Child survival strategies for Pakistan post-1987

The report begins by reviewing the health status of Pakistani children and the Pakistani health structure, including: the relation between federal and provincial health departments; the stress on curative rather than preventive care; organizational problems at the district and provincial levels; the paucity of information; and the implications of these problems for A.I.D. programs. Constraints to CS activities include the GOP"s lack of commitment, a lack of technical leadership, and the isolation of women in Pakistani culture. A.I.D."s policy for selecting countries to participate in a CS program is outlined and new strategies are suggested based on the need for fundamental changes in leadership and in epidemiological surveillance, development of basic health management and health worker skills, promotion of high-impact programs such as oral rehydration therapy, and innovative funding. The paper concludes that a dramatic change in the health status of Pakistani children and mothers can be achieved given the right combination of resources, personnel, ideas, and political support.