Browsing by Subject "NGO"

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    Beyond Polio in Pakistan: Understanding the Development and Consequences of Eradication Strategies
    (2024-04-18) Sheikh, Shanzeh
    This thesis seeks to understand how the strategies of polio eradication and the development of the healthcare environment in Pakistan have led to the continued presence of polio in the country, despite its elimination in nearly every other country besides neighboring Afghanistan. Often the literature, focused on the execution of programs, overlooks the program design that in many ways occurs outside of Pakistan. I use a critical historical analysis to identify root causes of international and national stakeholders’ eradication strategies and rationale, paying close attention to how Pakistan’s history has shaped its perspectives and possibilities. I review archival sources from the Pakistani government, physicians, and international organizations, as well as research papers and reports on polio eradication and health infrastructure. I also conducted nine interviews with Pakistani physicians, researchers, and public health workers. Colonial medical interests have shaped international health regulations and Pakistan’s health system such that they are largely focused on combatting single diseases rather than investing in basic healthcare. The Pakistani state has created gaps in healthcare delivery that military conflict in the region has exacerbated, and that physicians struggle to fill within the politicized health environment. The failure to address community demands for other health services leads to mistrust and vaccine refusals, but international health organizations continue to focus efforts on disease-targeted strategies due to concerns about cost-effectiveness and sunk investments. Efforts to eradicate a disease like polio would be better served by a focus on basic health services. International organizations must re-evaluate what programs they prioritize to control diseases, center investment in public and primary health care as opposed to selective and targeted interventions, and empower the voices of those in marginalized communities to develop programs that respond to their needs, rather than the needs of high-income countries.
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    Is Alternative Rite of Passage the Key to Abandonment of Female Genital Cutting? A case study of the Samburu of Kenya
    (2016-04-25) Mepukori, Nash
    While Female Genital Cutting (FGC) has been condemned worldwide and seen as a violation of women’s right, individuals in communities that still practice the rite claim that it is an integral and respectable component of their culture. Up to date, there have been numerous NGO- and government-led grassroots programs geared towards eradication of FGC. Yet, there remains a wide gap in the literature evaluating the impact of such anti-FGC interventions (WHO, 2011). This dearth of information poses a significant threat to the project of FGC abandonment as policy-makers are unable to assess which interventions have worked and why, and which ones are failing, and why. This study, which focuses on Female Genital Cutting among the Samburu of Kenya, seeks to begin bridging this knowledge gap by evaluating the Alternative Rite of Passage (ARP) intervention program. For close to a decade now, Amref Health Africa, an international NGO based in thirty African countries, has been implementing the Alternative Rite of Passage in the Samburu community. A key objective of this study is to conceptualize the ways in which stories and understandings of Female Genital Cutting in Samburu have changed (if at all), in light of Amref’s Alternative Rite of Passage program. Using qualitative data collected through Focus Group Discussions and Key Informant in-depth interviews, this study attempts to piece together a complex puzzle that brings together history, politics, economics, customs, and beliefs. Analysis of data will reveal present community attitudes towards female circumcision and the ARP program. Furthermore, the complex role of the NGO in the battle against FGC will be addressed leading to a discussion around the suitability and sustainability of alternative rites of passage in this community.