Health

Using Incentives to Improve Performance of Polio Workers

Zara Salman and Shehryar Nabi

Since Pakistan reached an alarming high of 306 new polio cases in 2014, polio vaccination campaigns have helped reduce that number dramatically. But to ensure the long-term eradication of polio in Pakistan, the systemic problems affecting the administration of polio vaccines still have to be addressed. One of these problems is motivation: low pay for highly demanding work has left many health workers unwilling to perform well, which results in fewer vaccinations. According to IGC-funded research, both monetary and behavioural incentives show promising results as policy tools to motivate health workers.

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Determinants of Nutritional and Health Status of Children in Punjab

Zara Salman and Shehryar Nabi

Pakistan's children have some of the poorest health outcomes in South Asia. An estimated eight percent die before the age of five, 44 percent have stunted growth and a third of them are underweight. Pakistan's large primary care system has not effectively prevented this because the main determinants of health status - sanitation, education, income, and quality healthcare - have not been sufficiently dealt with. Uzma Afzal, Usman Ghaus and Jeffrey Hammer argue that current surveys are missing vital information on these determinants for designing sound health policies. They identify the gaps, and offer recommendations for how these surveys can improve.

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Primary Health Care in Punjab: Learning from Bangladesh

Zara Salman

The Government of Punjab (GoPb) invited Dr. Zafrullah Chowdhary and his team from Bangladesh to visit Punjab. The team setup a model BHU in the Nankana district, by tailoring the Bangladesh experience to local conditions. Based on their observations, it was highlighted that the unavailability of diagnostic and other medical facilities in BHUs and the lack of skills to utilize them needs to be addressed.

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The Constraints of Distance and Poverty on Institutional Deliveries in Pakistan: Evidence from geo Reference-linked data

Dr. Zeba Sathar

While institutional deliveries in Pakistan have risen substantially over the last few years, the change has mainly occurred among the wealthy and those with access to services in urban areas. The paper assess the influence of economic and geographic access to health facilities on institutional deliveries by linking household survey data and georeferenced distance to facilities equipped to provide services for obstetric care in nine districts in Pakistan. it suggests that disadvantages faced by poor rural women can be minimized by upgrading existing facilities at district and subdistrict levels to provide comprehensive emergency care and by facilitating transportation of poor rural women directly to these facilities when they experience life-threatening complications of childbirth.

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Evidence of Son Preference and Resulting Demographic and Health Outcomes in Pakistan

Dr. Zeba Sathar

This report explores the issue of gender-biased sex selection in Pakistan and makes evidence-based recommendations for responding to adverse sex ratios at birth. It presents reproductive healthcare providers’ perspectives on the risk and incidence of prenatal sex selection in Karachi. It postulates that pre-conditions for these practices exist: son preference persists, the small family norm is prevalent, and the practice of disclosing the sex of the foetus, while discouraged by some, is widespread.

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