The role of social geography on Lady Health Workers' mobility and effectiveness in Pakistan
Bibliographic Data
| ID | 4601776 |
|---|---|
| Authors | Zubia Mumtaz (0000-0003-4590-9739), Sarah Salway (0000-0002-7688-5496), Candace I J Nykiforuk (0000-0002-1017-5475), Candace Nykiforuk, Afshan Bhatti, Anushka Ataullahjan (0000-0001-5261-5523), Bharati Ayyalasomayajula |
| Year | 2013 |
| Volume | 91 |
| Pages | 48-57 |
| Publication date | 2013-08-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2013.05.007 |
| PMID | 23849238 |
| OpenAlex | W2003108774 |
| Language | EN |
| Citations received | 22 |
| References cited | 17 |
The Pakistan Lady Health Worker (LHW) program provides door-step reproductive health services in a context where patriarchal norms of seclusion constrain women's access to health care facilities. The program has not achieved optimal functioning, particularly in relation to raising levels of contraceptive use. One reason may be that the LHWs face the same mobility constraints that necessitated their appointment. Past research has documented the influence of gendered norms and extended family (biradari) relationships on rural women's mobility patterns. This study explores whether and how these socio-cultural factors also impact LHWs' home-visit rates. A mixed-method study was conducted across 21 villages in one district of Punjab in 2009-2010. Social mapping exercises with 21 LHWs were used to identify and survey 803 women of reproductive age. The survey data and maps were linked to visually delineate the LHWs' visitation patterns. In-depth interviews were conducted with 21 LHWs and 27 community members. Members of a LHW's biradari had two times higher odds of reporting a visit by their LHW and were twice as likely to be satisfied with their supply of contraceptives. Qualitative data showed that LHWs mobility led to a loss of status of women performing this role. Movement into space occupied by unrelated males was particularly shameful. Caste-based village hierarchies further discouraged visits beyond biradari boundaries. In response to these normative proscriptions, LHWs adopted strategies to reduce the amount of home visiting undertaken and to avoid visits to non-biradari homes. The findings suggest that LHW performance is constrained by both gender and biradari/caste-based hierarchies. Further, since LHWs tended to be poor and low caste, and at the same time preferentially visited co-members of their extended family who are likely to share similar socioeconomic circumstances, the program may be differentially providing health care services to poorer households, albeit through an unintended route
Caste · Context (archaeology · Developing country · Economic growth · Geography · Political science · Qualitative research · Seclusion · Socioeconomics · Sociology · Demographic Trends and Gender Preferences · Global Maternal and Child Health · Medicine · Migration, Health and Trauma · Gerontology
Mapping implementation science in Pakistan’s health sector
How do gender relations affect the working lives of close to community health service providers? Empirical research, a review and conceptual framework
How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature
Community Health Workers Can Provide Psychosocial Support to the People During Covid-19 and Beyond in Low- and Middle- Income Countries
Barriers in reaching new-borns and infants through home visits
Breaking the silence on gendered harassment and assault of community health workers
The community health worker as service extender, cultural broker and social change agent
South Asia’s unprotected poor
A light touch intervention with a heavy lift – gender, space and risk in a global vaccination programme
The family context of Asha and Anganwadi work in rural Rajasthan
The Relationship of Safety with Burnout for Mobile Health Employees
Understanding the roles of community health workers in improving perinatal health equity in rural Uttar Pradesh, India
What can motivate Lady Health Workers in Pakistan to engage more actively in tuberculosis case-finding
Volunteers in Ethiopia’s women’s development army are more deprived and distressed than their neighbors
I am my own person,’ women's agency inside and outside the home in rural Pakistan
Where there is no weighing scale
Per Diems in Polio Eradication
Epidemic Infrastructures and the Politics of Responsibility in Lahore
The Effect of Reframing the Goals of Family Planning Programs from Limiting Fertility to Birth Spacing
Professional competition amidst intractable maternal mortality
Healthcare workers 'on the move
Volunteers Are Not Paid Because They Are Priceless
Qualitative Data Analysis in Health Psychology
Maternal deaths in Pakistan
Determinants of institutional delivery in rural Jhang, Pakistan
Male gender preference, female gender disadvantage as risk factors for psychological morbidity in Pakistani women of childbearing age - a life course perspective
Gender-based barriers to primary health care provision in Pakistan
Poverty, Social Exclusion and the MDGs
Mobility of women and access to health and family planning services in Pakistan
I never go anywhere
Primary health care
God should give daughters to rich families only
Promoting health, promoting women
Disparate Views of Community in Primary Health Care
| Unique citing works | 22 |
|---|---|
| Citations per year | 2 |
| Citation span | 2015 - 2026 (12) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 20 |