Educations Role In Health And Fertility Change (Pakistan, south asia, development) - Presentation Transcript
Feyza Bhatti (Mahbub ul Haq Human Development Centre, Islamabad)
Roger Jeffery (University of Edinburgh)
Theoretical considerations
The context of Pakistan
RECOUP research
Marriage and motherhood transitions
Conclusions
Potential roles of education in transitions to marriage and motherhood (two key life-cycle transitions )
Delaying age at marriage
Increasing health/fertility knowledge
Increasing self-confidence
Changing attitudes around spousal communication
Increasing access to media and official sources of information
Classic patriarchal society
Large gender gaps in schooling and literacy indicators
Poor maternal and reproductive health outcomes
Discrimination within the household in terms of expenditure on schooling and access to food, health care etc
BUT juvenile sex ratio stable
World Bank, 2009 Edstats database
MHHDC 2008, Human Development in South Asia 2007 & DHS 2006/07
The Outcomes of Education and Poverty Survey, 2006/07
Conducted in nine districts from two provinces (Punjab and NWFP)
Collected community, household and individual level data from
27 communities
1094 households
around 9000 individuals
Four communities
Sargodha – 1 rural, 1 urban
Charsadda- 1 rural, 1 urban
Semi-structured interviews with 71 young women and 13 mother in laws
Sampling criteria
a) age 20-29 years old,
b) married at least with a child less than 6 years old ,
c) being educated (completed 10 years of education and above) or being uneducated ( has not completed any grade).
Equal numbers from
rural and urban areas,
consanguineous marriage and no blood relation with her husband
nuclear and joint households
Aims: providing insights to whether and how a poor young Muslim Pakistani woman’s educational experiences inflect her transition to marriage and motherhood
Transition to marriage
age at marriage
selection of spouse and consent
Marital rights
Transition to motherhood
decisions on timing of child birth
assistance during delivery.
Percentage of women married by the a certain age, women ages 20-29 Source: RECOUP Quantitative Survey Pakistan
I could not tell them(my parents) directly. I did not even say that I did not want to get married rather I would say that I wanted to study further. I took admission while and persuaded my parents with persistency but even then I could not study further (Aafia, 26, Gr12, Sargodha, rural)
Source: RECOUP Quantitative Survey Pakistan
Educated women are more likely to be asked about opinion before a decision is made, but it is not always necessary that their opinions are taken seriously.
“ I told my mother and father about my fears and I also pointed out a few negative things about that proposal but she said those were not important. At the end my parents decided, they asked me just to fulfill the formality” (Mehbooba, 27, Gr 12, Sargodha, Rural)
One of the reasons for “no say in spouse choice” seems like childhood engagements, which is very common in Charsadda. Girls who got engaged in childhood, even if they get higher education later, are not consulted at all.
Azeema said that before her engagement she asked her father that she want to see the boy with whom she would be married. Azeema also told her father that if they refused her request she will not marry the person. Upon probing on how she told all this to her father, she said she was the youngest child of the family and was very near and dear to her father . Azeema’s father never used to refuse her demands that is why he agreed with Azeema for meeting the boy before engagement.
When my in-laws came for the final decision, my husband also came to Karachi along with them. I saw him and liked him so only then I approved the proposal.
On further probing Azeema said that her father consulted her before engagement and then he took the decision. Azeema said that her father was very good in this regard. Azeema added that that she herself was very bold and no body could take any decision without consulting her . (Azeema, 26, Gr 12, Charsadda, Urban)
The education of the bride seems to be ineffective in the decisions made about the women’s rights to divorce , rather it is determined by the customs of the family. Even educated brides usually remain unaware of what is written in the marriage contract as they themselves do not read it. Educated women leave these matters to their parents:
“ I did not read the marriage contract as my parents knew everything and they were responsible for that. I left everything to them.” (Rahila, educated, Sargodha, urban)
“ Girls usually do not ask about divorce rights and dowry and even they don’t know about their marriage contracts. And if a girl asks about these things, people do mind it and then talk about her in bad words.” (Rubeena, educated, Charsadda, rural)
Source: RECOUP Quantitative Survey
Majority of women were happy to become mothers as it was their khawaish (desire) and considered it as “God’s will” rather than a decision .
Some educated women considered using family planning for delaying the first pregnancy, however they were not really successful in attain their desires as either they did not take any action towards it or they just surrendered to the wishes of others.
“ I did not want to become pregnant. I was very scared of all that. I asked my husband that I wanted to take birth control pills but he declined. My husband decided for the baby. I had my first baby after one and a half year of marriage.” (Mehbooba, 27, Gr 12, Sargodha, rural)
Source: RECOUP Quantitative Survey
Educated women both in Charsadda and Sargodha were more cautious about their diet during pregnancy, more likely to have regular antenatal checkups, more open to idea of ultrasound checkup and they were more aware about the problems related to pregnancy.
The reasons for having birth without any skilled attendance seem mainly financial as TBAs also accept in-kind payments.
Almost all educated women delivered either in a private clinic/hospital or government hospital. They were more likely to be aware of some private clinics that were affordable or charged fees according to the financial status of the patients.
Education brings some changes, but more in awareness than in action
The strongest effect is on age at marriage
Even young women with 10 or more years of schooling remain subordinate to the elders in key aspects of transitions
During transitions and within marriage, educated women’s voices are slowly being heard, but partially and ambiguously
One of the main outcomes of female schooling is sup more
One of the main outcomes of female schooling is supposed to be dramatic improvements in reproductive indicators, such as women’s access to health and family planning services, maternal morbidity and mortality, and indicators of infant and child health. Pakistan is a country where such beneficial outcomes are sorely needed: gross enrolment of girls in secondary schooling is only about 26%, the maternal mortality ratio is 320, and under-5 mortality rates are 90 for boys and 100 for girls. In these circumstances, it is imperative to understand better exactly how schooling contributes to the improvements in reproductive health, and what else might make a difference. In this paper we draw on quantitative and qualitative data collected by the RECOUP programme of research to address these questions. less
0 comments
Post a comment