72 research outputs found
Gender and Health Care Utilisation in Pakistan
This study is undertaken to test whether or not there exists gender bias in health care utilisation of sick children in Pakistan. Overall, the results are encouraging, as medical consultation has been sought for by a very high proportion (79 percent) of sick children. Moreover, there do not appear to be significant differences by gender in health care utilisation, be it curative or preventive. This is so in spite of the fact that many studies on various gender-related issues in Pakistan have generally shown significant gender bias in favour of male children. Thus one may conclude that parental altruism prevails at least in the provision of health care to sick children. However, the extent and magnitude of effect varies by geographical, socio-economic, and demographic characteristics of the mother. In view of these findings, efforts should be made to minimise gender differentials among various categories of people so that children living in any circumstances may have equal opportunity of health care utilisation. This will be possible when health care facilities are easily accessible to all. The Lady Health Workers Programme of the Government of Pakistan is a major positive step in this regard. Under this programme, health care facilities are provided at people’s door-step. The expansion of this programme will be extremely beneficial in helping parents to provide health care facilities to sick children, both male and female.
Socio-cultural Constraints and Women’s Decision-making Power Regarding Reproductive Behaviour
In a previous study [Ali, Siyal and Sultan (1995)], we observed a big gap between behaviour and desires. Only 35 percent women had the number of children that they had desired. Whereas, a very large number of women had more children than their stated ideal number of children. The same data set also showed that a majority of women (54 percent) either wanted to stop having children or wanted to wait at least two years before having another child [Ali and Rukanuddin (1992)]. In practice, all of these women were not protected; instead only 12 percent were practising contraception [Shah and Ali (1992)]. An argument was put forward that, had these women been empowered to decide about the number of children to be born, the scenario would have been different and small family size norms would have prevailed. However, the finding of that study revealed that generally, the women who were considered to be empowered were actually constrained to exercise fertility control behaviour. It was hypothesised that socio-cultural influences including those of husbands, in-laws and other family members impelled women to become incapacitated. In the present study, an effort has been made to investigate and identify factors that influence women’s decision making about reproductive behaviour. Furthermore, an attempt to measure the extent of these influences has been made.
Fertility Transition in Pakistan: Evidence from Census
In the absence of an accurate and complete registration system, efforts were made to estimate the levels of vital statistics through sample surveys. The first such effort was made through the Population Growth Estimation (PGE) project conducted from January, 1962 to December 1965. Later on, various demographic surveys were conducted almost at regular intervals and the last effort in the series was Pakistan Reproductive Health and Family Planning Survey (PRHFPS) in the year 2000-01. Although all these efforts were made to ascertain levels and trends of various demographic events, yet the estimates particularly the ones on fertility remained controversial. The first signal of fertility reduction was emanated from the 1975 Pakistan Fertility Survey (PFS) which estimated a Total Fertility Rate (TFR) of 6.3 children from over 7 children estimated earlier from PGE data. However, all hopes of the onset of fertility transition were shattered by the [Retherford’s, et al. (1987)] study entitled “Fertility Trend in Pakistan: The Decline that Wasn’t”. By using the Own Children Method, they confirmed that the decline in fertility was an artifact of the data. Another study by Shah, Pullum, and Irfan (1986) also termed the fertility decline shown by the PFS data as spurious. The Pakistan Labour Force and Migration Survey, conducted five years later, in 1979-80, estimated a TFR of 6.5 children, thus providing another proof supporting the fact that fertility had not declined to the extent believed.
The Disease Pattern and Utilisation of Health Care Services in Pakistan
Health is an important aspect of human life. In general terms, better health status of individuals reflects reduced illnesses, low level of morbidity, and less burden of disease in a given population. It is widely recognised that improved health not only lowers mortality, morbidity and level of fertility, but also contributes to increased productivity and regular school attendance of children as a result of fewer work days lost due to illness, which in turn have implications for economic and social well-being of the population at large. Hence investing in health is vital for promoting human resource development and economic growth in a country [World Bank (1993)]. A view of Pakistan’s health profile indicates that the sector has expanded considerably in terms of physical infrastructure and its manpower in both the public and private sector. This has contributed to some improvement in selected health status indicators over the years. However, the public health care delivery system has been inadequate in meeting the needs of the fast growing population and in filtering down its benefits to the gross-root level. As such, Pakistan still has one of the highest rates of infant and child mortality, total fertility and maternal mortality when compared with many other countries in the Asian region [UNDP (2000)]. Due to low priority given to social sector development in the past and low budgetary allocations made to the health sector, the evidence shows that mortality and morbidity indices have not reduced to the desired level and large gaps remain in the quality of care indicators, especially in rural areas [Federal Bureau of Statistics (2000)]. High levels of infant and child mortality and fertility in Pakistan point towards the fact that health and illness problems are severe for young children and mothers.
Gender and Health Care Utilisation in Pakistan
This study is undertaken to test whether or not there exists
gender bias in health care utilisation of sick children in Pakistan.
Overall, the results are encouraging, as medical consultation has been
sought for by a very high proportion (79 percent) of sick children.
Moreover, there do not appear to be significant differences by gender in
health care utilisation, be it curative or preventive. This is so in
spite of the fact that many studies on various gender-related issues in
Pakistan have generally shown significant gender bias in favour of male
children. Thus one may conclude that parental altruism prevails at least
in the provision of health care to sick children. However, the extent
and magnitude of effect varies by geographical, socio-economic, and
demographic characteristics of the mother. In view of these findings,
efforts should be made to minimise gender differentials among various
categories of people so that children living in any circumstances may
have equal opportunity of health care utilisation. This will be possible
when health care facilities are easily accessible to all. The Lady
Health Workers Programme of the Government of Pakistan is a major
positive step in this regard. Under this programme, health care
facilities are provided at people’s door-step. The expansion of this
programme will be extremely beneficial in helping parents to provide
health care facilities to sick children, both male and
female
The Relationship between the WES Interventions and the Incidence of Diarrhoea
Access to clean drinking water and sanitation facilities have a direct positive impact on health through prevention of water-borne diseases, especially diarrhoeal morbidity of children. Lack of WES (Water and Environmental Sanitation) services and poor hygiene practices in Pakistan contribute significantly to the prevalence of diarrhoea, a major cause of infant death and children less than five years of age. The estimates show that about 30 percent of total deaths among children are attributed to diarrhoeal disease [Gallup (2001); UNICEF (2000)], and 4.1 years in life expectancy can be added if water borne diseases are eliminated [Ali and Haq (2003)]. Hence, reduction of diarrhoeal morbidity stands out as an important policy goal, which can ultimately lead to reduction in infant/child mortality. In this paper, we shall examine the relationship of WES interventions with that of the incidence of diarrhoea among children under age 10.
Women’s Autonomy and Happiness: The Case of Pakistan
It is generally believed that “autonomy” brings happiness and satisfaction in women’s lives. In this study we examine whether or not the established autonomy indicators are a source of “happiness” for Pakistani women. By using the nationally representative data, only two indicators, i.e., “women’s education” and “decisionmaking authority”, prove to be important factors in finding “very happy” status in women’s life. Additionally, “possession of assets” also proves to be an important factor in providing the “very happy” status in a women’s life. However, the “possession and utilisation of assets” and “going alone outside the house” are not important indicators of a “very happy” status in women’s life in Pakistan and “Labour force participation” is indicative of unhappiness. The results of this study show that not all established indicators of autonomy bring about happiness in the lives of Pakistani women. This is because Pakistani society differs from other societies, in particular the western society, and hence the concept of “autonomy” in bringing about “happiness” in the lives of Pakistani women yields effects different from those in other societies. Thus, there is a need to focus on the advocacy of only those autonomy variables which lead to happiness in a woman’s life, which is the end-goal for women, who form a vital part of the society.Women
Labour Market Participation of the Elderly
Generally ageing of population is defined as the relative increase in the number of elderly. This process is the result of declining fertility and increasing life expectancy of elderly population. In today’s Pakistan, fertility has started declining and life expectancy of elderlies has been increasing and it is expected that in future both these processes will gain momentum, resulting into many fold increase in the population of elderly people [Afzal (1999); Sathar and Casterline (1998)]. These developments are expected to have adverse effects on Pakistan’s economy as support and welfare of elderly people will require additional allocation of resources. That is more so because traditionally welfare and socio-economic needs of elderly people remained the responsibility of their children especially the sons. However, the traditional extended/joint family system is fast breaking down and nuclear type of family set up is becoming more common rendering the elderly people helpless [Ali (2000)]. Moreover, in view of an increase in the incidence of poverty in Pakistan, intra-house resource distribution is also becoming scarce leading to a scenario where only productive members are the chief beneficiaries [Qureshi and Arif, (2001)]. On the other hand in Pakistan, the social sector also remained neglected and little progress has been made in the development of health, education, nutrition, housing and physical infrastructure. Moreover, social security and pension scheme for general public is also almost non-existent. Such a situation warrants development of policies especially for elderly people in general and for all those elderlies who can participate and contribute in the economic activities in particular so that economic well-being of these people is ensured.
Fertility Transition in Pakistan: Evidence from Census
In the absence of an accurate and complete registration
system, efforts were made to estimate the levels of vital statistics
through sample surveys. The first such effort was made through the
Population Growth Estimation (PGE) project conducted from January, 1962
to December 1965. Later on, various demographic surveys were conducted
almost at regular intervals and the last effort in the series was
Pakistan Reproductive Health and Family Planning Survey (PRHFPS) in the
year 2000-01. Although all these efforts were made to ascertain levels
and trends of various demographic events, yet the estimates particularly
the ones on fertility remained controversial. The first signal of
fertility reduction was emanated from the 1975 Pakistan Fertility Survey
(PFS) which estimated a Total Fertility Rate (TFR) of 6.3 children from
over 7 children estimated earlier from PGE data. However, all hopes of
the onset of fertility transition were shattered by the [Retherford’s,
et al. (1987)] study entitled “Fertility Trend in Pakistan: The Decline
that Wasn’t”. By using the Own Children Method, they confirmed that the
decline in fertility was an artifact of the data. Another study by Shah,
Pullum, and Irfan (1986) also termed the fertility decline shown by the
PFS data as spurious. The Pakistan Labour Force and Migration Survey,
conducted five years later, in 1979-80, estimated a TFR of 6.5 children,
thus providing another proof supporting the fact that fertility had not
declined to the extent believed
The Disease Pattern and Utilisation of Health Care Services in Pakistan
Health is an important aspect of human life. In general terms,
better health status of individuals reflects reduced illnesses, low
level of morbidity, and less burden of disease in a given population. It
is widely recognised that improved health not only lowers mortality,
morbidity and level of fertility, but also contributes to increased
productivity and regular school attendance of children as a result of
fewer work days lost due to illness, which in turn have implications for
economic and social well-being of the population at large. Hence
investing in health is vital for promoting human resource development
and economic growth in a country [World Bank (1993)]. A view of
Pakistan’s health profile indicates that the sector has expanded
considerably in terms of physical infrastructure and its manpower in
both the public and private sector. This has contributed to some
improvement in selected health status indicators over the years.
However, the public health care delivery system has been inadequate in
meeting the needs of the fast growing population and in filtering down
its benefits to the gross-root level. As such, Pakistan still has one of
the highest rates of infant and child mortality, total fertility and
maternal mortality when compared with many other countries in the Asian
region [UNDP (2000)]. Due to low priority given to social sector
development in the past and low budgetary allocations made to the health
sector, the evidence shows that mortality and morbidity indices have not
reduced to the desired level and large gaps remain in the quality of
care indicators, especially in rural areas [Federal Bureau of Statistics
(2000)]
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