Pakistan's lady health worker labor movement and the moral economy of heroism

Closser, Svea

doi:10.1111/napa.12061

Cited by 20 publications

(31 citation statements)

References 15 publications

(14 reference statements)

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“…156157 This is especially problematic given that the majority of community health workers are women and thus bear the greatest burden of uncompensated or undercompensated labour. 158159 …”

Section: Application Of Syndemic Models To Improve Global Healthmentioning

confidence: 99%

Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations

et al. 2017

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The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities. The term syndemic refers to synergistic health problems that affect the health of a population within the context of persistent social and economic inequalities. Until now, syndemic theory has been applied to comorbid health problems in poor immigrant communities in high-income countries with limited translation, and in low-income or middle-income countries. In this Series paper, we examine the application of syndemic theory to comorbidities and multimorbidities in low-income and middle-income countries. We employ diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, we illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients. We conclude with recommendations for research and systems of care to address syndemics in low-income and middle-income country settings.

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“…156157 This is especially problematic given that the majority of community health workers are women and thus bear the greatest burden of uncompensated or undercompensated labour. 158159 …”

Section: Application Of Syndemic Models To Improve Global Healthmentioning

confidence: 99%

Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations

et al. 2017

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“…Moreover, this includes CHWs advocating to their employer or other staff for resources that are needed in their organisations. Previous scholarship has documented CHWs advocating for the legitimacy of their own occupation to employers, medical professionals, and non-governmental organisations (Closser 2015;Sabo et al 2015).…”

Section: Levels Of Advocacymentioning

confidence: 99%

“…CHWs have been documented participating in advocacy for their clients, their communities, and their position in the United States and abroad (Closser 2015;Ingram et al 2008;Maes 2015;Nading 2013;Sabo et al 2013Sabo et al , 2015Wiggins et al 2014). Especially as these workers typically come from the communities with which they work, their intimate knowledge and shared structural vulnerability with their clients provides them with a foundation from which to eff ectively participate in advocacy.…”

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confidence: 99%

Being a Community Health Worker Means Advocating

Logan

2019

Anthropology in Action

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Community health workers (CHWs) participate in advocacy as a crucial means to empower clients in overcoming health disparities and to improve the health and social well-being of their communities. Building on previous studies, this article proposes a new framework for conceptualising CHW advocacy, depending on the intended impact level of CHW advocacy. CHWs participate in three ‘levels’ of advocacy, the micro, the macro, and the professional. This article also details the challenges they face at each level. As steps are taken to institutionalise these workers throughout the United States and abroad, there is a danger that their participation in advocacy will diminish. As advocacy serves as a primary conduit through which to empower clients, enshrining this role in steps to integrate these workers is essential. Finally, this article provides justification for the impacts of CHWs in addressing the social determinants of health and in helping their communities strive towards health equity.

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“…LHWs' strong local access to women has made it tempting for health policy makers to delegate more and more responsibilities to LHWs, and interventions indicate that the LHW training programme can be effectively extended to absorb additional skill sets to be integrated into their service (Bhutta et al, 2011). However, LHWs complain of being overburdened and under-compensated for extra activities (Closser, 2015).…”

Section: Maternal and Child Health Workersmentioning

confidence: 99%

Where there is no weighing scale: Newborn nourishment and care in Pakistani Punjab

Qureshi

Khawaja

2017

Women's Studies International Forum

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A third of babies in South Asia are born low birthweight, more than in sub-Saharan Africa. This epidemiological enigma has been linked to gender and generational inequalities and to poor health and nutrition over the whole of women's lives. High rates of breastfeeding initiation are accompanied by high rates of colostrum avoidance, the giving of prelacteal feeds and early supplementation with formula or animal milks as well as other substances. Meanwhile, in Pakistan-despite the extensive presence of public community maternal and child health workers-very few babies are weighed at birth. This paper draws on an ethnographic study conducted in 2014-16 in rural and urban Punjab, to shed light on the interpretation, nourishment and care of newborns who are identified to be kamzoor (weak), and to comment on the extent to which carers' efforts are influenced by community health workers, who are charged with spreading modern biomedical knowledge and practices. Kamzoori is understood to be caused by maternal depletion and is managed very simply at home by augmenting breastfeeding and giving supplementary milks, and by keeping the baby warm and massaged. In cases where weak newborns do not recover weight, spiritual explanations are invoked and treated through a variety of home remedies/methods. There are often similarities between the interpretations of mothers, grandmothers, and health workers. The paper therefore considers health workers to be engaged in complex cultural translations.

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Pakistan's lady health worker labor movement and the moral economy of heroism

Abstract: P a k i s t a n ' s l a d y h e a l t h w o r k e r l a b o r m o v em e n t a n d t h e m o r a l e c o n o m y o f h e r o i s m

Cited by 20 publications

References 15 publications

Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations

Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations

Being a Community Health Worker Means Advocating

Where there is no weighing scale: Newborn nourishment and care in Pakistani Punjab

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