Poor Performance of Health and Population Welfare Programmes in Sindh: Case Studies in Governance Failure (Demographic Perspectives) (Sindh, Pakistan) (Report‪)‬

Although Sindh is the most developed province in the country and about half of its population lives in urban areas--which is substantially higher than in other provinces of Pakistan--the health and population indicators for Sindh are as poor as in other provinces. The available data suggest that Sindh has experienced little improvements in any of the indicators over the past two decades. Lately, "Crises of Governance" has been identified as one of the factors in poor human development records in South Asia, and Sindh is no exception. In this paper we apply the concept of "Good Governance" to the performance of health and population sectors in Sindh. First we examine the trends in health and population indicators (such as infant mortality rate, total fertility rate, utilisation of health services, contraceptive prevalence rate etc.) over the past two decades. Then we review the government's existing programmes in the two sectors with the help of quantitative and qualitative data and our own experience of working closely with the government's programmes. In the final section we provide recommendations for improving the situation through bringing in changes in the governance, at the planning and implementation levels.