The Lady Health Worker Programme (LHWP) is a major public sector initiative to provide reproductive health care to women in Pakistan, employing almost 100,000 women as community health workers. The LHWP directly addresses women’s reproductive health needs by providing them with information, basic services and access to further care. The experience of LHWs can provide valuable insight into the impact of paid work on their lives and communities, and how processes of women’s empowerment are shaped. The LHWP is a huge employer of women and the most important link between communities and primary health care in the country. The respect the women are accorded by the community reflects the increase in recognition given to health care and family planning. As they engage with households, LHWs are crossing class and caste barriers that would previously have been denied to them. They have become role models for girls and show what education and employment can do.