field station has a current catchment population of 81,971 with 19,69 households and 13,3 married women of reproductive age (MWRA). A total of 21 community health workers (CHWs) are deputed at field station for door to-door visits. A random sample of 7 MWRA proportionate to population size was interviewed for the midline assessment, 17. Reproductive Health Characteristics About 34% women have 4 or more About 2% women chose private health facility for their last delivery. 43% women adopted any contraceptive method between 48 hours to 42 days of post-partum period. Condom was the preferred method of Figure-4: of MWRA according to Number of Living Children (n = 318) contraception (43.4%) for post-partum family planning and for post-abortion family planning; pills and condoms were both equally preferred (33.3% each). Majority of women who had miscarriage/abortion visited private facility for post-abortion care (83.%). Figure-7: Post-partum Family Planning Method Mix (n = 2) Current Contraceptive Use At midline survey, the mcpr in Malir Town is 47.% and has increased from baseline figure of 3.9% Commonly used modern methods were condom and female sterilization. Most of the contraceptive users were Figure-: Ever and Current Use of any Modern Method Pashto speaking and in the age group of 3 39 years having five or more Private facilities (47.%) were the main source of contraceptive supplies. Figure-13: Contraceptive Method Mix by Major Spoken Languages (n = 2) Socio-demographic Characteristics The median age of MWRA was 29 years (IQR 3) and 1.% were in between -29 years of age. About 68% women had some form of formal education, with.4% having secondary and higher level of education. Urdu is the most commonly spoken language. Figure-2: Education Status of MWRA (n = 7) Figure-: Place of Last Delivery (n = 224) Figure-8: Type of Health Facility Visited for Post-abortion Care (n = 36) Figure-11: Current Use of Contraceptive Methods (n = 7) Figure-14: Contraceptive Method Mix by Parity (n = 3) Figure-1: Age Distribution of MWRA (n = 7) Figure-3: Major Languages spoken (n = 7) Figure-6: Post-partum Family Planning Use (n = 222) Figure-9: Post-abortion Contraceptive Method Use (n = 9) Figure-12: Contraceptive Method Mix by Age Groups (n = 3) Figure-: Source of Obtaining Contraceptive Method Last Time (n = 18)

Health Department Education & Literacy Department Door-to-door Services by Aman CHWs About 91% MWRA were aware of the services of CHWs; of these, 87% reported household visit by CHWs. Sharing of information by CHWs were on the benefits of family planning (91.%) and methods of family planning Figure-16: Awareness about Aman Community Health Workers (n = 8) (8.7%). A small number of MWRAs reported CHWs sharing about side effects of family planning, their remedies and about the referral facilities in Bin Qasim. Figure-17: Discussion about Family Planning SUKH INITIATIVE Midline Assessment 17 Conclusions / Recommendations The use of modern methods of contraceptive has increased at all stations of Bin Qasim Town. However, still a large proportion of family planning users practice traditional methods. Among modern methods, condom is the most commonly used method; it is advised to promote other more effective methods. Knowledge imparted on the side effects is low; trainings on counseling and management of side effects is advised for CHWs and other providers. Fact Sheet Sukh Initiative is a multi-donor funded family planning and reproductive health project of Aman Health Care Services, implemented through a consortium of local and international organizations in collaboration with provincial government departments. The project aims to increase modern contraceptive prevalence rate by percentage points in the one million underserved peri-urban population of Karachi city, Sindh, Pakistan Bin Qasim Town Malir Provincial Government Partners Korangi Landhi Bin Qasim Population Welfare Department Project Partners AMAN COMMUNITY HEALTH PROGRAM

BIN QASIM TOWN FACT SHEET, MIDLINE ASSESSMENT 17 The Sukh Initiative emerged out of commitments made at the London Summit held in July 12. It is a partnership between three private foundations, the Aman Foundation, the Bill & Melinda Gates Foundation and the David and Lucile Packard Foundation. Sukh Initiative is a six-year program (13-19), with goal of increasing the use of modern contraceptives by percentage points amongst.8 million underserved and.2 million LHW covered peri-urban population of Karachi city of Sindh, Pakistan. Sukh Initiative is committed to provide FP related information, counseling, supplies, referrals and quality services to women of reproductive age residing in selected communities. The Initiative has the support of seven national and international consortium partners, of which five are supporting implementation, one strategic communication and one measurement. Sukh Initiative is being implemented in four towns of Karachi, namely Korangi, Landhi, Bin Qasim and Malir. For administrative purposes, Sukh Initiative established field stations in the catchment area, each covering a population of, approximately. Of these, field stations 1, 2, and 3 are located in Bin Qasim. Bin Qasim field stations have a current catchment population of 211,874 with 43,866 households and 3,864 married women of reproductive age (MWRA). A total of 2 community health workers (CHWs) are deputed in Bin Qasim Town for door to-door visits; at field station 1, at field station 2, and 17 at field station 3. A random sample of 8 MWRA proportionate to population size of each station was interviewed for the midline assessment, 17. Reproductive Health Characteristics About 42% women have 4 or more About 48% women chose private health facility for their last delivery. 14.3% women adopted any contraceptive method between 48 hours to 42 days of post-partum period. Condom and injections were the Figure-4: of MWRA according to Number of Living Children (n = 8) preferred method of contraception (.% and 29.2%, respectively) for post-partum family planning and for post-abortion family planning, condom was preferred method (.3% each) Majority of women who had miscarriage/abortion visited private facility for post-abortion care (64.7%). Figure-7: Post-partum Family Planning Method Mix (n = 222) Current Contraceptive Use At midline survey, the mcpr of Bin Qasim Town is 34.2%, which has increased from baseline figure of 28.2%. Field station 2 has the lowest mcpr of 33.4%. Commonly used modern methods were condom and female sterilization. Figure-: Ever and Current Use of any Modern Method Most of the contraceptive users were Urdu speaking and in the age group of 3 39 years having five and more Private facilities (4.%) were the main source of contraceptive supplies. Figure-13: Contraceptive Method Mix by Major Spoken Languages (n = ) Socio-demographic Characteristics The median age of MWRA was 28 years (IQR 24 34) and 6% were in between -29 years of age. About 2% women had some form of formal education, with 17.6% having secondary and higher level of education. Sindhi is the most commonly spoken language. Figure-2: Education Status of MWRA (n = 8) Figure-: Place of Last Delivery (n = 66) Figure-8: Type of Health Facility Visited for Post-abortion Care (n = 87) Figure-11: Current Use of Contraceptive Methods (n = 8) Figure-14: Contraceptive Method Mix by Parity (n = 87) Figure-1: Age Distribution of MWRA (n = 8) Figure-3: Major Languages spoken (n = 8) Figure-6: Post-partum Family Planning Use (n = 96) Figure-9: Post-abortion Contraceptive Method Use (n = 27) Figure-12: Contraceptive Method Mix by Age Groups (n = 8) Figure-: Source of Obtaining Contraceptive Method Last Time (n = 336)

Health Department Education & Literacy Department Door-to-door Services by Aman CHWs About 92% MWRA were aware of the services of CHWs; of these, 89.6% reported household visit(s) by CHWs. Sharing of information by CHWs were on the benefits family planning (94.%) and Figure-16: Awareness about Aman Community Health Workers (n = 64) methods of FP (87.8%). A small number of MWRAs reported CHWs sharing about side effects of family planning, their remedies and about the referral facilities in Landhi Town. Figure-17: Discussion about Family Planning SUKH INITIATIVE Midline Assessment 17 93 92 91 9 89 88 Awareness of CHWs Ever visited by CHWs 92.2 92 92.4 89.6 89.6 89.6 Landhi Town Station 8 Station 9 Landhi Town and Stations 9 8 7 6 87.8 Discussed about various methods 94. Discussed benefits of Family Planning 62.6 Explained side effects Aman CHWs Practices 48.2 46.9 Discussed remidies of side effects Informed about referral facilities Conclusions / Recommendations The use of modern methods of contraceptive has increased at both stations of Landhi. However, still a large proportion of family planning users practice traditional methods. Among modern methods, condom is the most commonly used method; it is advised to promote other more effective methods. Knowledge imparted on side effects is low; trainings on counseling and management of side effects is advised for CHWs and other providers. Fact Sheet Sukh Initiative is a multi-donor funded family planning and reproductive health project of Aman Health Care Services, implemented through a consortium of local and international organizations in collaboration with provincial government departments. The project aims to increase modern contraceptive prevalence rate by percentage points in the one million underserved peri-urban population of Karachi city, Sindh, Pakistan Provincial Government Partners Korangi Landhi Town Malir Landhi Bin Qasim Population Welfare Department Project Partners AMAN COMMUNITY HEALTH PROGRAM

LANDHI TOWN FACT SHEET, MIDLINE ASSESSMENT 17 The Sukh Initiative emerged out of commitments made at the London Summit held in July 12. It is a partnership between three private foundations, the Aman Foundation, the Bill & Melinda Gates Foundation and the David and Lucile Packard Foundation. Sukh Initiative is a six-year program (13-19), with goal of increasing the use of modern contraceptives by percentage points amongst.8 million underserved and.2 million LHW covered peri-urban population of Karachi city of Sindh, Pakistan. Sukh Initiative is committed to provide FP related information, counseling, supplies, referrals and quality services to women of reproductive age residing in selected communities. The Initiative has the support of seven national and international consortium partners, of which five are supporting implementation, one strategic communication and one measurement. Sukh Initiative is being implemented in four towns of Karachi, namely Korangi, Landhi, Bin Qasim and Malir. For administrative purposes, Sukh Initiative established field stations in the catchment area, each covering a population of, approximately. Of these, field stations 8 and 9 are located in Landhi. Landhi Town field stations have a current catchment population of 1,43 with 29,996 households and 21,932 married women of reproductive age (MWRA). A total of 32 community health workers (CHWs) are deputed in Landhi Town for door to-door visits; 18 at field station 8 and 14 at field station 9. A random sample of 64 MWRA proportionate to population size of each station was interviewed for the midline assessment, 17. Reproductive Health Characteristics % women have 4 or more 8% women chose private health facility for their last delivery. 11.8% women adopted any contraceptive method between 48 hours to 42 days of post-partum period. Condom was the preferred method of Figure-4: of MWRA according to Number of Living Children (n = 479) 2.4.2.9 13.2 27.1 1 2 3 4 No of living children contraception for post-partum family planning and for post-abortion family planning (4.4% each) Majority of women (69.2%) who had miscarriage/abortion visited private facility for post-abortion care. Figure-7: Post-partum Family Planning Method Mix (n = 17) 4 3 7.3.9 8..9 4.4 Implant IUCD Pills Injection Condom Withdrawal LAM Method Contraceptive methods 6.8 1.1 4.6 Female Sterilization Current Contraceptive Use At midline survey, the mcpr in Landhi Town is 47.% and has increased from baseline figure of.7%. More or less, all three stations have similar mcpr. Commonly used modern methods were condom and injections. Figure-: Ever and Current Use of any Modern Method 8 7 6 Ever Use, Baseline Ever Use, Midline 71 71 72 9 9 9 47 47 47 31 31 Landhi Town Station 8 Station 9 Landhi Town and Stations Most of the contraceptive users were Punjabi speaking and in the age group of 4 49 years having five and more Private facilities (42.2%) were the main source of contraceptive supplies. Figure-13: Contraceptive Method Mix by Major Spoken Languages (n = 64) Socio-demographic Characteristics The median age of MWRA was 29 years (IQR 34) and 1.4% were in between -29 years of age. About 64% women had some form of formal education, with 29.4% having secondary and higher level of education. Pashto is the most commonly spoken language. Figure-2: Education Status of MWRA (n = 64) 3 36.3 No schooling 22.9 Upto Primary 11. 19.1.3 Middle Secodary Higher Educational levels Figure-: Place of Last Delivery (n = 36) 8.% 23.7%.1% 3.2% Govt Private Welfare Home Delivery Figure-8: Type of Health Facility Visited for Post-abortion Care (n = 3) 7 6 13.9 69.2 14.1 Public Facility Private Facility Dkt Facility Don't remember Type of facility 2.7 Figure-11: Current Use of Contraceptive Methods (n = 64).8% 1.1% 21.8% 9.% 6.4% 4.% 3.7% 2.4% 7.% Female Sterilization Implants IUCD Injections Pills Condom LAM Rhythm method Withdrawal Figure-14: Contraceptive Method Mix by Parity (n = 484) Figure-1: Age Distribution of MWRA (n = 64) Figure-3: Major Languages spoken (n = 64) Figure-6: Post-partum Family Planning Use (n = 36) Figure-9: Post-abortion Contraceptive Method Use (n = 11) Figure-12: Contraceptive Method Mix by Age Groups (n = 64) Figure-: Source of Obtaining Contraceptive Method Last Time (n = 277) 29.8 24.3 18.1.7 6.4 3. 2.1-19 - 24-29 - 34 3-39 - 44 4-49 Age groups 3 36.7 22.7 11. 9.7 8.7 6.1 4.6 Urdu Punjabi Sindhi Pashto Balochi Hindko Others Major Spoken Languages 3.8% 9.4% 2.4% 2.4% Yes, within 48 hours Yes, between 48 hours to 42 days Yes, between 42 days to one year No 4 3 Female Sterilization 9.2 9.2 27 9.2 4.4 Implants Injections Pills Condom Public Facilities Private Facilities Community Services 47.7 42.2 37.6 31..2 32.2. 26.3 21.9 Landhi Town Station 8 Station 9 Landhi Town and Stations