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

BMC International Health and Human Rights

Research Article

Sarah Salway¹  Laura Shanner²  Lory Laing²  Afshan Bhatti²  Zubia Mumtaz² 

[1] Sheffield Hallam University, City Campus, Howard Street, Sheffield, UK;University of Alberta, School of Public Health, Edmonton, Alberta, Canada;

关键词: Maternal Health;    Maternal Death;    Maternal Health Service;    Maternal Health Care;    Caste System;   

DOI  :  10.1186/1472-698X-11-S2-S4

来源: Springer

【 摘 要 】

BackgroundA 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.MethodsUsing 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.FindingsShida 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.ConclusionsThe 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.

【 授权许可】

CC BY   
© Mumtaz et al; licensee BioMed Central Ltd. 2011