Sir: I am writing this letter with reference to the Supreme Court notice to provincial chief secretaries regarding Lady Health Workers (LHWs) of September, 15, 2014. I want to add further that though all the provincial governments have taken the lead in fulfilling their moral obligation through regularising the services of LHWs, the Punjab Assembly should have taken this initiative much earlier. Though the LHW programme is an excellent initiative in primary healthcare, the evidence indicates that the manner of its implementation leaves much to be desired. Lack of skill and health education among workers, insufficient equipment, and low remuneration are some of the common difficulties facing these health workers, which need to be addressed and call for specific attention by our leaders, policy makers and implementers. In 1994, the government of Pakistan first introduced the LHW cadre with the objective of improving access to primary health services and to address unmet health needs in rural and urban slum areas, but this programme was suspended after the 18th Amendment to the Constitution passed on April 8, 2010, which gave the right to provincial governments for improving the health sector of their respective province. Making LHWs permanent government employees may strengthen their working functions but we cannot ensure essential care and reduce newborn deaths or maternal and child mortality until and unless we have sufficient numbers of skilled and well equipped health workers. The responsibility of the government does not end by just regularising LHWs, rather it is the first step towards providing essential and appropriate healthcare to all. It is now compulsory for all provincial and the federal governments to invest in a strong health workforce by improving their skills through training and workshops and providing basic health equipment that is fit to prevent and treat the causes of maternal, newborn and child mortality. BILQUEES GAYAS Islamabad