Who is excluded and how? An analysis of community spaces for maternal and child health in Pakistan

Health Research Policy and Systems
Ayesha AzizGeof Wood

Abstract

The maternal, newborn, and child health (MNCH) indicators of Pakistan depict the deplorable state of the poor and rural women and children. Many MNCH programmes stress the need to engage the poor in community spaces. However, caste and class based hierarchies and gendered social norms exclude the lower caste poor women from accessing healthcare. To find pathways for improving the lives of the excluded, this study considers the social system as a whole and describes the mechanisms of exclusion in the externally created formal community spaces and their interaction with the indigenous informal spaces. The study used a qualitative case study design to identify the formal and informal community spaces in three purposively selected villages of Thatta, Rajanpur, and Ghizer districts. Community perspectives were gathered by conducting 37 focus group discussions, based on participatory rural appraisal tools, with separate groups of women and men. Relevant documents of six MNCH programmes were reviewed and 25 key informant interviews were conducted with programme staff. We found that lower caste poor tenants and nomadic peasants were excluded from formal and informal spaces. The formal community spaces formed by MNCH programmes across P...Continue Reading

References

Oct 7, 2004·Lancet·Davidson R GwatkinCesar G Victora
Mar 9, 2005·Lancet·Joy E LawnUNKNOWN Lancet Neonatal Survival Steering Team
Mar 16, 2005·Lancet·Lynn P FreedmanAllan Rosenfield
Dec 7, 2007·The British Journal of Psychiatry : the Journal of Mental Science·Craig MorganStefan Priebe
Jun 7, 2008·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Sadiqua JafareyFariyal Fikree
Aug 9, 2012·BMC Pregnancy and Childbirth·Zubia MumtazLory Laing

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