Pakistan’s Lady Health Workers: Offering a Lifeline of Health and Hope

As the sun rises over the desert of Tharparkar, the small village of Chehlar begins to wake up under a blistering sky. Despite the harsh heat, the people of Chehlar continue their daily routines. Parveen, 39, a mother of two, has already prepared a simple breakfast for her family and sent her daughters to school, which is miles away. Now, she gathers her materials, pamphlets, and tools for her session at the local health house.

Today, in her role as a lady health worker, Parveen will meet with a group of women who have walked, some for over an hour along with their children, to address a diarrhea outbreak in the village. Poor sanitation and lack of clean water have made many sick, and there is a risk of acute malnutrition if the situation persists. Sitting in a circle in the stifling heat, the women listen attentively to Parveen.

"It is important to wash hands frequently," she advises. "If you don't have access to clean water, boil it before drinking, and eat soft foods such as potatoes, boiled rice, and lentils to boost your immune system."

During the session, Parveen records the names of those needing further examination and prepares to refer them to the nearby health center for nutrition assistance. She then checks the children for malnutrition, using a simple tape measure around their upper arms. Today, an eight-month-old boy shows signs of severe undernourishment. His mother watches anxiously as Parveen gently reassures her, offering guidance on nutrition and registering the child for additional care.

This is just one part of Parveen's work. For 24 years, she has walked from home to home, teaching mothers how to prepare nutritious meals and reminding them about vaccinations.

"At first, people didn't trust me," Parveen says. "But over time, they saw that I was here to help. Now they respect me, and they listen."

Lady health workers like Parveen are lifelines in their communities, bridging the gap between households and healthcare systems. They teach families essential health practices, guiding mothers on hygiene, and nutrition and preparing meals that improve family diets. Parveen's expertise developed under the Community Management of Acute Malnutrition (CMAM) Surge programme, equips her to assess malnutrition, monitor pregnant women, and coach new mothers.

The CMAM Surge approach, launched in Umerkot in 2021 and now expanded to Tharparkar, strengthens health systems in regions with high malnutrition rates. Funded by the European Union and implemented by WFP and Concern Worldwide, the programme provides tools and training to health workers like Parveen, who help detect malnutrition and link communities to critical care. This model, embedded across 12 health centers, enables responsive, effective care during seasonal surges of malnutrition caused by poverty, limited clean water, and high vulnerability to infections and drought.

Since Pakistan's Lady Health Worker (LHW) was launched in 1994, it has empowered community health champions in underserved areas, setting a global standard for grassroots health. LHWs like Parveen are crucial in spotting malnutrition early and establishing reliable referral networks to ensure families get timely help, especially during crises. In the past year, Parveen has referred 180 malnutrition cases to the Basic Health Unit in Chehlar, providing each with dedicated follow-up.

Prepared for any emergency, from floods to disease outbreaks, Parveen carries her essential health kit - fetoscope, measuring tape, weight scale - delivering accurate, prompt care wherever needed.

"This new way of doing things has really improved the system," Parveen says.

She glances at the women still gathered around her, their faces reflecting the heat but also hope. "Now, when we send someone to the health facility, they know who to go to, and they get the right care. The link between us and the hospital is much stronger."

- - Anam Abbas

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