CITIZEN’S EMPOWERMENT LEADS Citizen’s empowerment leads to increase in demand for better RMNCH facilities and swift infrastructure improvements. Provision of infra-structure, water sanitation and hygiene facilities in tertiary hospitals is vital in providing meaningful health services to communities at grass root level in promoting lifelong health and enhancing the well-being of children and their families. The toilet facilities in some Basic Health Units were in dire need of repair or construction, causing great inconvenience to service users especially, females prior to Community Uplift Program (CUP) intervention in district Charsadda. Preliminary mobilization revealed that the toilet facilities for both male and female patients in 9 BHUs were either non-functional or nonexistent. BHU Dhaki, Mandani, Mazzara and Ridawon had no toilet facilities at all whereas BHU Abazai, Bagh-e-Bakhtiar, Hassanzai, Mardhand, and Sarki Pul, toilets systems were non-functional due to non-availability of water, light, doors, maintenance or cleanliness. This situation resulted in fewer female patients coming to the BHUs. Whereas male patients defecating in open areas of BHU were also causing health hazards and diseases in and around health centers. The Interface Meetings of the 1st Community Score Card provided a platform to the community lead activists as well as the BHU staff to flag this important issue in front of the DHO and District Member Charsadda for its early resolution who swiftly approved allocation of funds for the construction and repair of toilet facilities for patients according to the agreed action plan. Kalsoom Bibi, a resident of village Redawan recalls how non-availability of functional toilet facility for females forced her, her family members and other women from her village to go to other distant hospitals like Rural Health Centre, District or Tehsil Head Quarter Hospitals in Charsadda instead of her own BHU for even simple medical needs such as sugar or pregnancy tests. The Privacy needs for females in deep rooted Pashtun culture made things even more challenging for females. The female staffs working in the BHU were also reluctant to work due to lack of functional toilet facilities. “I use to go to watchman’s home, some 150 meters across the road, for toilets needs, which caused great inconvenience and resulted in more number of awaiting patients” remarked female BHU staff. “I am glad that our BHU now has a toilet facility which will save us time and money spent on going to distant hospitals” I am thankful to CUP team who helped us resolve this issue in a short span of time” exclaims Kulsoom. The Community Score Card innovation improved the service delivery in the healthcare system and resulted in significant improvements in the overall scenario and physical conditions of the BHUs’ status since the inception of the HANIF project. We feel much aware and empowered and have a say in matters related to our healthcare improvement, she concluded.