The plight of lady health workers

Recent news reports highlighting ongoing protests by Lady Health Workers (LHWs) due to non-payment of salaries, as the government initiated the 106th Polio Drive, are bad news for all the stakeholders. Pakistan, unfortunately, is still fighting to eradicate the menace of polio, needs as many resources it can possibly gather to fight not only polio, but its plethora of public health-related issues. In a traditional society like ours, LHWs are the unsung heroes who have truly done a remarkable job to spread awareness and helped countless families in the rural towns across the nation. They have reached out to the masses at a ground level and provided women and children tangible support. LHWs have been able to bridge the communication gap and distributed information on family planning, the importance of vaccination courses and provided general health-related counselling which is of immense importance. However, the shabby manner in which the LHWs have been treated is a cause for concern. Last August, due to unstinting efforts made by Bushra Arain, on behalf of All Pakistan LHW Association, to increase the salary structure, Supreme Court of Pakistan ordered a raise in their monthly stipend from Rs 3,000 to Rs 7,000. However, this increase naturally resulted in an additional burden on financial resources of the government, causing health ministry to take extra measures. The devolution of ministries has created uncertainty in public health sector and authorities are yet to get out of this quagmire. Currently, there are over 23,000 LHWs working under Federal Government's project "National Programme for Family Planning and Primary Health (NPFPPH)." While the LHWs are anxious for their future and demand regularisation of their services, the federal government is showing its reluctance. The provinces aren't helping the matters as they find it beyond their capacity to incur the costs of various health projects. Now with this impending threat of boycotting the polio drive, the government needs to make a move, fast. The importance of LHWs cannot be overstated. They have access to remote areas of the country and their presence is relatively less questionable than that of NGOs which are often looked at suspiciously. The LHWs are better able to integrate the women and children and resultantly, serve in an efficient manner. The LHW programme was initiated during the second tenure of Benazir Bhutto's government back in 1994 when 10,000 women were inducted. After its success, another 20,000 were employed by the end of same year. After 17 years, the programme has grown considerably and employs over 100,000 lady health workers in different projects across the country. Despite evidence of programme's success across the length and breadth of the country, however, the current rift comes at a time when the menace of polio is making a return. Pakistan is one of the last few countries which have still been unable to completely eradicate it, along with Afghanistan, India and Nigeria. In the current year, as many as 132 cases of polio have already been reported. The government-supported polio vaccination drive can have a fighting chance only with the help of LHWs. Recent incidents in Fata region show that health NGOs were targeted due to their perceived connection with foreigners. Also, local community boycotted the drive due to hate campaigns initiated by local clerics, who claimed that vaccines were haram. Such pre-conceived notions can only be overcome with help of local LHWs who have been doing a sterling job since last many years. It is, therefore, imperative that the government must step in at the earliest and treat the matter with due importance. Ensuring job security for the LHWs as well as provision of past dues must be made urgently. Partnerships with global donors could also help provide an economic boost and required motivation to LHWs which can help ensure improved performance, ultimately leading towards a healthier Pakistan. Copyright Business Recorder, 2011