Male gender preference, female gender disadvantage as risk factors for psychological morbidity in Pakistani women of childbearing age - a life course perspective

Abstract

BackgroundIn Pakistan, preference for boys over girls is deeply culturally embedded. From birth, many women experience gendered disadvantages; less access to scarce resources, poorer health care, higher child mortality, limited education, less employment outside of the home and circumscribed autonomy. The prevalence of psychological morbidity is exceptionally high among women. We hypothesise that, among women of childbearing age, gender disadvantage is an independent risk factor for psychological morbidityMethodsA cross-sectional catchment area survey of 525 women aged 18 to 35 years living in Islamabad and Rawalpindi. The effect of gender disadvantage was assessed as a latent variable using structural equation modelling. Indicators were parental gender preference, low parental care, parental overprotection, limited education, early age at marriage, marital dissatisfaction and low autonomy. Psychological morbidity was assessed using the 20 item Self Reporting Questionnaire (SRQ).ResultsGender disadvantage was independently predictive of psychological morbidity. Among married women, socio-economic status did not predict psychological morbidity, and the effect of education was mediated through gender disadvantage rather than socioeconomic status (SES). The women's own preference for a male child was strongly predicted by their perceptions of having been disadvantaged by their gender in their families of origin.ConclusionsThe high prevalence of psychological morbidity among women in Pakistan is concerning given recently reported strong associations with low birth weight and infant stunting. Social action, public policies and legislation are indicated to reduce culturally embedded preferences. Neglect of these fundamentals will entrench consequent inequities including gender bias in access to education, a key millennium development goal.

Socio-Economic Inequalities and their Impact on Health in Pakistan

“…Culturally, women are given a low status in Pakistani families and this result in poor health seeking behavior. Females in Pakistan are entitled to low social status as they do not carry the family name, cannot continue the family trade and are not expected to provide any care to their parents when they are old (Andersson et al, 2010;Qadir et al, 2011). Apart from this, unemployment is also extensively claimed to be one of the main issues behind the emerging inequalities among the masses of Pakistan.…”

Confinement Following Child Birth and Associated Postpartum Mental Distress

“…Surprisingly, level of education, marital status, and parity have been found to have no statistically significant relationship with mental distress in the present study (X 2 = 09.904, P < 0.924; X 2 = 7.889, P < 0.246; X 2 = 1.164, P = 0.884 respectively). Contrary to these findings, Pattyn et al, [25] and Clarke et al, [24] reveal more complaints of psychological distress by women with low education level, and Qadir et al, [26] emphasizes that education is viewed as a protective element against mental distress because it shapes attitudes, lifestyle and behaviors, which may enhance the mental health of women. Marriage in many societies is considered an essential part of life and therefore, it is not uncommon to find no relationship between mental distress and marital status, especially given that in some cultures including Zambia, marriage is a means of support for women, and Open Journal of Psychiatry in this case serves as a protective factor against postpartum mental distress, although it is argued that women are more vulnerable to mental distress arising from marriage compared to their male counterparts [27].…”

A hospital based prospective survey of perinatal depression in Chinese women of Jiamusi city

“…Though, this rise was statically insignificant it can be assumed that the previous abortion didn't impact PND as majority of them were planned abortion for unplanned pregnancy or intentional female feticide [29]. Though strict laws are being incorporated in China but still sex-determining abortion are rampant in rural China and same in case here in our study base.…”