Sarhad J. Agric. Vol.25, No.1, 2009 AVAILABILITY AND UTILIZATION OF SOCIAL SERVICES (EDUCATION AND HEALTH) BY RURAL COMMUNITY IN DISTRICT CHARSADDA MUHAMMAD ISRAR*, MALIK MUHAMMAD SHAFI* and NAFEES AHMAD** * Institute of Development Studies, NWFP Agriculture University Peshawar, Pakistan ** Department of Economic, University of Malakand, Pakistan ABSTRACT The study was based on a sample survey conducted in three villages of Charsadda District from September to November, 2005. The principle objective of the study was to examine availability and utilization of rural social services and the factors hindering the full utilization of these services. For this purpose a total of 130 respondents i.e. 17 from Haryana, 38 from Najimabad and 75 from Mehmoodabad were interviewed with the help of a pre-tested interview schedule. The study finds that the various services provided by the government are insufficient and the already available ones are not fully utilized by the rural community. The reasons are manifolds. For example, in the education sector, the major factors were lack of funds and qualified teachers. In the health sector, the health services were not easily accessible and were poorly equipped. The study recommends that special attention should be given to the social sector in rural areas by providing them adequate funds, buildings and skill training programmes for education and health professionals. Key Words: Charsadda, Education services, Health services, Rural community, Social services Citation: Israr, M., M.M. Shafi and N. Ahmad. 2009. Availability and utilization of social services (Education and Health by Rural community in District Charsadda. Sarhad J. Agric. 25(1): 95-101. INTRODUCTION The increasing concern with social aspects of development finds its roots in the realization that a unit of investment in education, health, social welfare or other branches of manpower planning is in the long run as productive as unit of investment in agriculture industry or trade. Evidence point out to a close association between social expenditure and subsequent economic development (Govt. of Pakistan 2005). It is for this justice consideration that the social orientations of the development programs finds embodiment with regards to education and health. The focus of this study is especially on the availability and also utilization of social services of education and health; therefore in the following paragraphs we briefly highlight these sectors. The discussion is followed by the objectives. Education Education is the dire need of the day. It plays an important role in human capital formation. It raises the productivity and efficiency of individuals and produces skilled manpower that is capable of leading the economy towards the path of sustainable economic development. The developed countries attach highest priority to education so do the developing countries. The constitution of Pakistan accepts education as one of the fundamental rights of every individual as well as the constitutional commitment of the government is to make education easily accessible to every citizen. However, like many other developing countries the condition of the education sector in Pakistan is not very encouraging. The low enrolments rates at the primary level, wide disparities between regions and genders, lack of trained teachers, deficiency of proper teaching materials, and poor physical infrastructure of schools indicate the poor performance of this sector. The national literacy rate, at present, is estimated at 53 % (male 64 % and female 39 %). In the country there were 155000 primary schools, 28700 middle schools and 16100 higher secondary schools. In addition to these institutes, there were some technical colleges, and Universities where post graduate education facilities can be availed (Economic Survey 2004-5). The literacy rate of the rural are is just 41.6 % as against 69.7 % in urban area. The literacy rate of the country is lower than many other countries (like India, Sri Lanka and China) having more or less similar socio economic conditions. In the NWFP the literacy rate was 43 % (lower than that of the national level). In rural area the literacy rate was 39.8 % as against 58.3 % in the urban area.
Muhammad Israr et al. Availability and utilization of social services 96 Health Provision of health facilities is one of the important requirements of all human beings. In Pakistan, attempts have been made to improve the health condition of the people through availability of trained personals, adequate supply of medicines and establishment of health services units. The health concept not only includes freedom from communicable and other diseases but also availability of facilities for maternity and child care. The infrastructure of health sector, therefore, cover establishment of hospitals, dispensaries, basic health units and maternity child health care centers and their staffing with adequate number of doctors and other paramedical staff. In Pakistan, there are 916 hospitals, 4582 dispensaries, 530 rural health centers and 5301 basic health units. The number of doctors is 113206, dentists 6127, nurses 48446, lady health visitors 6741 and midwives 22,401 (Economic Survey, 2004-5). In the country the health care system as a whole is not what it should be and is still deficient in many respects. The main health problems are preventable immedicable diseases, severe malnutrition and high evidence of birth resulting in a high proportion of infant and maternal mortality. There are also clear differentials in health condition by rural and urban areas, unsanitary conditions, and polluted water. Illiteracy among rural mothers, urban slum and high fertility and inadequate administrative structure has been identified as the main hurdles in the progress of health conditions. In Pakistan, the growth of health infrastructure is fairly slow and inadequacy of such health services is reflected in the very high rates of infant mortality and low life expectancy in comparison to other countries of the regions having more or less similar socio economic conditions. For example, infant mortality rate in Pakistan is 98 (per one thousand) as against 69 in Bangladesh, 37 in China and 7 in Malaysia. Similarly, life expectation of the country is 62 years as against 74 in Sri Lanka, 71 in China and 73 in Malaysia (Economic Survey 2004-5). These facts indicate that the proper considerations are to be given to improve health conditions of Pakistan. Many researchers (Adeel1999, Alam1994, Markandan 1995, Idris 1994) are of the view that social aspect of development finds its roots in the realization that a unit of investment in social welfare or other branch of manpower planning in the long run is as productive as unit of investment in agriculture, industry or trade. The contribution of these studies towards the literature on social sector is remarkable. The present study tries to probe availability and utilization of education and health facilities in the study area and identify measures for the improvement with the following objectives. Objectives i. To study the availability and utilization of social services (education and health) in the rural community in the sample area. ii. To find out the factors responsible for non-availability of the social services. iii. To give suggestions for improvement in the availability and utilization of the social services. MATERIALS AND METHODS This study was aimed to find out the availability and utilization of rural social services such as health and education by rural community in District Charsadda from September to November, 2005. Three villages namely Haryana, Najimabad and Mehmoodabad of the district were randomly selected. households in the sampled area were above 860. Due to time limitation and financial constraints only a sample of 15% of the total households in the sample villages was selected through random sampling, so the sample size was fixed at 130 in these villages i.e. 17 from Haryana, 38 from Najimabad and 75 from Mehmoodabad. In the following paragraphs we present the result and discussion of the study. The discussion starts with education to be followed by health. RESULTS AND DISCUSSION Education The literacy rate in Charsadda was 31.1 % (lower than that of the national and provincial levels). The educational institutions in Charsadda district consist of 333 primary schools, 13 middle schools, 30 high schools, and 3 degree colleges for the total population of over one million where as rural population is accounted for over 80%. In the district of the total educated people, 12.6 % were below primary, 27.4 % had passed primary, 19.1 %
Sarhad J. Agric. Vol.25, No.1, 2009 97 middle, 21.2 % matriculate, 7.7 % intermediate, 3.4 % graduate, and 1.8 % post graduates while 0.4 % was diploma holders. Besides these governments institutions, there were also a number of private education institutions which were serving for the promotion of education to the people of this district (Directorate of Education NWFP, 1999-2000). Literacy Status of the Sample Respondents The overall literacy of the sampled respondent stood at 75%. The literacy ratio was higher in Haryana followed by Mehmoodabad and Najimabad (Table I). Education Level of the Sample Respondents Table II indicates that of the total literate sample respondents, 54% respondents were primary pass, 29% respondents were matric pass, and 14% respondents were intermediate pass while 3% respondents were of higher qualification. In village Haryana, 40% respondents were primary pass, 46% were matric pass, and 7% respondents were intermediate pass while 6% respondents were of high qualification. In village Najimabad, 67% respondents were primary pass, 18% respondents were matric pass, while 15% respondents were intermediate pass. In village Mehmoodabad, 51% respondents were primary pass, 29% respondents were matric pass, and 16% respondents were intermediate pass while 4% respondents were of high qualification. Availability of Schools Facilities It is evident from the Table III that 29% of the sample respondents were found to be happy with the existing facilities (mentioned below) in the schools, while 65% were not happy. However, 6 % respondents did not know about the existing facilities available in the school. Dissatisfaction shown by the respondents over the existing facilities was due to: (i) non-availability of proper school building and equipment, (ii) no proper cleaning of the school, (iii) inadequate space for the students and (iv) electricity and bathroom problems, (v) punctuality of staff. Table I. Literacy status of the sample respondents Illiterate Literate Haryana 02 12 15 88 17 Najimabad 11 29 27 71 38 Mehmoodabad 20 27 55 73 75 Project Area 33 25 97 75 130 Table II. Education level of the sample respondents Primary Metric Intermediate Above Inter Haryana 06 40 07 46 01 7 1 7 15 Najimabad 18 67 05 18 04 15 - - 27 Mehmoodabad 28 51 16 29 09 16 2 4 55 Project Area 52 54 28 29 14 14 3 3 97 Table III. Response of the sample respondents regarding the availability of facilities in the schools Yes No Don t know No % Haryana 5 29 12 71 - - 17 Najimabad 11 29 22 58 5 13 38 Mehmoodabad 21 28 51 68 3 4 75 Project Area 37 29 85 65 8 6 130
Muhammad Israr et al. Availability and utilization of social services 98 Standard of Education in the Project Area Table IV indicates that 33% of the sample respondents were satisfied with the present standard of education of the schools, while 67% were not satisfied with the present standard of education of the schools. Different reasons for the poor standard were reported by the sample respondents and some which are: (i) lack of interest of some teachers, (ii) shortage of teaching staff and (iii) in-sufficient space for students in the school (iv) day today changes in the government policy, (v) un necessary teaching stuff. Problems Faced by Sample Respondents Regarding Sending their Children to School Table V depicts that 62% of the sample respondents had transport problem while 38% of the sample respondents responded negatively. Similarly, 64% of the sample respondents stated that they cannot afford school charges while 36% of the sample respondents reported no problem regarding school expenses. Seventy-one percent respondents had transport problem in village Haryana. 59% of the sample respondents stated that they cannot afford school expenses while 41% of the sample respondents reported no problem regarding school expenses. Similarly in village Najimabad and Mehmoodabad 60% and 55% of the sample respondents had transport problem; 72% and 62% could not afford to send their children to school, respectively.different reasons reported by sample respondents who complained against transport problem and school charges are (i) transport facilities are not easily available, (ii) school charges are too much i.e. stationery charges, uniform etc. and (iii) schools are at longer distance from their villages. Response of Sample Respondents about Female Education Table VI shows that in the project area 82% of the sample respondents were in favour of female education, while the remaining 18% of the sample respondents were against female education. In village Haryana, 76% of the sample respondents were in favour of female education while 24% of the sample respondents were against female education. Similarly, in village Mehmoodabad, 84% of the sample respondents were in favour of female education while 16% of the sample respondents were against female education. Different reasons were reported by sample respondents Some of the reasons were (i) cultural factor which disallows female education (ii) poverty due to which the parents y cannot afford school expenses (iii) long distance to school and the parents do not want to allow their daughter to go to far away schools and iv) the parents are of the view that female would become house wives and the education is of no use for them. The above facts indicate that majority of the people are not satisfied with the performance of the education department. Table IV. Satisfaction/dis-satisfaction expressed by the sample respondents regarding present standards of education Satisfied Not Satisfied Haryana 3 18 14 82 17 Najimabad 29 24 29 76 38 Mehmoodabad 31 41 44 59 75 Project Area 43 33 87 67 130 Table V. Problems with regard to sending their children to school Transport Problem School Charges Yes % No % Yes % No % Haryana 12 71 5 29 10 59 7 41 Najimabad 23 60 15 40 27 72 11 28 Mehmoodabad 41 55 34 45 47 62 28 38 Project Area 76 62 54 38 84 64 46 36
Sarhad J. Agric. Vol.25, No.1, 2009 99 Table VI. Response of the sample respondents in favour and not in favour of female education In favour Not in favour Haryana 13 76 4 24 17 Najimabad 30 79 8 21 38 Mehmoodabad 63 84 12 16 75 Project Area 106 82 24 18 130 Health Medical facilities available to the people of Charasdda District consist of 5 hospitals, 3 rural health centers, and 43 Basic Health Units, 2 Mother Child Health Centers and 10 Dispensaries (Directorate of Education NWFP, 1999-2000). However, for all the major surgeries the local people were generally sent to Hospitals in Peshawar. The health services available in the sample villages and its utilization by the respondents are discussed as under: Utilization of Health Services Table VII reveals that 66% of the sample respondents were utilizing the available health services, while 34% of the sample respondents were not utilizing the health services in the project area. In village Haryana (76%), Najimabad (66%) and Mehmoodabad (64%) of the total respondents were utilizing the available health services. The main reasons for not utilizing the health services were: (i) lack of medicine, ii) irresponsible behaviour of medical staff, iii) waiting too long for consulting the doctor, iv) high cost of medicine, v) no proper facilities of various medical test and X ray, and vi) non-qualified medical staff. Availability of Medical Care It is evident from the Table VIII that 53% of the sample respondents reported that they got immediate medical care, while 47% of the sample respondents complained about non-availability of immediate medical care. In village Haryana 53% of the sample respondents reported that they got immediate medical care while 47% complained about non-availability of immediate medical care. In village Mehmoodabad, 57% of the sample respondents got immediate medical care while 43% respondents did not receive immediate medical care. The main cause for not receiving immediate medical care at due time was the non availability of medical staff. Availability of Home Health Care The response of the sample respondents with respect to the home health care can be seen in Table IX. The table shows that 23% of the sample respondents had received public home health care (provided by the government), 21% of the sample respondents had received private home health care (other than the government), while 56% of the sample respondents had not received any home health care in total project area. The sample respondents that received public home health care were 23%, 24% and 23% in village Haryana, Najimabad and Mehmoodabad respectively. While respondents that had received private home health care were 18%, 34% and 17% in villages Haryana, Najimabad and Mehmoodabad, respectively. Private health facilities provided by health practitioner and chemist and druggist in the area were also inadequate. There was no adequate private health infrastructure facility which fulfills the health needs of the population in the area. Satisfaction/Dissatisfaction Regarding Available Heath Facilities Table X shows that 51% of the sample respondents were satisfied with the existing health facilities while 49% were not satisfied with the available existing health facilities in the total project area. In village Haryana, 29% of the sample respondents were satisfied with the existing health facilities while 71% were not satisfied with the existing health facilities. In village Najimabad, 71% of the sample respondents showed satisfaction over existing health facilities while 29% showed dissatisfaction over existing health facilities. In village Mehmoodabad, 45% of the sample respondents showed satisfaction over availability of existing health facilities while 55% showed dissatisfaction over availability of existing health facilities. The respondents expressed their dis-satisfaction because of low quality of medicines and irresponsible behaviour of the medical staff. So it is essential that medical staff must be cooperative and behave in a good manner.
Muhammad Israr et al. Availability and utilization of social services 100 Table VII. Respondents attitude in favour and not in favour about the utilization of rural health services in the sample villages In favour Not in favour Haryana 13 76 4 24 17 Najimabad 25 66 13 34 38 Mehmoodabad 48 64 27 36 75 Project Area 86 66 44 34 130 Table VIII. Response of sample respondents about the medical care availability with in the project area % reporting availability of medical care % Not availability of medical care Haryana 9 53 6 47 17 Najimabad 17 45 21 55 38 Mehmoodabad 43 57 32 43 75 Project Area 69 53 61 47 130 Table IX. Response of sample respondents with respect to the house health care (other than the government health care) in the project In favour Not in favour Public Private No % Haryana 4 23 3 18 10 59 17 Najimabad 9 24 13 34 16 42 38 Mehmoodabad 17 23 11 17 47 62 75 Project area 30 23 27 21 73 56 130 Problems faced by Sample Respondents in Consulting Doctor Table XI indicates that 29% of the sample respondents stated that doctor did not pay attention, 21% stated that cost was high, 37% stated that they had to wait too long while 13% stated that there was no continuous treatment in consulting the doctor. In village Haryana, 23% of the sample respondents stated that doctors did not pay attention, 18% stated that cost was high, 29% stated that they had to wait too long while 30% stated that there was no continuous treatment in consulting the doctor. In village Najimabad, 29% of the sample respondents stated that doctors did not pay proper attention, 18% stated that cost was high, 35% stated that they had to wait too long while 18% stated that there was no continuous treatment in consulting the doctor. In village Mehmoodabad, 31% of the sample respondents stated that doctors did not pay proper attention, 22% stated that cost was high, 40% stated that they had to wait too long while 7% stated that there was no continuous treatment, in consulting the doctor. Although two rupees were charged from the patient but the main problem faced by the patient was that they have to wait too long. Table X. Response of the sample respondents who showed satisfaction/dis-satisfaction with existing health facilities available Satisfied Not satisfied Haryana 5 29 12 71 17 Najimabad 27 71 11 29 38 Mehmoodabad 34 45 41 55 75 Project Area 66 51 64 49 130
Sarhad J. Agric. Vol.25, No.1, 2009 101 Table XI. Problems faced by the sample respondents in consulting the doctor Not pay High Cost Wait too long No continuous attention treatment No `% No % Haryana 4 23 3 18 5 29 5 30 17 Najimabad 11 29 7 18 13 35 7 18 38 Mehmoodabad 23 31 17 22 30 40 5 7 75 Project Area 38 29 27 21 48 37 17 13 130 CONCLUSION AND RECOMMENDATION The study finds that the various social services provided by the government were insufficient. The reasons are many folds. In the education sector the major constraining factors turned out to be lack of schools building, teachers interest, teaching aids, proper seating arrangement for students, un necessary teaching stuff and so on. A number of factors other than government s role which contributed towards lower level of literary were poverty and the concept of no use of female education among parents. In the health sector, a number of factors were found to be responsible for it s under utilization. The health services were not easily accessible and were poorly equipped. The following recommendations are made for making the social services easily available and also ensure efficient utilization of these services. Education i. More schools both for male and female should be opened by the government. ii. Proper school facilities (building, desks, chairs, bathrooms, electricity, water etc.) training of existing teachers and recruitment of new qualified teachers is very essential. Health i. Facilities like X-ray, urine test, blood test and incentives for doctors and medical staff should be provided in the rural health centers of the project area. ii. Public awareness scheme about health and public hygiene should be started through different information media. REFERENCES Abama, E.A. and J. Mangvwat. 1993. Adult education and rural development in Nigeria. J. Afr. Assoc. For Literacy and Adult Edu. 7(2): 23-28. Govt. of Pakistan 2000. Economic Survey 1999-2000. Finance Div. Econ. Advisor s Wing, Islamabad. Govt. of Pakistan. 1999. District Census Report of Charsadda. Population Census Org. Statistics Div. Islamabad. Idris, M. and M. Zafarullah. 1994. Determinants of males education in the rural village of Pakistan. Sarhad J. Agric. 10(3): 237-244. Khan, A.N. and R. Atta.1997. Effectiveness of rural health center: a case study of rural health center Gara Tajik. J. Rural Dev. and Administ. 29(3): 116-140. Markandan, N. 1995. Education for rural development: a blue print. Kurukshetra. 43(4): 10-13, 21. Midhet, F., S. Becker and J. Sinha. 1998. Contextual determinants of maternal mortality in rural Pakistan. Social Sci. and Med. 46(12): 1587-1598.