From Grassroots to Global Goals: Evaluating the Impact of Lady Health Workers on Maternal and Child Health in Resource-Limited Settings in Pakistan.

Abstract

Maternal and child health is a key priority in low-resource settings and an integral part of the Sustainable Development Goals (SDGs). However, even after the MDG era, several developing countries still have high rates of infant mortality, limited access to primary health care services, and high out-of-pocket health expenditure. Community Health Worker (CHW) programs, in this context, have proven to be useful ways to reach underserved populations for preventive and primary care. The study evaluates the effect of the Lady Health Worker (LHW) programme, as part of the IRMNCH & Nutrition, on the maternal and child health outcomes of rural Dera Ghazi Khan. Primary survey data were used in both program and non-program areas to analyze prenatal and postnatal care, breastfeeding, vaccination coverage, birth spacing, and infant mortality. The findings show that the LHW programme leads to a significant increase in service utilisation, better preventive healthcare practices, and, to some extent, a reduction in infant mortality. In addition to these empirical findings, the study positions the programme in a broader development context, identifying links between health outcomes and socioeconomic dimensions like livelihoods, access to energy, financial inclusion, etc. They are not measured directly, but they help to make sense of how the community health interventions can improve health and economic resilience. The study concludes that the LHW programme is an inexpensive intervention that promotes progress towards maternal and child health-related SDGs and should be scaled up in similar low-resource settings.