KARACHI: Shaikh Dr Tanwer Ahmed, the Chief Executive of health and nutrition development society (HANDS) working in Thar on health and nutrition issues in Thar region, in a press statement said the organization has received a financial assistance from the Bill and Melinda Gates Foundation for provision of quality family planning services to the undeserved and underprivileged population in two districts Tharparkar and Thatta of Sindh with the estimated cost of Rs 500 million for four years with special focus on Thar to control the ticking atom bomb of population growth. Dr Shaikh said that Mr Gates and her spouse were worried over the alarming situations in Thar and other backward areas and pleased to donate the funds so the basic issue of the desert region specially birth space could be addressed properly. He informed foundation and his organization would -hold a launching ceremony in that regard in Karachi he added and stated the intervention sites are non-LHW areas where the Public sector outreach services were mostly deficient. “ These two districts are finalized after discussion with Population Welfare Department and Costed Implemented Plan secretariat Sindh. These are included in their priority districts and fall in low FP coverage districts” added the Dr Shailh . “ The project is planned to cater approximately 1 million population to address the unmet need of family planning services through its professional and dedicated teams of 945 grass root community workers – Marvis, 55 LHVs and project management teams” “The aim of this project is to support the Sindh Government in achieving 45% CPR by 2020 under Costed Implementation Plan. The goal of this CIP is to increase the CPR to 45 percent of Married Women Reproductive Age (MWRA) in Sindh, which would total approximately 3 million women by 2020” added the statement adding he told that entailed the expansion of services to serve 1.2 million additional users through the existing infrastructure, as well as the expansion of facilities and staff accordingly. Dr Shaikh stated that Population Welfare Department had already signed Memorandum of Understanding (MoU) with Hands for provision of contraceptives in targeted areas of Sindh to ensure RH and FP services.at districts to strive hard to achieve the target “ The unmet need is not translated in to effective demand and is rising in rural areas due to three major factors: There is inadequate access to FP information and services, due to cultural limitation on female mobility, expensive transportation, unavailability of trained health care providers especially the female providers, and lack of understanding and knowledge of the health care providers. These result in missed opportunities to address potential family planning clients such as pregnant women that require counseling during the antenatal period, services in early post-partum period and information to newly-wed couples or low parity women. The second factor is the religious and cultural barriers , including religious misconceptions, which retain a strong hold in remote rural areas, rejection by religious leaders on the economic basis for fertility limitation, men’s preference for large families, and limited spousal communication. The third is the discontinuation and disillusionment with modern contraceptives. The two most important reasons for discontinuation are side effects or health concerns, and pregnancy through method failure. Better counselling, provision of better quality contraceptives, and ensuring availability of a range of methods, including longer-acting methods, could bring major benefits to women who are discontinuing contraception despite wanting to avoid or postpone another pregnancy. “The public and mostly private sector facilities will be identified in the intervention union councils, through mapping. The health care provider especially women doctor, lady health visitors, FWW, CMW and male doctors wherever possible will be trained on client centered approach, counseling of all women who are not using any FP method, and pre & post natal women for PPFP; quality FP services especially implant, PPFP and Post Abortion Care. “ The Marvi workers will be linked to these health care providers and referred for the defined FP and RH services. Their clinics will be developed as branded service and referral points for quality FP services. Critical Partnership with public & private sector organizations. Published in Daily Times, January 26th 2018.