Leveraging Change

26th November 2010

LondonMr. Niaz Ullah KhanCountry DirectorPakistan

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What it takes to implement a strategy!

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Our Country!

• Population of Pakistan 170 million

• 796,000 Sq Kms (3 GBs), 134 districts

• Number of poor i.e. 20%? 35%?

• Economic poverty, Food poverty, Multi-dimension poverty?

• 2% economic growth rate?

• 0.5% spent on social protection of all vulnerable groups

• Key challenges are preventive health, low education rates and energy crisis & inaccessible infrastructures

• Aid for Trade or Trade for Aid

• IDPs, War and Floods

Governance Structure in Pakistan

Provincial

Empowerment

Fiscal decentralization

AdministrativeAutonomy District

Tehsil Municipal

Administration

Community Citizens BoardsCommunity Organizations

CapacityBuilding

Linkages

National

Community carePrevention andhealth promotionFirst level healthfacility

Tertiary eye careSecondary eyecare

HMIS structuresData analysis andplanningReporting anddissemination

Primary Health Care Eye Health

Health Management Information System

Venn Diagram - Three Systems in Health

Eye healthin PHC

informationsystem

Community carePrevention andhealthpromotionFirst levelhealth facility

Tertiary eyecareSecondary eyecare

HMISstructuresData analysisand planningReporting anddissemination

PHCreporting

Eye Healthreporting

Eye healthcomponent

of PHC

Venn Diagram - Health Systems Strengthening

Primary Health Care Eye Health

Health Management Information System

Category 10

1000000

2000000

3000000

4000000

5000000

6000000

7000000

20052009

27% increase

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• MoU with WHO

• Strategic Vision Workshops of Provincial Partners for leadership successions

• School screening programme in five urban cities of Pakistan

• Shifting PEC training Component to National Program for PHC from Eye Care partners

• Trachoma survey in eight districts of Pakistan

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Eye Health- Key Innovations

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Education- Key Initiatives & Changes

Pilot – 2 schoolsDemonstration

16 schoolsPolicy

Core groupNational

StandardsPre-Service

Teachers

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Disability – Building Alliances

Islamabad Declaration

Islamabad Recommendations

UNESCAP

South Asia Disability Forum

Asia Pacific Development

Center for Disability

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• DFID funded project continued the identification of adaptable and acceptable local community based solutions for persons with disabilities

• Follow up to National Consultation on barriers to Inclusive Development

• Introducing Child Eye Health with social mobilization at selected districts and urban slums

• Accessible WATSAN for persons with disabilities

• Developing partnership with British Council Active Citizen Programme

Community Development – Key Initiatives and Changes

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Humanitarian Assistance

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www.sightsavers.org.pk

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Way Forward

• Identify STRATEGIC INTEGRATION POINTS for maximum impact

• SUPPORT SYSTEMS needed to fit in with wider health/education/development sector strategies

• IMPROVED COORDINATION issues need to be considered

• SCALING UP for wider impact

• SCALABILITY is addressed on component basis

Nothing is impossible – only thinking makes it so!