Research on the Role of Community Spaces and Mechanisms in Health Promotion among the Poor Communities in Rural Pakistan

Given the distressingly high rates of maternal, neonatal, and infant mortality in rural Pakistan, there is a dire need to investigate the ways in which communities access information and make decisions regarding the health of women and children. The Rural Support Programmes Network conducted research to understand the role of community spaces and mechanisms in health promotion amongst the poor communities in rural Pakistan. This was an eight-month research project, supported by the Research and Advocacy Fund, which explored the dynamics of formal and informal community spaces in rural Pakistan, in the context of maternal and child health. With a particular focus on studying how the most poor and marginalised groups in a community are affected by these dynamics, the research took place in three geographically distinct districts of Pakistan:

  • Rajanpur, located in South Punjab, a region characterised by plains
  • Ghizer which is located in Gilgit-Baltistan and is a mountainous region
  • Thatta, a district in Sindh which is a delta region

The objectives of this project were:

  • To identify the types of community spaces for maternal, newborn and child health promotion
  • To understand the role of community spaces in empowering women, poor people and marginalised groups
  • To suggest ways in which community spaces can be made more effective for maternal, newborn and child health promotion

Methodology

Using qualitative research methods including focus group discussions, selected participatory rural appraisal tools and a brief ethnography, the research explored the impact of community spaces on the inclusion and empowerment of the poor and socially excluded members of society, and women in the most vulnerable villages of Thatta, Rajanpur and Ghizer.

Conceptual Framework

Results

As a result of this research, the need for implementers and designers of Maternal, Newborn and Child Health (MNCH) programmes to include the rural and poor women and men in their community spaces for health promotion was highlighted. The role of community spaces in empowering the rural and poor communities had never been brought to light.

The research emphasised the fact that even today; a mother dies every 20 minutes as result of giving birth. Rural women bear a higher risk than urban women do and neonatal mortality is about 55% higher for the poorest households as compared to the richest 20 percent. The study found that MNCH programmes have improved awareness and healthcare seeking behaviours through provision of facility based care, door to door visits, group awareness sessions, and formal groups and committees. However, empowerment and social organisation of the disadvantaged is not their agenda as they do not focus on including the poor, and therefore, fail to improve the health outcomes of the poor and marginalised. For the full research report, visit the publications section of this page.

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