I have cautiously preferred community of layyah city for cultural analysis paper because I am zealous to be the part of that community. I have acquaintance with the community of layyah because I am the part of that area .currently I am living in Islamabad because I am doing my post RN Bsc N from PIMS college of nursing I used to visit there every year in my summer vacations during early age of my school and still now. Layyah District (formerly spelled as Leiah) is bounded to the North by Bhakkar District, to the east by Jhang District.
The Indus River flows to its Western side across which lies district Dera Ghazi Khan and to the south Muzaffargarh District. People of layyah adoring me since my childhood, due to their humble way of living, dressing, food and particularly I like the language which those people use, known as Punjabi, the major language which is spoken that’s saraiki which is one of the sweetest language in Pakistan. I have adequate knowledge about their cultural aspects. Life is so demanding, we have to achieve so many assignment even we cannot fulfill our own longings.
But my Post RN academic requirement fulfill this desire, now we have been given an assignment of scholarly article by Sir Shafique for cultural analysis and I have been given sufficient time to discover about the community to whom I am going to culturally analyze. I have made some struggle to write a cultural analysis paper about the community of layyah. Majority of people in Layyah are native speakers of Saraiki language. Urdu and Punjabi is also understood and spoken. The medium of education is Urdu and English. The district had a population of 1,520,951 of which only 20.47% are urban in 2005.layyah is city of edocation. layyah is a backward area. My community which has about10 60 houses roughly count . Additionally I observed that the streets were neat and clean but the houses were not healthy maintained.
They speak Punjabi and saraiki instead of Urdu. The majority of the people in Layyah are native speakers of Saraiki language, more than 90 % population is Saraiki speaking, Punjabi and Urdu is also widely spoken after the partition (1947). The medium of education is Urdu and English. There be present many schools and colleges but there are no university in my community. The people celebrate auspicious events like Eids very enthusiastically and with religious eagerness. Unfortunately, they believe in caste system and strictly abandon to its customs.
There are so many negative cultural practices which are not good for health and other aspect of life of local people. Most of the people are not educated and aware of modern health practices. They believe in peer fakir and tawiz and dum for illness. They are against of love marriages. Dowry system has affected our community.The people of my city are very meticulous and competent.
They wear simple clothes according to their culture. Muslims and Christian live together in a peaceful atmosphere in our community. There is only one hospital namely DHQ in the city which cannot cater to the needs of the people. So, people are facing many problems concerning their health. We request the health authorities especially the Chief Minister of Punjab, to provide more healthcare facilities to people so that they do not undergo survival on account of health issues and concentrate their attention on nation-building activities. Mostly people of my community are poor.
They are lading life hand to mouth. The rural villagers of layyah commonly live in houses made of bricks, clay or mud. These typically have two or three rooms which house extended families. In the urban area they are living by making separate home for each family but they don’t live way from each other, they are extending their villages by making more homes. Most of the people are farmers but other rural occupations include blacksmiths, hairdressers and tailors’, shepherds. their income is so slow for daily expenditures.
Socioeconomic status among there is often based upon the ownership of agricultural land, which also may provide social prestige in village cultures. The majority of the inhabitants livelihoods is based upon the rearing of livestock, which also comprises a significant part of layyah’s gross domestic product. Some livestock raised by rural People include cattle and goats. The link between poverty and health is well established worldwide, but the connection is both direct (lack of access to health services) and indirect (lack of awareness about health-related issues). Poverty helps produce ailments and ill-health pushes people towards poverty. It is a vicious cycle.
Socioeconomic conditions create situations that can lead to ill-health. Health emergencies can cost individuals and families, dearly aggravating poverty. According to the World Bank, 25 percent of hospitalized people in India fall below the poverty line. In Pakistan, little research based on empirical data has been found to understand the link between health and poverty. However, a World Bank study found out that approximately four percent of the population in Pakistan falls into poverty due to health shocks each year.The expenses of food and healthcare have increased for the poor. Increasing costs of healthcare have constrained access to health services.
Increasing poverty and poor health in Pakistan is understandable.In the last few years, newspapers in Pakistan have increasingly published stories about poverty-related crimes including theft, robbery, and suicide. Video clips show how poor workers snatch food offered to them after political meetings. Moreover, such scenes create a bad image among fellow citizens; a kind of self-inflicting strategy remains in place. Due to the high costs of modern healthcare, the incidence of seeking healthcare from quacks has increased.
The bad stories about quacks have been aired on television, leaving adverse effects on Pakistanis. Poverty has a strong relationship with mental health. Stress, anxiety, and depression are frequently reported ailments that are linked to poverty. The number of people seeking psychological care has increased during the last several years. Mostly people of layyah believe in superstations and also have some wrong concept and negative cultural practices.
According to them and their belief doctors are not good persons only earned money and have no any soft corner related to their patient. There is no concept of proper hygienic systems such as hands washing techniques before meal and after using washroom, but they take healthy diet, they eat household things such as use the vegetables of his home and drink the water of hand pump and tube well. Most of the families don’t like to perform their deliveries and c. section in hospital. They like to deliver their babies at home by non-technical dais.
Complications of pregnancy and childbirth remain the leading cause of death and disability for childbearing women in Pakistan. With a maternal mortality ratio of 297 per 100?000 live births, Pakistan is 1 of 6 countries contributing to more than 50% of all maternal deaths worldwide. An intervention in 2009 provided women in the Jhang district of Punjab who met poverty selection criteria with highly subsidized antenatal, delivery, and postnatal care through a low-cost voucher scheme and reimbursement of travel costs. The effects of these interventions on levels and disparities in maternal health care use has been variable.
Bhutta et al.9 reported a 10% increase in facility births (54% vs 44%; P?=?.07), but these authors did not explore variations by socioeconomic status; this was a surprising omission given that their intervention was based on geographic clusters rather than targeted to particularly poor women, and therefore, introduced the possibility of differential benefits between social groups. The PAIMAN intervention was found to increase levels of skilled birth attendance and postpartum care across all wealth quintiles, but did not decrease the differential between the rich and the poor. In terms of institutional delivery, no increase was seen among the poorest wealth quintile, and there was an increased disparity between the poorest and all other wealth groups (17% vs 74% in the richest quintile post intervention).6 The voucher scheme,10 which specifically targeted poorer women, appeared to have more success in tackling inequalities, with a significant increase in institutional delivery among the poorest quintile (31%–47%) and a reduction in the disparity between this group and the richest group (33%–16% points). Nevertheless, even after the introduction of the scheme, more than 60% of the poorest quintile of women reported not receiving adequate antenatal care, and more than 50% did not deliver in a health care facility.
Importantly, Agha10 reported that selling the vouchers to women was a difficult and time-consuming task, but that utilization of the vouchers for antenatal care and delivery care was very high (approximately 97% in the latter case). Males are dominant in families of layyah. there is considerable gender difference in my community .The present status of women in Pakistan is an outcome of several interactive forces: the repressive socio-cultural law prescribed by the Hindu religion, the Islamic social norms, and perhaps, the failure of policy to provide opportunities for improvement. In my community conservative families, there is no needing felt to educate her beyond the very initial levels. Giving education to a daughter usually implies that she leaves the “protection” of the home. Also, there is a fear of her getting in?uenced by the “modern” thoughts that can be taught in the schools and thus becoming rebellious towards the social status quo.
Finally, an educated daughter, being not allowed to work, becomes a liability as she may not fare too well in the marriage market, partly because she will require a more educated groom and partly because many future in-laws do not prefer educated daughters-in-laws. Also, for marriage of a daughter, it requires not only the arranging of a husband but also the provision of an adequate dowry, a practice which has no support in religion. The issue of dowry leads to many post-marital con?icts for the woman. One of these issues is the domestic violence against the woman.
Although violence against women has many forms in Pakistani society, nonetheless, she is terribly harassed due to inadequate legal and social loopholes. Stove burning is very common form of domestic violence against the woman. There is also early marriages and sexual abuse of the underprivileged woman of the rural areas. Awan et al. (2005, pp.
9-10) have traced the roots of this repression of woman in Pakistani society partly to the British colonial rule of sub-continent and partly to the narrow cultural values. They assert that, “Gradually, the notion of woman being subordinate became so deeply entrenched in the social psyche that even where religion and formal laws gave certain rights to women, the sheer force of customs and traditions has denied them the same. These attitudes not only affected woman participation in various ?elds, but also undermined their potential power to contribute to society.” They also contend that poverty is being, “feminized” and that violence and discrimination against woman is a part of the, “global culture” and that western society is also not above the exploitative and discriminatory treatment of the woman (p. 10). The statistic provided by Awan et al.
(2005, pp. 12 and 13) on violence against woman are stunning, and show to the extent the moral and social fabric of the society have declined. The report states that, 1,030 rapes took place during 2004,some 1,600 cases of injury and torture, about 310 cases of burning, and 870 incidents of honor killing. These ?gures also reveal the decline state of law and governance in the country.
This situation is in particularly impacting the lives of woman in Pakistan. This earlier cultural form of social inequality between men and women is further augmented by the cultural shaping of the behavior at the school. Arnot (2002) in her book, Reproducing Gender explores how educational system transmits and sustains gender inequality. She emphasizes that we need to investigate and expose the, “ways in which the educational system transmitted and sustained gender inequalities and the ways in which male dominance of educational privileges related to the forms of social class dominance reproduced through the school system. “In addition to the cultural notions about gender inequalities, biological factors also play important role in the composition of male and female segments of the population as well as feminity ratios of the human society.
Pakistan has been no exception to this biological factor. The Health Belief Model (HBM) was developed in the early 1950s by social scientists at the U.S. Public Health Service in order to understand the failure of people to adopt disease prevention strategies or screening tests for the early detection of disease this model can impose of community of layyah for positive cultural health practice adaptation. Later uses of HBM were for patients’ responses to symptoms and compliance with medical treatments of people Janz et al (2002). The HBM suggests that a person’s belief in a personal threat of an illness or disease together with a person’s belief in the effectiveness of the recommended health behavior or action will predict the likelihood the person will adopt the behavior. The HBM derives from psychological and behavioral theory with the foundation that the two components of health-related behavior are 1) the desire to avoid illness, or conversely get well if already ill; and, 2) the belief that a specific health action will prevent, or cure, illness.
Ultimately, an individual’s course of action often depends on the person’s perceptions of the benefits and barriers related to health behavior. There are six constructs of the HBM. The first four constructs were developed as the original tenets of the HBM. The last two were added as research about the HBM evolved. Perceived susceptibility – This refers to a person’s subjective perception of the risk of acquiring an illness or disease.
There is wide variation in a person’s feelings of personal vulnerability to an illness or disease. Perceived severity – This refers to a person’s feelings on the seriousness of contracting an illness or disease (or leaving the illness or disease untreated). There is wide variation in a person’s feelings of severity, and often a person considers the medical consequences (e.g., death, disability) and social consequences (e.g., family life, social relationships) when evaluating the severity. Perceived benefits – This refers to a person’s perception of the effectiveness of various actions available to reduce the threat of illness or disease (or to cure illness or disease). The course of action a person takes in preventing (or curing) illness or disease relies on consideration and evaluation of both perceived susceptibility and perceived benefit, such that the person would accept the recommended health action if it was perceived as beneficial.
Perceived barriers – This refers to a person’s feelings on the obstacles to performing a recommended health action. There is wide variation in a person’s feelings of barriers, or impediments, which lead to a cost/benefit analysis. The person weighs the effectiveness of the actions against the perceptions that it may be expensive, dangerous (e.g., side effects), unpleasant (e.g., painful), time-consuming, or inconvenient. Cue to action – This is the stimulus needed to trigger the decision-making process to accept a recommended health action. These cues can be internal (e.g., chest pains, wheezing, etc.) or external (e.g., advice from others, illness of family member, newspaper article, etc.). Self-efficacy – This refers to the level of a person’s confidence in his or her ability to successfully perform a behavior.
This construct was added to the model most recently in mid-1980. Self-efficacy is a construct in many behavioral theories as it directly relates to whether a person performs the desired behavior. In conclusion health promotion is very relevant today. There is a global acceptance that health and social wellbeing are determined by many factors outside the health system which include socioeconomic conditions, patterns of consumption associated with food and communication, demographic patterns, learning environments, family patterns, the cultural and social fabric of societies; sociopolitical and economic changes, including commercialization and trade and global environmental change. In such a situation, health issues can be effectively addressed by adopting a holistic approach by empowering individuals and communities to take action for their health, fostering leadership for public health, promoting intersectional action to build healthy public policies in all sectors and creating sustainable health systems. Although, not a new concept, health promotion received an impetus following Alma Ata declaration.
Recently it has evolved through a series of international conferences, with the first conference in Canada producing the famous Ottawa charter. Efforts at promoting health encompassing actions at individual and community levels, health system strengthening and multi sectorial partnership can be directed at specific health conditions. It should also include settings-based approach to promote health in specific settings such as schools, hospitals, workplaces, residential areas etc. Health promotion needs to be built into all the policies and if utilized efficiently will lead to positive health outcomes. Health-related awareness programs through media and schoolbooks should be launched to address social and cultural dynamics of health.
The campaigns should focus on preventive strategies. Finally the public environment of my layyah city needs to improve for better hygienic conditions and awareness to not follow the negative cultural practice which impact on health directly or in directly. Human relations need to be socially engineered in such a way that support structures could improve the health of individuals. Mental health must be given due attention as it remains a significant producer of ill-health.
Pervasive conflict in public life should be addressed by promoting tolerance and the institution of family must retain its supportive role. Human relations need to be socially engineered in such a way that support structures could improve the health of individuals. Mental health must be given due attention as it remains a significant producer of ill-health. There must be developed inexpensive filtration plants/devices; we can develop such filtration facilities in both urban and rural areas all across Pakistan. we are the product of our culture. Culture safety with positive health practice will promote my city day by day. ALLAH blesses my city Ameen.
References
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- J. Auckland, F. Cicuttini et al. (2003), The Victorian ambulatory care sensitive conditions study: Rural and urban perspectives. Soz Praventivmed., Volume 48(1), pp. 33-43.
- Awan, Z., Naz, R., Kamal, S. and Rizvi, M. (2005), Pakistani Women in Context: A Companion Volume to the Pakistan Country Gender Assessment, World Bank, Islamabad. Bussemaker, J. and van Kersbergen, K. (1999), “Contemporary social-capitalist welfare state and gender inequality”, in Sainsbury, D.
- (Ed.), Gender and Welfare State Regimes, Oxford University Press, Oxford. Dankelman, I. (2004), “Gender, environment and sustainable development: understanding the linkages”, Natural Resources Management and Gender: A Global Resource Book, KIT (Royal Tropical Institute), Oxfam. Janz NK, Champion VL, Strecher VJ. The Health Belief Model.
- In: Glanz K, Rimer BK, Lewis FM, editors. Health behavior and health education: theory, research, and practice. SanFrancisco: Jossey-Bass, 2002: 45-66. Rosenstock IM. Historical origins of the Health Belief Model.
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