PROJECT OVERVIEW

Pathfinder’s Women-Led Climate Resilience program strengthened health systems, enhanced women’s and young people’s leadership, and improved community resilience to climate change. The program worked alongside women and girls in low-resource communities to develop the tools, knowledge, networks, and resources they need to ensure reliable access to quality health care, build foundations for economic growth, and strengthen their communities and health systems so they are resilient to future shocks. Takeda Pharmaceutical Limited’s Global Corporate Social Responsibility Program supported the initiative from 2022–2025 across five districts of Bangladesh (Sylhet, Sunamganj, Netrokona, Kishoreganj, and Cox’s Bazar) and six districts of Pakistan’s Sindh and Khyber Pakhtunkhwa provinces (Badin, Sanghar, Thatta, Umerkot, Charsadda, and Kambar Shahdadkot), serving over 1.2 million people.

This brief focuses on the implementation phase, during which the project equipped clinical providers and Monitoring and Evaluation (M&E) officers with the clinical, supervisory, and data-use skills required to implement the TSTS framework safely and effectively. These efforts strengthen provider performance and service quality while establishing the systems needed for sustained clinical mentorship and routine monitoring of results. This phase is critical because provider training and capacity strengthening translate policy intent into safe, high-quality service delivery for mothers, newborns, and communities.

These sudden terminations halted 15 Pathfinder projects, including 6 of the organization’s largest across Africa and South Asia. Valued at US$221.6 million, these six projects delivered family planning, maternal and child health, and women’s economic empowerment services at national scale. They supported more than 3,500 health facilities in Egypt, Pakistan, Burkina Faso, Uganda, and Mozambique.

We projected that award terminations would result in:

• 571,000 family planning clients losing access to services
• 713,000 unintended pregnancies
• 287,000 unsafe abortions no longer averted
• 1.1 million children missing routine vaccinations and treatment for common childhood illnesses
• 450,000 women and young people losing access to life skills, economic literacy, and reproductive health education

In response, Pathfinder focused on maintaining continuity of essential services, protecting core systems, and working closely with local ministries of health and partner organizations to transition services to prevent collapse. Download our brief above to see how Pathfinder projects worked to sustain services and reduce harm during this tumultuous period.

Pathfinder International works alongside women to reduce systemic barriers and drive a better future for society and the environment. By co-designing innovative solutions at the intersections of health, climate resilience, and leadership with women and their communities, we ensure a context-sensitive approach grounded in lived realities.

From July 2024 to June 2025, Pathfinder operated in 16 countries, implemented 40+ projects, and supported 1,200+ health facilities. Together with local partners, we’ve driven sustainable solutions to strengthen communities—enabling women to navigate change, shape their own futures, and lead healthy lives.

In October 2024, the Ministry of Health in Côte d’Ivoire signed a decree making family planning services free in the public sector. With support from the Gates Foundation, Pathfinder and Jhpiego are collaborating with the MOH to realize the Ivorian government’s vision of universal access to modern contraception by 2030.

Pathfinder Côte d’Ivoire has been a trusted partner to the Ministry of Health in their efforts to make public family planning services more affordable. In 2020, following sustained advocacy from Pathfinder and civil society partners, the MOH approved a free family planning program pilot that included free medical consultations, contraceptives, and consumables. Between 2021 and 2023, Pathfinder led pilot program implementation across 10 health districts with promising results. Over 18 months of continuous support, mCPR increased from 7% to 25% in Agboville, the department where the 10 pilot districts are located. Additionally, adolescents and young women under the age of 25 made up 52% of all new family planning users since the pilot began.

The pilot’s success led to the official decree making family planning services free in the public sector in October 2024. To support rollout of free family planning services, the Gates Foundation funded the Universal Access to Modern Contraception in Côte d’Ivoire (UAMC-CI) project. A three-year and $4M USD investment, Pathfinder leads UAMC-CI in 67 health districts in partnership with Jhpiego and the Ministry of Health.

To address these shortages and improve service delivery, Nigeria adopted the Task Shifting and Task Sharing (TSTS) policy in 2014, with revisions in 2018 and 2022. The policy expands the roles of lower-cadre health workers, including Community Health Extension Workers (CHEWs), Junior Community Health Extension Workers (JCHEWs) and Community Health Officers (CHOs) by expanding their roles in the provision of essential healthcare services. Building on the national direction. Aligned with the National Frameworks, Kaduna and Kano states have domesticated the TSTS policy prioritizing the delivery of key health interventions, including Reproductive, Maternal, Newborn, Child Adolescent and Elderly Health (RMNCHAE+N), Tuberculosis (TB), Malaria, HIV/AIDS, and other communicable and non-communicable diseases.

The TSTS investment (Investment INV-074254) seeks to generate evidence to support the full implementation and scale-up of the TSTS policy in Nigeria. By piloting the TSTS approach in Kano and Kaduna States, the investment aims to demonstrate the feasibility, effectiveness, and impact of task shifting and task sharing in improving service delivery outcomes at the Primary Health Care (PHC) level.

For more information on the implementation phase, during which the project equipped clinical providers and Monitoring and Evaluation (M&E) officers with the clinical, supervisory, and data-use skills required to implement the TSTS framework safely and effectively, read: Operationalizing TSTS at the Frontline: Strengthening Clinical and Data Capacity in Kaduna and Kano.

This toolkit—informed by Pathfinder’s implementation of the Advancing the Leadership of Women and Girls Towards Better Health and Climate Change Resilience project in Bangladesh and Pakistan—offers a practical guide for applying a gender-transformative approach (GTA) to efforts aimed at enhancing community resilience in the wake of climate change induced emergencies and disasters. The toolkit helps users develop GTA-based interventions to promote women’s leadership in improving community resilience to climate change and expanding access to quality health care.

This toolkit will walk you through the three phases of our GTA approach: (1) Collaborative Design, (2) Co-implementation—with a distinct set of activities to address four levels of the Socio-Ecological Model (SEM)—and (3) Monitoring, Evaluation, and Learning. For each phase, you will find practical guidance, links to relevant tools and templates, and real-life examples of these concepts in action.

Annexes

1. Community Risk Assessment
2. Baseline Questionnaire
3. Planning Individual-Level GTA Interventions to Build Women’s Agency
4. Health Facility Assessment
5. Health Facility Assessment: Disaster Preparedness and Service Readiness Assessment of the Health Facilities in the Climate Vulnerable North-Eastern Areas in Bangladesh 
6. SRHR and Climate Change Module
7. Nutrition and Climate Change Module
8. Climate Champions’ Information, Education, and Communication Material
9. Media Consent Form
10. I Want to Change…
11. Personal Beliefs vs. Social Norms
12. Worksheet: Collective Action Plan
13. Information, Education, and Communication Materials – Bangladesh
14. Flipchart Manuals – Bangladesh
15. Facility-Level Disaster Preparedness Contingency Plan
16. Gender Training Module – Bangladesh
17. Curriculum Incubation Hub
18. School-Based Disaster Risk Management Guidebook
19. School Safety Plan Module – Bangladesh
20. GTA Pre- and Post-Questionnaire

Pathfinder International, with generous support from the Takeda Pharmaceutical Company Limited’s Global CSR Program, implemented the Advancing the Leadership of Women and Girls Towards Better Health and Climate Change Resilience in Bangladesh and Pakistan from 2022 to 2025. The project strengthened health systems, enhanced women’s and young people’s leadership in climate adaptation, and improved community resilience to climate change.