Digital Commons Network^™

Exploring Digital Health Interventions For Pregnant Women At High Risk For Pre-Eclampsia And Eclampsia In Low-Income And-Middle-Income Countries: A Scoping Review, Anam Shahil Feroz, Noreen Afzal, Emily Seto

Community Health Sciences

Objective: To explore digital health interventions that have been used to support pregnant women at high risk for pre-eclampsia/eclampsia (HRPE/E) in low-income and middle-income countries (LMICs).
Design: Scoping review.
Data source: EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched between 1 January 2000 and 20 October 2020.
Eligibility criteria: The review included original research studies that were published in English, involved pregnant women at HRPE/E and implemented digital health interventions for PE/E in LMICs.
Data extraction and synthesis: Two reviewers independently completed the data extraction for each of the 19 final …

Anal Human Papillomavirus Infection Among Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Pakistan: Findings From A Cross-Sectional Study, Muslima Ejaz, Soren Andersson, Salma Batool, Tazeen Saeed Ali, Anna Mia Ekström

Community Health Sciences

Objectives: The aim of this study was to determine the prevalence of infection, genotypes and risk factors for human papillomavirus (HPV) among men who have sex with men (MSM) and transgender women living with and without HIV in Pakistan. Anal infection with HPV is very common worldwide among MSM, particularly among MSM living with HIV. The high prevalence of HIV among MSM and male-to-female transgendered individuals in Pakistan is a significant health concern since access to screening and health-seeking is often delayed in this stigmatised key population.
Design: This cross-sectional study was conducted between March 2016 and November 2017.
Participants, …

Exploring Community Perceptions, Attitudes And Practices Regarding The Covid-19 Pandemic In Karachi, Pakistan, Anam Shahil Feroz, Naureen Akber Ali, Ridah Feroz, Noshaba Akber, Salima Nazim Meghani

Community Health Sciences

Background: The Government of Pakistan is facing difficulty to contain the surge of COVID-19 due to the country's social, political, economical and cultural context. Experiences from the previous epidemic suggest that community perceptions, social norms and cultural practices can impede COVID-19 containment. To understand social responses towards COVID-19, the study aims to explore the understanding of COVID-19 and the acceptance of control measures among community members.
Methods: We conducted an exploratory qualitative study using a purposive sampling approach, at two communities of Karachi, Pakistan. In-depth interviews were conducted with community members including, young, middle-aged and older adults of both genders. …

Perceptions And Experiences Of Healthcare Providers During Covid-19 Pandemic In Karachi, Pakistan: An Exploratory Qualitative Study, Anam Shahil Feroz, Nousheen Pradhan, Zarak Hussain Ahmed, Mashal Murad Shah, Nargis Asad, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Objective: To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.
Design and setting: We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.
Participants: Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.
Results: A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced …

Smokeless Tobacco Initiation, Use And Cessation In South Asia: A Qualitative Assessment, Faraz Siddiqui, Ray Croucher Ray Croucher, Fayaz Ahmad, Zarak Hussain Ahmed, Roshani Babu, Linda Bauld, Fariza Fieroze, Rumana Huque, Maira Mubashir, Narjis Rizvi

Community Health Sciences

Introduction: Smokeless tobacco (ST) is a significant South Asian public health problem. This paper reports a qualitative study of a sample of South Asian ST users.
Methods: Interviews, using a piloted topic guide, with 33 consenting, urban dwelling adult ST users explored their ST initiation, continued use and cessation attempts. Framework data analysis was used to analyse country specific data before a thematic cross-country synthesis was completed.
Results: Participants reported long term ST use and high dependency. All reported strong cessation motivation and multiple failed attempts because of ease of purchasing ST, tobacco dependency and lack of institutional support.
Conclusions: …

Impact Of Social Isolation On Mortality And Morbidity In 20 High-Income, Middle-Income And Low-Income Countries In Five Continents, Ryo Naito, Darryl P. Leong, Shrikant Ishve Bangdiwala, Martin Mckee, S V. Subramanian, Sumathy Rangarajan, Shofiqul Islam, Alvaro Avezum, Karen E. Yeates, Syed Iqbal Azam

Community Health Sciences

Objective: To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries.
Design: Population-based prospective observational study.
Setting: Urban and rural communities in 20 high income, middle income and low income.
Participants: 119 894 community-dwelling middle-aged adults.
Main outcome measures: Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases.
Results: Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and …

Impact Of The Covid-19 Pandemic On Mental Health And Well-Being Of Communities: An Exploratory Qualitative Study Protocol, Anam Shahil Feroz, Naureen Akber Ali, Noshaba Akber Ali, Ridah Feroz, Salima Nazim Meghani, Sarah Saleem

Community Health Sciences

Introduction: The COVID-19 pandemic has certainly resulted in an increased level of anxiety and fear in communities in terms of disease management and infection spread. Due to fear and social stigma linked with COVID-19, many individuals in the community hide their disease and do not access healthcare facilities in a timely manner. In addition, with the widespread use of social media, rumours, myths and inaccurate information about the virus are spreading rapidly, leading to intensified irritability, fearfulness, insomnia, oppositional behaviours and somatic complaints. Considering the relevance of all these factors, we aim to explore the perceptions and attitudes of community …

Healthcare Utilisation And Expenditure Patterns For Cardio-Metabolic Diseases In South Asian Cities: The Carrs Study, Priti Gupta, Kalpana Singh, Roopa Shivashankar, Kavita Singh, Ajay Vamadevan, V Mohan, Muhammad Masood Kadir, Nikhil Tandon, K M. Narayan, Dorairaj Prabhakaran, Mohammed K. Ali

Community Health Sciences

Objective: To estimate average annual expenditures per person, total economic burden and distress health financing associated with the treatment of five cardio-metabolic diseases (CMDs-hypertension, diabetes, heart disease (angina, myocardial infarction and heart failure), stroke and chronic kidney disease) in three metropolitan cities in South Asia.
Design: Cross-sectional surveys.
Setting: We analysed community-based baseline data from the Centre for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study collected in 2010-2011 representing Chennai and New Delhi (India), and Karachi (Pakistan).
Participants: We used data from non-pregnant adults (≥20 years) from the aforementioned cities that responded to a cost-of-illness questionnaire. We estimated health …

Global Strategies And Local Implementation Of Health And Health-Related Sdgs: Lessons From Consultation In Countries Across Five Regions, Sameen Siddiqi, Wafa Aftab, Fahad Javaid Siddiqui, Luis Huicho, Roman Mogilevskii, Peter Friberg, Johanna Lindgren-Garcia, Sara Causevic, Anil Khamis, Mashal Murad Shah, Zulfiqar Ahmed Bhutta

Community Health Sciences

Evidence on early achievements, challenges and opportunities would help low-income and middle-income countries (LMICs) accelerate implementation of health and health-related sustainable development goals (HHSDGs). A series of country-specific and multicountry consultative meetings were conducted during 2018-2019 that involved 15 countries across five regions to determine the status of implementation of HHSDGs. Almost 120 representatives from health and non-health sectors participated. The assessment relied on a multidomain analytical framework drawing on existing public health policy frameworks. During the first 5 years of the sustainable development goals (SDGs) era, participating LMICs from South and Central Asia, East Africa and Latin America demonstrated …

Impact Of The Societal Response To Covid-19 On Access To Healthcare For Non-Covid-19 Health Issues In Slum Communities Of Bangladesh, Kenya, Nigeria And Pakistan: Results Of Pre-Covid And Covid-19 Lockdown Stakeholder Engagements, Syed A K Shifat Ahmed, Motunrayo Ajisola, Kehkashan Azeem, Pauline Bakibinga, Yen-Fu Chen, Narjis Rizvi, Syed Iqbal Azam, Romaina Iqbal, Ahsana Nazish, Komal Tabani

Community Health Sciences

Introduction: With COVID-19, there is urgency for policymakers to understand and respond to the health needs of slum communities. Lockdowns for pandemic control have health, social and economic consequences. We consider access to healthcare before and during COVID-19 with those working and living in slum communities.
Methods: In seven slums in Bangladesh, Kenya, Nigeria and Pakistan, we explored stakeholder perspectives and experiences of healthcare access for non-COVID-19 conditions in two periods: pre-COVID-19 and during COVID-19 lockdowns.
Results: Between March 2018 and May 2020, we engaged with 860 community leaders, residents, health workers and local authority representatives. Perceived common illnesses in …

Multicomponent Intervention Versus Usual Care For Management Of Hypertension In Rural Bangladesh, Pakistan And Sri Lanka: Study Protocol For A Cluster Randomized Controlled Trial., Tazeen H. Jafar, Imtiaz Jehan, H. Asita De Silva, Aliya Naheed, Mihir Gandhi, Pryseley Assam, Eric A. Finkelstein, Helena Legido Quigley, Marcel Bilger, Aamir Hameed, John David Clemens, Shah Ebrahim, Elizabeth L. Turner, Anuradhani Kasturiratne

Community Health Sciences

BACKGROUND:

High blood pressure (BP) is the leading attributable risk for cardiovascular disease (CVD). In rural South Asia, hypertension continues to be a significant public health issue with sub-optimal BP control rates. The goal of the trial is to compare a multicomponent intervention (MCI) to usual care to evaluate the effectiveness and cost-effectiveness of the MCI for lowering BP among adults with hypertension in rural communities in Bangladesh, Pakistan and Sri Lanka.

METHODS/DESIGN:

This study is a stratified, cluster randomized controlled trial with a qualitative component for evaluation of processes and stakeholder feedback. The MCI has five components: (1) home …

Can Right To Health Help Policy Makers To Address Maternal Mortality?: A Short Communication, Sumera Aziz Ali, Nadir Suhail, Savera Aziz Ali

Community Health Sciences

No abstract provided.

Landscape Analysis Of Multi-Sectoral Initiatives For Under-Nutrition In Pakistan, Zulfiqar Ahmed Bhutta, Albertha Nyaku, Jane Keylock, Shehla Zaidi, Jai Das

Community Health Sciences

Mapping of Multi-Sectoral Initiatives for Nutrition in Pakistan, Challenges faced, Opportunities, and potential for Cross- Sectoral Synergies.