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Full-Text Articles in Medicine and Health Sciences

The Causes Of Preterm Neonatal Deaths In India And Pakistan (Purpose): A Prospective Cohort Study, Sangappa M. Dhaded, Sarah Saleem, Shivaprasad S. Goudar, Shiyam Sunder Tikmani, Kay Hwang, Gowdar Guruprasad, Gayathri H. Aradhya, Varun B. Kusagur, Sana Roujani, Sayyeda Reza Nov 2022

The Causes Of Preterm Neonatal Deaths In India And Pakistan (Purpose): A Prospective Cohort Study, Sangappa M. Dhaded, Sarah Saleem, Shivaprasad S. Goudar, Shiyam Sunder Tikmani, Kay Hwang, Gowdar Guruprasad, Gayathri H. Aradhya, Varun B. Kusagur, Sana Roujani, Sayyeda Reza

Community Health Sciences

Background: Preterm birth remains the major cause of neonatal death worldwide. South Asia contributes disproportionately to deaths among preterm births worldwide, yet few population-based studies have assessed the underlying causes of deaths. Novel evaluations, including histological and bacteriological assessments of placental and fetal tissues, facilitate more precise determination of the underlying causes of preterm deaths. We sought to assess underlying and contributing causes of preterm neonatal deaths in India and Pakistan.
Methods: The project to understand and research preterm pregnancy outcomes and stillbirths in South Asia (PURPOSe) was a prospective cohort study done in three hospitals in Davangere, India, and …


Are Women With Disabilities Less Likely To Utilize Essential Maternal And Reproductive Health Services?-A Secondary Analysis Of Pakistan Demographic Health Survey, Shafaq Mahmood, Waqas Hameed, Sameen Siddiqi Aug 2022

Are Women With Disabilities Less Likely To Utilize Essential Maternal And Reproductive Health Services?-A Secondary Analysis Of Pakistan Demographic Health Survey, Shafaq Mahmood, Waqas Hameed, Sameen Siddiqi

Community Health Sciences

Background: People with disabilities deal with widespread exclusion from healthcare services, including sexual and reproductive health (SRH) rights. Studies analyzing the relationship between disability and key SRH utilization outcomes have often reported mixed findings. In Pakistan, very little to no literature is available on this topic, therefore we aim to determine inequalities in the utilization of essential maternal and reproductive health services between women with and without disabilities in Pakistan.
Methods: This was a secondary analysis of Pakistan Demographic Health Survey 2017-18 performed on a weighted sample of 6,711 women aged 15-49 years with a live birth in the 5 …


The Global Network Socioeconomic Status Index As A Predictor Of Stillbirths, Perinatal Mortality, And Neonatal Mortality In Rural Communities In Low And Lower Middle Income Country Sites Of The Global Network For Women's And Children's Health Research, Archana B. Patel, Carla M. Bann, Cherryl S. Kolhe, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sarah Saleem Aug 2022

The Global Network Socioeconomic Status Index As A Predictor Of Stillbirths, Perinatal Mortality, And Neonatal Mortality In Rural Communities In Low And Lower Middle Income Country Sites Of The Global Network For Women's And Children's Health Research, Archana B. Patel, Carla M. Bann, Cherryl S. Kolhe, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sarah Saleem

Community Health Sciences

Background: Globally, socioeconomic status (SES) is an important health determinant across a range of health conditions and diseases. However, measuring SES within low- and middle-income countries (LMICs) can be particularly challenging given the variation and diversity of LMIC populations.
Objective: The current study investigates whether maternal SES as assessed by the newly developed Global Network-SES Index is associated with pregnancy outcomes (stillbirths, perinatal mortality, and neonatal mortality) in six LMICs: Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan, and Zambia.
Methods: The analysis included data from 87,923 women enrolled in the Maternal and Newborn Health Registry of the NICHD-funded …


Factors Associated With Home Delivery In Rural Sindh, Pakistan: Results From The Global Network Birth Registry, Afreen Sadia, Shafaq Mahmood, Farnaz Naqvi, Seemab Naqvi, Zahid Soomro, Sarah Saleem Mar 2022

Factors Associated With Home Delivery In Rural Sindh, Pakistan: Results From The Global Network Birth Registry, Afreen Sadia, Shafaq Mahmood, Farnaz Naqvi, Seemab Naqvi, Zahid Soomro, Sarah Saleem

Community Health Sciences

Background: According to global estimates for 2017, nearly 295,000 maternal deaths occurred worldwide. Thus, approximately 810 women die every day due to pregnancy-related complications. This burden of maternal deaths in LMICs is primarily due to poor healthcare service utilization, as indicated by relatively low rates of institutional deliveries and skilled-birth attendance (SBA). We conducted this study with an aim to assess the factors associated with home delivery and its subsequent effect on the pregnancy outcome in rural Sindh, Pakistan.
Methods: Data for this study were taken from The Global Network's Maternal Newborn Health Registry (MNHR), which is a prospective, population-based …


What Stops Us From Eating: A Qualitative Investigation Of Dietary Barriers During Pregnancy In Punjab, Pakistan, Muhammad Asim, Zarak Hussain Ahmed, Amy R. Nichols, Rachel Rickman, Elena Neiterman, Anita Mahmood, Elizabeth M. Widen Mar 2022

What Stops Us From Eating: A Qualitative Investigation Of Dietary Barriers During Pregnancy In Punjab, Pakistan, Muhammad Asim, Zarak Hussain Ahmed, Amy R. Nichols, Rachel Rickman, Elena Neiterman, Anita Mahmood, Elizabeth M. Widen

Community Health Sciences

Objective: Adequate dietary intake during pregnancy is vital for the health and nutritional status of both mother and fetus. The nutritional status of reproductive age women in Pakistan is poor, with 14 % being underweight (BMI < 18·5) and 42 % experiencing Fe deficiency anaemia. This may stem from beliefs, practices and other barriers influencing dietary intake. This qualitative study seeks to determine which factors impact dietary intake during pregnancy in rural Punjab.
Design: In-depth interviews and focus group discussions were conducted and then analysed using thematic analysis.
Setting: Three purposively selected rural districts (Sahiwal, Okara and Pakpatan) with the highest prevalence of maternal and child malnutrition in the province of Punjab, Pakistan.
Participants: Mothers with children under age two (n 29) and healthcare providers with at least 5 years of experience working in the district (n …


The Unspoken Grief Of Multiple Stillbirths In Rural Pakistan: An Interpretative Phenomenological Study, Muhammad Asim, Sehrish Karim, Hajra Khwaja, Waqas Hameed, Sarah Saleem Feb 2022

The Unspoken Grief Of Multiple Stillbirths In Rural Pakistan: An Interpretative Phenomenological Study, Muhammad Asim, Sehrish Karim, Hajra Khwaja, Waqas Hameed, Sarah Saleem

Community Health Sciences

Background: Pakistan has the highest rate of stillbirth (30.6 stillbirths per 1000 total births) as compared to other South Asian countries. The psychological impact of stillbirths on bereaved women is well documented; however, there is a dearth of literature on lived experiences of women with multiple stillbirths in Pakistan.
Objective: The purpose of this research is to understand the lived experiences of women who had multiple stillbirths in Thatta, Pakistan.
Methods: An interpretative phenomenological study was conducted in district Thatta with eight women who experienced more than one stillbirth. A semi-structured in-depth interview guide was used for data collection. The …


Knowledge, Attitude And Practices Of Pregnant Women Related To Covid-19 Infection: A Cross-Sectional Survey In Seven Countries From The Global Network For Women's And Children's Health, Farnaz Naqvi, Seemab Naqvi, Sk Masum Billah, Sarah Saleem, Elizabeth Fogleman, Nalini Peres Da-Silva, Lester Figueroa, Manolo Mazariegos, Ana L. Garces, Sana Yousaf Feb 2022

Knowledge, Attitude And Practices Of Pregnant Women Related To Covid-19 Infection: A Cross-Sectional Survey In Seven Countries From The Global Network For Women's And Children's Health, Farnaz Naqvi, Seemab Naqvi, Sk Masum Billah, Sarah Saleem, Elizabeth Fogleman, Nalini Peres Da-Silva, Lester Figueroa, Manolo Mazariegos, Ana L. Garces, Sana Yousaf

Community Health Sciences

Objective: We sought to understand knowledge, attitudes and practices (KAP) regarding COVID-19 in pregnant women in seven low and middle-income countries (LMIC).
Design: Population-based prospective, observational study.
Settings: Study sites in DRC, Kenya, Zambia, Bangladesh, India (two sites), Pakistan and Guatemala.
Population and sample: Pregnant women in the Global Network's Maternal and Neonatal Health Registry (MNHR).
Methods: A KAP questionnaire was administered in face-to-face interviews with pregnant women from September 2020 through October 2021 in the MNHR.
Main outcome measures: KAP regarding COVID-19 during pregnancy.
Results: In all, 25 260 women completed the survey. Overall, 56.8% of women named ≥3 …


Quality Of Care Assessment For Small And Sick Newborns And Young Infants In Pakistan: Findings From A Cross-Sectional Study, Nousheen Pradhan, Sumera Aziz Ali, Sana Roujani, Ammarah Ali, Syed Shujaat Hussain, Samia Rizwan, Shabina Ariff, Sarah Saleem, Sameen Siddiqi Jan 2022

Quality Of Care Assessment For Small And Sick Newborns And Young Infants In Pakistan: Findings From A Cross-Sectional Study, Nousheen Pradhan, Sumera Aziz Ali, Sana Roujani, Ammarah Ali, Syed Shujaat Hussain, Samia Rizwan, Shabina Ariff, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Introduction: Pakistan is facing a challenging situation in terms of high newborn mortality rate. Securing pregnancy and delivery care may not bring a substantial reduction in neonatal mortality, unless coupled with the provision of quality inpatient care for small and sick newborns and young infants (NYIs). We undertook this study to assess the availability and quality of newborn care services provided and the readiness of inpatient care for NYIs in Pakistan.
Methods: We conducted a cross-sectional study across Pakistan from February to June 2019, using a purposive sample of 61% (23) of the 38 sick newborn care units at public …


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 Jan 2022

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 …


Do Empowered Women Receive Better Quality Antenatal Care In Pakistan? An Analysis Of Demographic And Health Survey Data, Muhammad Asim, Waqas Hameed, Sarah Saleem Jan 2022

Do Empowered Women Receive Better Quality Antenatal Care In Pakistan? An Analysis Of Demographic And Health Survey Data, Muhammad Asim, Waqas Hameed, Sarah Saleem

Community Health Sciences

Introduction: Quality antenatal care is a window of opportunity for improving maternal and neonatal outcomes. Numerous studies have shown a positive effect of women empowerment on improved coverage of maternal and reproductive health services, including antenatal care (ANC). However, there is scarce evidence on the association between women's empowerment and improved ANC services both in terms of coverage and quality. Addressing this gap, this paper examines the relationship between multi-dimensional measures of women empowerment on utilization of quality ANC (service coverage and consultation) in Pakistan.
Methods: We used Pakistan Demographic and Health Survey 2017-18 (PDHS) data which comprises of 6,602 …