KARACHI: Serious administrative and audit discrepancies have surfaced in the restructuring of the Sindh Lady Health Workers (LHW) Program for Family Planning & Primary Health Care (FP & PHC), which was shifted from the development to the non-development side in July 2020 under the Reproductive Maternal Neonatal and Child Health (RMNCH) Directorate, Sindh.
According to official correspondence from the Directorate General Health Services Sindh (RMNCH Wing), multiple audit observations have been raised over conflicting titles, overlapping authorities, and ambiguity in budget allocations related to cost center HB-0644. Despite the structural shift, the Program Director post for the Sindh LHW Program (BPS-20) was never formally abolished and continues to appear in the provincial budget book for the fiscal year 2020–21.
Documents reveal that both the Deputy Director General (RMNCH) and the Program Director (LHW Program) hold identical job descriptions and powers in BPS-20, creating duplication in administrative functions and financial authority. Currently, the DDO powers are being exercised by the Deputy Director General (RMNCH), while the budget continues to be released in favor of the Provincial Coordinator, Sindh LHW Program for FP & PHC — a conflict noted by the audit authorities.
The Directorate’s letters to the Health Department and Finance Department of Sindh highlight that this overlapping structure has caused confusion in the execution of RMNCH activities and triggered repeated audit objections for fiscal years 2016–17 through 2023–24. Officials have recommended that the title “Provincial Coordinator, Sindh LHW Program for FP & PHC – HB-0644” be formally changed to “Reproductive, Maternal, Neonatal & Child Health (RMNCH)” to align with the new organizational setup and violence order by sindh government cabinet.
The correspondence further requests that the redundant post of Program Director (Sindh LHW Program) be abolished to ensure clarity in administrative hierarchy, financial management, and accountability under the RMNCH framework.
Health experts say such prolonged administrative ambiguities not only affect governance but also delay service delivery in critical maternal and child health programs across Sindh.
