Grant: Operating Grant

Two-thirds of all maternal deaths worldwide occur in just 13 countries. Despite two decades of the Safe Motherhood initiative and the inclusion of maternal mortality rate as a UN Millennium Development Goal, complications of pregnancy and childbirth remain a leading cause of death for women in these nations. While simple, cost-effective strategies can reduce maternal deaths, vulnerable women living at the economic and social margins of society often do not receive the necessary services. This study will examine how class and gender influence the design and delivery of maternal health services, and how these factors may affect poor women's access to health services in Pakistan, one of the 13 countries with the highest maternal mortality rates. Social understandings of class, caste, gender and related distinctions as experienced in Pakistan will be explored using a range of interdisciplinary methods, and patterns of maternal health care usage (and barriers to usage) according to these social distinctions will be documented. Information will be collected from two groups of participants: (1) poor, socially disadvantaged women and men, and (2) district, provincial and federal level policy-makers, program managers and health service providers. Later workshops with policy-makers and service providers will facilitate translation of these research results into improved maternal health policy and practice. This project will also increase interdisciplinary research capacity in both Canada and Pakistan. These outcomes promote a key Canadian policy objective: to deliver a durable impact on the world's key development challenges, including social inequalities.