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Compilation of Book Reviews for
The Sociology of South Asian Women’s Health, Springer 2020
Contents
Pakistan Development Review- Pakistan Institute of Development Economics,...........................1
Dawn- Book Reviews......................................................................................................................5
LSE Book Review...........................................................................................................................8
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Pakistan Development Review- Pakistan Institute of Development Economics,
https://www.pide.org.pk/pdf/PDR-Vol59-Number2.pdf
Sara Rizvi Jafree (Ed.). The Sociology of South Asian Women’s Health.
Switzerland: Springer Nature. 2020. 236 pages. Price USD 116 (Hardback).
In this lucidly written book, The Sociology of South Asian Women’s Health, Sara
Rizvi Jafree, emphasises how health policies have left out the cultural knowledge about
the unique circumstances and experiences of South Asian women. The author deftly
explored the importance of re-conceptualising health policy development with a
culturally and socially appropriate background for women in South Asia. In the
introductory chapter of the book, Jafree starts by giving a concise structural description of
how South Asian women’s health behaviour and health outcomes are affected by social
systems of family, gender, faith, culture, government, schooling, and the media. Sara
Rizvi Jafree aims to connect health policy efforts with knowledge of socio-environment
and structural factors to propose better health policies for women. The book consists of
nine chapters that are co-authored by different scholars with Jafree.
In Chapter Two, titled, South Asian Women’s Health Behaviour: Theoretical
Explanations, authors comprehensively discuss the diverse theoretical frameworks that
are used to describe South Asian women’s health behaviours, consumption, and choices.
Authors acknowledge that these theories’ epistemological grounds are mainly derived
from Western women’s lived realities. That is because researchers are hesitant to extend
the scope of their analyses due to the rapidly evolving realities for South Asian women,
including but not limited to frequent changes in the postmodern era, diverse ethnicities,
culture, and religious beliefs in the region. In light of the discussed theories, authors
conclude that in South Asian societies, gender norms related to access to health and
health care are influenced and governed by culture, religion, family, state structures, and
personal choices, hence difficult to change or improved. Besides the structural
deficiencies in the public health sector, the bad affairs of women’s health in the region
are also due to a lack of social acceptance and support for the continuous health-being of
women in South Asian societies.
Chapter Three, titled, Oral Narrations of Social Rejection Suffered by South Asian
Women with Irreversible Health Conditions, builds on the lived experiences of four
women with chronic illnesses or has experienced significant health setbacks in life.
Interview based qualitative inquiry is carried out with women from Pakistan, Bangladesh,
and India. Authors expand her analysis of social complexities on women’s lives, living
with paralysis, blindness, cancer, and infertility. Authors conclude that South Asian
women’s most challenging problem is not lack of resources or access to health services,
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but the lack of support systems and acceptance from family and communities throughout
their lifespan.
In the Fourth Chapter, titled, Women’s Role in Decision-making for Health Care
in South Asia, authors explore the complexity of health decision-making by using the
latest available Demographic Health Surveys from Bangladesh, India, and Pakistan.
Authors discuss significant factors impacting health decision-making, including gender,
family, education, work, and health behaviour. Authors recommend that to break the
various cycle of women’s poverty in South Asia, systematic and well-planned policies
are required not only for cash transfer, loan provision, but also the encouragement of
education enrolment and work participation. Authors assert that micro-interventions of
varying natures at the community level are essential to benefit the heterogeneous
populations across South Asia.
Chapter Five, titled, Poverty, Health Coverage, and Credit Opportunities for South
Asian Women starts with discussing the concept and evolution of poverty and expands on
identifying factors responsible for feminisation of poverty in the context of women’s
ability to access healthcare. These factors are family composition, control over resources,
access to education and health, inequality in social protection, and labour market
inequalities. Authors provide readers with a stimulating discussion and suggest
coordinated and structured efforts for poverty reduction and health coverage for South
Asia women. She further suggests the need to replicate successful poverty alleviation
programmes at state/micro levels and the provision of universal health insurance for
women across South Asia.
In Chapter Six, titled, Refugee, Displaced, and Climate-Affected Women of South
Asia and Their Health Challenges, authors provide an insightful discussion on the health
issues of women who have undergone displacement, war, and disasters, forced migration,
and climate change. These women face increased emotional and physical pressures than
men and are at risk of increased exposure to aggression and sexual assault. Authors
discuss the policy constraints, including lack of proper and disaggregated estimation of
affected women population, lack of sustainable and systematic support from
governments, and over-reliance on non-governmental organisations for assistance.
Authors recommend systemic collection of data on women exposed to any such disasters,
primary and specialised healthcare services, improved housing quality with protection,
safety, and privacy, and issuance of provisional identification cards, educational
opportunities, employment benefits, and protection.
Chapter Seven titled, Social Barriers to Mental Well-Being in Women of South
Asia, authors discuss how the social and cultural complexities including negative
construction of mental health distress, the lack of awareness, patriarchal values, marriage
and reproductive burden and religious fallacies, with the lack of health delivery system in
South Asia are exacerbating the mental health crisis for women. Using the secondary
data, authors assess the prevalence of mental health issues in Bangladesh, India, Nepal,
Pakistan, and Sri Lanka. The authors present a case study that thematically analyses the
perceptions of women health practitioners in South Asia about mental health. They were
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asked about their experiences with mental health issues coexisting with medical problems
and structural and societal obstacles to mental health care. Findings show that both
reportage of the mental health issues and mental health services are unsatisfactory due to
a culture of blame and shame in South Asian countries.
In Chapter Eight, titled, The Political Sociology of South Asian Women’s Health,
the authors discuss why political health sociology is a vital tool for reducing the social
gaps of health inequality and improving women’s health behaviours and outcomes in the
South Asian region. Authors elaborate on how political reluctancy towards a commitment
to women’s health is woven in the region’s socio-political and anti-feminist fabric. As a
result, women’s health issues linked to mental well-being, communicable and noncommunicable
diseases, and disability are typically ignored, and health policies are
almost non-existent for marginalised and vulnerable women in the region. To improve
the women health, authors recommend the provision of quality services from primary to
tertiary care, access to health care for marginalised populations, improvement the
engagement of women in politics, systematic policies for poverty alleviation, compulsory
participation in the education, labour laws, marriage and divorce rights, mental wellbeing,
sports and leisure activities. Authors also stress on introduction and reforms of
public health laws and an increase in the health budget.
In the last chapter, The Culture of Health Regulation and Its Implications on
Maternal and Reproductive Health in South Asia, authors with a focus on maternal
health, argue that cultural and traditional practices are responsible for the regressive and
inefficient regulatory affairs in South Asia and health policy desperately need a shift. By
using the DHS data, authors find that maternal and child health measures in South Asia
are not satisfactory, which implies a gap in state regulation. To improve maternal health,
authors propose a shift in cultural perceptions, both for competitive and regulatory
policies, including introducing different regulatory instruments in a co-regulatory and
decentralised manner and the need for regulatory bodies to raise awareness and find ways
to minimise the risk of maternal and child mortality.
The book invites readers to think through complex interactions between
sociocultural and political practices/norms with women’s health in South Asia. It is worth
mentioning that book discusses women’s health comprehensively, including issues like
infectious and non-communicable diseases, mental health distress, and injuries and not
only maternal health in South Asia. Although the book is inclusive on many accounts, it
misses the discussion on digitalisation of health care in South Asia and its impact on
women in the region. The book’s discussion proposes some fundamental changes not
only on the delivery front for health care but also calls for change in social systems
influencing health behaviour and outcomes for women in the region. Nonetheless, it is
not sufficiently clear how to do healthcare financing, health budgeting, and, most
critically, how to create the political will to reform social structures that adversely impact
women’s health outcomes and make politicians commit to women’s health from a
lifespan perspective. Overall, the book deals with a complex issue and guides the reader
through the argument with great clarity. The book will be appealing to a wide range of
readers, including policy-makers, scholars, students, or anyone interested in South Asian
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women’s health, and deservedly so.
Saman Nazir
Pakistan Institute of Development Economics, Islamabad.
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Dawn- Book Reviews
https://www.dawn.com/news/1597989/non-fiction-addressing-womens-health
Dr. Ehsanullah Tarin
The reviewer is a health policy and systems specialist who till recently worked with World Health
Organization. He undertook his doctorate from Nuffield Centre for International Health and
Development at the University of Leeds, UK.
_____________________________________
Sara Rizvi Jafree, Assistant Professor of Sociology at Forman Christian College University,
Lahore, has edited a volume, The Sociology of South Asian Women’s Health, which was critically
needed to mobilize critical development in health policy for women of South Asia. Dr. Jafree has
co-authored all the chapters and this has helped bring coherency to the book, preventing the
central message from getting lost consistently across the chapters. The co-authors from
Bangladesh, India and Pakistan, are not just academic scholars, but practicing clinicians and
specialists in the field, bringing with them rich experience to discuss the social and cultural
determinants of health behavior and health outcomes in women of South Asia.
The first chapter is an asset for students and researchers as it brings together theories to address
women’s health challenges and barriers. The chapter mostly employs Western theories to explain
South Asian behavior, and though these theories have been used relevantly and effectively, the
authors compel South Asian scholars to consider development of indigenous theories related to
women’s health, and sets the premise for the rest of the chapters: “There have been
substantial changes in gender theories of health, from structural theories to
actor theories and, nally, to postmodern theories. However, what all of them
have in common is an assertion that society, structures, and the
environment play a signicant role in inuencing the health choices and
challenges faced by South Asian women”.
This volume does not just rest on theory and discussion, but from chapter 2 onwards each essay
uses empirical evidence to provide substantiation for ground problems and limitations related to
culture and policy respectively. Each chapter then concludes with key recommendations for
support and improvement for women’s health outcomes. A combination of qualitative and
quantitative data, both primary and secondary, have been used, commendably to help the reader
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understand issues related to: mental health, maternal and child health, displacement and climate
change, chronic disease burden, physical disability, social ostracization, and policy failure.
The second chapter includes case-studies of women from Bangladesh, India and Pakistan, whose
journey of ill-health and recovery has been made more challenging due to the lack of social
support and family rejection. What is highlighted are the feelings of pain and anguish of women
who would have been able to manage their health issues better if they had received more
community and family acceptance. At the same time, this chapter brings to focus the strong
agency, financial independence, and immense capability of women, like the blind masseur and
the crippled food caterer. The authors have tried to highlight that support in education,
employment, state subsidization, and gender solidarity would be the best ways to fight family
and community level stigma and discrimination against women’s with disability, infertility and
chronic health problems.
In chapter four and nine, the Demographic Health Survey data from Bangladesh, India and
Pakistan has been used to describe challenges faced with regard to decision-making and health
insurance access, respectively, which in turn influence maternal health and mortality. Given that
maternal health indictors are still not satisfactory or meeting Millennium Development Goals,
these chapters are significant, but like the authors stress not just for women, but also because
mothers health and autonomy has the greatest impact on the quality of lives of children,
household dependents, and the family overall. The authors further emphasize: “If there is a
magic bullet, it would have to be cultural reform for women’s acceptability in making health
decisions autonomously. There is thus need for micro community-level interventions of different
natures and degrees to benefit the heterogeneous populations controlled by culture and
traditions.”
One of the strengths of this book is the recognition of neglected populations- the impoverished,
refugees, IDPs and climate affected women and discussion of their unique health challenges.
Chapters five and six discuss in detail the impact of the feminization of poverty and feminization
of displacement and bring to attention two important realities which are less considered. Firstly,
the problem of sustained poverty and lack of universal access to healthcare in poor women of
South Asia which contributes to under-reportage and “he iceberg of disease in women of South
Asia”. And secondly the plight of the over ten million displaced women who face: “cyclical ill
health… due to posttraumatic stress and recurring problems of adaptation and resettlement.”
Similarly, chapter seven on women’s access to mental healthcare is a poignant reminder not just
of the stigma faced by women in the region regarding mental distress, but also the lack of
adequate services, further bringing to light that: “The gap that initially existed in South Asia for
women’s mental healthcare has widened due to growing mental health challenges and due to
regional and economic pressures and increasing population rates.” Primary data collected by the
authors from women physicians in the communities of South Asia is able to confirm the co-
existence and relationship between chronic health disease and mental health, something that
needs urgent addressing when designing health policy for women.
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The last two chapters discuss in detail the political and regulatory frameworks of South Asian
countries, but from the angle of culture, something that is rarely discussed. Inadequate political
knowledge in the masses has neglected to consider that: “health is political because the planning
and distribution of public health services is dependent on political intervention and also because
some social groups have more access compared to others” and that: “culture and traditions
influence regulatory practices of the state, and in fact, it is culture that is responsible for
sustaining regressive and inefficient regulatory policies in a nation”.
There is no doubt that health overall is an area that needs policy reform in South Asia. This book
does not consider other segments of society such as men, children, the elderly, and the
transgender community. But at the same time, the focus of the book is women’s health. This
collection and focus was necessary in order to exclusively integrate and highlight the needs of
women. The book also provides impetus for other researchers and policy-makers to recognize
society, politics, religion, economy, poverty, education, and environmental factors when
designing health policy for marginalized population groups, especially in regions like South
Asian, which are dominated by culture, traditions, and religious interpretations. Overall, the book
succeeds in driving home the fact that culture and environment must be considered foremost for
health policy development, while recommending salient and realistic strategies for improvement
for both health and social protection for women of South Asia.
____________________________________________________________________________
The Sociology of South Asian Women’s Health
Edited By: Sara Rizvi Jafree
Springer Nature
ISBN: 978-3-030-50204-1.
https://link.springer.com/book/10.1007/978-3-030-50204-1
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LSE Book Review
https://blogs.lse.ac.uk/lsereviewofbooks/2021/06/15/book-review-the-sociology-of-south-asian-
womens-health-edited-by-sara-rizvi-jafree/
Dr. Parveen Ali
June 15th, 2021
Book Review: The Sociology of South Asian Women’s Health edited by
Sara Rizvi Jafree
In The Sociology of South Asian Women’s Health, Sara Rizvi Jafree brings together
contributors to explore gender inequity in health access in South Asia and the
inadequacy of cultural and regulatory forces supporting South Asian women’s health
and wellbeing. This timely and accessible volume will be a valuable resource for
students and researchers working across a range of areas, including sociology, health
studies and development, as well as community health workers and social protection
officers, writes Parveen Ali.
The Sociology of South Asian Women’s Health. Sara Rizvi Jafree (ed.). Springer. 2020.
Find this book (affiliate link):
There has been a welcome shift away from the narrow focus on women’s health
research from North America and Europe, towards a growing interest in both the health
and sociological experiences of women from developing countries. Women’s and
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Gender Studies are moving away from the highly theoretical concerns of a few years
ago to more concrete and meaningful efforts to understand the realities of women’s
lives.
The Sociology of South Asian Women’s Health is a very timely volume. The concerns
this book raises are relevant. Progress has been made regarding gender inequity,
women’s participation in society and politics, for example, in many parts of the world.
But South Asia has made less progress. This book addresses salient topics related to
gender inequity in health access and the inadequacy of both cultural and regulatory
forces supporting South Asian women’s health and wellbeing. The contributing authors
present their arguments using a factual approach and marshal their points carefully and
logically. I cannot imagine this book losing its relevance any time soon.
The editor, Sara Rizvi Jafree, has assembled an impressive team of contributing
authors. The fact that she has co-authored each chapter has helped the volume to have
a coherence that some edited collections lack. The authors’ understanding of South
Asian women’s health is strongly based on both theory and previous research, with the
collection drawing on broadly accepted understandings in both Women’s and Gender
Studies and in Health Policy, Sociology of Health and related disciplines. Each chapter
uses quantitative or qualitative evidence to present problems and limitations and ends
with appropriate recommendations for development.
What is novel about this volume is that it collapses the experiences of South Asian
women. Although these women belong to different backgrounds and communities, it is
time to recognise that they have cultural and historical commonalities which should be
explored. There is a definite appeal in the joint recommendations for South Asian
healthcare and social policy reform outlined in this book. Surprisingly, the volume does
not project unremitting pessimism. Instead, it supports positive initiatives for improved
health outcomes for women, emphasising what outcomes and interventions have
worked and what can be further developed or benchmarked and replicated in other
settings in the region. Of particular merit are the recommendations for improved
regulation of the health sector in South Asia to bolster women’s health in Chapter Nine,
authored by Ainul Momina and Jafree. The chapter includes insightful arguments for the
utility of co-regulation in a decentralised manner and the building of private and public
partnerships with the state at the apex of the triangle.
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Image Credit: Crop of ‘A Bangladeshi nurse helps treat a patient suspected of suffering
from diphtheria in the Kutupalong Rohingya refugee camp near Cox’s Bazar,
Bangladesh, January 2018’ by DFID – UK Department for International
Development licensed under CC BY 2.0
The nine substantive chapters are both thorough and well-researched. The authors
have made use of primary and secondary data, case studies and narrative material to
highlight women’s experiences. The most relevant areas of women’s healthcare
experiences, barriers, challenges and oppression that South Asian women face are
presented effectively. Specific areas that have been constructively covered across the
chapters include mental health; reproductive and maternal health; decision-making
rights for health-seeking behaviour; refugee and displaced women’s health; and micro
health insurance for impoverished women.
The book also makes clear connections between health and women’s economic
situations and, most particularly, the problems they face in extremely patriarchal
societies. A model describing a pathway for poverty alleviation and health coverage for
women of South Asia in Chapter Five by Fionnuala Gormley and Jafree is especially
valuable, as it highlights the cultural barriers and includes sociocultural interventions to
target poverty alleviation. Evidence from Bangladesh, Pakistan and India encapsulates
social and environmental problems that keep women in cyclical problems related to
poverty and health. A case study for the role of microfinance in supporting poverty
alleviation and health simultaneously is also included to underscore region-specific
solutions.
I found that all the chapters were strong. Chapter One by Jafree successfully brings
together significant and diverse sociological theories addressing why South Asians face
greater vulnerability to health challenges. As many as 50 theories have been discussed
effectively by the authors, making this a valuable chapter for students and researchers
alike. Chapter Two, authored by Jafree and Deepti Sastry, provided some powerful
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foundations for the claims made in the rest of the book. I particularly enjoyed the
detailed life stories presented in this chapter. The contexts and life circumstances of the
women help to bring into focus the opportunities and limitations offered by family and
community. These highlight how individual self-efficacy and health behaviours are
sometimes not in the control of women, even when they come from privileged and
educated backgrounds. Conversely, the challenges in health-seeking behaviours for
women from impoverished backgrounds and with physical disabilities are
insurmountable without community support and protective social policy.
Chapter Four, authored by Jafree, Rubeena Zakar and Shaheda Anwar, uses the
Demographic Health Survey data from different South Asian countries to provide
statistical evidence for demographic and social areas that need reform to improve
independent decision-making for women’s health. This chapter provides direct solutions
to improve maternal and child health indicators across the expanse of South Asia and is
a must read for policymakers and researchers alike. Similarly, Chapter Seven, authored
by Masha Asad Khan, Jafree and Tahira Jibeen, provides evidence for the co-existence
of mental health and medical problems in women, as perceived by practising women
primary health care physicians of South Asia. This again is worthy information to provide
impetus to invest in the mental health of South Asian women, a seriously neglected area
for many years.
The chapter on refugee and displaced women, Chapter Five, raised issues that are less
often covered in books about health. An extremely useful summary table in this chapter
lists environmental alterations faced by women due to displacement and climate change
and the corresponding health impact. This summary can be used by policymakers in
immediate interventional support of the large number of refugee and displaced women
in South Asia, estimated to be above 10 million. At the same time, much more research
is needed in this area, and perhaps the authors would like to concentrate and specialise
in this research gap for future collaborations.
The underpinning assumption of the volume is that women matter, that women’s
experiences are valuable and should be recognised and that women are
disproportionately affected by inequality, discrimination and oppressions. While we live
in an age that seems to be moving to the right, these assumptions are both valid and in
need of expression. Having said this, I can well imagine some male students and
audiences, especially in the more patriarchal parts of South Asia, reacting with
indignation at the findings of this volume. But bringing this well-researched and well-
presented material to their attention, and promoting more scholarship like this from
South Asia, is needed to help in addressing male biases in the region. This will also play
a role in securing the male championship of health policy and protection for women in
South Asia.
I strongly recommend this volume as a valuable book. Because of the accessibility of
the language, this collection will be valued by graduate and upper-level undergraduates
working in this area. In addition, the collection will appeal to researchers in Sociology,
Social Policy, different branches of Health Studies, especially Social and Health Policy,
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Nursing, Epidemiology and Social Work, as well as those working in Development
Studies and International Relations, and Women’s and Gender Studies. There is a
critical need in South Asia to accelerate the role of Community Health Workers and
Social Protection Officers for women’s health and wellbeing, especially at the primary
level. This volume will also be a critical resource for such workers and officers as more
jobs and avenues are created for them across the region.
About the author
Dr. Parveen Ali
Dr. Parveen Ali completed her PhD from University of Sheffield and is a Registered
Nurse, Registered Midwife (Pakistan) Registered Nurse Teacher, Senior Fellow of
Higher Education Academy, and a Fellow of Royal Society of Arts, Manufactures and
Commerce. Currently Dr. Ali is a Professor in Nursing at the University of Sheffield and
has been researching areas under gender-based violence, domestic abuse, inequalities
in health related to gender and ethnicity, and health care professionals’ preparation. She
is a mixed method researcher and has led and contributed to many projects over the
past decade. She is also an Associate Editor of Nursing Open (Wiley). Dr. Ali is a
recipient of numerous awards, including: Sigma’s Emerging Nurse Researcher Award
for Europe and Pakistani Diaspora Achievement Award.
Posted In: Asia | Gender and Sexuality | Health
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