32 research outputs found
Socio-economic Development, Population Policies, and Fertility Decline in Muslim Countries
Islam is one of the worldâs major monotheistic religions. Its followers, spread all over the world and numbering about 1.5 billion people, constitute about one-fourth of the worldâs population. The Economist (2003). Muslims are mainly concentrated in about 50 countries, most of which have had slow pace of fertility transition, mainly due to low level of socio-economic development, on the one hand, and lack of effective population policy, on the other. With the help of macro level data available on Muslimmajority countries, this paper examines fertility decline in these countries, their socio-economic indicators, and support for family planning. Examples from two neighbouring countriesâPakistan and Iranâare also given.Population Policy, Fertility
Changing Demographic, Social, and Economic Conditions in Karachi City, 1959â94: A Preliminary Analysis
Kingsley Davis (1961) had argued that the reason that the ancient cities failed to survive was that they were too deadly. He suggested that âthree of their (cities) main traits....the crowding of many people in little space, their dependence on widespread contacts (due to in-migration), and their wealth...laid them open to contagious diseases, environmental contamination, occasional starvation and warfareâ. Even in the medieval age, some European cities provide examples of such problems; but especially so following the Industrial Revolution. Do the events of the 1980s and the 1990s in Karachi suggest that the city may be heading in the same direction. Recently, The Times London in a lead article in November 1994, labelled Karachi as a âCity of Riches and Shattered Dreamsâ. It further said that Karachi had grown into a megalopolis where life moved fast and street violence had become a norm. Indeed, more than 65 percent of Pakistanâs industries and 80 percent of its finance, banking, and business are concentrated in the city and people come to it from all over the country to find jobs and fulfil their dreams [Husain (1994)]. During the past decade, street violence in the form of ethnic clashes has become a sort of regular event in Karachi. At times, these clashes have been more frequent and even bloodier than the ones before. According to the local newspaper accounts, between 1985 and 1988 (in four years), about 400 people died in Karachi due to violence, which has increased substantially over time. Thus, while the number of violent deaths remained between 350â500 during 1991â93, in 1994 alone the number exceeded 1,100, and during the first three months of 1995, over 300 persons have died due to violence.
Poor Performance of Health and Population Welfare Programmes in Sindh: Case Studies in Governance Failure
Over the past few years, the issue of what is meant by âgood governanceâ has generated increasing attention and debate both at the national and international level [Streeten (1997)]. The role of state and how that role is to be exercised is appearing high on the agenda of politicians, policy-makers and academicians in the developing world. Governance has been defined by the World Bank as âthe manner in which power is exercised in the management of the countryâs economic and social resourcesâ [World Bank (1994)]. The somewhat narrow scope of this definition has been broadened in recent years to âthe sum of the many ways individuals and institutions, public and private, manage their common affairsâ [Commission on Global Governance (995)] The Human Development Report [UNDP (1999)] goes beyond these definitions and gives a much more radical notion of good governance, underpinning the importance of peoplesâ participation in shaping their own governance and development. This type of governance has been labeled as âhumane governanceâ. A review of existing literature thus shows that governance has been interpreted to have different elements such as management of economic and social resources for development, formulation and implementation of policies, discharging of functions, accommodation of diverse interests towards cooperative action and above all, accountability to people and ownership by the people of the governance process. In view of the above, one may ask what constitutes good governance for the health sector? Management of resources pertains to the concept of efficiency, a term appearing with increasing frequency in global literature on health care reforms; policy formulation and discharging of functions allude to the objective of effectiveness which itself has a wide scope encompassing relevance, quality and availability of health care; while âhumane governanceâ brings in the notion of community participation and accountability with regards to decision-making and delivery of health care.
Changing Demographic, Social, and Economic Conditions in Karachi City, 1959â94: A Preliminary Analysis
Kingsley Davis (1961) had argued that the reason that the
ancient cities failed to survive was that they were too deadly. He
suggested that âthree of their (cities) main traits....the crowding of
many people in little space, their dependence on widespread contacts
(due to in-migration), and their wealth...laid them open to contagious
diseases, environmental contamination, occasional starvation and
warfareâ. Even in the medieval age, some European cities provide
examples of such problems; but especially so following the Industrial
Revolution. Do the events of the 1980s and the 1990s in Karachi suggest
that the city may be heading in the same direction. Recently, The Times
London in a lead article in November 1994, labelled Karachi as a âCity
of Riches and Shattered Dreamsâ. It further said that Karachi had grown
into a megalopolis where life moved fast and street violence had become
a norm. Indeed, more than 65 percent of Pakistanâs industries and 80
percent of its finance, banking, and business are concentrated in the
city and people come to it from all over the country to find jobs and
fulfil their dreams [Husain (1994)]. During the past decade, street
violence in the form of ethnic clashes has become a sort of regular
event in Karachi. At times, these clashes have been more frequent and
even bloodier than the ones before. According to the local newspaper
accounts, between 1985 and 1988 (in four years), about 400 people died
in Karachi due to violence, which has increased substantially over time.
Thus, while the number of violent deaths remained between 350â500 during
1991â93, in 1994 alone the number exceeded 1,100, and during the first
three months of 1995, over 300 persons have died due to violence.
According to the Karachi Police sources, most of the victims of violent
deaths in Karachi during 1994 were men in the age group
13â50
Socio-economic Development, Population Policies, and Fertility Decline in Muslim Countries
As societies transform from a predominantly traditional to a
predominantly modern system, they tend to experience considerable
demographic changes. Coale (1984) notes that this âtransformation is the
substitution of slow growth achieved with low fertility and mortality
for slow growth maintained with relatively high fertility and mortality
ratesâ. Demographic transition in Muslim countries is a fairly late
phenomenon as discussed in the next section. Most of these countries
have followed a similar trend as by many other developing countries.
According to the most recent estimate provided by The Economist
[September (2003)], the number of Muslims was 1.5 billion in 2003, of
which about 97 percent were living in Asian and African countries. About
one fourth were concentrated in South Asia and another one-fifth in the
Middle-East and North Africa (Arab countries). Figure 1 provides the
breakdown of Muslim population living in different regions of the World.
Percentage of population in major Muslim countries and their estimated
number at the beginning of the 21st Century are given in Table 1. Of 47
Muslim-majority countries, where more than 50 percent of the total
population is reported to be followers of Islam,1 36 have populations
that are more than 85 percent Muslims, while only seven of them contain
less than 70 percent Muslims. However, the six largest Muslim-majority
countries (in order, Indonesia, Pakistan, Bangladesh, Iran, Turkey and
Egypt) contain about two-thirds of th
Poor performance of health and population welfare programmes in Sindh: case studies in governance failure
Over the past few years, the issue of what is meant by âgood governanceâ has generated increasing attention and debate both at the national and international level [Streeten (1997)]. The role of state and how that role is to be exercised is appearing high on the agenda of politicians, policy-makers and academicians in the developing world. Governance has been defined by the World Bank as âthe manner in which power is exercised in the management of the countryâs economic and social resourcesâ [World Bank (1994)]. The somewhat narrow scope of this definition has been broadened in recent years to âthe sum of the many ways individuals and institutions, public and private, manage their common affairsâ [Commission on Global Governance (995)] The Human Development Report [UNDP (1999)] goes beyond these definitions and gives a much more radical notion of good governance, underpinning the importance of peoplesâ participation in shaping their own governance and development. This type of governance has been labeled as âhumane governanceâ. A review of existing literature thus shows that governance has been interpreted to have different elements such as management of economic and social resources for development, formulation and implementation of policies, discharging of functions, accommodation of diverse interests towards cooperative action and above all, accountability to people and ownership by the people of the governance process. In view of the above, one may ask what constitutes good governance for the health sector? Management of resources pertains to the concept of efficiency, a term appearing with increasing frequency in global literature on health care reforms; policy formulation and discharging of functions allude to the objective of effectiveness which itself has a wide scope encompassing relevance, quality and availability of health care; while âhumane governanceâ brings in the notion of community participation and accountability with regards to decision-making and delivery of health care
The hidden figure: sexual intimate partner violence among Pakistani women
Background: The objectives of the present study were to determine the magnitude and factors associated with sexual intimate partner violence (SIPV) in women presenting to tertiary-care hospitals of Karachi, Pakistan. Methods: Five hundred women who presented to four tertiary-care hospitals to deliver were interviewed from September to December 2005. SIPV was assessed by using questions on sexual abuse in WHO Domestic Violence Module designed to determine intimate partner violence. Multiple logistic regression analysis was applied to determine factors associated with SIPV. Results: Twenty-one percent of women reported experiencing sexual violence in their married life. Gravida with five or more pregnancies [adjusted odds ratio (AOR) = 2.78, 95% confidence interval (CI) 1.12-6.96], index pregnancy as unwanted (AOR = 2.64, CI 1.16-6.02) and conflict with in-laws (AOR 1.9 CI 1.14-3.16) were independently associated with sexual abuse. Women who had social support were less likely to be abused by their intimate partners (AOR 0.76, CI 0.58-0.98). Conclusion: One in five women reported spousal sexual abuse in their married life. Women having more than five children, unwanted pregnancies or reporting differences with in-laws are more likely to be subjected to such abuse. Social support protects women from sexual abuse by intimate partner
Knowledge, attitudes and practices (KAP) regarding sexuality, sexual behaviors and contraceptives among college/university students in Karachi, Pakistan
OBJECTIVE: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual behaviors and methods of contraception, among college/university students of Karachi, Pakistan.
STUDY DESIGN: Cross-sectional observational study.
PLACE AND DURATION OF STUDY: Higher Education Commission-recognized government and private colleges/universities in Karachi from 2005-2006.
METHODOLOGY: Two colleges/universities were randomly selected from each category i.e. government medical, government non-medical and private medical and non-medical colleges/universities. Three stage cluster sampling was employed to draw a representative sample of students. A self administered questionnaire was used to elicit information on knowledge, attitudes and practices regarding high risk sexual behaviors, methods of contraception and sources to obtain information about sexual issues.
RESULTS: A total of 957 students were interviewed. They comprised 542 (56.6%) males and 415 (43.4%) females with mean age of 21 1.8 years. Bivariate analysis showed that students enrolled in medical colleges/universities were less likely to watch adult films (O.R. 0.7, CI; 0.5-0.9) to acquire sex related knowledge and go out on dates (O.R. 0.6, CI; 0.4- 0.8). Similarly, medical students were less likely to consider contraception as being against Islamic teachings (O.R. 0.7, CI; 0.5-0.9).
CONCLUSION: The curricula of non-medical studies at undergraduate level should include education regarding sexual health and contraception
Case-control study of suicide in Karachi, Pakistan
Background: In recent years suicide has become a major public health problem in Pakistan. Aims: To identify major risk factors associated with suicides in Karachi, Pakistan. Method: A matched case-control psychological autopsy study. interviews were conducted for 100 consecutive suicides, which were matched for age, gender and area of residence with 100 living controls. Results: Both univariate analysis and conditional logistic regression model results indicate that predictors of suicides in Pakistan are psychiatric disorders (especially depression), marital status (being married), unemployment, and negative and stressful life events. only a few individuals were receiving treatment at the time of suicide. None of the victims had been in contact with a health professional in the month before suicide. Conclusions: Suicide in Pakistan is strongly associated with depression, which is under-recognised and under-treated, The absence of an effective primary healthcare system in which mental health could be integrated poses unique challenges for suicide prevention in Pakistan
11. Son Preference in Pakistan: Its Effects on Sex Ratio, Preferential Treatment of Boys and Sex Differentials in Infant Mortality
In Pakistan as well as in many other countries in Asia, there is a strong son preference. Using data from the 1998 population census and sample surveys conducted during the past decade, this paper examines: evidence of sex preference in Pakistan; sex ratios at birth; sex ratios among children under five; sex differentials in mortality in infancy and early childhood; and, whether preferential treatment is given to male (over female) children.Since Pakistan has not reached yet a stage of low fertility, sex-selective abortion to the purpose of having a son is rarely practised. Instead, couples who desire to have male children do so by having successive female children until they achieve their goal. Consequently, the sex ratio at birth in Pakistan is currently consistent with the accepted biological norm. Thus, it appears that although there is a strong desire for sons, daughters are not unwanted or grossly neglected after birth. However, a more rapid decline in infant mortality is observed among males than among females.Au Pakistan comme dans de nombreux autres pays en Asie, il existe traditionnellement une forte prĂ©fĂ©rence pour les fils. En utilisant les donnĂ©es du recensement de 1998 et dâenquĂȘtes conduites au cours des dix derniĂšres annĂ©es, lâauteur Ă©tudie les tendances rĂ©centes du rapport de masculinitĂ© Ă la naissance et chez les enfants de moins de cinq ans, de mĂȘme que les diffĂ©rentiels de mortalitĂ© infantile et juvĂ©nile selon le sexe. Il examine Ă©galement la possibilitĂ© de traitements prĂ©fĂ©rentiels selon le sexe, pouvant favoriser les garçons.Etant donnĂ© que la fĂ©conditĂ© est encore Ă©levĂ©e au Pakistan, les avortements sĂ©lectifs selon le sexe sont encore trĂšs peu pratiquĂ©s. Les couples ne renoncent pas pour autant Ă un fils, mais acceptent de faire plusieurs tentatives, câest Ă dire dâavoir plusieurs filles, avant dây parvenir. Par consĂ©quent, le rapport de masculinitĂ© Ă la naissance au Pakistan est conforme Ă la norme biologique. Lâauteur dĂ©montre Ă©galement que, en dĂ©pit dâune forte prĂ©fĂ©rence pour les fils, les naissances de filles ne sont pas malvenues, et que les filles ne sont pas particuliĂšrement discriminĂ©es aprĂšs leur naissance. Il constate cependant que, ces derniĂšres annĂ©es, la mortalitĂ© infantile des garçons a diminuĂ© plus vite que celle des filles