The Pakistan arm of the THRIVE OpenSRP deployment focused on developing solutions for Household registers, Vaccination registers, and a Stock register (embedded in the Vaccination solution). The deployment took place in Korangi town--an ethnically and economically diverse urban area within Karachi city with an estimated population of 1.2 million people. Healthcare in Korangi is available through a mixture of public and private healthcare facilities, but with much of the population unable to afford private care, most depend on the public health sector for essential health services.
At the household level, publicly-provided community health workers such as Lady Health Workers (LHWs) and Vaccinators are often the first and only point of contact for health care services. With an overall shortage of qualified physicians and nurses, these workers play a prominent role in the public sector. LHWs are selected from amongst their communities to raise awareness on family planning, nutrition and hygiene, and to generate demand for antenatal care, child immunizations, and use of skilled birth attendants during delivery. Vaccinators are responsible for ensuring young children receive complete immunization coverage and are specifically focused on polio eradication.
The health sector faces a severe lack of necessary oversight and monitoring of health workers, combined with extensive paper work which makes verifying data figures reported extremely difficult. While Pakistan has made great strides recently in developing a national civil registry, half of the population has still not taken advantage of registering for a national ID number. As a result, immunization targets are based on inaccurate and outdated population data, severely hampering efforts to estimate immunization coverage and effectiveness of government campaigns to eradicate polio and improve various other health care efforts. Given the LHW’s proximity to the members in her community, she could play a vital role in establishing the actual population baseline for care and ensuring everyone is registered and receiving routine health coverage.