Anyone who witnesses a polio vaccination campaign in Pakistan will notice something remarkable: in most areas, the majority of health workers moving house to house to vaccinate children against this highly infectious paralytic disease are women.
But despite their outsize role in providing life-saving vaccinations and other essential services to children in every corner of the country, these frontline workers are rarely consulted on matters of health policy. This year, as Pakistan strives to eradicate wild polio once and for all, input and feedback from the women leading these efforts on the ground must be incorporated into the programme's design. There is no hope of success otherwise.
A polio-free Pakistan is within our grasp, and the women on the frontlines will help to carry us over the finish line. Recognising this reality, the country's polio eradication programme launched an unprecedented initiative to listen to underrepresented female health workers and engage them as co-partners in designing solutions to end polio.
The first step was to gather data at scale by surveying a representative sample of more than 2,600 women working in the highest-risk districts. They answered questions about their experiences and challenges in the field, including the barriers to reaching children during campaigns and administering vaccines in homes, as well as their motivations and safety concerns.
At 14 in-person workshops across the country, attendees suggested solutions for the biggest hurdles to ending polio in their districts and shared their hopes for future livelihoods beyond polio. The leadership at Pakistan's National Emergency Operations Centre (NEOC) promised to review and act on the valuable feedback gathered from these structured listening sessions.
I was lucky enough to attend one of the workshops, and the sense of excitement was palpable. Knowledgeable women, whose extremely valuable work has been underappreciated for too long, finally had the floor and were eager to help design a more effective programme that better reflects the reality they face every day.
The importance of such an exercise was evident from their creative ideas for addressing practical challenges like having to choose between walking for hours or hiring private transport during rush hour in order to get to work on time. They also brainstormed about how to overcome parental fears, owing to misconceptions about how best to protect their children, and disrespect for polio workers in many communities.
This co-design initiative is just one example of the Pakistani government's revitalised commitment to engage women more deeply in public-health efforts. The NEOC, for example, established its own National Gender Group, tasked with giving a voice to the women who are essential to eradication efforts -- starting with initiatives like this one.
Pakistan's government was the first in the Global Polio Eradication Initiative to launch such a programme, and I am encouraged to see that we are not alone. With similar efforts to listen to and learn from female health workers now underway in Somalia, Nigeria, and other countries, a global movement is taking shape. In many places, it is the first time that women have a seat at the policymaking table.
As the world faces a historic convergence of crises, from climate change to pandemics and persistent conflict, women's policy input is indispensable -- and not just to improving health care. After years spent engaging with local communities in order to battle outbreaks and provide essential services, these frontline workers will play a crucial role in designing solutions far beyond the eradication of polio.
Here in Pakistan, our polio programme's National Gender Group has much work to do. Female health workers nationwide have proposed hundreds of solutions to address the key challenges they face, and the programme is deciding which to implement.
Thousands of women have raised their voices, and we owe it to them to act. At the workshop, I understood that the future of Pakistan rests in their hands. Following their lead in fine-tuning Pakistan's polio eradication effort is the key to ending this disabling and life-threatening disease. ©2023 Project Syndicate
Atiya Aabroo, Deputy Director of Pakistan's Ministry of National Health Services, is a core member of the National Gender Group within the National Emergency Operations Centre.
