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A girl presents at a forum on children’s health




why Plan works in Pakistan

in Pakistan

• Only 56 per cent of children go to primary school • There are 150,000 street children in Pakistan

• Protecting the health of children and young people

• 23 per cent of the population live below the official poverty line of US$1 a day

• Improving the education of children and their communities – from preschool level to adulthood • Offering families opportunities to increase their incomes and financial security • Promoting the rights of women and children and ensuring they have a say in matters affecting their lives • Supporting families in areas of Pakistan affected by disasters or emergency situations

‘Families were keen to clean up their surroundings and adopt a healthier lifestyle’ Syrd





Pakistan Facts cent), Sindhi (12 per cent), Siraiki (10 per cent), Pashtu (8 per cent), Urdu (official, 8 per cent), English (official) and other languages Climate: Pakistan has four seasons: a cool, dry winter from December through February; a hot, dry spring from March through May; the summer rainy season, or southwest monsoon period, from June through September; and the retreating monsoon period of October and November. The onset and duration of these seasons vary somewhat according to location. Rainfall can vary radically from year to




year, and successive patterns of flooding and drought are also not uncommon. Economy: In recent years the structure of the Pakistani economy has changed from a mainly agricultural base to a strong service base. Agriculture now only accounts for roughly 20 per cent of the GDP, while the service sector accounts for 53 per cent of the GDP. Significant foreign investments have been made in several areas including telecommunications, real estate and energy. Other important industries include textiles (almost 60 per cent of total GDP), food processing, chemicals manufacture, and the iron and steel industries.

The boundaries of Jammu and Kashmir shown on this map do not imply official endorsement or acceptance by Plan International.






The final status of Jammu and Kashmir has not been agreed upon by the parties.




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Country Office Program Units



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Capital: Islamabad Population: 176 million Languages: Punjabi (48 per



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Focus On:

better health for children and young people Many children in Pakistan’s poorest communities grow up with the daily threat of chronic ill-health or life-threatening disease. Our work includes supporting communities to lobby for better health services. We are protecting the health of pregnant women, providing access to ante-natal care and safe deliveries. We are improving healthcare for mothers, babies

and young children. We promote child health initiatives like eyesight screening and vaccination. We work with adolescents to raise awareness of reproductive health. And we make sure that families benefit from clean water, decent sanitation and healthier living environments.

Healthy Habits in Dhoke Kado

It’s a delicate subject, but ancient traditions are not always the best, as Shabbar, a villager from Dhoke Kado, a small community in eastern Pakistan, will admit.

healthier lifestyle, especially when Zafar from the village Basic Health Unit explained the link between poor sanitation and potentially fatal diseases.

Ever since his grandfather’s time, Shabbar, his family and neighbours in the village have gone outside whenever they needed the toilet, using the open fields. With no proper sanitation they had little choice, but nor did they understand the dangers of what they were doing.

Plan and SABAWON make no apologies for making villagers feel shocked by their behaviour. It’s an essential part of encouraging them to change.

If human waste is not disposed of hygienically, it can contaminate the local water and food supplies, putting children at risk of serious diseases like cholera and dysentery. But no one had ever explained this to Shabbar’s community, and although it may seem obvious to us, life in Dhoke Kado is different. Families here are among the poorest in Pakistan. They have little or no access to decent healthcare, or health information. Community-led approach For the last four years, Plan has worked with families across the Chakwal area of Pakistan to install around 1500 latrines in their homes. We began to realise, however, that on its own this was not solving families’ sanitation problems. Many were not using their latrines, preferring instead to go outside. The habits of a lifetime were hard to break. It was clear that Plan and our local partner organisation SABAWON had to find a new approach if we were to help families protect their children’s health. After some initial research, we agreed to begin a scheme in Dhoke Kado called Community-Led Total Sanitation (CLTS). As its name suggests, CLTS involves the whole community, including children, in learning about hygiene, identifying bad practice in their village and putting long-term solutions in place. The motivation to make it work must come from the community itself. Fortunately, in Dhoke Kado, there was no shortage of enthusiasm. Families were keen to clean up their surroundings and adopt a

Produced for Pakistan by Plan International Australia.

‘I feel it [poor sanitation] has harmed my children and taught them bad habits,’ says Noor, a local mother. ‘I feel that I have been eating other people’s faeces; this is a horrible realisation for me which is why we all now use our latrine at home.’ Finding solutions As part of CLTS, the community draws up a map of the particularly contaminated areas in their village and decides on a plan to stop using them. Some families resolve to cover their waste with soil so that it does not spread diseases. Others, like Shabbar, have built their own household latrine. With guidance from Plan and SABAWON, families in Dhoke Kado monitor the progress of CLTS in their village. They check whether the dirtiest areas on their map are less polluted. They assess whether behaviour is changing. They are vigilant about pressing others to mend their ways.

Parents look at ways to improve the health of their children

The Bigger Picture Plan is working with children, families and communities to find sustainable solutions to the challenges in Pakistan. We have only given you a small insight into Plan’s work in Pakistan with this report but over the past year we also: • Built or rehabilitated 51 preschools • Worked with partners to launch a Youth Helpline offering counselling and advice on health issues to young people • Enabled families to enjoy better incomes by helping to establish 71 credit and loans groups with 1775 members in Vehari, eastern Pakistan Your support as a sponsor is crucial to achieving these results. With the resources provided by sponsors, Plan expertise and the collaboration of communities and local partners we are making a big difference to the lives of people in Pakistan. Thank you for your involvement!

To learn more about Plan’s work in Pakistan visit

‘I have suggested to other community members to stop this practice and construct latrines to save us from disease,’ says Shabbar. Gradually, Dhoke Kado is working towards the day when no one uses the fields as a toilet – when they are officially declared, ‘Open Defecation Free’. As village accolades go, this may not sound appealing, but for families here it’s the best award they could receive. It will mean they are giving their children the chance of a healthy life.

Fortunately, in Dhoke Kado, there was no shortage of enthusiasm. Families were keen to clean up their surroundings and adopt a healthier lifestyle

‘What keeps us all committed to Plan is not only the scale of the challenges and the consequences for children, their families and communities, but also knowing that real progress can be made and positive change can indeed happen’ – Haider Yaqub, Plan’s Country Director in Pakistan

Plan Pakistan Annual Progress Report 2010  

A summary report on Plan International programs in Pakistan for the year ending 30 June 2009