The representative sample of this s

The representative sample of this study shows
that in low income areas such as slums and
Goths in countries like Pakistan, women are
trained to be submissive to their husbands and
hence have very little say in choices regarding
health seeking behavior. New methods need to
be devised which enable women to recognize
this lack of choice so as to improve the seeking
of better health care for themselves and their
children, and initiate their empowerment to help
them to make healthier choices. Some stages
in attaining change in this behavior can be: (a)
The woman does not recognize this as an issue
and is not interested in change; (b) the woman
sees this as an issue and considers a probable
change; (c) the woman is convinced to change
this status and makes a plan; (d) the woman goes
through the plan; (e) the woman decides to utilize
ANC services. Ante natal care service utilization
benefits need to be highlighted to the women and
their families. More focused group discussions
should be done within the squatter settlements. It
brings the community together, assists in sharing
their views and learning. Medical camps could be
I T A L I AN JOURNA L OF PUB L IC HE A L TH
THEME P A P E R S 2 6 7
IJPH - Year 9, Volume 8, Number 3, 2011
another way to reach out to these women. Street
theatres could assist in making a woman aware
of ANC benefits. Vocational training and capacity
building for lady health workers and community
health workers as skilled birth attendants may be
helpful where community outreach is required.
Community midwives can be given a permanent
place in the health systems of the developing
world as they have access to far reaching areas.
Even TBA’s (Traditional Birth Attendent Wata
Satta i.e. a brother and sister married to another
brother and sister. In exchange of each other)
could be engaged , at least ad interim. They can
be given some training and incentive to follow
aseptic practices. This way, marginalized women
living in slum areas, could also be included into the
ANC utilizing population. Financial independence
goes a long way in promoting confidence and
hence rendering women capable of making better
choices for themselves. This could be achieved
through public and private partnerships. Raising
awareness, promoting better pre natal and post
natal practices, improving accessibility and skill
training generally for women to make them
financially independent, all could be done through
Non Governmental Organizations (NGOs) and
government working together. Media involvement
should be encouraged. Radio, television and
news papers. It is interesting to note that some
television sets were present in these shacks. TV
can be used to promote and advocate behavioral
change. The goth leader could convince the
goth prayer area to promote and support ANC
utilization by married woman. All this would assist
in increasing ANC service utilization acceptance
within the low income populations. This study
focused on one settlement. Quantitative studies
should be done with larger sample sizes, in order
to form a database upon which health policy
planners and government officials could rely.
Without authentic data sets being made available,
it is cumbersome to design any policy changes.