Pakistan's Lady Health Workers "Best in the World"

[Riaz Haq]

“It’s one of the best community-based health systems in the world,” said Dr. Donald Thea, a Boston University researcher about Pakistan's Lady Health Workers Program. Thea is one of the authors of a recent Lancet study on child pneumonia treatment in Pakistan. He talked with the New York Times about the study.

Published in British medical journal "The Lancet" this month, the study followed 1,857 children who were treated at home with oral amoxicillin for five days and 1,354 children in a control group who were given standard care: one dose of oral cotrimoxazole and instructions to go to the nearest hospital or clinic. The home-treated group had only a 9 percent treatment-failure rate, while the control group children failed to improve 18 percent of the time.

Launched in 1994 by former Prime Minister Benazir Bhutto's government, Pakistan’s Lady Health Workers’ program has trained over 100,000 women to provide community health services in rural areas. The program website introduces it as follows: "This country wide initiative with community participation constitutes the main thrust of the extension of outreach health services to the rural population and urban slum communities through deployment of over 100,000 Lady Health Workers (LHWs) and covers more than 65% of the target population. The Programme contributes directly to MDG goals number 1, 4, 5 & 6 and indirectly to goal number 3 & 7. The National Programme for Family Planning and Primary Health Care is funded by the Government of Pakistan. International partners offer support in selected domains in the form of technical assistance, trainings or emergency relief."

A recent comprehensive review of the program found that as compared to communities not served by the LHWs, the served households were 11% more likely to use modern family planning methods, 13% were more likely to have had a tetanus toxoid vaccination, 15% more were likely to have received a medical check-up within 24 hours of a birth, and 15% more were likely to have immunized children below three years. The improvements in health indicators among the populations covered by the LHWs were not entirely attributable to the program alone; researchers noted that other positive changes such as economic growth, increased provision of health services and better education services helped to enhance the impact. While the program had managed to sustain its impact despite its large expansion, evaluators found that serious weaknesses in the provision of supplies, and equipment and referral services need to be urgently addressed.

The program is now a major employer of women in the non-agricultural formal sector in rural areas, and is being more than doubled in size if budget allocations can be sustained. If universal coverage is achieved, every community in the country will have at least one lady health worker, one working woman and potential leader, who could serve as a catalyst for positive change for women in her community. The health officials say that unlike the mid-1990s when it was difficult to recruit women because of the minimum 8th grade education requirement, now there are large numbers of women who meet the requirement lining up for interviews in spite of low stipend of just Rs. 7000 per month.

Private sector is also helping the LHW program. Mobile communications service provider Mobilink has recently partnered up with the United Nations Population Fund (UNFPA), Pakistan's Ministry of Health (MoH) and GSMA Development Fund in an innovative pilot project which offers low cost mobile handsets and shared access to voice (PCOs) to LHWs in remote parts of the country. Mobilink hopes to bridge the communication gap between the LHW and their ability to access emergency health care and to help the worker earn extra income through the Mobilink PCO (Public Call Office).

Due to economic downturn and security challenges in several conflict areas since 2008, Pakistan's chances of achieving its Millennium Development Goals (MDGs) by 2015 appear to be slim. However, significant timely expansion in the LHW program and making it more effective can still help Pakistan get close to its MDGs on important health indicators like the infant mortality rate (IMR) and the maternal mortality rate (MMR).

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[Riaz Haq]

Dailytimes | #ImranKhan to perform ground-breaking of #Karachi's cancer hospital on Dec 29 - #PTI http://go.shr.lc/2hjSPmp via @Shareaholic

The ground-breaking ceremony of Shaukat Khanum Memorial Cancer Hospital and Research Centre in Karachi would be held on December 29, 2016.

Pakistan Tehreek-e-Insaf's chairman Imran Khan, who is also Chairman Board of Governors Shaukat Khanum Memorial Trust will lay the foundation stone.

In February this year, the then Chief of Army Staff General Raheel Shareef had granted a 20 acre plot for the construction of the cancer hospital in Defence Housing Authority located at the Karachi-Hyderabad Super Highway.

A statement of Shaukat Khanum Memorial Trust said, "The construction of a comprehensive cancer diagnosis and treatment facility in Karachi will not only provide the most modern cancer treatment to the people of Sindh, but will also help raise healthcare standards and provide training and employment opportunities in the region."

It is Shaukat Khanum Memorial Trust's third Cancer Hospital and Research Centre in the country. Trust has already established two hospitals - one in Lahore and the other is in Peshawar.

[Riaz Haq]

#Hospital on wheels for patients in rural #Pakistan.

http://tribune.com.pk/story/1280279/hospital-wheels-patients-rural-...


..digital disruption empowering rural women in Pakistan has been brought by RingMD, an international healthcare company headquartered in Singapore which is operational in 10 countries around the world. It came to Pakistan thanks to global healthcare sales specialist and now Country Head of RingMD Hassan Chattha. He realised it was needed most in Pakistan considering our local healthcare system is in doldrums. With 400 Pakistani doctors and 40,000 international doctors on board, this telemedicine platform allows doctors and patients to talk via phone or video call through a computer, tablet or smartphone even in low bandwidth environments.


With a team of 30 in Pakistan, RingMD has been able to provide consultations to thousands of patients in rural areas around Lahore, Okara, Kasur, Bahawalpur, Sheikhupura, Rawalpindi, Faisalabad and Sargodha. After a positive response in Punjab, they have the support of Sindh government to start their operations in the province very soon.


Before these WiFi-enabled mobile vans arrive to connect rural patients with city doctors, the company takes permission from the village leaders and explains the concept to them in detail. Once the leader agrees, influential people in the community spread the word through the mosque’s loudspeakers or share a place where the camp can be set up for maximum attendance. These influential people are essentially “enablers” for RingMD’s programs and once they see how the camps operate, they are then trained to carry out these activities independently for their villages. “We are also training teachers and educated young people to arrange tele-consultations. This way we are able to create new jobs and give confidence to people,” Chattha says.

Most of all, RingMD provides privacy to female patients as they can sit alone in the van with a laptop and explain all their symptoms to a female doctor without any fear of being heard or judged by others. Shame is also a factor that restricts women in urban centres from getting treatment for their psychiatric problems in Pakistan and this is an area where RingMD can make a big difference by providing a range of mental healthcare professionals so that women are able to get treatment and support for taboo illnesses like stress anxiety and depression.

[Riaz Haq]

In Pakistan, empowering midwives to empower women

https://reliefweb.int/report/pakistan/pakistan-empowering-midwives-...

In 2014, UNFPA – together with the Department of Health and Sindh Province’s Maternal, Newborn and Child Health programme – launched a pilot effort to supplement the midwifery courses with hands-on training. Midwifery coaches visited the midwives’ clinics, offering guidance and mentorship.

Today, Ms. Tresa proudly says she “provides quality of services like a medical doctor.”

Overcoming doubt and criticism

But the midwives also faced challenges beyond education and training.

In rural Pakistan, many people consider it shameful or unorthodox for women to work outside the home. According to a 2012 survey in Pakistan, 70 per cent of respondents said that when women work, their children suffer.

Many of the midwives faced these attitudes, as well.

“My in-laws and other relatives were against me,” said Shabana Jabir Ansari, 27, from Mushtrika Colony. “Sometime due to my duties – morning and evening shifts – people said negative comments. That hurt me.”

Fozia Foto, 32, had the same experience in Hussain Khan Laghari Village. “I was the first girl who studied in my family and the first to become a midwife, so initially our relatives were against me,” she said.

She stayed in hostels while enrolled in the midwifery school, which critics also used against her.

“People said that I was living alone at the school and said so many bad things about my character,” she remembered.

Empowered women saving lives

Community members were also sceptical of the midwives’ abilities.

The midwifery school and coaching programme gave them the skills to save lives, but they were not always afforded the opportunity.

“People didn’t trust me initially. Even for delivering babies, they didn’t refer cases to my birthing station,” said 30-year-old Reshma Korejo, from Meer Mohammad Korejo Village.

She had to deliver two or three babies safely before she gained villagers’ trust.

“It was a big challenge for me to face those types of negative behaviours,” she said, but “slowly and gradually things changed.”

And as the midwives became established, they started changing minds, even raising awareness about issues that were not widely accepted – such as family planning.

“There are myths in the minds of women,” said Ms. Ansari about contraceptives like the intrauterine contraceptive device (IUCD).

Slowly, the midwives say, use of modern family planning methods is increasing.

And they are also accomplishing the goal that motivated them in the first place: They are saving lives.

Kousar Dahri, 32, remembered reviving a newborn baby in her village of Khamiso Khan Dahri.

“There was a woman in the community. She already had six babies, and she came for the delivery of the seventh,” Ms. Dahri said. “She delivered a son who required resuscitation, which I had been trained on. I started CPR, following the steps, and the baby was successfully resuscitated.”

Expanding training and support

So far, over 300 midwives have benefitted from the coaching and mentorship programme.

Plans are now underway to scale up midwifery training efforts.

The 18-month midwifery training programme is being expanded to 24 months, with help from UNFPA. And the midwifery coaching programme will be rolled out to all the districts in Sindh through 2018.

These programmes will empower more women to save lives.

As for Ms. Dahri, she says the experience of saving that newborn stays with her.

“Saving any child feels like saving all of humanity,” she said.

[Riaz Haq]

#UAE to build first ever #medical mall in #Islamabad, #Pakistan. The project will include therapeutic and recreational areas, a regional #Cardiology center, an orthopedic centre and 400-bed #university #hospital. https://www.thenews.com.pk/latest/357797-uae-to-build-first-ever-me...

A prominent UAE-based MBF Group has announced to establish an integrated medical city that will also feature a first-ever medical mall of the country in Islamabad.

The agreement of MBF with Ibchez Housing and Nixon, according to the report, will include the construction of a hospital that will provide medical services at international standards.

The founder and owner of MBF Group Shaikh Mohammad Bin Faisal Al Qasimi ,in an interview with the Gulf news said the project will include a 400-bed university hospital that will offer the most advanced levels of healthcare services.

The medical city will also feature the country’s first medical mall, therapeutic and recreational areas, a regional cardiology centre, and an orthopedic centre, he added.

He noted that the city will include a nursing college and is expected to serve some one million patients and clients on a monthly basis.

There is a need for such advanced hospitals to serve Pakistan’s growing population, he stressed.

Shaikh Mohammad pointed out that the investment provided for the medical city has reached US$970 million (Dh3.52 billion), while noting that its land has been purchased, as well as the desire of all parties to complete the project on time, in a bid to answer the growing demand for medical services in Islamabad and provide specialist health services that are in short supply.

He informed that the group will manage the city’s 1,000 medical, technical and administrative staff, who will all be Pakistanis, and is responsible for providing medical equipment and beds.

[Riaz Haq]

WaPo Editor's Non-Response to FAIR on WaPo story on #Polio, #Pakistan and the #CIA: Ask "Pam Constable, who has reported from the region since 1998 and who has maintained the highest journalistic standards over her long and distinguished career." - http://bit.ly/2VFxr0G

Washington Post editor Martin Baron responded to FAIR’s recent action alert (5/14/19) calling on the Post to acknowledge the role of CIA deception in fueling distrust of vaccination in Pakistan. Asked about the alert by FAIR associate Norman Solomon, Baron replied (links added by FAIR):

First, I have nothing to do with editorials. I oversee our news and features coverage. So, I had no involvement in the editorial cited by FAIR, which was mistaken in suggesting otherwise.

Second, with respect to the Post’s May 10 news story mentioned: It notes that it was an April 22 incident that set off the recent panic, after many years in which vaccines were being administered frequently and safely, sharply reducing the incidence of polio in the country. As the New York Times noted: “In the vaccination drive that ended Saturday, Pakistan managed to vaccinate more than 37 million children, nearing its target of 39 million.”

That’s quite an achievement. As to whether a fake 2011 vaccination drive in Abbottabad related to the hunt for bin Laden bears meaningful responsibility for today’s scares and violence against medical personnel, you might wish to directly ask the reporter, Pam Constable, who has reported from the region since 1998 and who has maintained the highest journalistic standards over her long and distinguished career.

As Baron notes, the alert dealt with an omission manifested in both Washington Post news reporting and editorializing. There’s no one who oversees both aspects of the paper—other than publisher Fred Ryan or owner Jeff Bezos, neither of whom we want to encourage to interfere in the Post‘s content—which is why we selected Baron as a contact.

Constable (and co-author Haq Nawaz Khan) indicate—in a way that would be missed by the vast majority of readers—that they do believe that the CIA’s use of a fake vaccination campaign as a cover for a hunt for Osama bin Laden in 2011 has at least some connection to Pakistanis’ distrust of vaccines. Blaming lack of vaccination on “mistrust, born of ignorance and rumor-mongering,” the reporters write that Pakistani parents’ “fear is fanned by cultural taboos, religious propaganda and tales of foreign plots.”

Washington Post editor Martin Baron responded to FAIR’s recent action alert (5/14/19) calling on the Post to acknowledge the role of CIA deception in fueling distrust of vaccination in Pakistan. Asked about the alert by FAIR associate Norman Solomon, Baron replied (links added by FAIR):

First, I have nothing to do with editorials. I oversee our news and features coverage. So, I had no involvement in the editorial cited by FAIR, which was mistaken in suggesting otherwise.

Second, with respect to the Post’s May 10 news story mentioned: It notes that it was an April 22 incident that set off the recent panic, after many years in which vaccines were being administered frequently and safely, sharply reducing the incidence of polio in the country. As the New York Times noted: “In the vaccination drive that ended Saturday, Pakistan managed to vaccinate more than 37 million children, nearing its target of 39 million.”

That’s quite an achievement. As to whether a fake 2011 vaccination drive in Abbottabad related to the hunt for bin Laden bears meaningful responsibility for today’s scares and violence against medical personnel, you might wish to directly ask the reporter, Pam Constable, who has reported from the region since 1998 and who has maintained the highest journalistic standards over her long and distinguished career.

[Riaz Haq]

BISP, Citizenship and Rights Claims in Pakistan


By Rehan Rafay Jamil


https://researchcollective.blogspot.com/2019/03/bisp-citizenship-an...


Taking Stock of Ten Years of the Benazir Income Support Programme (BISP)

Over ten years since its establishment, the Benazir Income Support Progamme (BISP) has become Pakistan’s largest social safety net, providing coverage to over 5.6 million women and their households across the country. The expansion of BISP over the past decade marks an important shift in social policy in Pakistan. BISP has now been overseen by three elected governments and has resulted in a significant increase in federal fiscal allocations for social protection. Despite vocal reservations about its name expressed by some political parties, the program remains Pakistan’s largest flagship poverty alleviation program with international recognition.[1]

Third party impact evaluations of BISP have largely focused on its poverty alleviation, nutritional and gender empowerment impacts.[2] [3] These evaluations point to important reductions in poverty and improved nutritional levels for beneficiaries and their households. Oxford Policy Management’s 2016 evaluation finds reductions in BISP households’ reliance on casual labor and an increase in household savings and asset accumulation.[3]

BISP is one of the largest cash transfer programs targeted exclusively at women in the Global South, making the gender impacts of BISP important to understand. In their evaluation, Ambler and De Brauw (2017) find some changes in gender norms and attitudes amongst beneficiaries and their families. Their study finds that female beneficiaries are more likely to have greater mobility to visit friends without their spouse’s permission, are less likely to tolerate domestic violence and male members are more likely to contribute to household work.

BISP and the transition from Cash Transfer Beneficiaries to Citizens

The evaluation reports provide some evidence that BISP has also had a wider set of intended and unintended consequences in influencing beneficiaries’ access to public institutions and spaces. Perhaps the most frequently cited impact of BISP has been a marked increase in rural women’s access to computerized national identity cards (CNICs), a prerequisite for obtaining the program. CNICs can be seen as the first step to citizenship and rights claims in Pakistan. The most significant impact of the rapid increase in CNIC registration amongst BISP beneficiaries has been with regards to voting. Ambler and De Brauw (2017) find evidence that BISP beneficiaries are more likely to vote in national elections. But whether BISP beneficiaries are empowered by the cash transfer to make a wider set of rights claims and access local state services, is less clear.

In order to understand some of the changes brought about by BISP in the lives of rural women, I conducted qualitative field work, including in-depth interviews and focus group discussions with beneficiaries and their spouses, in the district of Thatta in Lower Sindh. Thatta has a high proportion of BISP beneficiaries (47 percent), being a high poverty district. The aim of the fieldwork was to develop an understanding of how beneficiaries and their families perceive of BISP and whether the program has brought about any changes in their engagement with local state services.

[Riaz Haq]

#WHO's Dr Palitha Gunarathna Mahipala has lauded #Pakistan's efforts in tackling #coronavirus, noting that the country had come up "with one of the world’s best National Response Program against the virus". #COVID19 #CoronavirusPandemic #health

https://www.thenews.com.pk/latest/628662-pakistan-has-worlds-best-n...

KARACHI: World Health Organisation (WHO) Country Representative Dr Palitha Gunarathna Mahipala, lauded Pakistan's efforts in tackling coronavirus, noting that the country had come up "with one of the world’s best National Response Program against the virus".

The WHO official urged people to follow the precautionary and preventive measures to avoid contracting the lethal virus, which is extremely contagious but not as lethal as some other members of the coronavirus family.

“Pakistan has timely come up with one of the world’s best National Response Program against COVID-19 and it is being implemented very effectively. Authorities are doing their job and now it is the responsibility of the people to follow the instructions and take preventive and precautionary measures to avoid contracting the viral disease”, Dr Mahipala said while speaking exclusively to The News International during his visit to Karachi.

The WHO representative inspected the isolation ward of the Jinnah Postgraduate Medical Centre (JPMC) in Karachi and during his meeting with the Executive Director JPMC Dr Seemin Jamali, expressed satisfaction over steps taken by the health institute for dealing with the suspected patients. He called for more testing facilities in the public sector in case the number of patients increases.

He also visited the Dow University of Health Sciences (DUHS) Ojha Campus and inspected their diagnostic lab as well as their isolation facility, terming the health institute a "world-class diagnostic and treatment facility".

As part of his engagements in the city, Dr Mahipala also met the provincial health minister Dr Azra Pechuho and inquired about the status of diagnostic kits and Personal Protective Equipment (PPE) and offered WHO’s support in the provision of kits for the testing of suspected COVID-19 patients in Sindh.

Talking to The News at the WHO sub-office in Karachi, Dr Mahipala noted that the federal and provincial governments had arranged around 2,000 isolation beds in the country to house suspected patients while extraordinary screening arrangements had been made at the points of entry by the authorities, which were helpful measures to keep the virus away from the country.

“At the moment Pakistan has seven diagnostic labs which are capable of conducting 15,000 tests but there is a need for more diagnostic facilities in case the number of suspected patients go up,” he said.

"Authorities have even established a mobile diagnostic facility that had been dispatched to the Taftan border for testing and diagnosing suspected people coming from Iran," acknowleged the WHO official.

Highlighting the severity of the COVID-19 pandemic, he said even countries with well-advanced health systems like South Korea and Italy failed to contain COVID-19 but added that Pakistani authorities timely responded to the threat and took measures which resulted in keeping the virus at bay for a longer time at a time when other counties were already battling a rising number of cases.

“Maintaining hand hygiene is the key to prevent oneself from contracting not only COVID-19 but also many other transmissible diseases. People should regularly wash their hands with soap and water at least for 20 seconds and use sanitisers when they can’t wash their hands”, he said adding that adopting coughing etiquettes was also very import as it would prevent spreading the virus to the others.

“And it is very important that people remain indoors for some days if they have flu-like symptoms. It would prevent other people from contracting the disease even if it is not COVID-19”, Dr Mahipala said.

[Riaz Haq]

#Pakistan National #Security Committee Announces Country's Response to #Coronavirus Outbreak. Shuts #schools, Cancels #PakistanDayParade , closes western borders, sets up testing/isolation/quarantines at borders, bans public gatherings & big weddings. https://www.dawn.com/news/1540587

The National Security Committee (NSC) on Friday decided to take a number of steps to contain the spread of coronavirus in the country, including closing the border with Iran and Afghanistan and banning all large public gatherings.

The high-level NSC meeting, chaired by Prime Minister Imran Khan, was attended by the provincial chief ministers and the civilian and military leadership.

Major decisions taken by the NSC:

Border with Iran, Afghanistan to be closed for two weeks
Schools shut until April 5
Large public gatherings including weddings banned for two weeks
International flights to operate only from Karachi, Lahore and Islamabad
Pakistan Day parade cancelled
Remaining PSL matches to take place in empty stadiums
Special Assistant to the Prime Minister on Health Dr Zafar Mirza and other government officials detailed the decisions taken by the body at a press conference, with Mirza revealing that Pakistan now has 28 cases of COVID-19.

"There is a lot of speculation about the total number of cases in the country. However, I can confirm that Pakistan has 28 cases of coronavirus," said Mirza, who was accompanied by government spokesperson Firdous Ashiq Awan and PM's Special Assistant on National Security Division and Strategic Policy Planning Moeed Yousuf.

He said the seven new cases had all been reported in Taftan among Pakistani pilgrims who have returned from Iran. All seven people are stable and recovering.

Mirza announced that Pakistan's border with Afghanistan and Iran will be closed "completely" for two weeks, following which the situation will be reviewed. During this period, the system for screening and preventing further infections from entering the country will be made stronger.

He said the first batch of pilgrims who have returned to the country from Iran has left for provinces after completing its 14-day quarantine period at the Taftan border. The details of these pilgrims will be provided to the provincial governments, which can test or place the pilgrims under quarantine again.

It was decided during the meeting that only three airports in the country — Karachi, Islamabad and Lahore — will be allowed to operate international flights, a move intended to reduce the entry points and ensure better arrangements there.

Mirza said all large public gatherings will be banned, including weddings and conferences, for a period of two weeks. Cinemas will also be closed while all remaining Pakistan Super League (PSL) 2020 matches will take place in empty stadiums.

The matter of whether religious congregations should be banned has been referred to the religious affairs minister and the chairman of the Council of Islamic Ideology. They have been tasked with consulting with all stakeholders and give their advice to the government based on which a decision will be taken, Mirza said.

Schools closed
It was decided to close all educational institutions in the country for three weeks. Education minister Shafqat Mehmood tweeted that schools will remain shut until April 5.


Mirza said the government will also request the chief justice to close civil courts and adjourn cases for a period of three weeks. Judicial magistrates and judges of sessions courts will be requested to decide criminal cases within jails while relatives of prisoners will not be able to meet them for three weeks in jails.

A media campaign will be started to brief the public regarding coronavirus prevention measures and a system will be established to prevent misinformation and relay facts to the people from a "central" source.

[Riaz Haq]

March 16, 2020—Aisha Yousafzai, associate professor of global health (at Harvard University), is the principal investigator of two large randomized controlled trials focused on early childhood development in Pakistan—Pakistan Early Child Development Scale-Up (PEDS) and Youth Leaders for Early Childhood Assuring Children are Prepared for School (LEAPS).

https://www.hsph.harvard.edu/news/features/helping-vulnerable-child...

What do you see as policy and research priorities in early childhood development?

We know that young children need good health, proper nutrition, and early learning opportunities. But they also need security and stability. It’s important that they have consistent caregivers in early life who they can trust and rely on. When children don’t have these things, it can be harmful to their development and impact their health and future prospects.

Policies that support families and help children thrive include investing in parenting programs and ensuring access to good quality, affordable child care and parental leave. And we should not be separating children from their caregivers who provide safe stable nurturing care.

We still need to better understand what works for the most vulnerable and disadvantaged children, such as those living through a humanitarian crisis. It’s not enough to focus just on the immediate emergency phase. We need to address the long-term needs of these children and their families. Another understudied population is children with developmental delays and disabilities. We need to look at how to strengthen health care systems to address their needs.

What results have you found from PEDS and LEAPS?

In the PEDS trial, we wanted to see if Pakistan’s Lady Health Workers (LHW) program—which provides home visits to promote health and nutrition in mothers and young children—could also effectively promote children’s development. Community health worker interventions like the LHW program were set up in recent decades in low- and middle-income countries to promote child survival. Now that we are seeing improvements in child survival in many countries, we need to think about how these programs can deliver interventions beyond survival that help children thrive.

For this study, we adapted a curriculum developed by the World Health Organization and UNICEF, and evaluated it in a randomized controlled trial. Results were favorable up to age two, and some of the benefits to children’s cognitive-language and motor development were sustained at age four.

But alarm bells were raised when we saw that only about a quarter of children in rural communities had access to preschool—and even those who did weren’t necessarily getting quality education.

That challenged us to think about the continuity of services for children, from the first 1,000 days of life to the early years of education and beyond. We developed a way to address the need for better preschool in Pakistan that also helped fill a gap in training and employment for young women. Working with Pakistan’s National Commission on Human Development, we established a training program for women ages 18–24 to become preschool teachers (LEAPS) and placed trainees in villages with no established preschool services.

Our pilot found that this program provided a good school readiness benefit for children as well as a boost to youth employment. Now, we’re scaling up across four districts, and also looking at how well the country’s education system is able to absorb this intervention.

[Riaz Haq]

WHO Director-General's opening remarks at the media briefing on COVID-19 - 7 September 2020

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---7-september-2020

Pakistan deployed the infrastructure built up over many years for polio to combat COVID-19. Community health workers who have been trained to go door-to-door vaccinating children for polio have been utilized for surveillance, contact tracing and care.

There are many other examples we could give, including Cambodia, Japan, New Zealand, the Republic of Korea, Rwanda, Senegal, Spain, Viet Nam and more.

Many of these countries have done well because they learned lessons from previous outbreaks of SARS, MERS, measles, polio, Ebola, flu and other diseases.

That’s why it’s vital that we all learn the lessons this pandemic is teaching us.

Although Germany’s response was strong, it is also learning lessons.

I welcome the announcement by Chancellor Angela Merkel over the weekend that her government will invest 4 billion euros by 2026 to strengthen Germany’s public health system.

I call on all countries to invest in public health, and especially in primary health care, and follow Germany’s example.