British Pakistani Women Research Articles

Identifying the Health Concerns of Pregnant British Pakistani Women Living in Deprived Areas: A Qualitative Study

IntroductionPregnant British Pakistani women have disproportionately poorer health than the wider population. Bradford has a strong Pakistani presence and a wide range of public health problems including high levels of gestational diabetes, high obesity rates and a high infant mortality rate, which is highest for babies of Pakistani origin. For women to be healthy, we need to know what concerns they have about their health so they can be addressed appropriately. The aim of this study, therefore, was to explore the health concerns of pregnant British Pakistani women living in deprived areas.MethodsSemi-structured qualitative interviews were conducted with 21 pregnant Pakistani women in a hospital setting. Data were analysed using thematic analysis.ResultsPakistani women identified safety issues, barriers to undertaking physical activity in the areas where they live, concerns surrounding exercising during pregnancy and cultural and religious constraints that prevented them from engaging in physical activity. They reported issues around food, concerns around a lack of culturally appropriate diet information, the cost of unhealthy food locally, and the lack of healthy food options in their residences. Women were unsure on where to obtain health promotion information and reported a lack of access in obtaining that information. Language barriers in accessing health promotion information were further reported as a concern.DiscussionResearchers, midwives, health providers, local authority and policy makers interested in improving the health of pregnant Pakistani women may use these findings to develop further research and interventions to improve the poor health of this population.

Reflections from an insider researcher ‘doing’ feminist participatory action research to co-produce a research agenda with British Pakistani women; a seldom heard group

Participation of community stakeholders in health research priority setting is an emerging trend. Despite this, the involvement of marginalised groups in research prioritisation is limited and where they are involved, sample sizes are small, where individuals are merely consulted with, rather than coproducing the research agenda. Without addressing power dynamics inherent in research prioritisation with marginalised groups, their engagement in the research process can be tokenistic and the resulting research agenda unreflective of their needs. This article, therefore, aims to generate knowledge on how feminist participatory action research was used to co-produce an obesity research agenda with British Pakistani women, a seldom heard population, living in deprived areas. The methodology enabled Pakistani women to be involved in all stages of the project, culminating in the co-production of an obesity research agenda that accurately reflects their unmet needs. Women’s engagement in the project led to their increased confidence, the formation of relationships that lasted beyond the research project, improvements to their lifestyles, and engagement in further research. Feminist participatory action research may be used by researchers as a guiding methodology due to its ability to improve women’s lives and develop research agendas for women’s health.

Patient patients: middle-aged British Pakistani women and the intuition of limits to care

This paper examines the affective inequalities underpinning the extensive responsibilities of care that are shouldered by chronically ill ­middle-aged British Pakistani women. In the context of ethnic health inequalities, chronic illness and premature ageing are ubiquitous. Further, mid-life generates gendered pinchpoints in the dynamics of care. The paper draws on extended conversations with women over seven/eight years and tracks their unsettled perspectives on sabar (patient endurance). Middle-aged women described how, over the long haul of living alongside chronic illness, they intuited that they must place some limits on caring for others, and that care required self-care – not in a biomedical sense, but in the sense of attention to their own bodily and relational needs. The paper extends anthropological critiques of Levinas’s philosophy of infinite responsibilities to care, tracking how changes at several temporal scales – the life course, intergenerational re-negotiations – affect care. While social transformations of gender, and the proliferation of neoliberal discourses on self-care do affect the traction of normative notions of selfless care for others, the paper locates women’s changing perspectives on sabar primarily in the provocations of everyday life.

Introduction: Citational Politics in Medical Anthropology.

Introduction: Citational Politics in Medical Anthropology.

The role of knowledge, primary care and community engagement to improve breast-screening access for Pakistani women in the United Kingdom: A secondary analysis of a qualitative study.

Breast cancer incidence is rising among Pakistani women in the United Kingdom. However, uptake of breast screening remains low. This study aimed to improve access to breast screening for British-Pakistani women by exploring their knowledge of breast cancer and the role of primary care and community networks to support screening access amongst British-Pakistani women. We undertook a secondary qualitative analysis of 18 semi-structured interviews with British-Pakistani women from East Lancashire in the United Kingdom. Anonymized transcripts of the interviews were used for a thematic analysis. Three themes were identified in the interviewees' responses: (i) 'Women's knowledge of breasts and breast cancer', which described how a cultural taboo exists around Pakistani women's bodies and around breast cancer; (ii) 'Role of primary care', which detailed how General Practitioners can support informed decisions and offer a trusted and valued information source; (iii) 'Community engagement', which described the potential to disseminate breast-screening information through the whole community, including primary care providers, all family members and mosques. Our analysis suggested three main targets for future interventions to improve access to breast screening for British-Pakistani women: (i) co-produced strategies to increase knowledge of breasts and breast screening; (ii) greater collaboration with local General Practitioners to support women to make informed choices about screening; and (iii) community engagement involving General Practitioners and community leaders, to inform everyone - not just screening-age women - about breast cancer and screening.

British-Pakistani homeworkers and activist campaigns, 1962–2002

ABSTRACT This article focuses on the testimony of twelve British-Pakistani women living in Oldham, drawn from a larger study about British-Pakistani women's relationship with formal and informal labour, between 1962-2002. These interviewees were either homeworkers for the garment industry or were the children of homeworkers. Homeworking is the practice of ‘doing paid employment in the home… for an employer, with little control over the way the work is done’. This work was inherently exploitative, given the long hours and menial pay. Nonetheless, my interviewees revealed that they were not passive victims of economic exploitation, despite being amongst the lowest paid workers in twentieth century Britain. Their testimony highlighted how resistance took many forms, as women managed the demands of waged labour with family responsibilities. Alongside small-scale acts of resistance taking place in homes across Britain, formalised activist campaigns emerged from the mid-1970s, with the purpose of informing homeworkers about their employment rights and changing labour laws. A long-held problem for campaigners-who were often white and middle-class- was reaching migrant women. By the 1990s, sources suggest that campaigns addressed this issue by employing South Asian activists, who were often better positioned to build connections with South Asian homeworkers.

Exploring the obesity concerns of British Pakistani women living in deprived inner-city areas: A qualitative study.

IntroductionBritish South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner‐city areas of Bradford.MethodsThree focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically.ResultsThis exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women‐only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information.ConclusionThese findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels.Patient or Public ContributionPublic contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis.

Developing an obesity research agenda with British Pakistani women living in deprived areas with involvement from multisectoral stakeholders: Research priority setting with a seldom heard group.

IntroductionBritish Pakistani women have exceptionally high rates of obesity and yet are seldom heard in a research priority setting concerning weight management. The objectives of this study were (i) to ascertain what multisectoral professionals perceive to be the most pressing unmet obesity needs or topic areas that need more research in relation to Pakistani women living in deprived areas of Bradford and (ii) to determine the top 10 obesity health priorities for this group to develop an obesity research agenda.MethodsA two‐step process was adopted using the following: (i) a survey of a wide range of multisectoral professional stakeholders (n = 159) and (ii) a ranking exercise involving Pakistani women living in deprived areas of Bradford (n = 32) to select and prioritize their top 10 obesity health concerns and unmet needs from a list of 31 statements identified in the survey and previous research. Survey data were analysed using inductive content analysis and themes were identified. Themes were translated into statements to be ranked by Pakistani women. The ranking exercise was conducted by telephone either via voice or video call. Data were analysed using a reverse scoring system.ResultsSurvey responses were grouped into statements reflecting the following three categories: education needs; healthy behaviour barriers and mental well‐being. The highest rankings were given by Pakistani women to statements on mental health and the need for education. The top 10 prioritized statements were developed with members of the public into an obesity research agenda that reflected the target population.ConclusionActively engaging British Pakistani women in setting research priorities provided a unique opportunity to understand the key areas they think are important for future research. The culminating research agenda can be used by researchers to advance the field of obesity research in Pakistani communities, thus producing research outputs that are relevant to and have impact in this population.Patient or Public ContributionParticipants in the ranking exercise collected data. Public contributors were involved in developing the prioritized statements into a research agenda.

Social reproduction and gender beliefs of ethnic minority women

AbstractResearch suggests that ethnic minority women in employment negotiate more than one culture and grapple with beliefs that stem from a bi‐cultural experience. Research also contends that gender is at the center of social reproduction and the production of labor and social reproduction is invariably linked. However, how is social reproduction at work, and how gender beliefs influence social reproduction and work‐life choices amongst highly educated, employed, second‐generation ethnic minority women, deserves in‐depth attention. Contributing to the intersection of social reproduction and diversity research, the present paper offers two life stories of highly educated second‐generation British Pakistani women and examines in‐depth the role of two cultures on gender beliefs and the influence of those gender beliefs on social reproduction and work‐life choices. Drawing on Ridgeway and Correll's (2004) work on gender beliefs, we extend their work by focusing on two cultures (the host country and the country of ethnic origin). While the literature has generally focused on issues of social reproduction across generations, our study also takes into account the contours of social reproduction across cultures. Our findings reveal the mechanisms of social reproduction, the push and pull of two cultures in the creation of gender beliefs within one person, the fluidity and fixity of gender beliefs, and the ways these are negotiated while the individual contributes toward social reproduction and makes work‐life choices.

Distinct Serum Metabolic Profiles in Early Pregnancy Characterise Gestational Diabetes Mellitus Incidence in High-Risk Women

ObjectivesThis study aimed to investigate and characterise the metabolic profiles of gestational diabetes mellitus (GDM) in white European (WE) and British Pakistani (BP) women with and without GDM. Methods146 serum metabolites quantified by nuclear magnetic resonance, from 2668 WEs and 2671 BP pregnant women ≤28 weeks’ gestation from the Born in Bradford cohort were analysed. Partial least squares discriminatory analyses (PLSDA) and sparse PLSDA (sPLSDA) were used to investigate the ethnic-specific metabolite signatures of future incidence of GDM. Metabolite features driven by pre-pregnancy weight status and known GDM risk factors (age, parity, multiple pregnancies and smoking status) were also explored. ResultsModels explained 60% of variance between future GDM cases/non-cases in WE mothers but only 35% in BPs, after adjusting for BMI, age, parity, smoking, and non-singleton pregnancies. Across both ethnic groups, 8 metabolites associated with future GDM status. When ethnic groups were investigated independently, 7 additional metabolites associated with future GDM in WEs were identified, while no additional associations were observed in BPs. Further stratification by BMI (healthy vs overweight/obese) uncovered a metabolic profile (characterised by fatty acids and glycolytic metabolites) unique to normal-weight BP women who later developed GDM. No difference was observed between the metabolic profiles of overweight/obese women, irrespective of ethnicity. ConclusionsIn early pregnancy, the metabolomes of future GDM cases and non-cases are distinct and differ by ethnicity. While the metabolic profiles of overweight women are largely similar in WE and BPs, a unique metabolic profile was observed in healthy weight BP women who went on to develop GDM and offers insight into the early metabolomic perturbations that precede GDM development in this high-risk (but healthy) population. Further exploration regarding the interaction between genetics and lifestyle on modifying metabolic profiles associated with GDM risk will help inform ethnically appropriate nutrition strategies. Funding SourcesHF is supported by a doctoral scholarship from the University of Leeds.

The introduction of risk stratified screening into the NHS breast screening Programme: views from British-Pakistani women

BackgroundUK national guidelines suggest women at high-risk of breast cancer should be offered more frequent screening or preventative medications. Currently, only 1 in 6 high-risk women are identified. One route to identify more high-risk women is via multifactorial risk assessment as part of the UK’s NHS Breast Screening Programme (NHSBSP). As lower socioeconomic and minority ethnic populations continue to experience barriers to screening, it is important that any new service does not exacerbate issues further. To inform service development, this study explored views of women from underserved backgrounds regarding the introduction of risk stratification into the NHSBSP.MethodsNineteen semi-structured interviews were conducted with British-Pakistani women from low socioeconomic backgrounds from East Lancashire, UK. Fourteen interviews were conducted via an interpreter.ResultsThematic analysis produced three themes. Attitudes toward risk awareness concerns the positive views women have toward the idea of receiving personalised breast cancer risk information. Anticipated barriers to accessibility emphasises the difficulties associated with women’s limited English skills for accessing information, and their I.T proficiency for completing an online risk assessment questionnaire. Acceptability of risk communication strategy highlights the diversity of opinion regarding the suitability of receiving risk results via letter, with the option for support from a healthcare professional deemed essential.ConclusionsThe idea of risk stratification was favourable amongst this underserved community. To avoid exacerbating inequities, this new service should provide information in multiple languages and modalities and offer women the opportunity to speak to a healthcare professional about risk. This service should also enable completion of personal risk information via paper questionnaires, as well as online.

The challenges of fitting in

PurposeIntersectional scholarship on work and organizations while focusing on subjectivities and intersections largely overlooks the systemic dynamics of power (Rodriguez et al., 2016). One of the systemic dynamics of power is organizational practice (Acker, 2006). Intersectionality research on minority ethnic women pays relatively less attention to the role of organizational practices in career progression. The purpose of this paper is to draw attention to the interaction of intersectional identities of second-generation British Pakistani women managers and professionals with organizational practices and norms, and the resulting challenges and career implications.Design/methodology/approachA qualitative research approach was used with interviews of 37 participants who were in managerial or professional positions.FindingsThe research finds a resilience of discrimination because of expectations of compliance with dominant workplace cultures. This expectation presents challenges for minority ethnic women managers. The paper reveals that the intersectionality of gender, ethnicity and religion clashes specifically, with organizational expectations of being male, of being white, and of work-related socializing, which may adversely affect career progression. Organizations, thus, may feed into minority ethnic women managers’ inability to fit in and merge by implicitly demanding compliance or fitting in. These findings carry implications for HRM policies and practices.Originality/valueAdvancing intersectionality scholarship, the research finds the disadvantage caused by the intersection of gender, ethnicity and religion (intersectional identities) continues to be reproduced because of particular organizational demand and expectations and the non-compliance of minority ethnic women managers to merge and fit in. In other words, organizations implicitly demanding fitting in, and the inability to fit in and merge by minority ethnic women managers, hampers their careers.

Engagement barriers and service inequities in the NHS Breast Screening Programme: Views from British-Pakistani women.

ObjectivesPrevious research has largely attempted to explore breast screening experiences of South Asian women by combining opinions from Pakistani, Bangladeshi, and Indian women. This research often fails to reach the most underserved sub-groups of this population, with socioeconomic status not routinely reported, and English fluency being a participation requirement. With uptake low amongst British-Pakistani women, this study explores the experiences these women encounter when accessing the NHS Breast Screening Programme.Methods19 one-to-one semi-structured interviews were carried out with British-Pakistani women from East Lancashire, UK. 14 interviews were conducted via an interpreter.ResultsData were analysed using thematic analysis. Three themes were identified: ‘Absence of autonomy in screening and healthcare access’ describes how currently the screening service does not facilitate confidentiality or independence. Access requires third-party intervention, with language barriers preventing self-expression. ‘Appraisal of information sources’ makes distinctions between community and NHS communication. Whereas community communication was invaluable, NHS materials were deemed inaccessible due to translation incongruences and incomprehensible terminology. ‘Personal suppositions of breast screening’ explores the subjective issues associated with disengagement, including, the cultural misalignment of the service, and perceiving screening as a symptomatic service.ConclusionsBritish-Pakistani women face some unique challenges when accessing breast screening. To promote uptake, the service needs to address the translation of screening materials and optimize upon community networks to disseminate knowledge, including knowledge of the screening environment within the context of culture to promote informed choice about attendance.

British Pakistani and Bangladeshi women, Higher Education and Defensive Othering

Despite the rapid increase in the numbers of Pakistani and Bangladeshi girls entering higher education, practitioners of widening participation (WP) interventions continue to focus on access, under the mistaken belief that both groups have a strong cultural prevalence for early marriage and motherhood, have low attainment levels, or lack sufficient or effective careers guidance to help inform their academic or career choices. While more recent research has set out to challenge these stereotypes, there remains a paucity of research exploring the experiences of those who have successfully made the transition into, through and beyond higher education (HE). As a result, these stereotypical perspectives continue to prevail. This qualitative study examines the ways in which young Pakistani and Bangladeshi women have not only absorbed these stereotypical views but also, explicitly and implicitly, use stereotyping to define themselves in opposition to those women they deem ‘unsuccessful’. In adopting a position of ‘defensive othering’, taken in opposition to what they perceive to be ‘your typical Asian’, the women also position themselves as the Other. Drawing upon interviews with young women, we explore how the tensions between constructions of identity and the use of stereotypes from within their communities reveal some of the emotional difficulties they encounter in accessing both higher education and the workplace. Our paper therefore has importance for policy makers and academics involved in widening participation and student progression activities.

Moral ambivalence and veiling amongst British Pakistani women in Sheffield

ABSTRACTThis article explores perceptions and performances of veiling as they are mediated by notions of piety, overlapping and alternative moral narratives, and understandings of belonging. For the young British Pakistani women I met in Sheffield, expressions of piety such as veiling, are negotiated through an underlying understanding of possessing ‘good intention’ and related moral discourses of being a ‘good person’ and a ‘good girl’. Discussions of what it means to be ‘good’, whether explored through narratives of piety, universal personhood or gendered ethnic identity, are mediated by relations with kin, the wider Pakistani community and understanding of British multiculturalism. In this article, the author argues that veiling practices should be explored not only through the multiple moral discourses which influence women's choices, but the wider raced and classed structures in which such choices are embedded.

Fertility and education among British Asian women: a success story of social mobility?

High fertility among immigrant groups is often analysed as an expression of specific cultural factors and/or lower social status. I hypothesise that differences in educational attainment explain the fertility differentials across immigrant groups and generations in the UK. Building on previous work, and using household survey data and the Own-Child reverse-survival method, the paper presents for the first time total fertility and age-specific fertility estimates by broad categories of educational attainment for immigrant and second-generation British Pakistani, Bangladeshi, Indian, and Chinese women. I use these estimates to analyse how education influences childbearing across British Asian ethnic groups, and compare the fertility patterns of these groups to those of the whole UK population. High levels of educational attainment contribute substantially to the low overall fertility levels of Indian and Chinese women. Higher education also contributes to the lower fertility levels of the second-generation British Pakistani and Bangladeshi women relative to those of the immigrant generation. Some differences between groups remain after decomposing by educational level, which suggests that there are additional influencing factors. The results are discussed in the context of social theories on the incorporation of immigrants and minorities.

Gendering and diaspora: The case of second-generation British Pakistani women in the UK

This paper uses a life story approach to study the gendering of second- generation British Muslim women of Pakistani heritage. It argues and demonstrates that gendering is a contextual and structur...

Young British Pakistani Muslim women’s involvement in higher education

This article explores the implications for identity through presenting a detailed analysis of how three British Pakistani women narrated their involvement in higher education. The increased participation of British South Asian women in higher education has been hailed as a major success story and is said to have enabled them to forge alternative, more empowering gender identities in comparison to previous generations. Drawing on generative narrative interviews conducted with three young women, we explore the under-researched area of Pakistani Muslim women in higher education. The central plotlines for their stories are respectively higher education as an escape from conforming to the “ good Muslim woman”; becoming an educated mother; and Muslim women can “ have it all.” Although the women narrated freedom to choose, their stories were complex. Through analysis of personal “I” and social “We” self-narration, we discuss the different ways in which they drew on agency and fashioned it within social and structural constraints of gender, class and religion. Thus, higher education is a context that both enables and constrains negotiations of identity.

Shaping Eyebrows and Moral Selves: Considering Islamic Discourse, Gender, and Ethnicity within the Muslim Pakistani Community of Sheffield (UK)

In the past five to ten years, the popularity of eyebrow beautification (as a practice and a profession) has come under close scrutiny amongst the Muslim Pakistani community in Sheffield (UK) due to the apparent incompatibility of eyebrow modification with revivalist interpretations of Islamic doctrine. In this article I consider how the seemingly insignificant act of shaping the brow incites complex discussions regarding Islamic permissibility, being a ‘good girl’ within the Pakistani community and what it means to be a ‘good person’. Analysing how such moral subjectivities are shaped by local, raced and classed articulations of femininity, the article contributes to the scholarly debates on both beauty work and young Muslim British-Pakistani women’s complex identifications.

Suicidal ideation during pregnancy in British Pakistani women

IntroductionSuicide is a major public health problem and one of the common causes of maternal mortality. Rates of suicide and self-harm are higher in British South Asian women compared to the majority white population. Suicidal Ideation (SI) is a significant risk factor associated with self-harm and suicide.ObjectiveTo explore the prevalence and risk factors of SI in British Pakistani women.AimTo identify risk factors associated with SI, in order to inform future preventive strategies.MethodThis is a secondary analysis of a larger study which looked at depression during pregnancy and infant outcomes. Participants who consented (women aged 18 or over, in their third pregnancy trimester) were initially assessed for maternal depression using the Edinburgh Post-Natal Depression Scale (EPDS), with one of the questions on the EPDS being on SI. Participants who met the study criteria, were further assessed regarding socio-demographic factors, perceived social support, social adversity and isolation.ResultsThe rate of SI in this group of women was 8.1%, with baseline interview results suggesting that women with SI being significantly more likely to be aged 20 or less, have experience of severe life events and being less likely to have social support.ConclusionThis area of research is key to understanding SI in British Pakistani women, to better develop culturally sensitive interventions for use within this group.Disclosure of interestThe authors have not supplied their declaration of competing interest.