Poverty remains a serious concern in Pakistan.
With a per capita gross national income (GNI) of $420, poverty
rates had fallen substantially in the 1980s and early 1990s but
started to rise again towards the end of the decade. According
to the latest figures, as measured by Pakistan's poverty line,
33 percent of the population is poor.
also significant gender gaps in both literacy and health status
in Pakistan. Gender disparities in education remain significant.
While the male population completes an average of five years of
schooling, the female population in Pakistan completes only two
and a half years. Maternal mortality remains high at 200 per 100,000
live births. Gender disparities in Pakistan are severe and pervasive.
Deep rooted cultural and institutional constraints prevent Pakistani
women from fully participating in the development of their society.
Their presence in the public sphere is condemned under the guise
of cultural and religious values, thus, making their contribution
outside the home difficult, if not impossible. Institutionalized
violence against women in Pakistan allows crimes of 'passion'
and 'honor' to go unpunished and has become, in the past two decades,
one of the biggest constraints to widening their role in the public
programs in Pakistan are playing a major role in the fight for
poverty alleviation as well as making significant progress in
reducing gender inequality. They are bringing about myriad social
changes as they target mostly women. At
the forefront of the MFIs in Pakistan, is Kashf Foundation, a
non-government Grameen Trust partner organization that is not
only working for women in order to achieve economic sustainability,
but is actually run by women themselves, a rare occurrence in
a country dominated by religious beliefs that foster patriarchy.
But this did not deter Kashf from being amongst the top 10% of
MFIs across the world in 2003, with an outreach of over 45,000
clients and a phenomenal growth of 189% from the previous year,
while achieving full financial self-sufficiency.
Loan To Cope With Crisis
products and services are completely geared to serve the rural
poor women and apart from the General Loans, the Emergency Loan
is fast gaining popularity, due to the relentless marketing done
by the staff to introduce this product to their clients. Kashf’s
General Loan clients are eligible to apply for the Emergency Loan,
which acts as a security blanket and can be used during times
of financial crisis to pay for medicines, utility bills, school
books etc. The Emergency Loan, based on the idea of a credit card,
allows Kashf clients to draw small amounts of cash of up to Rs.
4,000. In 2003 alone, Kashf disbursed 26,925 Emergency Loans worth
Rs.52.7 million while the cumulative disbursement reached Rs.65.1
million. In terms of its General Loans, in 2003, the organization
recorded a growth of 286% as they disbursed 45,763 new loans worth
Rs.331.8 million while their total loans outstanding remained
at Rs.447.8 million.
living in one of the poorest urban slums of Lahore, praises the
Emergency Loan, which she used to buy medicines for her 12-year-old
son. “The Emergency Loan has put me at ease as I know that
in case of emergencies, I don’t have to worry and can use
this product to meet the unforeseen needs of my household”.
Accidental Insurance –
New Entrant in the Products and Services Portfolio
The accidental insurance is a new financial product
added to Kashf’s portfolio. The product has been devised
on a partner-agent model where Kashf will work with an insurance
company in giving insurance coverage to all its clients. The insurance,
in case of accidental death, offers coverage to the client by
paying the outstanding loan amount and also paying Rs. 7,500 to
the deceased family for bearing burial and other such expenses
at the time of death. The insurance ‘premium’ consists
of a one-off payment of Rs. 100 by the client at the time the
client is insured. The product has been highly appreciated by
the Kashf client and has been introduced to mitigate the risk
in the lives of Kashf clients.
Accidental and the previously existing life insurance
are provided as one package to the clients and all of the active
clients are insured. Till date, the cumulative number of insurance
claims paid out is 471 and amounting to Rs. 7.3 million.
According to a recent Impact Assessment Study
conducted by DFID (UK), 32% of Kashf’s client households
are able to move out of poverty within a year, while 60% of them
belong to those earning less than a dollar a day. This automatically
brought about a marked increase in household expenditures for
better nutrition, healthcare and other basic necessities.
Promoting Women’s Healthcare
Reproductive healthcare is an extremely neglected
area in rural Pakistan, where Maternal Mortality Rate is as high
as 350 per 100,000 births and Infant Mortality Rate is a staggering
85 per 1,000 births. This is partly due to the purdah, or veiling,
practiced by a large number of Muslim women, as well as widespread
illiteracy and ignorance triggered by prevalent poverty, that
prevents the women from seeking medical help beyond their homes.
To tackle this growing problem, Community Support Concern (CSC),
a not-for-profit, NGO and partner organization of Grameen Trust,
launched an innovative program called Integrated Rural Reproductive
Health Project in October 2001, to provide healthcare services
to poverty-stricken rural and urban areas around Lahore. The project
is funded by DFID (UK) with technical assistance provided by Population
Concern (UK). CSC’s project involves the implementation
of Community Clinics, which would provide its destitute clients
with primary healthcare.The Clinics offers Health Insurance
Schemes under which a family can have all their primary health
concerns attended to by paying Rs.50 per family per month. Non-insured
people can also avail the services of the clinics by paying on
a per service basis.
The clinics are run by Lady Health Visitors and
female visitors, so that women are more comfortable visiting them.
The clinics are also regularly visited by a mobile team, consisting
of a female and a male doctor, who provide back-up support and
ultrasound facilities for the patients. The Community Clinics
as part of the reproductive health services, also counsels its
clients on pre-natal/ post-natal care, family planning, infertility,
pediatric care, early detection of cervical and breast cancer
etc. Confidentiality is highly regarded and strongly enforced
in the counseling sessions.
To reduce maternal and infant mortality rates,
CSC, under IRRHP offers training courses for Traditional Birth
Attendants (TBA), who are usually the ones most likely to perform
deliveries in the villages even though they lack proper training
and expertise. The training is focused on conduction of safe deliveries,
prevention of unsafe abortions, adoption of aseptic measures,
identification of high risk pregnancies and timely referral and
transfer of complicated cases to appropriate and nearby hospitals.
Apart from the Community Clinics, CSC also disseminates
information about AIDS and the practice of safe sex, a taboo topic
in the altogether conservative Pakistani society. Their target
groups are factory workers, male and female college students,
commercial sex workers and beggars among others.
As of the end of 2003, CSC has provided much needed
healthcare services to more than 100,000 poor people from Pakistan’s
rural and urban communities and despite the social hurdles they
face in tackling sensitive issues like birth-control and AIDS
prevention, the staff still remain undeterred to carry on their
Report prepared by Zain Bari
References: The World Bank Report on Pakistan (www.worldbank.org),
Community Support Concern Annual Report 2002, Kashf Foundation
Annual Report 2003 and Kashf Foundation Quarterly Report for the
period January-April 2004.