Expanding Sustainable Access to Self-Care While Strengthening Last-Mile Worker’s Livelihoods

A Grand Challenges Canada–funded initiative expanding access to post-abortion care in Sindh by enabling trained women health workers to deliver safe, affordable reproductive health and self-care services while earning sustainable livelihoods.

Program Overview

The program addresses gaps in access to safe post-abortion care (PAC) and self-care information for women aged 19–45 years in underserved communities of Sindh, Pakistan. Through the Baji Connect digital platform, 150 trained community-based women health workers (“Sitara Bajis”) provide PAC counseling, family planning, and self-care services. By combining digital enablement, community outreach, and social entrepreneurship, the initiative improves women’s knowledge, choice, and access to quality care while creating income-generating opportunities for last-mile female healthcare providers.

At‑a‑Glance Information

Target population(s): Women aged 19–45 years; community women health workers (Sitara Bajis)
Geographic coverage: Pakistan → Sindh → Korangi, Orangi, Landhi, Baldia, Malir, Thatta, Umerkot, Tharparkar, Sanghar, Dadu
Service delivery channels: Community-based outreach, digital platform, door-to-door services
Program start – end: July 2025 – October 2026
Key donors: Grand Challenges Canada (with support from BMGF)
Key partners: healthcare providers, pharmacists, Sitara Bajis

Problem Statement

Women aged 19–45 years in low-income and peri-urban communities face limited access to safe post-abortion care due to lack of information, stigma, affordability barriers, and weak community-level service delivery. Many women are unaware of where to seek reliable PAC services, increasing the risk of unsafe practices and poor health outcomes.

Existing health systems struggle to reach women at the last mile due to workforce shortages, fragmented referral systems, and limited incentives for community-based providers. Trained women health workers often lack sustainable income opportunities, leading loss of jobs and skills. This program addresses these gaps by empowering trusted community women to deliver services, generate demand, and earn livelihoods through a digital platform “Baji Connect.”

Key Program Interventions

Digital Enablement of Sitara Bajis for sustainable livelihood

Objective: provide employment opportunities to female last mile health workers. Primary beneficiaries: Sitara Bajis. Implementation modality: Digital platform of Baji Connect.

Recruitment and training of 150 Sitara Bajis
Training on PAC, self-care, IPC, and entrepreneurship
Deployment of the Baji Connect platform
Linkages with pharmacies and healthcare providers
Mentorship and supportive supervision
Geographic focus: 10 districts of Sindh
Key risks & mitigation: Digital literacy gaps mitigated through hands-on training

Community Outreach & Awareness

Objective: Increase knowledge and demand for post-abortion care and self-care. Primary beneficiaries: Women aged 19–45 years. Implementation modality: Community-based outreach.

Neighbourhood meetings and door-to-door visits
Self-care education and counseling
Health related product distribution
Key risks & mitigation: Stigma addressed through peer-led engagement

13 field photos

Community outreach in Sindh

Door‑to‑door visits, neighbourhood meetings, and Sitara Bajis in action.

13 images · March 2026

IMPACT & RESULTS

Through collaboration with government partners and Sitara Bajis, the program has achieved:

34,280 self-care services delivered by 150 Sitara Bajis across 10 districts (2025–2026)
4,894 women received post-abortion care services
3,005 women counseled on post-abortion family planning
5,327 women trained on self-care through 315 neighbourhood meetings
150 Sitara Bajis recruited and fully trained on self-care, IPC, and social entrepreneurship
573 packs of Bliss sold (PKR 111,162 value) and 1,993 packs of Grekie distributed (PKR 312,901 value)
Baseline surveys completed in 10 districts of Sindh

Outcomes narrative: To date, the program has strengthened community-level access to post-abortion care and self-care services for women aged 19–45 years through trained and supported Sitara Bajis. Thousands of women have already received counseling, services, and self-care information through door-to-door outreach and neighbourhood meetings. Sitara Bajis are actively applying their skills to deliver services, engage communities, and generate income through product distribution and sales. As implementation continues, the program is building evidence on how digitally enabled, community-based women health workers can sustainably expand access to quality reproductive health services at the last mile.

STORIES & TESTIMONIALS

Beneficiary, Sindh

Woman from Korangi

“Before this, I didn’t know where to go or who to trust. Talking to a woman from my own community made all the difference.”

FEATURED PROGRAM STORIES

🌟 COMMUNITY IMPACT

Someone Finally Listened

Sindh, Pakistan 2025

The Sitara Baji listens without judgment. She explains options in simple words, reassures her, and guides her toward safe post-abortion care.

In a quiet neighborhood of Sindh, a young woman sits with a Sitara Baji inside her home. The conversation is gentle, unhurried. For the first time, she is able to ask questions she has carried silently for months—about her body, her health, and the care she needs after a difficult experience.

The Sitara Baji listens without judgment. She explains options in simple words, reassures her, and guides her toward safe post-abortion care. What stands out is not just the information shared, but the trust built in that moment. The woman's body language softens and her voice steadies. She is no longer alone.

Through Baji Connect, Sitara Bajis like her are reaching women where they feel safest at home, within their communities. For many women aged 19–45 years, these interactions are the first time reproductive health conversations feel respectful, private, and empowering. What begins as a visit becomes a turning point: knowledge replaces fear, and choice replaces uncertainty.