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RafPakistan Australian Government - ausAID Department for International Development
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Progress to date

Since its inception in 2008, RAF has held five calls for proposals, and currently funds a portfolio of research and advocacy projects on a range of issues in 75 districts throughout Pakistan, including all 10 districts in Azad Kashmir. 

 


 


Project Title: Evidence for innovating to save lives
Research Objective/s: To understand effective and viable intervention models for promoting healthy timing and spacing of pregnancies in predominantly rural and under-served communities.
Duration: 33 months (September 2010- May 2013).
Location of the project: Naushehro Feroz, Nawabshah, Pakpattan, Khanewal, Bahawalpur, Haripur, Rajanpur and Abbottabad.
 

 
Project Title: How far can I go; Social Mobility of Community Midwives (CMWs) in ten districts of Azad Jammu and Kashmir
Grantee: Children First- Azad Jammu and Kashmir
Research Objective/s: To identify the barriers of social mobility and acceptability of CMWs in rural population in Azad Jammu and Kashmir(AJK) in terms of geographical, economical and socio-cultural and gender aspects. Findings on social mobility and acceptability of CMWs in rural AJK will help in identifying barriers and help improve CMWs service outreach.
Duration: 12 months (February 2011 to January 2012)
Location of the project: District Bhimber, Kotli, Mirpur, Muzaffarabad, Hattian, Neelum, Poonch, Haveli, Bagh, Sudhnati in Azad Jammu and Kashmir
 

 
Project Title: Exploring Operational Barriers of Community Midwives (CMWs) Services in Khyber Pakhtunkhwa and Punjab.
Grantee: Human Development Programme
Research Objective/s: The research will investigate the root causes of the operational barriers to services delivered by CMWs. This study will also explore the perceived operational barriers by CMW’s. In context of organizational factors (i.e. logistic arrangements, administrative norms, Medicine & supplies, personnel, monitoring and evaluation) for running CMW’s services, barriers will also be explored from manager at provincial and district levels.
Duration: 9 months (May 2011 to January 2012)
Location of the project: District Mardan and Swat in Khyber Pakhtunkhwa province, and District Kasur and Okara in Punjab province.
 

 
Project Title: Making birthing safe for Pakistani women. 
Grantee: Association for Social Development
Research Objective/s: To conduct a cluster randomised controlled trial comparing the utilisation of available safe birthing and Emergency Obstetric and Neonatal Care (EmONC) services and the reduction in neonate mortality among pregnancies offered. The study will distinguish the effects of addressing the “decision” and “access” delays, to safe birthing and EmONC services, in the context of the provincial Maternal Newborn and Child Health (MNCH) Programmes.
Duration: 28 Months (February 2011 to May 2013).
 

 
Project Title: Are community midwives addressing the inequities in access to skilled birth attendance in Punjab, Pakistan?
Grantee: University of Alberta
Research Objective/s: The proposed research project aims to investigate whether the Community Midwives (CMWs) are fulfilling the government objective of improving access to the full scope of skilled maternity care for the poor and disadvantaged women in Pakistan. Specifically the research will investigate:
-       Whether the CMWs are providing maternity services to poor and/or socially excluded women
-       Describe challenges (organizational, social, financial) encountered by CMWs in providing care to the poor and socially marginalized women
-       Assess social, financial and other barriers that poor and socially excluded women face when accessing CMW services?
Duration: 20 months (1st September 2011 to 30th April 2013)
Location of the project: Jhelum and Layyah
 

 
Project Title: Role of Community-Based Savings Groups (CBSGs) in enabling greater Utilisation of Community Midwives (CMWs) in Chitral District of Pakistan
Grantee: Agha Khan Foundation
Research Objective/s: This study will assess how membership in CBSGs contributes to utilization of Maternal and Newborn Health services in the community, specifically those offered by CMWs and to produce evidence to support a model that will directly address the major obstacles to accessing skilled birth attendance i.e., distance, inability to pay, perception of risk for an obstetric emergency, traditional preference for home delivery and cultural barriers to women’s mobility outside the home.
Duration: 16 months (1st September 2011 to 31st Dec. 2012)
Location of the project: Chitral (Khyber Pakhtunkhwa)
 

Project Title: Study on Post Abortion Care in Pakistan.
Grantee: Population Council
Research Objective/s: The proposed research will generate updated estimates on the number of post abortion complications based on numbers of women presenting in health facilities; provide information on changes in the conditions and practice of unsafe abortion and the degree to which women are obtaining facility care.
Duration: 23 months (1st July 2011 to 31st May 2013)
Location of the project: National.
 

 
Project Title: Research on Removing Three Delays for Improving Access to Emergency Obstetric and Neonatal Care (EmONC) in Non-Lady Health Workers (LHWs) covered areas of Pakistan
Grantee: Rural Support Programme Network (RSPN)
Research Objective/s: To develop and demonstrate community based intervention model to remove the three delays for Improving Access to Emergency Obstetric and Neonatal Care for non-LHW covered Areas of Pakistan. And to generate robust evidence to push for scaling up of proven, community based interventions with focus on improving EmONC services and access for the poor and marginalised communities in non-LHW covered Areas.
Duration: 16 months (Jan 2012 to 31st May 2013)
Location of the project: District Dadu in Sindh province
 

 
Project Title: Strengthening the Knowledge and Skills of Community Midwives in Pakistan
Grantee: Greenstar Social Marketing Pakistan (Guarantee) Limited
Research Objective/s: The primary focus of the project will be on improving the service delivery skills of midwives; secondary objective will be to increase CMWs’ ability to raise an income to support themselves.
Duration: 16 months (Jan 12 to 15th May 13)
Location of the project: 12 districtsin Punjab province (Dera Ghazi Khan, Jhang, Khanewal, Mianwali, Muzaffargarh, Rajan Pur, Sargodha, Toba Tek Singh, Vehari, Bahawalnagar, Bahawalpur and Bhakkar), 5 districts in Sindh province (Dadu, Khairpur, Larkana, Jacobabad and Sukkur)  and 4 districts in Khyber Pakhtunkhwa province (Peshawar, Charsadda, Nowsehra and Swat)
 

 
Project Title: Myths and beliefs on Maternal and Newborn Health (MNH) in Kalat – Balochistan
Grantee: Poverty Alleviation Organisation Balochistan, Kalat
Research Objective/s: To assess the effects of local myths and beliefs, working as barriers to the utilisation of maternal and newborn health services. This research will explore traditional health practices and beliefs on maternal and neonatal health in Kalat, a central district of Balochistan.
Duration: 13 months (August 2010- August 2011)
Location of the project: Kalat district, Balochistan.
 

 
Project Title: Community mobilisation through Community Midwives (CMWs) – An initiative for community behaviour change and mobilisation: Can enhanced communication skills of CMWs improve maternal health?
Grantee: Health Services Academy
Research Objective/s: To identify feasible, acceptable and appropriately targeted service delivery intervention for CMWs, focusing on behaviours related to MNH care in the rural communities that can and need to be changed by utilising appropriate messages and approaches; to deliver services at scale and within existing health systems. Formative research is being conducted that will assist in providing information on rural community’s knowledge, attitudes and behaviours regarding maternal and neonatal health issues and identify opportunities for feasible community engagement assisting uptake and maintenance of healthy behaviours (change). 
Duration: 12 months (March 2011 to February 2012)
Location of the project: District Attock in Punjab Province.
 

 
Project Title: Assessment of Community Participation in the Community Mid-Wives (CMW) Programme.
Grantee: Khyber Medical University
Research Objective/s: The study aims to determine the role assigned to the community in the CMW programme policy, planning and implementation strategies with special focus on how the issues of poverty, gender and social exclusion are being addressed.
Duration: 6 Months (March 2011 to August 2011).
Location of the project: District Mardan in Khyber Pakhtunkhwa province.
 

 
Project Title: Preference of Birthing Place: A mixed methods study of Communities, Households, Community Midwives and MNCH Programme.
Grantee: Human Development Research Foundation
Research Objective/s: This is a cross sectional mixed method study. The key objective is to explore the household’s preference for placement of CMWs and their reasons for the choice. Another objective is to have a deeper understanding of the issues and challenges foreseen by the MNCH programme, CMWs, women and the community including religious leaders and elders.
Duration: 12 months (March 2011 to February 2012). 
Location of the project: National.
 

 
Project Title: An Analysis of Equity Issues in Public Spending on Maternal and Newborn Health (MNH) in Pakistan.
Grantee: Dr. Saadia Malik
Research Objective/s: The key objective of this project would be to facilitate evidence based policy advocacy for a just and equitable allocation of public resources on MNCH.
Duration: 7 months (18th November 11 to 17th June 12)
Location of the project: National 
 

 

Project Title: Post-abortion Care – From Pledge to Practice
Objective/s: Utilise the process of developing and disseminating evidence to engage with senior policy makers, health managers and providers, gate keepers and community members to increase understanding of the importance of addressing Post-abortion Care as a key intervention in reducing maternal death and disability. Stimulate and support action among policy makers and services providers.
Motivate gate keepers to promote utilisation of PAC services and to hold the providers and policy makers accountable for ensuring these are high quality services and mobilise general public interest in maternal and newborn health related issues.
Duration: 23 months (June 2011-May 2013)
Location of the project: Khyber Pakhtunkhwa, Punjab, Baluchistan and Sindh.
 

 
Project Title: Green Rose
Grantee: Stitching Oxfam Novib (SON)
Implementing partner(s): Women Empowerment Group
Objective/s: To contribute to reducing maternal and new-born mortality and morbidity amongst adolescent girls and their infants - by facilitating the Pakistani boys' and girls' access to full and comprehensive Sexual and Reproductive Health and Rights (SRHR) education providing them with knowledge, skills and attitude required to empower them to exercise their SRH rights and make their own free decisions about reproductive health in a free and enabling environment.
Duration: 18 Months (1st Dec 11 to 31st May 13)
Location of the project: Islamabad, Districts Peshawar and Abbottabad in Khyber Pakhtunkhwa, Pishin and Quetta in Balochistan, Jamshoro in Sindh and Lodhran in Punjab
 

 
Project Title: Adolescent Girls Empowerment
Grantee: Rutgers World Population Fund Pakistan
Objective/s: 
-       To contribute to improved maternal health indicators among adolescent girls in Sindh by reducing the incidence of early marriages and pregnancies. This contribution will be made by mobilising communities to prevent early marriages while strengthening civil society advocacy efforts to raise the legal age of marriage for adolescent girls from 16 to 18.
-       To create awareness and acceptance at the community level regarding the harmful social, economic, and health consequences of early marriage.
-       To minimise opposition and mobilise support through strengthening the advocacy efforts of civil society for catalysing the passing of the bill on increasing the minimum age of marriage for adolescent girls from 16 to 18.
Implementing partner(s): Health and Nutrition Development Society
Duration: 20 Months (1st January 12 to 31st May 13)
Location of the project:  Sindh:
 

 
Project Title: Ensuring SRH Component in SOPs of National Disaster Management Plans
Grantee: Rahnuma- Family Planning Association of Pakistan
Objective/s: The objective of the proposed advocacy project is to include the provision of MISP (Minimum Initial Service Package) as a part of the Standard Operating Procedures of the National Disaster Management Plan at the federal, provincial and district levels.
Duration: 12 Months (1st July 2011 to 30th June 2012)
Location of the project: National
 

 
Project Title: Improving Health Services through Participatory Governance
Grantee: Human Research Development Society (HRDS)
Implementing partner(s): Organisation for Integrated and Sustainable Development (OISD)
Objective/s: There are three main objectives that the project intends to achieve during the nine month period of its operation.
-       Civil society and community at grassroots especially marginalised segment of society sensitised to take part in decision making processes;
-       Institutionalisation of DHMT after observance of good practices
-       Policy makers’ sensitisation for sustainability and legalisation of DHMT.
Duration: 1st November 11 to 31st July 2012
Location of the project: District Mansehra in Khyber Pakhtunkhwa province 

 

 

Project Title: We CARE- Financial Empowerment of Women to Enable and Enhance Access to Maternal and Newborn healthcare.

Grantee: Strengthening Participatory Organisation (SPO)
Objective/s: 
-       To assess the impact and limitations of existing SSNs such as cash transfer schemes in Pakistan on women’s health in general, and MNH in particular, within most-marginalised (belonging to poorest quintile), and socially excluded women groups.
-       To derive policy directives, in light of best practices within international SSNs (policies and programs) that have contributed to improvement of women’s health in general, and MNH in particular, within most-marginalised women groups, to feed into subsequent informed policy advocacy.
Duration: 16 months (January 12 to 31st May 13)
Location of the project: Balochistan, Khyber Pakhtunkhwa, Sindh and Punjab
Project Title: An Analysis of Equity Issues in Public Spending on MNCH in Pakistan
Grantee/Principal Investigator: Dr. Sadia Marium Malik 
Research Objective/s: The study provides analysis of: a) who benefits from public health spending on MNCH related services in Pakistan? Is the distribution of public health spending pro-poor or pro-rich? b) What is the observed pattern in the distribution of public health benefits for MNCH related services in Pakistan between 2007-08 and 2010-11? c) What are the key policy insights that arise from our analysis? In particular, the study provides recommendations on how the level and pattern of budgetary allocations on health can be made more efficient and equitable.
Download:

Project Title: The Punjab Antenatal services Assessment (PASA) Study.
Grantee: Research Society, Allama Iqbal Medical College
Research Objective/s: To assess, both quantitatively and qualitatively, antenatal care services being provided at first level care facilities (BHUs and RHCs) in Punjab. The assessment seeks to identify inputs (in terms of resources, infrastructure, supplies, drugs and service delivery protocols), processes (client/patient interaction; patient history examination and assessment; case management, follow up) and facility performance. 
Duration: June 2010 –  November 2011
Location of the project: District Bahawalnagar, Gujranwala, Kasur, Multan, Rawalpindi, Sargodha, Sahiwal, Toba Take Singh, Vehari of Punjab Province.
 
Download:

 
Project Title: Baseline Survey of Eight (8) Key Family Practices in Sindh
Grantee:  Provincial Health Development Centre. Sindh, Jamshoro.
Research Objective/s: To determine the dynamics and prevalence of eight key family practices related to mothers and neonatal health among mothers of newborns aged 28 days or less. These include antenatal health, nutrition during pregnancy, antenatal, natal and neonatal care services uptake, antenatal and neonatal immunization, newborn feeding practices, hygiene and illness related health seeking behaviours. It will also identify the socio-economic dynamics underlying and contributing to district level perceptions, knowledge and understanding held by mothers of newborns in these key areas.
Duration: June 2010- December 2011.
Location of the project:  Districts: Karachi (excluding Malir district), Hyderabad, Tando Allah Yar, Naushehro Feroz and Jacobabad in Sindh province.
 
 Download:
 

 
Project Title: Are Community Midwives (CMWs) Accessible in Sindh and Punjab?
Grantee: Arjumand and Associates
Research Objective/s: To identify key factors that influence pregnant women’s decisions to access or not access CMWs as their birth attendant; Identify key factors that inhibit or facilitate CMWs in reaching pregnant women to conduct deliveries and provide evidence based policy and programmatic recommendations to policy makers and programme managers to help them rectify obstacles & promote facilitation.
Duration: March 2011 to February 2012
Location of the project: 18 districts of Punjab(Attock, Bahawalpur, Chakwal, Dera-Gazi Khan, Gujrat, Jhelum, Jhang, Kasur, Layyah, Lodhran, Muzaffargarh, Mianwali, Multan, Okara, Rajanpur, Sahiwal, Toba Take Singh, Sialkot) and 9 districts of Sindh (Dadu, Ghotki, Karachi, Hyderabad, Naushehro Feroz, Tando Allah Yar, Thatta, Shahdadkot, Jacobabad)
 
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Project Title: Preference of Birthing Place: A mixed methods study of Communities, Households, Community Midwives and MNCH Programme.
Grantee: Human Development Research Foundation
Research Objective/s: This is a cross sectional mixed method study. The key objective is to explore the household’s preference for placement of CMWs and their reasons for the choice. Another objective is to have a deeper understanding of the issues and challenges foreseen by the MNCH programme, CMWs, women and the community including religious leaders and elders.
Duration: 12 months (March 2011 to February 2012). 
Location of the project: National.

 


 
Project Title: How far can I go; Social Mobility of CMW in ten districts of Azad Jammu and Kashmir.
Grantee: Children First- Azad Jammu and Kashmir
Research Objective/s: To identify the barriers of social mobility and acceptability of CMWs in rural population in AJK in terms of geographical, economical and socio-cultural and gender aspects. Findings on social mobility and acceptability of CMWs in rural AJK will help in identifying barriers and help improve CMWs service outreach.
Duration: 12 months (February 2011 to January 2012)
Location of the project: District of Azad Jammu Kashmir (Bhimber, Kotli, Mirpur, Muzaffarabad, Hattaian, Neelum, Poonch, Haveli, Bagh, Sudhnati).

 

 
 
Project Title: Assessment of Community Participation in the Community Mid-Wives (CMW) Programme.
Grantee: Khyber Medical University
Research Objective/s: The study aims to determine the role assigned to the community in the CMW programme policy, planning and implementation strategies with special focus on how the issues of poverty, gender and social exclusion are being addressed.
Duration: 6 Months (March 2011 to August 2011).
Location of the project: District Mardan in Khyber Pakhtoonkhwa province.

 

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