Village Allah Ditto Lashari is a remote village in district Sujawal, Sindh, Pakistan, with no educational or health facility. It has about 165 households with a population of a little over 1,000 people. Piped or safe drinking water is not available. Electricity is available in the village, but there are power outages that can last for hours.
Ameena is a Marvi worker in the village. She is 45 years old and has four children, who she wanted to educate but was unable to because of lack of resources. Her husband is an agricultural laborer and works hard to provide for his family. Though Ameena’s literacy level is low, she is committed to serving her community and to improving her family’s circumstances.
When HANDS identified Ameena as a Marvi worker, she was provided skills-based training on community mobilization and awareness-raising on family planning with the help of videos in Sindhi, the local language; she was also trained to use tablets to show the videos. The community helped build a space called the ‘Marvi House’, where she conducts family planning awareness sessions and where a Lady Health Visitor visits every fortnight to provide additional services including IUCD insertion and removal and injectable contraceptives.
Ameena now provides counseling about different family planning methods and its benefits, especially to young couples, and encourages inter-spousal communication and women’s participation in decision-making about family planning. Since she began her work a significant number of women have adopted modern contraceptive methods for birth spacing. A digital application prompts alerts for client follow up; HANDS is also introducing additional technology to upload real time data on family planning.
In addition to her family planning work, Ameena was provided a small grant of PKR 20,000 (approx. USD 150) to establish a small ‘Business in a Box (BiB) in her Marvi House. Here, she sells health, nutrition, and hygiene products as well as basic food items and vegetables at affordable prices, which have become very popular since the village has no shops, and people had to travel far to purchase basic items. The women in particular were dependent on their male relatives for their basic items. These women soon became Ameena’s customers, enabling her to start earning an income.
Eventually, Ameena was able to save enough money to purchase a motorbike for her family, which her husband uses to take their children to school and to take sick people from the village to a health facility. He has also been able to establish a small business of his own, through which he supplies milk to the nearby town, which further supplements their family income.
Ameena says, “Besides earning money and getting respect and recognition in the village, I feel delighted when I see my community being provided with quality services with the support of HANDS, knowing that I have contributed to this.” Samina, another Marvi worker in Umerkot district, Sindh, said she was inspired to join the program because, “In our village, there was no information about family planning. Many women died during childbirth.”
Today, Marvi refers to a network of literate or semi-literate village women aged 18 to 40 who provide information about family planning in their villages. The program has extended from 300 Marvi workers in one district to 3,600 Marvi workers in eleven districts across the country, serving a total population of more than 4 million population including more than 850,000 women and adolescent girls. Under this project, HANDS works with 900 such Marvi workers in remote rural areas in three districts in Sindh, Pakistan.