APPNA SEHAT : a description of the development of a health education programme in rural Pakistan.

Background Pakistan is a developing country with a high rate of mortality and morbidity. The rates of infant and maternal mortality are higher than some other countries in the region with a similar level of income. The APPNA SEHAT programme focused on these issues with the help of locally available resources and with a wider aim of capacity building. Aims We describe a programme of health promotion through health education, aimed at a rural population in Pakistan. Objectives The primary objective of the programme was to reduce mortality and morbidity in the population at highest risk. Secondary objectives included general improvement in health, literacy, and environment and sanitation. Intervention A survey of the population followed by health education, training of the professionals and provision of a small selection of services via the staff employed by the project. For the majority of the services, the communities rely on existing resources. Setting Initially 16,375 people living in 15 villages were recruited in the programme in 1989. The number increased to 180,000 in 91 villages in four districts in three provinces of Pakistan over a period of ten years. Results We discuss the evolution of the programme during its lifetime and its acceptance by local communities. We plan to report the results of interventions in a series of further papers