Country Assistance Strategy 2000-2001
PAKISTAN

1. National Context

1.1 Socio-economic and humanitarian evaluation

The Islamic Republic of Pakistan is located in the northwest of the Indian subcontinent, and bordered by Iran in the west, Afghanistan in the west and northwest, the People's Republic of China in the north-east, the Union of India in the east, and the Arabian Sea in the south. With a surface area of 804,000 sq. km. and a variance in altitude from sea level to the world's second-highest mountain at 8,611 metres (K 2), the landscape of Pakistan shows extraordinary contrast. The wide and flat Indus flood plains with their five main tributaries (Sutlej, Beas, Ravi, Chenab, Jhelum) give way to some of the world's most spectacular mountain ranges of the Himalayas and the Karakoram range in the north and the alluvial arid region of Baluchistan in the west. The population of Pakistan is estimated at around 133.3 million with an annual growth rate of 2.6 %. Life expectancy stands at 63 years with a high infant mortality rate of 88 per 1,000 (1998). The Human Development Index is currently below India at 0.508 (UNDP 1999).

After over 50 years of independence, Pakistan is based on a federal democratic structure with four provincial governments and federally-administered tribal areas. Although an Islamic republic, the constitution provides for a secular state. The judicial system includes both a High Court and Shariat (Islamic) Court, with the latter gradually increasing in importance. Continuing political disharmony has had a significantly adverse impact on Pakistan's overall development. In addition, Pakistan has officially become a nuclear power since the nuclear tests conducted in 1998.

The GNP per capita is estimated at USD 492 with a gradually declining growth rate (5.7% in 1995, est. 2.37% in 1997) (National Bank of Pakistan estimate 1998) The country's economy is mainly based on agriculture, manufacturing industry, heavy industry and, at a much more moderate level, tourism. Energy resources include large natural gas fields, oil, coal and hydroelectricity. In 1995, there were on average 53 doctors per 10,000 people, 17 hospital beds per 10,000 people (UNICEF: Statistics of South Asian Children and Women, 1997), and the country has some 4,600 basic health units with 500 rural health centres (1994). However, most health care is concentrated in urban areas which accounts for less than one third of Pakistan's population, and rural facilities are often dismally understaffed and under-equipped.

Social indicators show an average life expectancy of 63 years (1998), and an adult literacy rate of 54% for men and 27% for women (UNICEF, Children and Women in Pakistan, 1998). in 1995, 38% of children under the age of five years were moderately malnourished and 13% severely malnourished (UNICEF, Children and Women in Pakistan, 1998). Access to safe drinking water is put at 90% of the urban population and 76% of the people in rural areas (Pakistan Integrated Household Survey, 1995-8, GoP). The main rainy season occurs between July and September (monsoon) and December to March (winter depression).

1.2 Vulnerability analysis

Like its neighbours, Pakistan is located over some of the most active tectonic faults (Kirthar range in the west, Ornach Nal fault in the south, Hindu Kush in the north and the Himalayas in the north-east). The disaster-proneness of Pakistan varies with its regions and the altitude. The central Indus valley and, to an even greater extent, the vast Indus delta plain in the south are regularly the scene of devastating river floods, forcing hundreds of thousands of people to leave their homes and seek refuge on higher ground. These powerful floods inundate most of the land, leaving many homesteads totally marooned. Such a vast expanse of flooding causes significant damage, particularly in a predominantly agricultural society . Similarly, the hilly regions and mountain areas are affected during the rainy season by heavy downpours causing lethal flash floods. At the same time, the arid areas of Pakistan (e.g. Baluchistan) expose their inhabitants to acute food shortages due to the poor quality of the soil, and a sub-surface level of malnutrition is constant. Both the arid west and the mountainous north are regularly affected by devastating earthquakes.

Although Pakistan is not located in the traditional area where cyclones develop (Bay of Bengal), occasional cyclones move along the western ghats of India and make landfall along the coast of Sindh Province. As in many Asian countries, some of the poorest sections of the population live in the flood plains, and since the suburbs of Karachi are particularly overpopulated, cyclones in that area are extraordinarily damaging. Industrial pollution poses a serious threat to the inhabitants especially in and around major cities, e.g. Karachi.

One substantial threat in Pakistan is the increasing communal violence and the continuing conflict over territorial claims between Pakistan and neighbouring India. This is the more important since in recent months there has been a dangerous deterioration in relations, a sizeable increase in military operations between the two countries, and the fact that both have nuclear potential.

Traditional coping mechanisms are limited in scope and often fail in the face of new and unfamiliar hazards such as industrial emergencies, and in situations where the extent of the disaster is beyond normal abilities to cope. One important asset for those regularly affected by floods is the efficient and effective early warning system established many years ago by the authorities. An intricate system of communication has been set up from the upper reaches of the main rivers and their tributaries all the way to the Indus delta. In addition to this, a system of river dams and bunds offer the rural population and their livestock an escape route. As a result, even serious floods generally cause only limited loss of life. Over the years, many communities in flood-prone areas have also learned to change the construction pattern of their houses and, increasingly, farmsteads are being built on raised land, dams are better maintained, and a greater awareness has been created among disaster-prone communities by a variety of organizations. The possibilities open to local communities in rural areas to combat the main threats they face have been gradually recognized, and the Pakistan Red Crescent is one of the organizations addressing such issues as improved construction, proper water treatment, literacy training, and a better preparedness of the local communities to face disasters. In many rural areas, women's self-help groups are evolving, thus increasing the community's potential even further.

1.3 Analysis of the funding and assistance / co-operation environment

The Pakistan Red Crescent is a valued partner of its Government. This applies particularly to emergencies and disasters where the National Society has gained increased credibility particularly since, operationally, the PRCS has moved away from relying to a major extent on government resources to being more independent, providing relevant government offices with information from its own resources.

The National Society has a good public image despite having only limited public relations. Access to the media is effective, with regular appearances from PRCS spokespersons. In other areas, the Society maintains several blood banks, although the output could be substantially increased. Headquarters and branches work on separate financial systems with headquarters' main income originating from investments, some government grants, rental from real estate, membership fees, and through support from the International Red Cross and Red Crescent Movement. Branches are financially independent from headquarters and raise their own funds through a variety of activities, contributing 10% a year to the national headquarters.

Within the Movement in the past few years, the PRCS has received financial and programme support mainly from the German and Finnish Red Cross Societies and, more recently, through the ICRC Office in Islamabad. The Pakistan Red Crescent was a very important partner for the Movement with regard to the operation in Afghanistan. Today, with enhanced support from the Federation, new contacts have been made and detailed assistance programmes developed. The assistance from the Federation has in particular included fund-raising support from the South Asia Regional Delegation in times of emergencies and disasters. Further funding potential is being explored as well through contacts with embassies and the UN system.

2. National Society Context

Founded in December 1947 at the time of Pakistan's independence, the National Society was recognized by the ICRC and became a member of the Federation in 1948. In 1974, it changed its name from the Pakistan Red Cross Society to the Pakistan Red Crescent Society. It is now represented in the entire country and all of the current four provincial branches have a network of district branches. Recent changes in the Society's leadership have contributed to a steady organizational development through modernization and a progressive outlook. The PRCS is committed to upgrading facilities, systems and management, and creating better publicity, and some first steps have already been taken. The four provincial branches are headed by dynamic and progressive secretaries supported by an equally-committed central leadership. Considerable human resource development has started in the form of regular workshops and the participation of staff and volunteers in regional, national, and international training.

Recently, the Society undertook a major planning exercise to establish a programme document with a clear vision for the coming five years. This first Five-Year Development Plan takes into account the identified needs within Pakistan and also considers the long-term development perspective for South Asia presented by the Federation Regional Delegation.

The PRCS is also incorporating the follow-up to the Hanoi Regional Conference and taking into account the priorities of the Capacity Building Plan 2000-2003:

• Strengthening and expansion of the organizational network at all levels of human resource development, disaster preparedness, and relief service programmes;

• Expansion of health and community services programmes;

• Mobilization of provincial and district branches, Junior and Youth Red Crescent;

• Aiming at greater levels of institutionalization of service activities;

• Resource mobilization;

• Projection and dissemination of aims and objectives nationally and internationally;

government partners towards health and population programmes.

In its five-year plan, the National Society reviews the current situation, analyses possible approaches and develops a variety of objectives based on the goals above and on specific, relevant strategies. A very clear approach has been taken in terms of implementation:

• Year 1 (2000) - Training based on training needs assessment
• Year 2 (2001) - Institutional and organizational development
• Year 3 (2002) - Consolidation of achievements, review, revision if necessary
• Year 4/5 (2003/4)- Execution of actual programme plan.

• Institutional and Organizational Development

- Improving existing Training Facilities

- Finance Management Development

- At this stage, institutional and management training will be incorporated into the Federation's regional strategy.

• Emergency preparedness and response (traditional and community-based)

• Resource development

• Planning, development and management of PRCS health programmes

- Health and welfare programmes

- Balochistan Primary Health Care Infrastructure

- Safe Blood Programme

- Population Welfare Programme.

• Public relations development.

3. Priorities and Objectives for Federation Assistance

The Federation, after several years of sporadic assistance due to lack of funding and its focus on Afghanistan, now envisages a more structured and planned long-term support to the Pakistan Red Crescent in terms of institutional and organizational development and also in the area of programme support. The main aim is to maintain and further enhance the positive momentum within the National Society in its endeavour to modernize, upgrade, and prioritize. For that, work will be necessary with the National Society on programme identification, programme planning and management. This includes streamlining and improving the National Society's reporting practices. First steps, in terms of better and more concise assessments, have already been achieved in emergency work. It is now necessary to apply these first successes to other more development-oriented areas of the Society's work. This would offer meaningful support to the desire of the PRCS to strengthen its district branch structure.

In view of the disasters afflicting Pakistan every year, another aim of Federation support is to provide further training on disaster preparedness and response capacities. This could take the form of a provincial or national disaster preparedness plan and support to the Society's volunteer structure.

A further aim is to strengthen the Society's population welfare programme and health-related activities to achieve professional management of an important health area in Pakaistan.

Since January 1999, the Federation has maintained only a country office with experienced local staff. All technical advice and support for emergency as well as development programmes is provided through the South Asia Regional Delegation. It is an important aim for the Federation to re-establish a fully-fledged Country Delegation / Representation in Pakistan to ensure more structured and continuous support. In times of emergencies assistance from SARD might take the form of a country delegate based in Pakistan for a period to oversee and assist in a particular operation. Advice and technical assistance are being provided through regular contacts, structured and frequent visits, information sharing and the regional meetings every six months between the Secretary Generals of the regional National Societies. In addition, the various regional training initiatives undertaken by the Regional Delegation provide further support.

4. Priority Programmes for Federation Assistance

The Pakistan Red Crescent has produced an excellent analysis of its priority programmes, which is included under section 3. This was partly in direct response to the Hanoi Declaration follow-up process of the South Asia Regional Delegation, and partly a result of the Society's considerable planning effort to develop its Five-Year Development Plan (2000-2004). Some of these programmes are included in the Federation regional assistance strategy, and the remainder are addressed in this section.

4.1 Emergency preparedness and response

There will be four main areas within this programme, and all of them were suggested by the Pakistan Red Crescent:

1. Disaster-related training for PRCS staff and volunteers.

2. An extension to the existing Community-based Disaster Preparedness and First Aid programme. The 1999 cyclone provided a very good opportunity for the Pakistan Red Crescent and the Federation to work together on both disaster response and building a preparedness system for national headquarters and a provincial branch. It also enabled the National Society to perceive its own strengths and weaknesses.

3. The management of mass casualties.

4. Warehouse construction for disaster preparedness relief and emergency goods and management of stocked inventory. Considering today's realities, this will, however, need to be closely tied in with looking for ways to generate revolving funds to ensure restocking without external inputs in the longer term.

Budget Year 2000     CHF 180,910

            Year 2001     CHF 150,700

4.2 Health education and services

There are three programmes within this sector:

1. Reproductive and child health services through the establishment of PHC
infrastructure in Baluchistan.

2. A safe blood programme.

3. Strengthening reproductive and child health through 61 MCH centres and their surrounding peri-urban and rural communities.

These programmes are all part of the Federation assistance plan of two to four years. There is also a desire by the PRCS to develop, partly through these programmes, the planning and management of its health programmes as referred to in the Society's Development Plan.

4.2.1 Reproductive and child health services through establishment of PHC infra- structure in Baluchistan.

Baluchistan is a particularly underdeveloped area, with the lowest population of the four provinces. An estimated 5.5 million people share 43.6 per cent of the country's territory, resulting in a population density of less than 16 people per square kilometre. The average household consists of eight members, and settlements are typically very scattered. Some of the worst and most unsatisfactory health service infrastructure exists in the districts of Sibi, Mastung, Pishin and Chagai in the mid-west and far west of the provinces.

It is for this reason that the PRCS plans to establish primary health care (PHC) services in these four districts of Baluchistan as a pilot project with the capacity for future expansion. In each of the districts the PHC pilot project infrastructure will be made up of one MCH clinic, one mobile clinic and six first-aid posts. The services will be for the general public but particular emphasis will be on the most vulnerable in the communities - children, the elderly, and women (especially pregnant and lactating women).

The MCH centres will form an important nucleus focusing on traditional services such as health education, local disease control, epidemiology, MCH and family planning, essential drug provision, nutritional education, treatment of minor ailments, hygiene and sanitation education and activities.

Based on the needs and priorities, the PRCS provincial branch of Baluchistan will identify, with relevant health officers and the community, suitable locations for one MCH centre in each of the districts of Pishin, Mastung, Sibi and Chagai. These centres will serve as co-ordination, supervision and referral centres for the attached, decentralized services, as well as a district- level focal point for PRCS activities. Each MCH centre will have a basic staff comprising one doctor, one female health visitor, one midwife, one traditional birth attendant, one driver, one security guard, two motivators and 10 volunteers. Basic, essential furniture, equipment, and one vehicle, will be procured.

The appropriate sites for the first-aid posts will be chosen in a similar way. Each MCH centre will have five to six first-aid posts attached to it and provide the necessary co-ordination and supervision. Each first-aid post will be staffed by four volunteers to be recruited from within the respective community. This arrangement will provide some 24 volunteers per MCH centre, and nearly 100 volunteers for the entire programme. Each volunteer will undergo basic and annual follow-up training and exchanges at the MCH centre. The volunteers will be provided with a haversack containing first-aid materials and a few basic medicines, and will keep a record of the services provided and materials used. The strong community orientation in the selection and set-up of this component will provide an important link to related health education and disaster preparedness.

The third component of the proposed infrastructure is the organization of one mobile clinic per MCH centre. While the MCH centres and first-aid posts will provide essential static health services, they will need to be supplemented by an outreach programme aimed at the large number of people in western Baluchistan living in very remote and scattered locations. Each mobile clinic will have a staff of three: one female doctor, one midwife and one driver.

The set-up will include procuring a vehicle that can double as an ambulance for urgent referrals of emergencies. The vehicle will be equipped with basic medical supplies and equipment for mobile consultations as well as regular consumables. Each vehicle will also be equipped with a cellular phone for better co-ordination.

Given the strong medical background of the Society's senior officers, it is not anticipated that a health delegate will be required for this programme, although technical support can be provided if needed by the South Asia Regional Health Delegate.

PRCS has chosen to cover PHC needs in these underprivileged parts of the country where government health facilities are almost non-existent or where they do not enjoy people's confidence, since the few that do exist are understaffed or poorly supplied.

Budget Year 2000         CHF 212,258

           Year 2001         CHF 62,970

4.2.2 Safe Blood Programme

In Pakistan, blood transfusion services are provided by governmental, civil, military and private hospitals, as well as private blood banks and non-governmental organizations. With the exception of military medical facilities, services are highly unsatisfactory and blood collected and distributed is largely unscreened, and therefore unsafe. This is also due to the absence of a national blood policy and national regulations. At the same time, the high prevalence of hepatitis B and C, and the overall increase in HIV/AIDS, makes it essential that all blood be screened accurately with state-of-the-art equipment.

This project aims to increase the number of units the blood donor centre in Islamabad collects a year from 2,000 to 10,000 over a phased period. This upgrading of the blood programme, which includes expanding activities on motivation and dissemination, will require essential screening equipment, and transfusion and test kits. The programme will provide safe blood and blood products for an estimated three years, and by the end of that time it will be assisting 10,000 people a year, such as emergency, medical, surgical or trauma cases, thalassaemia patients, and patients with cancer or undergoing radiotherapy.

The programme includes the development of training/audio-visual training, as well as educational equipment. The Pakistan Red Crescent will cover the complete salaries and administrative costs for the staff.

During this programme, the PRCS will explore the possibility of establishing a realistic cost-recovery system which takes into account the background of deteriorating economic conditions, monetary depreciation, high inflation, unemployment, and international sanctions.

A mid-term evaluation of the project will be undertaken after two years, with a final evaluation at the end of the three-year term. The Society will make efforts to generate sufficient funds to sustain the programme after the third year. The programme will be subject to an annual audit. It is not foreseen that a delegate will be required for this programme. However, the South Asia Regional Delegation will focus on blood-related issues during the coming years, and technical support will be provided through regionally-available expertise.

Over the four-year planning period, the programme will be expanded to cover infrastructure development of the blood donor centres in other areas of Pakistan through PRCS district chapters.

Budget Year 2000         CHF 179,513

            Year 2001         CHF 78,145

4.2.3 Strengthening Reproductive and Child Health through 61 MCH Centres and their surrounding peri-urban and rural communities

The National Society's main focus in health is primary health care, which is directed specifically towards preventative MCH services to the most vulnerable women and children. During the past five years the PRCS has run an integrated project in 17 out of 61 MCH centres and surrounding communities in order to reduce maternal mortality as well as to improve the health of children through child spacing.

While the existing service providers possess the necessary skills for MCH, their skills will need to be upgraded for reproductive health and family planning. Additionally, the health centres will need to be provided with the necessary equipment and supplies to ensure the delivery of quality services. Finally, the communities will have to be made aware of the potential benefits of reproductive health and family planning.

The 61 MCH centres have been working for the past 30 years: 19 in North-West Frontier Province (NWFP); 25 in Punjab; 16 in Sindh; and one in Islamabad. The centres provide basic facilities for more than 200,000 women, such as pre- and postnatal care, delivery services and primary health care. Initially, no family planning (FP) services were provided. In 1993, FP services were added to 17 centres (four in NWFP, one in Islamabad, six in Sindh, and six in Punjab) which received financial support from the Finnish and German Red Cross Societies. Another component of the programme was limited income generation which focused primarily on providing some income for the women and limited funding for the centres themselves. The main activities included sewing and knitting with teachers provided by the Finnish Red Cross.

The PRCS has successfully controlled mortality rates and malnutrition problems in the operational areas. However, the society is not yet in a position to take over the entire operation financially, although it covers 85 per cent of national headquarters' costs related to the programme, 60 per cent of the costs at the district level and 56 per cent of the operating costs of 17 centres (in addition to the total costs of the remaining 44 MCH centres without FP services). The National Society has realized that decisive steps are needed to introduce cost- recovery and other alternatives to generate sustainable income for the programme and to maximize training and utilization of staff.

The current 17 MCH centres that offer integrated FP services will continue to do so in the provinces of NWFP, Punjab, Sindh and in Islamabad. The regular services (MCH, pre- and postnatal care, delivery services and PHC services) as well as the family planning (counselling, various temporary contraceptive methods) will be offered, and the home visits (averaging 16,000 annually with some 80,000 clients seen) by male and female health workers will continue. It is also planned to retain the existing staff in each centre to ensure the continuation of the integrated services as well as the structured dissemination of FP and talks on general health and hygiene. This continuation, however, will only be possible with external support.

The purpose of this project is to contribute towards a reduction in maternal and child mortality and morbidity rates through the provision of a range of services. The intended results are:

• Increased awareness of the benefits of RH / FP services at the community level in the four provinces of Pakistan.
• Improved skills and knowledge of medical and paramedical staff to deliver a range of RH / FP services.
• Provision of better-equipped MCH clinics, complete with related equipment and adequate contraceptive supplies.

• Target communities will be made aware of the potential benefits of RH / FP services.

• Women from targeted communities will receive reproductive health services through 61 health facilities.

• Workshops and training seminars will be provided for staff to upgrade their skills in the provision of RH / FP.

           Year 2001         291,980 CHF

4.3 Institutional and Resource Development

4.3.1 Finance development

The overall aim of the finance development programme is to enable the PRCS to have a transparent system of accounting, with appropriate internal controls, which is able to produce timely, accurate and transparent financial reporting for external donors and internal management purposes. The project will employ a qualified accountant to work with the finance staff in the National Society to standardize and improve the financial procedures and controls, and to develop the skills of the finance staff. The accountant will also work with senior management to introduce them to the concepts and tools of finance management.

The project will also provide computer hardware / software and training in its use to NHQ and some of the branches. This is the beginning of the process of automating the financial systems, and modernizing the working practices of the National Society.

Finally, the project will install a computerized accounting system at NHQ and some of the branches.

The Pakistan Red Crescent has 13 professional and 47 support staff at its headquarters, and a large number of staff in its provincial branches, with about 4.2 million members and volunteers nationwide. Although progress has been made in recent years in the area of institutional development, working practices at headquarters and the branches are still quite traditional. In May 1999, a qualified accountant was recruited to begin work on the finance development project, which was included in the 1999 Appeal. He has carried out detailed assessment work at NHQ and provincial branches, and is working with the accountants and management to improve the accounting and budgeting procedures. A financial management workshop will be held in Islamabad, and computers will be installed in one of the provincial branches in order to begin the process of automating some of the finance work. To benefit from the experience of sister Societies in the region, and to ensure a consistent approach throughout the region, the accountant has already visited the Nepal RC, which has a successful finance development programme, to be briefed on its operation.

The management of the Pakistan Red Crescent recognizes the importance of strengthening the financial systems and beginning to automate the financial procedures and therefore makes the programme a priority.

The objectives of the programme are as follows :

• To develop and improve the basic accounting, budgeting and financial management skills of finance staff.

• To train senior officers in the importance of, and the tools for, finance management.

• To standardize and to strengthen the existing financial procedures and systems at NHQ and branches, including the beginning of automating part of the procedures.

• To install a computerized accounting system at NHQ and branches.

The following indicators will ensure monitoring and later evaluation of the project:

• Accuracy, timeliness and transparency of bookkeeping
• Increased awareness by senior management of the importance of financial management
• Improved financial reporting to donors and management.

The Regional Finance Delegate will supervise the implementation of the project; the Pakistan Red Crescent Principal Accounts Officer will be responsible for its routine implementation, with the other members of the finance team based in the South Asia Regional Delegation. The Pakistan Country Delegation, once re-established, will provide first-level support. The computerization stage will need specific technical input from either an experienced communications delegate or a local consultant.

Budget Year 2000        CHF 71,247

           Year 2001         CHF 92,890

4.3.2 Upgrading the training facility in Islamabad

The PRCS has identified as one of its priorities increased emphasis on institutional development at all organizational levels, as well as more progressive training in areas such as training of trainers, first aid, traditional seminars, and programme training activities.

The current training facility at NHQ consists of a number of well-appointed rooms plus a 220-seat auditorium with a public address system, voting and translation facilities. While the structural facilities are adequate they are in need of renovation and upgrading, and the training equipment needs to be replaced.

Upgrading of the existing training facility will include: refurbishment and renovation of the present facility; procurement of essential training material (books, charts, models), basic computer and printing equipment for the production of good-quality training documents and essential training equipment (such as audio-visual aids); and partial coverage of running /personnel costs.

The Pakistan Red Crescent seeks financial support for this programme to cover the renovation of the premises, the procurement of training and technical equipment, and part of the personnel and administrative costs. External support is sought for approximately 60 per cent of the total costs, with the remaining 40 per cent covered by the National Society which will develop alternative funding sources such as cost-recovery through utilization of the training facility by external agencies or other programmes of the National Society. An in-depth study will be conducted by an external resource person into the future viability, possible expansion, detailed utilization and possible future financial coverage of the training facility.

Budget Year 2000 only CHF 57,685

4.4 Public Relations and Resource Development

A number of other activities related to the development of the PRCS will be covered by the country and regional delegation. These activities will mostly be conducted with the National Society's senior management and with assistance from the Regional Information Delegate as well as the Head of Country Delegation/Representative and, as required, the Head of Regional Delegation. The activities include:

• Co-ordination with government representatives, NGOs, UN agencies and other stakeholders.

• Co-ordination with print and electronic media for disseminating Red Cross/Red Crescent principles and Society activities.

• Awareness programmes, including drug addiction, hepatitis, AIDS and communica- ble diseases.

• Programmes with stakeholder groups for income generation.

5. National Society Activities Currently Supported by Donors

6. Resource Mobilization Strategy

Apart from owning premises in all branches and headquarters, material resources include warehouses, training facilities, an auditorium, and several buildings from which the National Society generates substantial rental income. The ability to attract professional staff and volunteers is demonstrated by the PRCS having some 4.2 million members nationwide. In addition to this, it has recently established a volunteer corps that will further enhance the human resources of the Society. Financially, the PRCS largely relies on traditional income from real estate, membership fees, investments and, to a lesser extent, an annual government grant.

Emergency funding has mainly been obtained through the traditional Federation and ICRC channels as well as contributions through the diplomatic missions in the country. A recent substantial funding support for Disaster Preparedness from the British Government (DFID) has substantially improved the programme-related funding situation.

The National Society has recognized the importance of developing a more structured approach to resource development. The South Asia Regional Delegation's plan to conduct a Regional Resource Development Workshop in the second half of 1999 will address the Society's desire to establish new, innovative fund-raising approaches. One untapped area of potential income is the corporate sector and another, to a lesser extent, is tourism. Regular sharing of newsletters and other publications betweeen the PRCS and the Federation will increase the chances of obtaining funds within Pakistan.

7. Criteria and Process for Evaluating the Assistance Strategy and Assessing

Possible Risks

Baseline surveys, feasibility studies and marketing investigations are all tools to be applied before programme development. The PRCS has only just begun to address programme development in a strategic way, and it will be part of the future development strategy of the Federation and the National Society to focus more on such planning tools. This will lead to a better definition of what 'Vulnerability' means in the context of Pakistan. Once vulnerability has been properly defined, it will be easier to establish the selection criteria for 'the most vulnerable', set appropriate project goals and, eventually, determine practical ways and means to evaluate the projects and programmes regularly against their original aims and objectives.

As a matter of regular practice, all programmes undergo a mid-term and/or final evaluation, depending on their duration. With longer-term programmes, an annual review also ensures that programme objectives and achievements are seen within the context of changing realities.

Some of the critical assumptions are:

• A more stable political climate in the country and the region will ensure that the development of the country proceeds with fewer obstacles. This more conducive environment will, in turn, ensure that the National Society can continue its work unhindered and with the full support of its Government and people.
• Current territorial disputes are settled peacefully, contributing to a reduction in communal violence and the likelihood of conflict.

• The current stable and proactive leadership of the PRCS continues to develop the National Society into a modern, relevant and progressive national and regional partner. This includes, in the interest of continuity and managerial strength, the follow-up on the 'second-in-command' structure already begun.

• Funding is found for the individual programmes and the general development of the National Society.
• With exposure to external supporters comparatively less than other regional National Societies, the PRCS will enhance its knowledge of funding realities and the needs of potential backers.

• Future plans are based on documented realities, facts, and more on assessments.

• Potential supporters are willing to invest in the PRCS, and are able to show medium to longer-term commitment to its institutional and organizational development.

• Constant relief needs do not hamper the development potential of the National Society but are addressed in a supportive way.

8. Budget Overview (2000)

(in CHF)

Project number	PPK000	PKK001	PPK002	PPK160
Name	National  Coordination	Population  Welfare	Finance  Development	DPP	Safe Blood	MCH  Baluchistan	Training  Facility  Upgrage	TOTAL
Shelter & construction
Clothing & textiles						1,290		1,290
Food & Seeds
Water
Medical & first aid		34,200			60,927	12,768		107,895
Teaching materials
Utensils & tools
Other relief supplies
Sub total supplies		34,200			60,927	14,058		109,185
Land & Buildings							21,400	21,400
Vehicles		90,000			23,179	65,700	2,800	181,679
Computers & telecom	4,000	2,800	16,400		4,967	780	6,000	34,947
Medical equipment					50,165	11,130		61,295
Other capital expenses	2,000	19,200			3,311	2,625	4,300	31,436
Sub total capital	6,000	112,000	16,400		81,622	80,235	34,500	330,757
Programme management	6,306	30,607	4,804	12,199	12,105	14,313	3,890	84,223
Technical services	1,888	9,162	1,438	3,652	3,623	4,284	1,164	25,212
Professional services	2,093	10,161	1,595	4,050	4,018	4,751	1,291	27,960
Sub total programme support	10,286	49,930	7,837	19,900	19,746	23,348	6,345	137,394
Transport & shortage	5,500	12,300			662	15,150	400	34,012
Personnel (delegates)		1,680	2,520	1,680				5,880
Personnel (local staff)	24,227	144,600	35,085	150,750	13,245	55,950	9,600	433,457
Personnel (support costs)
Sub total personnel	24,227	146,280	37,605	152,430	13,245	55,950	9,600	439,337
Travel & related expenses	1,000	47,000	7,500	3,750				59,250
Information expenses	400				3,311	3,912	4,700	12,323
Sub total Travel & Communications	1,400	47,000	7,500	3,750	3,311	3,912	4,700	71,573
Admin & general expenses	46,100	52,200	1,905	4,830		19,605	2,140	126,780
External worksh./seminars
Subtotalgeneral & administration	46,100	52,200	1,905	4,830		19,605	2,140	126,780
Total budget	93,513	453,910	71,247	180,910	179,513	212,258	57,685	1,249,038
Total assistance sought	93,513	453,910	71,247	180,910	179,513	212,258	57,685	1,249,038