The objective of this strategic review is to produce evidence-based options and recommendations for DFID’s strategy for engagement in Pakistan’s health and population sector over the next 3-5 years.The report suggests approaches that will work with- rather than just through– Government, enabling other stakeholders to complement and strengthen government services. For example, national/international NGOs might be contracted in certain districts by the provincial governments to help the latter deliver more and better sexual and reproductive health (SRH) services through the primary healthcare network.

Where primary healthcare is already contracted out the contractee/service provider should be encouraged to follow the same principle and contract in or out certain services (like SRH) so as to ensure synergy between SRH and maternal, neonatal and child health services and outputs.The 2 main themes recommended for support would include:Supporting the transition between emergency support and sustainable health programmes in flood-affected districts.Supporting the transition from centralised vertical programmes to more effective locally-led more integrated services.