The Nation’s Caregivers: Work Experiences, Professional Identities and Gender Politics of Pakistan’s Lady Health Workers

dc.contributor.authorDiwan, Malihaen
dc.contributor.departmentGlobal Development Studiesen
dc.contributor.supervisorTiessen, Rebeccaen
dc.date2013-07-03 11:49:42.069
dc.date2013-07-03 15:38:05.649
dc.date2013-07-03 16:28:46.91's University at Kingstonen
dc.descriptionThesis (Master, Global Development Studies) -- Queen's University, 2013-07-03 16:28:46.91en
dc.description.abstractLady Health Workers (LHWs) are community health workers who work under the Pakistani government’s National Programme for Family Planning and Primary Health Care, and provide basic medication, contraceptives, and nutrition and prenatal advice to expectant mothers. LHWs are a pivotal bridge between mothers, especially those who live in traditional households, and medical practitioners and policymakers. Several studies indicate that LHWs have been instrumental in decreasing maternal and infant mortality rates, lowering the incidence of tuberculosis in urban and rural populations, and treating depression among patients. In addition, they conduct vaccination campaigns including the WHO-supervised polio campaign. Since 2007 tensions have emerged between LHWs and the government regarding pay and working conditions. The LHWs have staged sit-ins, demonstrations as well as a march to the capital to highlight their plight and demand better working conditions from the government. This has resulted in disruptions in vaccination and awareness campaigns. Reports suggest that a higher morale amongst workers translates to higher productivity and more effective work results. Thus, understanding the issues affecting LHWs is essential to a more productive health care work force. By analyzing the dynamics underpinning the relationship between LHWs, the Pakistani government, and the community, policymakers can obtain a better understanding of how the intersecting influences of gender, culture and spaces impact the implementation of health care policies. This analysis could also shed light on the issue of worker retention in the medical field. Drawing from a series of semi-structured interviews conducted over a four-month period in the Pakistani city of Karachi, I analyse how LHWs view their work in relation to gender, agency, self-worth and human security in an urban setting. In addition, I locate the workers’ experiences within neocolonial and postcolonial systems. Findings indicate that while LHWs are extremely devoted to their work, a lack of security, compounded by irregular pay and gender discrimination, has contributed to low morale. The masculine and hierarchal systems LHWs operate within have contributed to the workers’ struggle to be recognised professionally. In addition, international development organisations’ agendas and government policies have had unintended and often negative consequences on LHWs’ morale and experiences.en
dc.relation.ispartofseriesCanadian thesesen
dc.rightsThis publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.en
dc.subjectInternational Developmenten
dc.subject.classificationMedical Anthropology
dc.subject.classificationHealth Care
dc.titleThe Nation’s Caregivers: Work Experiences, Professional Identities and Gender Politics of Pakistan’s Lady Health Workersen
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