NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, June 2, 2016

From 8am to 4pm, 25-year-old Samina Khaskheli travels door-to-door in rural Pakistan handing out free samples of condoms, birth control pills, and intrauterine devices.

“I was told ‘This is sinful’,” Samina says about the initial opposition to her selling birth control. She took the job warily. Her off-the-map village, Allah Bachayo Khaskheli, is home to roughly 1,500 people in the country’s south-eastern Sindh province. The flatlands are covered by livestock, and economic desperation leaves women toiling alongside men as farmhands, livestock breeders and cotton pickers.

Samina is a worker for the Marginalised Area Reproductive Health Viable Initiative – Marvi – once a popular emblem of female independence in Sindhi folklore. Today, Marvi refers to a network of literate or semi-literate village women aged 18 to 40 who travel door-to-door selling contraceptives. “In our village, there was no information about family planning. Many women died during childbirth,” says Samina about what inspired her to join.

Trained by the Karachi-based Health and Nutrition Development Society (Hands), roughly 1,600 Marvis are dispersed throughout Pakistan’s remotest villages, where government healthcare facilities are scant or nonexistent. In the Sanghar district where Samina’s village is located, at least 400 Marvis fill a gap left by a lack of government funded lady health workers (LHWs).