Problem In Pakistan Research Articles

The Health Costs of the Brick Kilns Emissions in Peshawar: A policy Analysis

Air Pollution especially resulting from Brick kiln is a major Environmental problem of Pakistan in general and Peshawar in Particular. World Health Organization in a recent document has declared Peshawar as the sixth most polluted city of the world. We in our latest study have tried to estimate the health cost related to the release of PM10 from these kilns. For the said purpose, we collected primary data pertaining to pollution and socio-economic of the brick producing and nearby areas. We collected socio economic data from respondents living within 3 kilometer of the kilns and also from a control group which were further away. Sample size was set at two hundred households, i.e. one hundred households were taken from the kilns group and another100 samples from the control group. We have used health diary method to collect health information from the respondents. We have estimated two reduced form equations, i.e., health production function and demand for mitigation cost using Poisson and Tobit regression models. The PM10 level in the kilns region was very high it was at average level is 415ug/m3, and the control group the PM10 level is low it was 180 ug/m 3 . Our regression analysis estimated that by reducing PM10 to safe level, every individual can save PKR 3315 (or USD 31) per annum through only mitigation cost. Total welfare gain to reduce air quality to safe level through mitigation cot for district Peshawar is PKR 6692.985 million or (PKR 6.7 billion) per annum (USD 63.44 million). Besides, the productivity loss by individuals is estimated as .36 day per annum. The monetary benefit to avoid from the restricted day of working is PKR 198 for one household whereas for the city the monetary benefit of bringing down the PM10 level is PKR 107.935 million (or USD 1.023 million). The study is suggesting implementing of the ban on the use of rubber as a fuel in these bricks kiln. The study also recommends that these kiln owners be punished/ taxed as per section 17 of the 1997 Environmental act.

Zinc supplementation fails to increase the immunogenicity of oral poliovirus vaccine: A randomized controlled trial

BackgroundPolio eradication remains a challenge in Pakistan and the causes for the failure to eradicate poliomyelitis are complex. Undernutrition and micronutrient deficiencies, especially zinc deficiency, are major public health problems in Pakistan and could potentially affect the response to enteric vaccines, including oral poliovirus vaccine (OPV). ObjectiveTo assess the impact of zinc supplementation among infants on immune response to oral poliovirus vaccine (OPV). MethodsA double-blind, randomized placebo-controlled trial was conducted in newborns (aged 0–14 days). Subjects were assigned to either receive 10mg of zinc or placebo supplementation daily for 18 weeks. Both groups received OPV doses at birth, at 6 weeks, 10 weeks and 14 weeks. Data was collected on prior immunization status, diarrheal episodes, breastfeeding practices and anthropometric measurements at recruitment and at 6 and 18 weeks. Blood samples were similarly collected to determine the antibody response to OPV and for micronutrient analysis. Logistic regression was used to determine the relationship between seroconversion and zinc status. ResultsOverall, 404 subjects were recruited. At recruitment, seropositivity was already high for poliovirus (PV) serotype 1 (zinc: 91.1%; control: 90.5%) and PV2 (90.0%; 92.7%), with lower estimates for PV3 (70.0%; 64.8%). By week 18, the proportion of subjects with measured zinc levels in the normal range (i.e. ≥60μg/dL) was significantly greater in the intervention group compared to the control group (71.9%; 27.4%; p<0.001). No significant difference in seroconversion was demonstrated between the groups for PV1, PV2, or PV3. ConclusionsThere was no effect of zinc supplementation on OPV immunogenicity. These conclusions were confirmed when restricting the analysis to those with measured higher zinc levels.

Causes of Tax Evasion in Pakistan: A Case Study on Southern Punjab

Introduction: Tax evasion is main problem in Pakistan due to which Pakistan remains under a lot of stress. Tax evasion results in less revenue. Many causes have been discussed which play major role in tax evasion in Pakistan. It is a primary research.Literature review: Many authors have discussed impacts of tax evasion in different sectors of economy. Previously tax evasion cause major trouble in Tanzania &amp; Greece.Methodology: A questioner has been filled by targeted population of 100 Professionals &amp; Business students of Department of Management Sciences Islamia University of Bahawalpur. Questioner was consisted of 5 major parts i.e. Tax System, High rate, Go with the flow, Corrupt Govt. &amp; Progressive taxation.Findings: Most of the population agrees that these causes play a vital role in the tax evasion in the Pakistan.Conclusion: Tax evasion is main problem of Pakistan which needs to be eliminating by following the recommendations that tax system must base on ground realities, tax rates should be low. There should be proper check &amp; balance of government, tax awareness in public should arise by different channels.

Microbial contamination of drinking water in Pakistan--a review.

Water pollution with pathogenic microorganisms is one of the serious threats to human health, particularly in developing countries. The main objective of this article is to highlight microbial contamination of drinking water, the major factors responsible for microbial contamination, and the resulting health problems in Pakistan. Furthermore, this study will be helpful for researchers and administrative agencies to initiate relevant studies and develop new policies to protect further deterioration of water supply with pathogenic microbes and ensure clean and safe drinking water to the public in Pakistan. In Pakistan, water at the source, in the distribution network, and at the consumer tap is heavily polluted with coliforms and fecal coliforms all over the country. An overview of more than 7,000 water samples reviewed here reveals that an average of over 71 and 58 % samples in the country was contaminated with total coliforms and fecal coliforms, respectively. Drinking water contamination accounts for 20 to 40 % of all diseases in the country, which causes national income losses of Rs 25-58 billion annually (US$0.25-0.58 billion, approximately 0.6-1.44 % of the country's GDP). Improper disposal of industrial and municipal wastes is the most important factor responsible for water pollution in the country followed by cross-contamination due to old and leaking pipes and lack of water filtration and disinfection facilities. There is an urgent need for emergency steps to stop further deterioration of water quality and improve the existing water quality so as to protect the public from widespread waterborne diseases.

Insurgency in Afghanistan: implications for Pakistan's internal and external security

In the aftermath of 9/11, the USA embarked on a massive global hunt for terrorists and launched its “Operation Enduring Freedom” in Afghanistan. Its failure to control insurgency in Afghanistan spilled over into Pakistan, with disastrous consequences. The resurgence of the Taliban with more formidable tactics and maneuvering skills has become more troublesome for both Afghanistan and Pakistan and for the USA and its allied forces. The fierce comeback of the insurgents has challenged the political and territorial integrity of Pakistan, one that it cannot tolerate. This article analyzes the current situation and its implications for Pakistan's security. Moreover, it looks into the internal and external security complexities that Pakistan faces and the possible implications of the US exit strategy for Pakistan's security. It concludes that the security situation in Pakistan is continuously deteriorating and no part of her territory is immune from terrorists' attacks. To be successful, Pakistan must pursue a broad-based strategy that encompasses military, political, social, economic and informational domains aimed at accomplishing four major objectives: (1) elimination of foreign terrorists and their facilitators; (2) strengthening of the political and administrative institutions in the Federally Administered Tribal Areas (FATA); (3) establishing a safe and secure environment conducive for sustained development and the realization of real socio-economic progress and (4) integrating the FATA into the national mainstream. In the long term, a strategy based on the concept of “Enlightened Moderation” is the right solution, not only to the internal problems of Pakistan but also for the Muslim world and the international community.

Microfinance - A Poverty Reducing Agent in Pakistan

Pakistan is a large country with a population estimated at 180 millions. The economy has a low Per Capita Income of US$ 600 approximately, with an estimated purchasing power parity of $ 2500. Poverty has always remained a major development problem of Pakistan. Many methods have been used in the past to alleviate poverty including Direct Credit Approach, focus on job creation, heightened economic activities etc. Islamic modes of financing included Fitrana, Sadqat, Ijarah, Istisna, Bai Muajal, Salam, Musarakah, Mudarabah, Leasings and so many other things, but the results are not encouraging. The main focus of these approaches was on income redistribution. However, there is immense evidence suggesting that a successful anti-poverty strategy should include a policy regime that promotes inclusive economic growth; investments in human capital, infrastructure, and micro-credit. In fact microfinance encompasses all these important aspects and that is the reason to work on this particular area and analyze broadly its effect on the economy of Pakistan.Microfinance arose in the 1980s as a response to doubts and research findings about US state delivery of subsidized credit to poor farmers. Grameen Bank’s of Dr. Yunus is still considered as the main pioneer in the provision of microfinance. In the 1970s US government agencies were the predominant methods of providing productive credit to those with no previous access to credit facilities. In Pakistan there are many formal, semi-formal and informal channels working for the provision of the micro-credit. In this paper, Pakistan Microfinance Network (PMN) and Aga Khan Rural Support Program (AKRSP) have been chosen for this purpose, and to discuss their maximum outreach including, the First Microfinance Bank, Kashf Foundation, Orangi Pilot Project, Punjab Rural Support Program and The Bank of Khyber. Microfinance has seemed to last a positive impacts on the Economy, culture and Psychology of the area where it was provided. Village organizations in the area of AKRSP seemed to have a positive impact (resulting in wealth creation, better productivity & income, better human resource management and conservation of natural resources). At the macro level provision of microfinance results in alleviation of poverty, female empowerment and development of overall financial system.

Personality dimensions and emotional problems: the mediating role of irrational beliefs in Pakistani adult non-clinical sample.

This study presents the first examination of the relation between the Big Five personality traits, irrational beliefs and emotional problems in Pakistan, which is an understudied country in the psychological distress literature. A total of 195 participants (aged 25-60 years), employees at COMSATS University, completed a demographic information sheet, the Big Five Personality Questionnaire, the Irrational Belief Inventory and two subscales of the Brief Symptom Inventory including depression and anxiety. Direct effects of neuroticism, openness and conscientiousness were also observed for depression and anxiety. Structural Equation Modelling demonstrated that irrational beliefs played a significant mediating role in the relationship between neuroticism and anxiety and neuroticism and depression. The results highlight the importance of cognitive beliefs in functionally linking personality traits and emotional problems.

Seroprevalence of HBV infection and viral loads in outpatients attending a district hospital located in Mardan, Pakistan

Abstract Hepatitis B is a major public health problem in Pakistan like other developing countries. HBV infection is a more contagious disease than HCV and HIV infection. The aim of the current study is to compare seroprevalence of HBV infection in outpatients who attended a district headquarter hospital of district Mardan, Pakistan. A total number of 270 patients were selected for this research work. Serum of patients were tested by HBsAg and ICT strip method and those found positive were sent to GCMBDR to confirmed for HBV DNA by Real Time PCR. Out of the total 270 screened patients, HBV DNA was confirmed in 94(34.81%) patients using Real Time PCR of which 56(59.6%) were male while 38(40.4%) were female outpatients. All the positive patients were divided into three categories on the bases of viral load categories such as low ( 10,000,000 IU/ml). On the bases of these categories 50 %( n=47) patients were found with low viral load, 33 %( n=31) with intermediate and 17 %( n=16) were found having high viral load. Female patients were slightly more susceptible to HBV infection compared to male patients. The highest HBV infection seroprevalence was found in patients of 21-40 age group. Majority of the sick subjects were however seen with low viral titers.

Estimation of Vehicle Damage Cost Involved in Road Traffic Accidents in Karachi, Pakistan: A Geospatial Perspective

Road Traffic Accidents (RTAs) are serious but ignored problem in Pakistan. Now this problem is under limelight due to disastrous impacts over society in general and over economy in particular. Karachi is considered to be the most income generating city of Pakistan. This city holds a typical feature of most road traffic accidents facing in the country and the fourth highest RTA fatalities in the world. More than 26,000 road accidents occur on the arteries of Karachi every year making it a worrisome place. Outcome of RTAs could be measured in tangible manner i.e., in term of number of life loss but intangible losses are very difficult to measure. In this paper an attempt has been made to capture the potential flaws in road geometry through Remote Sensing and embedding the land use data through the inventory of Geographic Information Systems. Moreover, overlay analysis techniques helps in identifying the high accident cost areas. In Karachi, over 35,000 vehicles are involved in crashes every year, resulting in loss of life as well as wealth. The overall repair cost over the vehicles involved in all types of RTAs in year2012 is more than 20,000,000 PKR with Landhi Town showing the highest cost. Shah Faisal Town showed the minimum repair cost of over 300,000 due to its small aerial extent and lesser number of economic land use making it a safer place for vehicle users. Moreover, map of Karachi showing the spatial pattern of vehicle repair cost. It is suggested that the serious measures need to be undertaken to combat this problem.

Pakistani Womens Perceptions and Experiences of the Psychological Impact of Advanced Breast Cancer

Background: Breast cancer is a common health problem in Pakistan. Due to limited breast health awareness, women often seek medical support when the disease is in an advanced stage. Breast cancer can be a frightening disease for women due to local beliefs about cancer and knowledge deficits. Objectives:This study examined the psychological impact of a diagnosis of advanced breast cancer in Pakistani women. Setting/ Subjects; 21 women with a diagnosis of advanced breast cancer participated in interview. Design: A qualitative study employing semi-structured interviews to explore women’s perceptions and experiences of the psychological impact of their diagnosis on their lives. Women adopted religious coping strategies to manage the long-term manifestations of their disease and the seriousness of their diagnosis. Many women questioned their perceptions of the challenges that they faced; the meaning of life for them as mothers, wives and constant fear of recurrence and impact that this could have in their lives. Possessions and money were of little consequence to them as their existence and duration of life was perceived to be limited. Conclusions: Many women revitalised their perceptions of the purpose of life and developed increased optimism for the future. This optimism was related to their renewed spirituality which they used as a coping strategy.

Rapid detection of Mycobacterium tuberculosis and Rifampicin Resistance in extra pulmonary samples using Gene Xpert MTB/RIF assay

Tuberculosis (TB) is a major health problem in Pakistan. The World Health Organization has recently endorsed the Gene Xpert MTB/RIF assay for rapid detection of smear negative and multidrug resistance tuberculosis. A total of 100 extra pulmonary samples were processed, which included 60 pus, 19 pleural fluids, 16 ascetic fluids and 5 CSF. Out of these 37% patients were Gene Xpert MTB/RIF Assay positive, 17% were LJ culture positive and 12 % were Zn smear positive. MTB was detected in 31 out of 60 (51.7%) Pus samples, 3 out of 19 (15.8%) Pleural fluid samples, 1 out of 16 (6.3%) Ascitic fluid samples and 2 out of 5 (40.0%) CSF samples. In this study we found that Gene Xpert MTB/RIF assay is rapid method for diagnosis of extra pulmonary tuberculosis as compared to conventional methods. Because of its simplicity, rapidity and sensitivity, this seems to be a very gorgeous tool for diagnosis of extra pulmonary tuberculosis from clinical samples.

MACROECONOMIC DETERMINANTS OF NON-PERFORMING LOANS (NPL): EVIDENCE FROM PAKISTAN

This analytical study investigates the determinants of non-performing loan in Pakistan. Secondary data is used in this study. The data is collected through World Bank Databank, international financial statistics and various issues of economic survey of Pakistan. The issue of Non-Performing Loan is one of the clusters of financial problems in Pakistan. No one can deny the importance of financial sector in any economy. In this study we find the macroeconomic factor that surge the NPL. We also suggest some strategies to cutback the non-performing loans. Current study uses the time series data of Pakistan, ranging from 1990 to 2013. Ordinary least square (OLS) method is used to investigate the problem. The dependent variable is non-performing loan and independent variables are exchange rate, interest rate, GDP, share prices, energy crisis, exchange rate and energy crisis. GDP has significant relationship with NPL and interest rate, share prices have insignificant relationships with NPL. A positive link has established between non-performing loans and various independent variables like energy crisis, exchange rate, interest rate, share prices. But on the other hand a negative relationship has been found between dependent variable and GDP.

TETANUS;

Background: Tetanus still remains a major public health problem in Pakistan like in most other developing countries, with ahigh morbidity and mortality. Objectives: To study the demographic profile the clinical profile, the outcome of the tetanus patients andeffectiveness of tetanus immunization coverage in district Faisalabad. Design: Retrospective record based study. Place and Duration:Surgical unit-5 DHQ Hospital, Faisalabad from January 2010 to December 2012. Subjects and Methods: All data of 198 patients oftetanus of any age and sex, diagnosed clinically was collected, compiled and analyzed from the Medical Records Department of theHospital. Results: Out of 198 patients of tetanus,138(69.7%) were males and 60(30.3%) were females. Their ages ranged from 1 to 85years with a mean and a standard deviation respectively of 29.36 and 17.48 years.162 (81.8%) were from rural and36(18.2%) were fromurban areas. 47(23.7%) patients were having prior immunization and151(76.3%) were not immunized. The most common presentingsymptoms were trismus (47.5%), body stiffness(24.2%),fits(19.2%) and respiratory distress(9.1%). 23(11.6%) patients were havingmild disease,71(35.9%) patients were having moderate disease,71(35.9%) patients were having severe disease and 33(16.7%) werehaving very severe disease. Overall mortality rate was 41.4%. Respiratory failure was the most common cause of death and there wasstatistically significant association between mortality and increasing grades of disease. Conclusions: By making expanded programmeof immunization(EPI) more effective and removing flaws from out-dated vaccination through incomplete vaccination. By improvingawareness in public and complete vaccination through EPI program, we can reduce the incidence of tetanus.

Teacher training intervention for early identification of common child mental health problems in Pakistan

School-based interventions involving teacher training programmes have been shown to benefit teachers’ ability to identify and manage child mental health problems in developed countries. However, very few studies have been conducted in low-income countries with limited specialist services. The aim of the study was to evaluate the impact of the training programme on teachers’ knowledge and awareness. A total of 114 primary school teachers from five schools in Karachi participated in a two-day (10–12 hours) workshop to provide them with an understanding of common child mental health problems and train them in basic skills. Their pre- and post-training knowledge was evaluated through a rating scale and open-ended questions. Single tailed t-test, involving paired differences, was applied for participants’ scores. Pre-/post-training differences were statistically significant. The training sessions were associated with an improvement in teachers’ knowledge and awareness of various signs and symptoms of common child mental health problems. The greatest improvement was noted in response to strategies of managing difficult behaviours, as 61% of respondents were able to formulate appropriate behavioural management techniques after the training. In low-income developing countries like Pakistan, teachers should be trained in early-intervention programmes for the identification and school-based management of less complex emotional and behavioural problems. Such interventions can maximise the use of sparse mental health resources.

Does Comorbidity Increase the Risk of Dengue Hemorrhagic Fever and Dengue Shock Syndrome?

Background. Dengue fever is an emerging public health problem in Pakistan. The aim of this study was to determine the relationship between comorbid conditions in individuals suffering from dengue fever and the development of dengue hemorrhagic fever or dengue shock syndrome. Methods. In this age- and sex-matched case control study, total of 132 cases of dengue hemorrhagic fever/dengue shock syndrome and 249 randomly selected controls were recruited from two major teaching hospitals of Lahore, Pakistan. A semistructured questionnaire was used to collect data through interview and by reviewing clinical records. SPSS version 18 was utilized for statistical analysis including conditional logistic regression. Results. Odds of developing dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) among diabetics are higher than in controls, but this association was not found statistically significant (OR. 1.26; 95% CI. 0.78–2.03; P=0.34). Similarly, no association was observed in individuals suffering from hypertension (OR. 0.93; 95% CI. 0.57–1.49; P=0.76). Odds of developing DHF and DSS were higher for bronchial asthma (adjusted OR. 1.34) and pulmonary tuberculosis (adjusted OR. 1.41); however P values were insignificant. Conclusion. Presence of diabetes mellitus, hypertension, ischemic heart disease and bronchial asthma among patients contracted dengue fever will not increase the risk of dengue hemorrhagic fever and dengue shock syndrome.

Impact of Electricity Crises on Sugarcane Industry of Pakistan

Pakistan is a least developed country with limited development in every era due to the junk of problems; as faced today by Pakistan as a country. Unfortunately, it has been initio non-exist. During 60s, realizing its significance, measures were taken for its development and since then the experts have been emphasized the balanced growth between industrial and agriculture sector. About 50 years ago, agriculture sector were overlooked considering their electricity traditionally an outdated sector. Electricity is pivotal in running machinery factories, mills, distillery units, industrial units, as well as lighting societies for the State. This area demands attention. Governments may focus on this subject seriously with the consultation of specialize people then it may cover electricity debit at certain level. Essential requirement of latest technologies like Bagasse/Biogas Energy plants as currently to instate, and fulfill the aggregate demand of electricity for the country. Pakistan needs around 15000 to 20000 MW electricity per day, however, currently it is able to generate about 10500 MW per day hence there is a shortfall of about 5000 to 10000 MW per day. This shortage is badly hampering the economic growth of the country. Electricity crisis has, moreorless, plagued all sectors of Pakistan’s machinery ranging from economy to industry, agriculture to social life, inflation to poverty and it is hampering national progress in a drastic manner. Electricity is the major problem of Pakistan is facing today. We should learn a lesson from China, Germany, Malaysia, Australia and Bangladesh are enormous Biogas/Bagasse cogeneration electricity producers. Since it is not possible to escalate area under sugarcane cultivation the suggested second step is to undertake efforts to develop new varieties offering higher yield and recovery through Agriculture Research Institutes and more effective measures required for disease control and better pesticides used. Availability of adequate supply of water, appropriate use of fertilizer and proper spraying of insecticides & pesticides can improve yield per hectare. Improvement also required in procurement and storage to reduce wastages, other than sugar it can diversify and produce Ethanol which has been proved to be very helpful in developing economies.

Immune response to 1 and 2 dose regimens of Measles vaccine in Pakistani children

Measles is a significant problem in Pakistan despite vaccine coverage rates reported at 80%. The purpose of this study was to determine the serologic response in children after one dose of measles vaccine at 9 mo versus two doses at 9 and 15 mo of age. From March through December 2006, children were enrolled from immunization clinics and squatter settlements in Karachi. Blood samples were taken from children in Group A at 9–10 mo of age prior to measles vaccine and 8 to 11 weeks later; from children in Group B at 16–17 mo of age after receiving 2 doses of measles vaccine; and from children in Group C who had received at least one dose of measles vaccine by 5 y of age. After the first dose of measles vaccine, 107/147 (73%) of children in Group A were seropositive, 157/180 (87%) of children in Group B were seropositive after two doses and 126/200 (63%) of children in Group C were seropositive at 5 y of age. The post-vaccination geometric mean antibody concentrations were higher in females than males in groups A (irrespective of pre-vaccination antibody levels) and B. The serologic response to one and two doses of measles vaccine was lower in children in Karachi than has been reported in many other countries. Two doses of vaccine were significantly better than one dose. An in-depth investigation is needed to determine the reason for the lower-than-expected protection rates. Differences in immunogenicity between genders need to be further studied. Recent introduction of supplemental measles vaccine doses should help control measles in Pakistan.

To investigate the surface properties for increasing efficiency of solar water heater

Energy crisis is becoming a major problem in Pakistan. Renewable energy sources are used to overcome this crisis. This research is about to increase the efficiency of fin type solar water heater by modification of its surface properties. During this research work, solar water heater module is fabricated and the modification of surfaces by using bare surface, external surface coated with high conductivity paint and lead electroplating is studied and the efficiency of solar heater is observed. The temperature profile and the heat transferred is studied and it was found that paint coated surface is more efficient than bare surface, further surface electroplated with lead is more efficient than painted surface for the same ambient conditions. The average increase in the heat absorption for lead plated and paint coated surface was observed 28.57% and 10.79 % respectively.

Energy Savings and CO&lt;sub&gt;2 &lt;/sub&gt;Reduction through Solar Water Heater Technology in Sindh Pakistan

Pakistan suffers worst energy crises due to unavailability of primary energy sources. One of the solutions to energy problems of Pakistan lies in utilization of renewable energy sources like solar energy. One of the possible uses of solar energy is in the form of water eating. This work explored the availability of solar energy in the Sindh province of Pakistan. Moreover potential fuel savings and reduction in CO2 emission due to the use of solar water heating system is also evaluated. The RETScreen software was used for evaluation of fuel savings and CO2 emission reduction from a solar water heating system. Results show that the annual natural gas supplied to an average household in the three main cities of Sindh i.e., Karachi, Hyderabad and Sukkur could be reduced by 513.5, 409 and 543.5 m3, respectively. Annual reductions in emissions of CO2 for Karachi, Hyderabad and Sukkur were estimated to be 1, 0.8 and 1 tCO2 respectively. It is concluded that the utilization of solar energy for water heating in domestic sector of Sindh Pakistan could save fuel fossil and reduce environmental pollutants that in-turn may help mitigate energy crises in the country.

Reforming Madrasa Education in Pakistan; Post 9/11 Perspectives

Pakistani madrasa has remained a subject of intense academic debate since the tragic events of 9/11 as they were immediately identified as one of the prime suspects. The aim of this paper is to examine the post 9/11 academic discourse on the subject of madrasa reform in Pakistan and identify the various themes presented in them. This paper also seeks to explore the missing perspective in this discourse; the perspective of ulama; the madrasa managers, about the Western demand to reform madrasa. This study is based on qualitative research methods. To evaluate the views of academia, this study relies on a systematic analysis of the post 9/11 discourse on this subject. To find out the views of ulama, in-depth interviews of leading Pakistani ulama belonging to all major schools of thought have been conducted. The study finds that many fears generated by early post 9/11 studies were rejected by the later ones. This study also finds that contrary to the common perception the leading ulama in Pakistan are open to the idea of madrasa reform but they prefer to do itinternally as an ongoing process and not due to outside pressure. This study recommends that in order to resolve the madrasa problem in Pakistan, it is imperative to take into account the ideas and concerns of ulama running them. It is also important to take them on board in the fight against the religious militancy and terrorism in Pakistan.