Group photo with RHIYA coordinator

Responsible Actions for Health

Project profile: As a new entrant into the RHIYA process, SACHET was only given one district to work in: Chakwal. SACHET initiated its activities in June 2004 with a special focus on ARH issues considered as taboo and controversial socially. SACHET aimed to promote awareness and sensitivity on gender and SRH related issues and narrow the existing gaps regarding rights, information, education and services faced by young people, especially by unmarried and females below the age of 18 in a hierarchical and patriarchal society such as Pakistan.

The foremost task of the programme was to create an enabling environment through which both the community and young people would accept and participate in RHIYA interventions. Social acceptance, participation and ownership of the programme by all stakeholders have been the biggest success of SACHET. It had indeed to overcome cultural and religious stereotypes about NGOs working on the ground and most importantly, to eradicate stigmas, misconceptions and fears attached to SRH issues.

Strategy: Realizing the major road blocks, SACHET spent the first 2 to 3 months concentrating on local issues assessment and understanding. Focusing on a socio-culturally approach based on communication, SACHET developed contacts with highly influential community members such as parents local teachers, health care providers, local counsellors and religious leaders and involved them to be part of Village Advisory Committees (VACs). SACHET was the first RHIYA partner to initiate advisory committees at this level, and it was proved very effective for mobilizing local communities (including parents) to participate and accept SRH interventions. Advisory committees were also established at district and youth levels with the expectation that these would generate both technical and social improvements of ARH issues.

It has to be said that being an advocacy focused organization, SACHET had designed messages that were socially acceptable, gender sensitive, religiously correct and ethically just. SACHET developed a booklet and related materials on Islam and Reproductive Health used by other RHIYA partners Also, the strategy adopted was based on regular consultation and interaction rather than on confrontation. SACHET thus used an indirect and blanket approach towards SRH issues and services, mainly offered through the 20 Youth Friendly Centers established in locations where maximum youths could use these services. This means that youth could benefit ARH counselling but also recreational activities and life skills trainings. There were 10 each for boys and girls in order to respect the cultural context and also to allow girls benefiting from the overall education they lack.

Outputs: 1) Stakeholders support for ARH interventions: SACHET was the only RHIYA partner to form VACs for males & females. This not only mobilized community members at local level, but also allowed lobbying at district government level for an improvement of the ARH situation. SACHET focused on advocacy as a way of sensitizing influential stakeholders. Around 1000 advocacy events were held, mainly at the union council level, and more than 2000 gatekeepers were sensitized on the importance of ARH development. SACHET also consulted extensively local mullahs and religious schools and gained their support owing to the completion of RH knowledge in the light of Islam. A series of seminars on “Islam & RH” were thus held and were greatly popular especially among females. Further, advocacy for ASRH was promoted at national level through 2 youth summits which allowed initiating dialogue with policy makers.

2) Improved awareness & SRH knowledge among A/Y: A wide range of tools were used to raise awareness and educate A/Y like school awareness campaigns, ARH awareness sessions at YFCs, and message dissemination through sports, cultural events and promotional material. Even village walls have been used in one union council as a way to disseminate ARH information. SACHET also insisted on the organization of dialogue forums between youth and stakeholders, in order to share SRH problems and reduce the communication gap preventing from undertaking actions for ARH. Apart from ARH related booklets, IEC material and BBC tools like theatre, videos or billboards, SACHET’s major achievement was the organization of Youth junctions in December each year, where A/Y came forward with various activities to show their concern about ARH: in 2004 A/Y’s participation was around 700 and above 1600 in 2006.

3) Increased access to youth oriented SRH services among A/Y: YFC Counsellors offered a number of youth friendly ARH services including counselling, referral, free contraceptives (condoms, pills, emergency contraceptives) STI management, but also recreational activities and like skill development. Medical services were given at the programme district office to at least 4000 A/Y and 800 were referred to secondary level health care for medical investigation and follow up. Both male and female staff was appointed and trained to keep in view young people’s needs, so as to ensure the youth friendliness of services. In addition, services at YFCs were free and A/Y prepared all the work plans YICs activities. Further, 900 Peer educators were recruited during the implementation course to reach A/Y. All services were confidential and non-judgmental as records were not kept when providing contraceptives.

4) Technical, planning & managerial capacity building strengthened: In total, 2871 stakeholders were trained on ARH related issues throughout the project period, including staff members, PE and community gatekeepers were trained through capacity building workshops. This was possible owing to the introduction of various modules tailored to A/Y needs during the implementation like ARH counselling, training-learning and advocacy packages, and manuals for pre marriage counselling, parents, teachers and health service providers training. Some 20 local NGO /CBO staff members were involved in several training workshops as building their capacity was seen as a means of sustaining ARH programs. Some staff was also trained on KMS to ensure smooth record keeping and data management of the project.

Lessons learned: Initially, peer education was not a part of the project, but it emerged as a need during the midterm review. SACHET adopted a PE manual tailored to Pakistan’s specific needs and conducted 10 PE camps that empowered A/Y (both girls and boys) to educate their peers in schools, neighbourhoods and workplaces. PE increased the number of A/Y visiting YFC. Equipping them with technical knowledge and skills for carrying out ARH education is a good way of ensuring the technical sustainability of the programme.

Theatre is a powerful BCC tool to impart knowledge and disseminate information on ARH issues in conservative society, mainly due do its indirect approach talking about ARH. Theatre performances received warm welcome by A/Y as these are also used as recreational activities. Participants included youth, parents, teachers, community elders and influential gatekeepers. Issues highlighted in these events affected the behaviour of the community.

Working with young people require the involvement of gatekeepers such as parents, teachers, health care providers and religious / political leaders: First, gatekeepers’ training / sensitization on ARH and related issues, especially that of parents', was necessary to reduce the communication gap with A/Y. Parents organized debates with teachers and religious leaders to conduct ARH sessions in schools and in mosques. Changing social attitudes and gradual disappearance of stereotypes regarding SRH were observed. Some union council Nazisms even assured to allocate funds for YFC buildings in coming years.

Seminars on “Islam & ARH” were really effective to raise the support of the community and change attitudes. This was a great step forward especially for female given that until now they were often denied access to ASRH information. SACHET is also trying to work more intensively with religious seminaries (Madrissahs) and keep them involved in RHIYA activities/seminars.

Partner Profile: Society for the Advancement of Community, Health, Education and Training (SACHET) is a multi-dimensional, gender focusing, forward looking organization registered in Islamabad in 1961. Devoted to extend both in the short and long term, SACHE (Society for the Advancement of Community, Health and Education) became SACHET (Society for the Advancement of Community, Health, Education and Training) in May 1999 to embrace the productive entity of Training as pre-requisite to successful interventions in health & education sector. SACHET seeks to provide social development, primarily in low-income localities, by investing in health, education, poverty alleviation, income generation skills, human resource and rural development. Grantees and beneficiaries are selected without regard to race, religion and political persuasion. SACHET is also the first NGO in Pakistan that has taken up steps to eradicate the issue of dowry through its unique project "Fight against Dowry."

Contact: SACHET Park Road, F-8, Markaz Islamabad Pakistan Tel: Fax: