Gender and reproductive health in Pakistan: a need for reconceptualisation

This thesis is a conceptual and empirical exploration of the links between women's gendered position and their reproductive health in Pakistan. A growing body of literature seeks to identify the relationship between gender inequality and women's reproductive health, most commonly their contraceptive use and fertility. However, to-date findings have been mixed and we lack a coherent picture of how these two aspects of women's well-being are related. This thesis illustrates that the focus on female autonomy, which is central to much of the discourse concerning gender and reproductive health in South Asia, is inappropriate to this cultural setting. An alternative framework for conceptualizing and measuring women's gendered position is presented in an attempt to further our understanding of the determinants of reproductive health. The study uses an integrated analysis of quantitative and qualitative data. The Pakistan Fertility and Family Planning Survey (1996-97) data show important socio-demographic and contextual differentials in women's mobility, decision-making, control over financial resources, communication with husband, exposure to information and health knowledge. Relationships between different measures of women's gendered position and reproductive health outcomes are shown to be varied, with only joint decision-making, communication with husband, and health knowledge having positive associations with both contraceptive and antenatal care use. A detailed ethnographic study of a Punjabi village reveals kinship structures based on an ideology of akhathe (jointness), and social networks and inter-personal relationships as the primary route to resources of all kinds. Women's interests are intricately linked with their family's well-being. They aspire to be mazboot (strongly connected) members of their families rather than autonomous individuals. The qualitative data inform the interpretation of the quantitative associations and suggest ways in which measures of women's gendered position can be refined. Both fertility control and pregnancy are shown to be highly gendered processes. However, an unexpectedly high contraceptive use rate, and the emergence of antenatal care use, are found in the absence of accompanying shifts in gender ideology. In such a context, the 'centrality' approach is suggested as a valid and sensitive way of conceptual ising women's gendered position in Pakistan. This approach incorporates the kinship and social structures and suggests women's mazbooti as a more acceptable and realisable goal for improving women's reproductive health and well being

Multi-objective optimisation for minimum quantity lubrication assisted milling process based on hybrid response surface methodology and multi-objective genetic algorithm

© 2019 by SAGE Publications Ltd.Parametric modelling and optimisation play an important role in choosing the best or optimal cutting conditions and parameters during machining to achieve the desirable results. However, analysis of optimisation of minimum quantity lubrication–assisted milling process has not been addressed in detail. Minimum quantity lubrication method is very effective for cost reduction and promotes green machining. Hence, this article focuses on minimum quantity lubrication–assisted milling machining parameters on AISI 1045 material surface roughness and power consumption. A novel low-cost power measurement system is developed to measure the power consumption. A predictive mathematical model is developed for surface roughness and power consumption. The effects of minimum quantity lubrication and machining parameters are examined to determine the optimum conditions with minimum surface roughness and minimum power consumption. Empirical models are developed to predict surface roughness and power of machine tool effectively and accurately using response surface methodology and multi-objective optimisation genetic algorithm. Comparison of results obtained from response surface methodology and multi-objective optimisation genetic algorithm depict that both measured and predicted values have a close agreement. This model could be helpful to select the best combination of end-milling machining parameters to save power consumption and time, consequently, increasing both productivity and profitability.Peer reviewedFinal Published versio

Meanings of blood, bleeding and blood donations in Pakistan: implications for national vs global safe blood supply policies

Contemporary public policy, supported by international arbitrators of blood policy such as the World Health Organization and the International Federation of the Red Cross, asserts that the safest blood is that donated by voluntary, non-remunerated donors from low-risk groups of the population. These policies promote anonymous donation and discourage kin-based or replacement donation. However, there is reason to question whether these policies, based largely on Western research and beliefs, are the most appropriate for ensuring an adequate safe blood supply in many other parts of the world

Study on genetic diversity in Pakistani wheat varieties using simple sequence repeat (SSR) markers

Common wheat ( Triticum aestivum L.) is a grass species, cultivated world wide. Globally, it is the most important human food grain and ranks second in total production as a cereal crop behind maize. Genetic diversity evaluation of germplasm is the basis of improvement in wheat. In the present study genetic diversity of 10 varieties of wheat (T. aestivum) were analyzed using 14 simple sequence repeat (SSR) primer sets. To estimate the genetic diversity among the genotypes, bivariate data matrix was generated and genetic distances were calculated using unweighted pair group of arithmetic mean (UPGMA) procedure. A high degree of genetic polymorphism was observed among the wheat varieties with average genetic distances ranged from 16 to 67%. SSR primer gdm-3, gdm-19, gdm-61, gdm-62, gdm-64, gdm-86, gdm-88, gdm 93-2a, 93-4b, gdm-13 and gdm-115 amplified 3, 2.9, 4.1, 4.7, 3, 1.7, 2.7, 3.7, 5.8, 4.1 and 1.4 loci per variety, respectively. Most diverse varieties of wheat were identified (Punjab-81 and Indus-79) and recommendations were made to utilize these varieties in future breeding program

Scavenger receptors in host defense: from functional aspects to mode of action

Scavenger receptors belong to a superfamily of proteins that are structurally heterogeneous and encompass the miscellaneous group of transmembrane proteins and soluble secretory extracellular domain. They are functionally diverse as they are involved in various disorders and biological pathways and their major function in innate immunity and homeostasis. Numerous scavenger receptors have been discovered so far and are apportioned in various classes (A-L). Scavenger receptors are documented as pattern recognition receptors and known to act in coordination with other co-receptors such as Toll-like receptors in generating the immune responses against a repertoire of ligands such as microbial pathogens, non-self, intracellular and modified self-molecules through various diverse mechanisms like adhesion, endocytosis and phagocytosis etc. Unlike, most of the scavenger receptors discussed below have both membrane and soluble forms that participate in scavenging; the role of a potential scavenging receptor Angiotensin- Converting Enzyme-2 has also been discussed whereby only its soluble form might participate in preventing the pathogen entry and replication, unlike its membrane-bound form. This review majorly gives an insight on the functional aspect of scavenger receptors in host defence and describes their mode of action extensively in various immune pathways involved with each receptor type

Design, Development and Evaluation of Portable Washer for Lotus Rhizomes

629-633The aim of the present study was to design, develop and evaluate a low cost portable washer for Lotus Rhizomes. Different performance parameters and colour values were studied to check the performance of the developed prototype in comparison to the manual washing. The capacity and efficiency of the machine was much higher than the existing manual method of washing. The colour coordinates (L* a* b*) revealed that washing through developed washer makes lotus rhizomes more clean and bright as compared to the  manual washing. Different sanitizers were also tested for shelf life enhancement of lotus rhizomes. Out of all tested sanitizers, the citric acid was found best with regard to shelf life enhancement and cleanliness of lotus rhizomes. The economic analysis reveals that the developed lotus rhizome washer can be beneficial for the people who are directly or indirectly involved in lotus rhizome trade

Improving the standards-based management: recognition initiative to provide high-quality, equitable maternal health services in Malawi. An implementation research protocol: Table 1

Background: The Government of Malawi is seeking evidence to improve implementation of its flagship quality of care improvement initiative — the Standards Based Management-Recognition for Reproductive Health (SBM-R(RH)). Objective: This implementation study will assess the quality of maternal healthcare in facilities where the SBM-R(RH) initiative has been employed, identify factors that support or undermine effectiveness of the initiative and develop strategies to further enhance its operation. Methods: Data will be collected in 4 interlinked modules using quantitative and qualitative research methods. Module 1 will develop the programme theory underlying the SBM-R(RH) initiative, using document review and in-depth interviews with policymakers and programme managers. Module 2 will quantitatively assess the quality and equity of maternal healthcare provided in facilities where the SBM-R(RH) initiative has been implemented, using the Malawi Integrated Performance Standards for Reproductive Health. Module 3 will conduct an organisational ethnography to explore the structures and processes through which SBM-R(RH) is currently operationalised. Barriers and facilitators will be identified. Module 4 will involve coordinated co-production of knowledge by researchers, policymakers and the public, to identify and test strategies to improve implementation of the initiative. Potential impact: The research outcomes will provide empirical evidence of strategies that will enhance the facilitators and address the barriers to effective implementation of the initiative. It will also contribute to the theoretical advances in the emerging science of implementation research

Maternal deaths in Pakistan : intersection of gender, class and social exclusion.

Background: A key aim of countries with high maternal mortality rates is to increase availability of competent maternal health care during pregnancy and childbirth. Yet, despite significant investment, countries with the highest burdens have not reduced their rates to the expected levels. We argue, taking Pakistan as a case study, that improving physical availability of services is necessary but not sufficient for reducing maternal mortality because gender inequities interact with caste and poverty to socially exclude certain groups of women from health services that are otherwise physically available. Methods: Using a critical ethnographic approach, two case studies of women who died during childbirth were pieced together from information gathered during the first six months of fieldwork in a village in Northern Punjab, Pakistan. Findings: Shida did not receive the necessary medical care because her heavily indebted family could not afford it. Zainab, a victim of domestic violence, did not receive any medical care because her martial family could not afford it, nor did they think she deserved it. Both women belonged to lower caste households, which are materially poor households and socially constructed as inferior. Conclusions: The stories of Shida and Zainab illustrate how a rigidly structured caste hierarchy, the gendered devaluing of females, and the reinforced lack of control that many impoverished women experience conspire to keep women from lifesaving health services that are physically available and should be at their disposal