Barriers to family planning use amongst the urban poor in Pakistan

This paper examines the determinants of family planning service use and the barriers in accessing family planning services among urban poor women in Pakistan. Data were collected from a household survey of 5338 married women of reproductive age (15-45) from slum areas of six cities.The use of family planning services by women in urban slums is strongly linked to individual and household socioeconomic factors. In particular, women were ten times more likely to have used a family planning service if her husband approved. This research has highlighted two key issues regarding the provision of family planning services to the urban poor. First, the urban poor cannot be treated as a homogenous group; there exist important socio-demographic variations within the urban poor population in relation to their use of family planning services and the barriers faced in service utilization. Second, although the urban poor are both economically and physicallydisadvantaged in access to services, women identified socio-cultural factors as the greatest barrier to family planning service use. This finding is consistent with studies focusing on the general population of Pakistan

Knowledge of personal and sexual development amongst young people in Pakistan

Pakistan has one of the largest cohorts of young people in its history, yet research on adolescents is still relatively new in Pakistan. This study conducted 24 focus group discussions to explore young peoples’ experiences of gaining knowledge on personal and sexual development. One of the most striking findings is the gendered pattern of knowledge acquisition. Young women typically gain information from a limited number of sources within the home; while young men accessed a wide variety of information sources outside the home. These findings highlight the need for gender specific information dissemination programs to young people in Pakistan. Also prominent is the event-based nature of gaining information, whereby specific events (i.e. puberty, marriage) trigger information provision to young people, however often too late to be educative. Young people were critical of the quality of information they received, which often led to confusion and stress in understanding sexual development and relations. These findings highlight a gap in formal, neutral information sources for young people in Pakistan on personal and sexual development. Although the merits of school-based information delivery were highlighted, this strategy may have little impact on young women due to their low levels of school attendance and high drop out during adolescence

Vietnamese Men’s Definitions of Intimate Partner Violence and Perceptions of Women’s Recourse-Seeking

The Vietnamese government has made efforts to promote gender equality and to discourage intimate partner violence (IPV), yet IPV remains a common experience for married women in Vietnam. IPV leads to severe injury, poor mental health, chronic disease, and substance abuse among women; yet, little is known about why men perpetrate IPV. We explored how men defined IPV and perceived women’s recourse seeking following IPV in Vietnam. Using data from 10 in-depth interviews and two focus group discussions with Vietnamese men, taken from a parent study on attitudes about IPV in Vietnam, we found that men often viewed IPV against women as normal, and justified violence occurring when a husband was ‘hot-tempered,’ drunk, or when the wife was seen as at fault. Men interviewed were often reluctant to endorse recourse-seeking on the part of the woman unless the violence was both frequent and severe. While frequent and severe IPV was seen as warranting recourse-seeking, infrequent or less severe IPV was normalized and seen as a private family issue. For less severe IPV men felt that women could potentially engage in recourse such as running or hiding from a husband to avoid instances of IPV. Only when IPV was happening multiple times per week and was severe enough to warrant medical treatment was recourse, such as approaching family or neighbors for help, notifying authorities, and petitioning for divorce seen as appropriate. Interventions with men are needed to support recourse-seeking for women and to reduce IPV in Vietnam

Social resources and Arab women’s perinatal mental health: A systematic review

Background Women’s mental health in the perinatal period is understudied worldwide and in Arab countries especially. Aim This systematic review explores evidence of the association between women’s social resources for empowerment in the Arab World and their mental health in the prenatal and postnatal (≤1 year postpartum) periods. Methods Guided by Kabeer’s framework of empowerment, the authors applied a search string in PubMed and Web of Science databases to identify studies in countries of the Arab League (hereafter the Arab World) that address mental health and social resources for women’s empowerment in the perinatal period. Findings Of 1865 electronically retrieved articles, 23 met the inclusion criteria. Overall, the majority of studies found a positive association between social resources for empowerment and perinatal mental health. Seven studies explored the relationship between familial or general social support and prenatal mental health in Arab women, and found a significant positive association. Sixteen of the 18 studies of women in the postnatal period found that enabling familial, extra-familial, and/or general social support was positively associated with mental health. Conclusion This review demonstrates an association between social resources and perinatal mental health, but there is a dearth of research in this area. We call for additional research on Arab women in the perinatal period using context-specific but standardized tools to assess social resources and mental health. Evidence on positive mental health, resilience, and the influence of social resources can guide the improvement of prenatal and postpartum care services

‘It's a part of me, I feel naked without it': choice, agency and identity for Muslim women who wear the niqab

In the context of heightened suspicion and anti-Muslim stereotypes in a post-9/11 and 7/7 era, Muslim women who wear the niqab (face veil) are stigmatised, criminalised and marked as ‘dangerous’ to British/Western values. Several countries have imposed bans on the wearing of face veils in public places based on the premise that the niqab is a ‘threat’ to notions of gender equality, integration and national security. While the wearing of the niqab has elicited a good deal of media, political and public debates, little attention has been paid to the opinions of Muslim women who wear it. Drawing on individual and focus group interviews with Muslim women who wear the niqab in the United Kingdom (UK), this article places at the centre of the debate the voices of those women who do wear it, and explores their reasons for adopting it. The findings show that the wearing of the niqab emerges as a personal choice, an expression of religious piety, public modesty and belonging to the ‘ummah’. It is also perceived as a form of agency, resistance and non-conformity to Western consumerist culture and lifestyle. It will be concluded that wearing the niqab empowers women in their public presence and offers them a sense of ‘liberation’, which is associated with the notion of anonymity that it provides them

Human and economic resources for empowerment and pregnancy-related mental health in the Arab Middle East : a systematic review

Purpose: This systematic review synthesizes research on the influence of human and economic resources for women’s empowerment on their pre- and post-natal mental health, understudied in the Arab world. Methods: We include articles using quantitative methods from Pub Med and Web of Science. Two researchers reviewed databases and selected articles, double reviewing five percent of articles designated for inclusion. Twenty-four articles met inclusion criteria. All 24 articles measured depression as an outcome, and three included additional mental health outcomes. Results: Nine of 17 studies found an inverse association between education and depression; two of 12 studies found contradictory associations between employment and depression, and four of six studies found a positive association between financial stress and depression. These results suggest that there is a negative association between education and depression and a positive association between financial stress and depression among women in the Arab world. Firm conclusions warrant caution due to limited studies meeting inclusion criteria and large heterogeneity in mental health scales used, assessment measures, and definitions of human and economic resources for women’s empowerment. Conclusions: It is likely that education reduces depression among post-partum women and that financial stress increases their depression. These findings can be used to aid in the design of interventions to improve mother and child outcomes. However, more research in the Arab world is needed on the relationship between human and economic resources for women’s empowerment and perinatal mental health, and more consistency is needed in how resources and mental health are measured

Impact of franchised family planning clinics in urban poor areas in Pakistan

Family planning programmes are costly to implement, so it is critical to determine their effect. This study uses a quasi-experimental design to determine the impact of new family planning clinics on knowledge, contraceptive use and unmet need for family planning, amongst married women in urban poor areas of six secondary cities of Pakistan. Baseline (n=5,338) and end-line (n=5,502) population surveys were conducted in four study sites and two control sites. Client exit interviews identified the socio-demographic and geographic characteristics of clinic users. The results show that the clinics contributed to a 5% increase in overall knowledge of family planning methods, and an increase in knowledge of female sterilisation and the IUD of 15% and 7% respectively. There were distinct effects on contraceptive uptake, with an 8% increase in female sterilisation and 7% decline in condom use. Unmet need for family planning declined in two sites, while there were variable impacts on the other sites. Although the new clinics are located within urban poor communities, users of the services are not the urban poor themselves but select sub-groups of the local populatio