Socio-economic Development, Population Policies, and Fertility Decline in Muslim Countries

Islam is one of the world’s major monotheistic religions. Its followers, spread all over the world and numbering about 1.5 billion people, constitute about one-fourth of the world’s 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 countries—Pakistan and Iran—are also given.Population Policy, Fertility

Changing Demographic, Social, and Economic Conditions in Karachi City, 1959–94: 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 “three 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 warfare”. 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 “City of Riches and Shattered Dreams”. 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 Pakistan’s 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 350–500 during 1991–93, 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 “good governance” 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 “the manner in which power is exercised in the management of the country’s economic and social resources” [World Bank (1994)]. The somewhat narrow scope of this definition has been broadened in recent years to “the sum of the many ways individuals and institutions, public and private, manage their common affairs” [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 peoples’ participation in shaping their own governance and development. This type of governance has been labeled as “humane governance”. 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 “humane governance” brings in the notion of community participation and accountability with regards to decision-making and delivery of health care.

DAMMING HUNZA RIVER BY MASSIVE ATTABAD LANDSLIDE, STORY OF A RISK MANAGEMENT INITIATIVE FROM HUNZA, PAKISTAN

The mountainous region of northern Pakistan is seismically active as Indian plate is subducting beneath the Eurasian plate. Various geological phenomena are active due to the mountain building and landslides are one of the most destructive natural disasters in the Karakoram range. The northern part of Pakistan, Gilgit-Baltistan, falling in this region is no exception to that. Attabad was a remote village situated on the right bank of Hunza River at a ground distance of almost 125 km from Gilgit city. The area falls into Darkut-Karakoram metamorphic complex composed of granites, granodiorite, and gneiss. A devastating landslide occurred on 4th January 2010, as mode of circular failure which blocked the Hunza River forming a lake behind. The debris material hit the opposite rock cliff, due to narrow gorge the landslide mass travelled downstream 1.5km with huge debris surges, hitting 8 houses in lower Attabad which came under rubble and 19 people died. Aga Khan Agency for Habitat previously FOCUS Pakistan developed an inventory of active landslides across the KKH in Hunza in 2000-2001, however this landslide was not identified. Later in 2002 after the Astore earthquake initial cracks developed at the top of the slope. The 8th October Kashmir earthquake destabilized and U-shaped demarcation appeared across the slope. Anthropogenic activities like irrigation of lands, seepage of water from rain and snow melt water further destabilized the land. Finally, an earthquake in November 2009 in Hindukush region triggered the landslide and brittle failure occurred on 4th January 2010

Living Sexualities: Negotiating Heteronormativity in Middle Class Bangladesh

‘Living Sexualities’ is a study of erotic desires, practices and identities, lived within the heteronormative and marriage-normative socio-sexual structures of the urban middle class in contemporary Bangladesh. The study is based on two years fieldwork during which data was generated through 35 life histories and narratives, in-depth interviews, case studies, academic and popular literature and participant observation. Taking sexuality, gender, class and space as central concepts the lived experiences of sexualities of three non-normative groups are analysed: gay men, women in/interested in same sex relations, and single heterosexual women. Space – as a physical, social and symbolic category – weaves through the understanding of sexuality, showing that within hetero- patriarchal social structures of family and household, and the public and virtual worlds, there still exist spaces for ambiguity, plural identities and non-heteronormative performances of gender and sexualities

Burden and Depression among Caregivers of Visually Impaired Patients in a Canadian Population

Purpose/Background. This study reports the degree of burden and the proportion at risk for depression among individuals who provide care to visually impaired patients. Study Design. This is clinic-based, cross-sectional survey in a tertiary care hospital. Methods. Caregivers were considered unpaid family members for patients whose sole impairment was visual. Patients were stratified by vision in their better seeing eye into two groups: Group 1 had visual acuity between 6/18 and 6/60 and Group 2 were those who had 6/60 or worse. Burden was evaluated by the Burden Index of Caregivers and the prevalence of being at risk for depression was determined by the Center for Epidemiologic Studies Depression scale. Results. 236 caregivers of 236 patients were included. Total mean BIC scores were higher in Group 2. Female caregivers, caregivers providing greater hours of care, and caregivers of patients who have not completed vision rehabilitation programs are at higher risk for depression

Disease pattern, health services utilization and cost of treatment in Pakistan

Population based data on disease patterns, health services utilization and cost incurred on treatment in Pakistan were collected through a nation-wide sample survey in 1982-83. The survey for the first time revealed, the burden of disease on the society. The analysis done here suggest, that about one-sixth of the population suffered from an illness during the past one month period. As expected, illness was more prevalent among children, women in reproductive ages and the elderly. Over two-thirds of those who fell ill, suffered from malaria and fever and one-fifth from diarrhoea and dysenteries. There was heavy reliance on private physicians for treatment of those who fell, about two- thirds in the urban and one-third in the rural areas, consulted private physicians. On the other hand, in both the areas, less than one-sixth utilized the government health facilities. The cost of health care on an average, was 4% of the total income in the urban and 5% in the rural areas. In both the areas, this constituted over 7% of the monthly household income of the poorest. Suggestions are made to overcome the high cost of health care through broad based national health policy and implementation of primary health care programme