A Perfect Storm: How CARE campaigned for reproductive health results in Pakistan

by 31st Jul 2013
A Pakistani woman. © CARE A Pakistani woman. © CARE

A recent WHO study re-confirmed that Pakistan has one of the highest maternal mortality rates in the world (nearly 300 women die for every 100,000 births) and many of them are under 20 years old. Despite the challenging political, economic and social context, sixteen parliamentarians from the main four provinces in Pakistan have recently promised to include sexual and reproductive health needs in their provincial health plans.

CARE recently published “Putting Policy Making into Practice at CARE International”. As I read it, I was thinking about how, as development practitioners, we try very hard to map out and pin down the mechanisms of the policy process, even while we acknowledge that, in the real world, advocacy campaigns are often successful when there is a ‘perfect storm’ – when all possible planned and unplanned factors come together to create a favourable environment.

As organisations, we can follow the guidance on how to create good policy, but we also have to be attuned to what is happening around us.  A good example of this is CARE’s recent Pakistan advocacy campaign on improved reproductive health for young mothers. In a major breakthrough, sixteen parliamentarians from the four main provinces pledged their support for the inclusion of sexual and reproductive health needs in provincial policies and tabled a resolution in each province. Thus far, the resolution has only been passed in only one province, Khyber Pakhtunkhwa (KPK), but the fact that the needs of young mothers has been documented, widely shared and placed firmly on politicians’ agendas is a major victory indeed.

The campaign strategy validates some of the top tips in CARE’s new guidance and made good use of the following:  

Maximising impact by working in partnership and coalitions:  CARE’s collaboration with a well-respected national family planning organisation in Pakistan, Rahnuma, made use of both organisations’ good reputation and experience.

Understanding the complexity of each political system:  To gain support, CARE and Rahnuma held a series of lobbying meetings to sensitise key stakeholders at district and provincial levels.  Next, they won the support of a cross-party parliamentary caucus which could table the legislation in different provinces.

Having clear messages, a clear ask and solution:   With compelling evidence, on the significant gaps in terms of policy and services for young women, CARE presented a clear case for engagement on this issue. CARE and Rahnuma had a clear answer when their receptive stakeholders asked:  What can we do?  How can we help?

While CARE planned and coordinated the highly-effective 16-month advocacy campaign, it recognised that other external factors helped to create the conditions for the perfect storm. The project staff report that:

  • The process of devolution of health services from federal to provincial level, which began in 2010, “offered a window of opportunity for reviewing old policies and formulating new ones.”    
  • The political context was favourable: due to the increase in number of parliamentary seats reserved for women in 2002, the critical threshold of women in the national parliament, provincial assemblies and local government led to several new pieces of legislation to protect women and girls.

Organisations need to lay the groundwork for a successful advocacy campaign, but also be able to take a read of the external environment and react accordingly.  

Alice Allan

I lead CARE’s policy and advocacy on women’s economic empowerment which includes influencing the private sector. I'm passionate about the social and economic benefits of savings-led financial inclusion.

I've been with CARE International UK since 2011 and have spend a big chunk of that time working with Barclays and other banks to responsibly link savers to their services. Before CARE I spent nearly 20 years working both ‘inside’ government – as a Human Rights Advisor at the Foreign and Commonwealth Office and as a researcher in the UK parliament – and ‘outside’ at supporter-led organisations, Amnesty International UK and Saferworld where I helped push for the Arms Trade Treaty. Before that I was a journalist in Colombia and Mexico.

My current interest is how to tackle the unpaid care economy and balancing being a mother and having a career.

One good thing I've read

Things Fall Apart by Chinua Achebe (1958). An all-time favourite book that sums up how change can go so wrong. Generally, however, I am an eternal optimist.

Email: Allan@careinternational.org