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Dr Zarka Riaz sits behind her desk at the Family Health Model Clinic (FHMC) set up by Rahnuma Family Planning Association of Pakistan (FPAP) in a low-income neighbourhood in Rawalpindi, a city of over two million next to Pakistan’s capital Islamabad. Even on this wet monsoon day, over a dozen women are gathered in the waiting area of the clinic. “Pakistan is experiencing a population explosion, women, especially those from underprivileged and marginalized sections of society are not able to gain access to contraception they so desperately want and need, to make choices for their families,” says Dr Zarka. Dr Zarka is a gynecologist, with a specialization in family planning. She has been working with FPAP for ten years but started working at this clinic 18 months ago. The family clinic is supported as part of the Women’s Integrated Sexual Health (WISH2ACTION) programme funded by the Foreign Commonwealth and Development Office (FCDO), under the strategy to ‘Leave No One Behind’. Across the country – Rahnuma-FPAP works through cluster networks. A pioneering model that brings together public and private specialist sexual and reproductive and health centers within a close radius referral network to ensure women and girls can receive life-changing care. Networks use poverty data mapping to ensure that services are targeted to areas where the population needs them most. "Under WISH we are offering free family planning services, which is extremely important for a low-income area such as this”, explains Dr Zarka. FPAP works in partnership with government and private clinics, community-based distributors, disability organizations and religious and community leaders as part of the clusters. Local pharmacies are also part of these networks and provide condoms and birth-control pills free of cost. Dr Zarka observes that a lot of women worry about unintended pregnancies but are not aware of family planning methods available. Pakistan is the world's fifth-most populous country, home to over 220 million people with an annual fertility rate of 3.6 children per couple. “There are a lot of myths and misconceptions about family planning. In male-dominated societies such as ours, women are often not able to make decisions about their reproductive health, which is why it is essential to engage men and mothers-in-law." Dr Zarka notes that it is becoming increasingly common for women in low-income areas to try to terminate unwanted pregnancies by getting unsafe abortion. “Abortion pills are readily available, and people use the internet to find out ways to abort unwanted pregnancies. However, women often take the wrong dosage and end up with too much bleeding or infections,” she says. “Access to free contraceptives can reduce the need for unsafe abortions, allow women to space their pregnancies and gain autonomy over their health and wellbeing,” she adds. Rahnuma implements the WISH programme across five provinces across the country and through its community awareness work is changing the discourse in Pakistan on family planning and sexual and reproductive health and rights.    

This report presents findings of a study exploring the influence of law on young people’s access to sexual and reproductive health in Nepal. Whilst there is a wealth of global research on the social, cultural and economic dimensions of sexual and reproductive health, much less is known about the influence of law on access to rights and services. This is despite the fact that every state around the world, without exception, has developed legislation that is in some manner designed to regulate, enable, restrict and control sexual and reproductive health, for different groups of people, and in different situations and circumstances.

Since August 25, more than 604 000 arrivals of Rohingyas from Myanmar have been recorded in Bangladesh  Most of them are taking shelter in makeshift settlements in dire conditions and are entirely dependent on humanitarian aid for survival. The population movement has created a critical and complex humanitarian emergency, which is likely to become a protracted crisis. The resources on the ground where they are being settled are obviously stretched leading to an acute need for shelter, food, sanitation, healthcare and clean drinking water. As per WHO Public Health Situation Update, 2017, poverty-ridden and without access to resources, the vulnerable people are completely dependent on what the Bangladesh Government and the relief agencies can provide them; such as primary and secondary healthcare, trauma care and rehabilitation, reproductive, maternal, neonatal, child health and mental health services and psychosocial support. Among the arrivals, an estimated 67 percent are women and girls, of whom 13 percent are pregnant or breastfeeding, and these numbers may rise (Source: UNFPA 2017). Through a field response team, comprising of Doctors, Nurses, Paramedics and Youth Volunteers well versed in humanitarian response, IPPF provided SRH and emergency medical services to pregnant women, new mothers, new-borns, men and young adolescent girls. Support IPPF in this endeavour to provide critical services to Women and girls in Bangladesh

This report summarises highlights of the results achieved during the past three years, findings of the assessment of the project, lessons learnt, challenges faced and outline of what impact it leaves for future in terms of sustainability of these achievements. In responding to address the unmet need of family planning services in the region, IPPF SARO provided 22.8 million services in 2016. Nearly, 38 percent of these services were provided to young people. The project played an important role in demand generation through reaching to young people. Moreover, the values and learnings from the Champions Project were adopted globally in IPPF’s new strategic framework 2016-2022. This will allow IPPF to maintain the momentum, deepen further advocacy efforts through the champions and expanding engagement of support groups.

 “When I was about to give birth, we called for an ambulance or a vehicle to help but even after five hours of calling, no vehicle arrived,” recalls 32-year-old Mona Shrestha. “The birth was difficult. For five hours I had to suffer from delivery complications.” Mona’s story is a familiar one for women in rural Nepal. Like thousands of women across the country, she lives in a small, remote village, at the end of a winding, potholed road. There are no permanent medical facilities or staff based in the village of Bakultar: medical camps occasionally arrive to dispense services, but they are few and far between. Life here is tough. The main livelihood is farming: both men and women toil in the fields during the day, and in the mornings and evenings, women take care of their children and carry out household chores. The nearest birthing centre is an hour’s drive away. Few families can afford to rent a seat in a car, and so are forced to do the journey on foot. For pregnant women walking in the searing heat, this journey can be arduous, even life-threatening. “Fifteen years ago, there was a woman who helped women give birth here, but she’s no longer here,” Mona says. “It’s difficult for women.” Giving birth without medical help can cause severe problems for women and babies, and even death. Infant mortality remains a major problem in Nepal, and maternal mortality is one of the leading causes of death among women. Only 36% of births are attended by a doctor, nurse or midwife.  A traumatic birth can cause long-term physical, psychological, social and economic problems from which women might never recover. Access to contraception and other family planning services, too, involves walking miles to the nearest health clinic. Mona says she used to use the contraceptive injection, but now uses an intrauterine device. Like many villages in Nepal, Bakultar is awash with myths and gossip about the side-effects of contraception. “There are so many side effects to these devices – I’ve heard the coil can cause cancer,” Mona says. “This is why we want to have permanent family planning like sterilisation, for both men and women.” These complaints heard frequently in villages like Bakultar. As well as access to facilities and contraception, people here desperately need access to education on contraception and sexual health and reproductive rights. Misinformation as well as a lack of information are both major problems. “It would be really helpful to have family planning services nearby,” says Mona.

This mapping study of networks, youth-led organisations, organisations that focus on youth development as well as youth-serving organizations has been conducted. A key aim of the study has been to bring these diverse organizations and networks on the same platform based on commonalities and also highlighting their strengths, so that through sharing of experiences, expertise and learning, SRHR with and for youth, including advocacy, can strengthen in the region

This document, a result of a mapping study undertaken in Nine countries in South Asia, showcases the dynamism of youth work and SRHR work in the region. It contains a purposive sample of 68 organisations/ networks working either on issues of SRHR, youth development and participation or both, with full recognition that the two are intrinsically linked. The data presented in the directory is information gathered either through primary data shared by the respective organisations/networks and/or supported by desk research. This is by no means an exhaustive list.

This study was designed to fill an important gap in research in Sri Lanka. The research included a desk-based review of existing laws, regulations and policies on SRH in Sri Lanka, as well as the collection and analysis of qualitative and quantitative data from young people, parents and SRH service providers in Sri Lanka. 

This study exploring legal barriers to young people’s access to sexual and reproductive (SRH) services in India contributes to filling an important gap in research. The research included a legal and policy review of laws related to SRH, as well as the collection and analysis of qualitative and quantitative data from young people, parents, and service providers in India.

IPPF South Asia Region implemented a program advocating for the integration of SRH and HIV in Afghanistan, Bangladesh, Iran, India, Maldives, Nepal, Pakistan and Sri Lanka at policy, system and service delivery level through its Member Associations in the respective countries. The uniqueness of the program is its multi-stakeholder, the multi-layered approach promoting the concept of SRHR HIV linkages and integration at various levels. It facilitated in building up cross learning platforms and partnerships with different stakeholders, innovative integrated service approaches through a provision of small grants and developing a series of knowledge products which are useful for both replication and sustainability. SRH HIV Integration captures the process and the achievements of the past four years of the programme which also includes the learning and the way forward.