Society of Rural Physicians of Canada - Société de la médecine rurale du Canada
Home Sitemap Contact Us
Communications The CJRM About the SRPC Our Resources Continuing Medical Education
Society of Rural Physicians of Canada
About Frontier Primary Health Care
2010 update on SRPC Pakistani partner
Our Resources
SRPC International CommitteeAbout Frontier Primary Health Care

Frontier Primary Health Care (FPHC) is a Pakistani non-governmental organization (NGO), providing primary health care services to more than 150,000 people in the Charsadda, Mardan and Swabi districts of Northwestern Frontier Province. Beginning as an international relief organization responding to the health care needs of a massive influx of Afghani refugees in 1980, FPHC achieved such success in improving health within the refugee camps that they were invited to extend services to surrounding Pakistani communities. The people in this area are mainly Pathans who speak Pushto and Urdu.

The primary health care services include immunization, antenatal care, clinical services, family spacing, growth monitoring, nutritional services, health education, access to safe water and sanitation. These services, provided at an average cost of 90 Rupees or $1.50 USD per person per year, have reduced infant, under-five and maternal mortality rates to a fraction of what they are elsewhere in Pakistan.

The services are sustained by the enthusiastic participation of the community, including an army of trained male and female health care volunteers. Female volunteers, in particular, have been essential to reach women in their homes in a society which still practices rigorous purdah and where female literacy is reported as low as 17%.

In addition to achieving greatly improved health parameters for the population they serve, FPHC has pioneered a number of important initiatives in Pakistan in gender training for the community and the use of peer group educators in adolescent reproductive health. FPHC’s active training unit has adapted material to the local culture and translated it into local languages in addition to providing ongoing training to staff, volunteers and community members.

FPHC operates six health centers, five literacy /vocational centers for girls, a number of outreach clinics and an emergency obstetrical unit from their headquarters in Mardan. Two PHC extension areas have been added. Many of the 200 staff have worked their way up through a number of different jobs in the organization, beginning as volunteers, making for a very committed workforce.

The range of services include ORT corners, child spacing programs, Hepatitis B vaccination, laboratory services, basic dental care, nutritional rehabilitation, training of Traditional Birth Attendants (TTBA) and literacy and vocation training for young women.

While health indicators are less than optimal, success over the years has resulted in remarkable improvements when compared to overall rates in Pakistan. Only 10% of children are underweight for age in FPHC areas compared to 38% in the rest of Pakistan. Almost 100% of the women served by FPHC are delivered by trained staff and fully immunized compared to 12% and 57% respectively in the rest of Pakistan and NWFP. Maternal Mortality is 50 compared to 450 for Pakistan as a whole while the Infant Mortality Rate is about one-third that of Pakistan.

About the Project
The Canadian Society for Rural Physicians, with its strong base of physicians working in remote communities will be working with Frontier Primary Health Care, an NGO active in North West Frontier Province, Pakistan to strengthen STI/HIV management in 30 health units serving 600,000 people . This comprehensive program over two years will include staff training, community mobilization and health education and providing equipment. Health education and training materials will be developed and piloted in English and Pushto.

FPHC has a strong training unit that has achieved remarkable success with an innovative program of motivating and health educating local and religious leaders at the same time as the communities, health workers and volunteers are trained and upgraded. The community leaders are thus in a position to support and extend the efforts of health workers so that synergy of efforts occurs as new information is absorbed. This approach, grounded in community mobilization and empowerment, allows for forward movement at a pace the community can accept while creating trust in the health system, thus permitting remarkable achievements within this conservative population. It also appears to ensure that the needed changes occur and health workers feel supported.

The Canadian SRPC team members are: Kay Wotton, Liz Hillman, Dale Dewar, John Guilfoyle and Jane Bishop. Liz and Don Hillman and Kay Wotton have worked with FPHC before.

This two year project builds on previous international work done by the SRPC. Canadian physicians working in rural areas have the team building, interactive training and community development skills needed in international work. This is just the first step but we hope it leads to an ongoing partnership with FPHC and more possibilities for sharing Canadian expertise and bringing home the considerable lessons in working with scarce resource and sustainability.

The project will start up in August 2006. We will keep you posted on project activities through the website.

For questions or comments please contact .
Back to top of page
© Copyright 2009 The Society of Rural Physicians of Canada All Rights Reserved.
P. O. Box 893 | 269 Main Street | Shawville, QC | J0X 2Y0
Toll Free: 1-877-276-1949 | Fax: (819) 647-2485