reproductive health

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Valuing Women’s Care Work in Pakistan: Lady Health Workers’ Struggle for Rights and Entitlements

This case study was conducted for the Pakistan Institute of Labour Education and Research (PILER), with the financial support of ActionAid France in 2017. It was published in both English and French. 

The Lady Health Workers (LHW) Programme, instituted in 1994, is considered one of the largest and successful community based primary healthcare initiatives in the world. The lady health workers’ role has received recognition by the global health bodies in improving Pakistan’s maternal and child health indicators. Currently more than 130,000 lady health workers reach out to 60 to 70 per cent of the country’s population residing in rural and low-income urban areas.

Perhaps if it was not a collective struggle for their rights, the lady health workers would have continued to suffer injustice in silence: a low wage, no benefits and insecure job. It was death of a health worker at child birth that compelled Bushra Arain, a Lady Health Supervisor, to rebel against the irony: health providers’ own deprivation of health facilities and lack of decent work conditions. She and several other lady health supervisors mobilised the workers and founded the union, the All Pakistan Lady Health Workers’ Welfare Association, in December 2008. By early 2009, each district had a Baji (elder sister), a dynamic activist health worker to prepare the cadre for struggle. The union took to legal intervention and street power to claim their due rights at work place. The phenomenon was unique: never before in Pakistan’s history had women workers exercised the right to ‘collective bargaining’ in any sector, much less in the low-paid care economy.

 The case study aims to document the LHWs’ struggle, review the constraints they faced as women workers in a public sector health programme and as caregivers, identify the union’s strategies and highlight the achievements of their eight-year long battle.

Click here to access the full report in English.

 

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The Flood Affected Population in Sindh Rebuilding Lives and Livelihoods: The Case for Structural Reforms

This research report was written for Pakistan Institute of Labour Education and Research (PILER), Karachi and was published in January, 2011.

Pakistan’s devastating floods caused by extraordinary rainfall in July-Sept 2010 affected over 20 million people, causing 1,985 deaths and injuries to 2,946 people. The floods wreaked havoc, washed away crops and rural settlements, flooded towns and urban centres, damaged roads, bridges and irrigation canals, schools, hospitals and all social and physical infrastructures. The disaster led to unprecedented displacement of 1,550,000 people from flooded areas to dry places, mostly nearer homes and to urban centres in the home districts. A large number of people from the affected districts in Sindh, took refuge in the cities of Karachi and Hyderabad. The families who had resources, assets and support systems in dry districts cities stayed with their relatives and friends. The majority of the IDPs who lost their abodes, meagre assets and means of livelihoods had to take refuge in shelters and makeshift camps put up by the provincial governments, NGOs and international humanitarian agencies. The displaced persons in the camps overwhelmingly belonged to the lowest stratum of society.

In addition to relief work, PILER undertook a profiling and livelihood needs assessment survey to gauge socio-economic indicators and the livelihood status of the IDPs prior to the floods and get an idea of their future plans and aspirations. The objectives were to share the findings with relevant stakeholders (i.e. state, civil society, resource institutes) for possible linkages that would facilitate the IDPs in the reconstruction and rehabilitation phase and provide a basis to the PILER advocacy inputs towards a rehabilitation plan that commits to upgrading the living and work conditions of the IDPs and facilitate their access to fundamental rights and citizenship based entitlements.

Click the link below to view the full report:

The Flood Affected Population in Sindh  – Rebuilding Lives and Livelihoods: The Case for Structural Reforms