Pinning down social vulnerability in Sindh Province,Pakistan: from narratives to numbers,and back again

This paper reflects critically on the results of a vulnerability assessment process at the household and community scale using a quantitative vulnerabilities and capacities index. It validates a methodology for a social vulnerability assessment at the local scale in 62 villages across four agro‐ecological/livelihood zones in Sindh Province, Pakistan. The study finds that the move from vulnerability narratives to numbers improves the comparability and communicational strength of the concept. The depth and nuance of vulnerability, however, can be realised only by a return to narrative. Caution is needed, therefore: the index can be used in conjunction with qualitative assessments, but not instead of them. More substantively, the results show that vulnerability is more a function of historico‐political economic factors and cultural ethos than any biophysical changes wrought by climate. The emerging gendered vulnerability picture revealed extremes of poverty and a lack of capacity to cope with contemporary environmental and social stresses.     

Reproductive health in Afghanistan: results of a knowledge, attitudes and practices survey among Afghan women in Kabul

A reproductive-health knowledge, attitudes and practices (KAP) survey was carried out among 468 Afghan women of reproductive age. A convenience sample of women was selected from attendees in the outpatient departments of four health facilities in Kabul. Seventy-nine per cent of respondents had attended at least one antenatal consultation during their last pregnancy. Two-thirds (67 per cent) delivered their first child between 13 and 19 years. The Caesarean-section rate was low (1.6 per cent). Two-thirds (67 per cent) of deliveries occurred in the home. The contraceptive prevalence rate was 23 per cent (16 per cent modern and 7 per cent natural methods). Twenty-four per cent had knowledge of any STIs, although most of these women did not know correctly how to prevent them. Most of the women (93 per cent) needed authorization from their husband or a male relative before seeking professional health-care. In multivariate analysis, women's schooling was significantly associated with antenatal-care attendance (AOR 4.78), institutional delivery (AOR 2.29), skilled attendance at birth (AOR 2.07) and use of family planning (AOR 4.59). Reproductive-health indicators were noted to be poor even among these women living in Kabul, a group often considered to be the most privileged. To meet the reproductive-health needs of Afghan women, the socio-cultural aspects of their situation--especially their decision-making abilities -- will need to be addressed. A long-standing commitment from agencies and donors is required, in which the education of women should be placed as a cornerstone of the reconstruction process of Afghanistan.