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

MUMTAZ, Z, SALWAY, Sarah, SHANNER, L, BHATTI, A and LAING, L (2011). Maternal deaths in Pakistan : intersection of gender, class and social exclusion. BMC International Health and Human Rights, 11 (Supp 2), S4.


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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.

Item Type: Article
Research Institute, Centre or Group: Centre for Health and Social Care Research
Identification Number:
Depositing User: Rebecca Jones
Date Deposited: 18 Jan 2012 15:28
Last Modified: 16 Nov 2018 12:39

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