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Story and Perspective

The Power of Options: Hawa’s Journey to a Healthier Future


In my community, having a large family is considered a success, a blessing from God that should not be interfered with.

Hawa, a 28-year-old mother of four from Khairpuir, Sindh, was no exception to this belief. For years, she had followed the path laid out for her, giving birth to three children with no spacing between them. After the birth of her fourth child, within just seven years of marriage, she found herself exhausted, seeking guidance and a solution.

Hawa’s story took a turn for the better when she crossed paths with Lady Health Worker (LHW) Mujhtiaran during one of her rounds. The Lady Health Worker Program, one of the largest community health programs in the world, provides health services to the doorsteps of underserved communities in Pakistan. LHW Mujhtiaran recognized the challenges Hawa faced and counseled her on the availability and use of contraceptives. The World Health Organization guidelines, often unheard by the community, recommend waiting for 24 months before planning the next pregnancy for the well-being of both the mother and child.

I had a lot of fears and was misinformed of the risks of contraceptive methods before. Thanks to LHW Mujhtiaran, I am now confident to explore my options.

However, the road to change was not without obstacles. Pakistan had been hit hard by the 2022 floods, which left homes destroyed and many people below the poverty line . LHW Mujhtiaran herself was among those affected, with her home clinic reduced to rubble.

In June 2023, the Building Healthy Families Activity (BHFA), a USAID- funded project implemented by Pathfinder, provided essential kits and support to 25,000 LHWs, one of which was Mujhtiaran, enabling them to continue their crucial work and serve clients such as Hawa in Sindh. The kits contained delivery sets, infection prevention supplies, and basic furniture for the LHWs.

The Building Healthy Families Activity:

  • Assists the Government of Pakistan in achieving its FP2030 goals
  • Establishes local partnerships in Sindh and Khyber Pakhtunkhwa provinces
  • Strengthens the capacity of private health institutions to deliver family planning (FP) and reproductive, maternal, newborn, and child health (RMNCH) services
  • Encourages use of quality FP/RMNCH products and services

Photo: Hawa receives a routine checkup after the insertion of the Jadelle implant and receives counseling from Lady Health Worker Mujhtiaran at her house in Khairpur, Sindh, Pakistan. Photo: Pathfinder Pakistan

With LHW Mujhtiaran’s unwavering support and guidance, Hawa switched from short-term pills to a long-term contraceptive method, a Jadelle implant inserted at Kausar Hospital to ensure no unwanted pregnancies occur. She is now exploring a more permanent method, such as tubal ligation.

“I had a lot of fears and was misinformed of the risks of contraceptive methods before. Thanks to LHW Mujhtiaran, I am now confident to explore my options.”

Hawa’s story serves as a testament to the power of options. The LHW program, rooted in the concept of primary care, continues to play a key role in achieving the Sustainable Development Goals (SDGs) and strengthening Sindh’s primary health care system, supporting clients like Hawa, for a healthier future.

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