Impact of the Challenge Initiative’s Community Health Volunteers (CHV) on Public Sector Service Provision of Family Planning Services in Urban Sindh, Pakistan

To counter the high unmet for family planning in urban areas of Sindh province, Pakistan, Greenstar Social Marketing began implementation of The Challenge Initiative (TCI) in collaboration with governments’ departments of Population Welfare and Health in eight urban districts of Sindh province. This study aimed to assess the impact of TCI’s Community Health Volunteers (CHVs) on public sector service provision of family planning services in eight urban districts of Sindh province, Pakistan. Contraceptive Logistics Management Information System (cLMIS) and Department of Health Information (DHIS) were used to obtain monthly contraceptive data from June 2022 to December 2024. CHVs began implementation at different time-points in each district, starting from January 2023 to October 2023, when CHVs became operational in all the eight districts. Descriptive statistics and two sample t-test were used for data analysis. CHVs significantly improved family planning service provision, particularly for short- and long-acting methods at the facility level, with greater impact observed in Department of Health facilities. The study provides preliminary evidence on the effectiveness of CHVs on increasing public sector service provision of contraceptives, particularly for DOH facilities. CHVs bridge the gap between the community and the facility, particularly in areas uncovered by government’s existing mobilization staff.