Characteristics of health markets

Khan, F. and Aziz, A. (2014).The Role of Community Spaces and Mechanisms in Health Promotion amongst the Poor Communities in Rural Pakistan.Rural Support Programme Network.
The report is a qualitative research on the role of community spaces and mechanisms in health promotion amongst the poor communities in rural Pakistan. The study was conducted by the Rural Support Programmes Network (RSPN) with support from the Maternal and Newborn Health Programme – Research and Advocacy Fund (RAF) in one district each from Sindh, Punjab and Gilgit-Baltistan, based on their deprivation ranking. The study identifies the different kinds of community spaces and explores if and how these spaces have included or excluded the poor and marginalized and contributed to their empowerment and health promotion. The findings of this report demonstrate that most MNCH programmes focus on creating large transitory and emerging institutional spaces that do not have a well-defined structure, membership criteria and functional mechanisms for including the poor and marginalized. Furthermore, the MNCH programme facilitators were selected on the basis of their educational level and belonged to the better-off castes, therefore in the formal spaces they tended to associate with their relatives or friends and continued to carry their prejudices against the poor and marginalized groups. Thus, the report suggests that formal spaces should be made more inclusive and representative of the whole community, and not merely limited to the inclusion of notables.
http://www.rafpakistan.org/userfiles/Final Summary Rep.pdf

K, Ayesha and K, Adnan. (2013). Key Findings of the National Nutritional Survey 2011.Research and Development Solutions, Policy Brief Series, 41.
This policy brief highlights the finding of the nutrition survey taken in 2011 and gives a brief overview of the nutritional status of women and children in Pakistan. It portrays the poor nutritional status of the Pakistani population and has consequent implications on the nutrition, growth and health of the population. The findings suggest very high rates of malnourishment of women and children and are extremely alarming.According to the policy brief, the lack of differences between rural and urban areas is unexpected and warrants a more detailed sub- provincial analysis. It also suggests that it would be more useful if data were disaggregated by wealth status, family size and correlated with economic indicators such as family income.While some level of malnutrition may be addressed using a program approach, as was seen for iodine deficiency, these findings suggest a more holistic economic and development approach to address malnutrition which ultimately is the end result of poverty.
http://www.resdev.org/files/policy_brief/41/Policy Brief 41 – Nutritional Status.pdf

Hadden, W. C., Pappas, G., & Khan, A. Q. (2003). Social stratification, development and health in Pakistan: an empirical exploration of relationships in population-based national health examination survey data. Social science & medicine, 57(10), 1863-1874.
This paper develops empirical measures for social standing along the poverty-affluence and two other dimensions of development, education and social development, and explores the relationship between these and health as measured by nutritional status. The results show that poor nutritional status measured with low BMI, anemia, or diet diversity becomes less common with increases in education, economic status, and community development. The univariate relationships, however, do not all hold up in multivariate analyses controlling for age and sex differences. In the multivariate model of under-weight, economic status is the only significant socio-economic indicator. This suggests that given sufficient resources households in Pakistan are able to obtain basic nutrition. Thus, these results are a first step toward understanding the complex process through which urbanization and evolving stratification systems affect diet and nutritional status. The findings of this paper highlight the importance of measuring multiple dimensions of socio-economic status in order to uncover the source of causal effects. The results show that community development and economic standing are often more closely related to nutritional status than is education. In contrast, in other studies level of maternal education has shown a particularly close association with infant and child health.
http://www.sciencedirect.com/science/article/pii/S0277953603000522