Medicine and Health Sciences Commons^™

Perpetuation Of Gender Discrimination In Pakistani Society: Results From A Scoping Review And Qualitative Study Conducted In Three Provinces Of Pakistan, Tazeen Saeed Ali, Shahnaz Shahid Ali, Sanober Nadeem, Zahid Memon, Sajid Bashir Soofi, Falak Madhani, Yasmin Karim, Shah Mohammad, Zulfiqar Ahmed Bhutta

School of Nursing & Midwifery

Background: Gender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender discrimination. The aim of this study is to assess the factors that influence gender discrimination in Pakistan, and its impact on women's life.
Methods: A mixed method approach was used in the study in which a systematic review was done in phase one to explore the themes on gender discrimination, and qualitative interviews were conducted in phase two to explore the perception of people regarding gender discrimination. The qualitative interviews (in-depth interviews and …

Experiences Of Mothers And Significant Others In Accessing Comprehensive Healthcare In The First 1000 Days Of Life Post-Conception During Covid-19 In Rural Uganda, Grace Nakate, Sean Mackay, Eunice Ndirangu, Valerie Fleming

School of Nursing & Midwifery, East Africa

Background: COVID-19 presented an unprecedented global public health challenge because of its rapid and relentless spread, and many countries instituted lockdowns to prevent the spread of infection. Although this strategy mayhave been appropriate to reduce infection, it presented unintended difficulties in rural Uganda, especially in maternal and born newborn care. For example, some services were suspended, meaning the nearest health facility was at a considerable distance. This study explored the experiences of mothers and their significant others of comprehensive care in the first 1000 days of life post-conception during the COVID-19 pandemic in Bunghokho-Mutoto sub-county, Mbale District, Uganda.

Methods …

Resilience And Prenatal Mental Health In Pakistan: A Qualitative Inquiry, Shireen Shehzad, David Arthur, An-Sofie Van Parys, Nicole Letourneau, Gail Wagnild, Shahirose Sadrudin Premji, Nargis Asad, Olivier Degomme

School of Nursing & Midwifery

Background: Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention.
Methods: The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A …

Capacity Building Among Nursing And Midwifery Professional Associations In East Africa, Stephen Ruhmel, Eunice Ndirangu, Joseph Mwizerwa, Ahmed Sarki, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background: Despite improvements in educational opportunities, policy changes, and pay raises in the nursing and midwifery professions in East Africa, poor working conditions, few professional development opportunities, and a general lack of respect for these professions predominate. These issues contribute to a low quality of care among a population with a high burden of communicable diseases. Health professional associations may help to address these challenges by providing a voice for nurses and midwives.

Objective: This study evaluated the impact of a 5-year programme focused on strengthening nurses’ and midwives’ professional associations in East Africa. Methods: This study used …

Association Between Suicidal Attempts In Connection To Discrimination Among Trans Genders, Asghar Ali, Saad Ahmed Khan, Shah Zeb, Zahir Munir, Tazeen Saeed Ali

School of Nursing & Midwifery

Suicide has become a serious public health challenge across the world with around 800,000 people dying by suicide each year. Amongst these a majority of the people (79%) belongs to low and middle-income countries.
Objective:The study aimed to identify the association between suicidal attempts in connection to discrimination among transgender.
Methods: An analytical cross-sectional study was conducted. Data were collected from a registered NGO (Gender Interactive Alliance) from February to May, 2020, using a universal and purposive sampling technique.DatawasanalyzedonSPSS(version21.0).Meanandstandarddeviationwas calculated for frequency distribution, while Chi-square was used for categorical variables.
Results: Overall, 250 transgender were approached through a registered …

Prevalence, Distribution, And Histopathological Features Of Malignant Tumors Reported At Tertiary Level In Afghanistan: A 3-Year Study, Haider Ali Malakzai, Ahmed Maseh Haidary, Saleema A. Gulzar, Mujtaba Haidari, Abdul Sami Ibrahimkhil, Ramin Saadaat, Ahmadullah Hakimi, Sayed Murtaza Sadat Hofiani, Soma Rahmani, Jamshid Abdul Ghafar

School of Nursing & Midwifery

Purpose: Cancer is one of the leading causes of mortality and morbidity, and therefore, tremendous research work is continuously being done around the world with consideration of etiopathogenesis as well as identification of therapeutic targets. Decades of continuous war in Afghanistan has left the medical infrastructure of the country in a miserable situation. There is a serious deficiency in research work in the fields of pathology and oncology at the moment with minimal data available to elaborate about the demographic characteristics of various malignant disorders in the country, which would be indispensable to pave the way for further research and …

Factors Influencing Utilisation Of Services Provided By Community Midwives And Their Non-Retention In District Thatta, Pakistan: A Qualitative Study Protocol, Bakhtawar M Hanif Khowaja, Anam Shahil Feroz, Sarah Saleem

Department of Obstetrics & Gynaecology

Introduction: Drawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to provide skilled birth attendance to pregnant women living in rural areas. Despite a large investment in CMW programme, the availability of community midwives in rural areas following their training is a constant struggle. The concerns related to the training, support and acceptability of community midwives need to be studied in order to identify gaps in the provision of skilled maternal and newborn healthcare. Therefore, this study aims to explore …

A Qualitative Inquiry On Smokers’ Perceptions Of Smoking Cessation During Covid-19, Sajid Iqbal, Rubina Barolia, Kiran Iftikhar, Pammla Petrucka, Jeniefer Anastasi, Faris Farooq Saeed Khan, Naheed Feroz Ali

School of Nursing & Midwifery

Background: This qualitative exploratory study explores smokers’ perspectives regarding smoking cessation processes amid the COVID-19 pandemic.
Methods: Purposive sampling was employed to conduct semi-structured interviews with cigarette smokers visiting cardiac and pulmonary clinics at a tertiary care hospital in Karachi, Pakistan. Thematic analysis was performed to identify themes from the participants’ responses.
Results: Three themes emerged from the thematic analysis. These were smoking cessation facilitators, smoking cessation barriers, and COVID-19 impacts on smoking cessation. Awareness and education, threat of acquiring health problems, religious beliefs and family or support system behave as smoking cessation facilitators. While, role modeling, associating smoking to …

Midwife-Led Community Transformation (Milcot) Nursing Now Challenge In Uganda, Harriet Nayika, Cliff Aliga, Lisa Bayliss-Pratt, Robert Kagwire, Grace Edwards

School of Nursing & Midwifery, East Africa

Summary

This paper describes the journey of a young African midwife utilising the Nursing Now Nightingale Challenge framework to undertake a gap analysis and a mapping exercise to provide high-quality continuous professional development education for midwives working in isolation in a deprived suburb in Uganda. The project was completed in three stages:

• Stage one mapped out the services available within Nansana, Uganda
• Stage two identified the gaps in education for midwives and nurses within the area
• Stage three developed and offered educational study days for nurses, midwives and adolescents based on the gap analysis.

Knowledge, Attitudes, And Preparedness For Managing Pregnant And Postpartum Women With Covid-19 Among Nurse-Midwives In Kenya, Rose Maina, Rachel Kimani, James Orwa, Bernard Mutwiri, Carolyne K. Nyariki, Sheila Shaibu, Valerie Fleming

School of Nursing & Midwifery, East Africa

Introduction: Globally, maternal morbidity and mortality have increased during the COVID-19 pandemic. Given the high burden of maternal and neonatal mortality in Kenya prior to COVID-19, front line health workers, including nurse-midwives, must be competent to ensure continued quality maternal services. Knowledge and awareness of COVID-19 transmission influence nurse-midwives risk perception and ability to implement prevention strategies.

Objective: We examined nurse-midwives’ knowledge, attitudes, and preparedness in managing pregnant and postpartum women with COVID-19 in Kenya.

Methods: A cross-sectional online survey was conducted among 118 nurse-midwives between July 2020 and November 2020. A 31-item survey comprising 15 knowledge, …

Healthcare Providers' Experiences With A Clinical Mentorship Intervention To Improve Reproductive, Maternal And Newborn Care In Mwanza, Tanzania, Kahabi Isangula, Columba Mbekenga, Tumbwene Mwansisya, Loveluck Mwasha, Lucy Kisaka, Edna Selestine, David Siso, Thomas Rutachunzibwa, Secilia Mrema, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Introduction: There is increasing evidence suggesting that clinical mentorship (CM) involving on-the-job training is one of the critical resources—friendly entry points for strengthening the knowledge and skills of healthcare providers (HCPs), which in turn facilitate the delivery of effective reproductive, maternal, and newborn health (RMNH) care. The article explores the experiences of HCPs following participation in the CM program for RMNH in eight districts of Mwanza Region in Tanzania.

Materials and Methods: A qualitative descriptive design employing data from midterm project review meetings and Key Informant Interviews (KIIs) with purposefully selected HCPs (mentors and mentees) and District Medical Officers (DMOs) …

Perinatal Care In Western Uganda: Prevalence And Factors Associated With Appropriate Care Among Women Attending Three District Hospitals, Mercy Muwema, Dan K. Kaye, Grace Edwards, Gorrette Nalwadda, Joanita Nangendo, Jaffer Okiring, Wilson Mwanja, Elizabeth N. Ekong, Joan N. Kalyango, Joaniter I. Nankabirwa

School of Nursing & Midwifery, East Africa

Background: Perinatal mortality remains high globally and remains an important indicator of the quality of a health care system. To reduce this mortality, it is important to provide the recommended care during the perinatal period. We assessed the prevalence and factors associated with appropriate perinatal care (antenatal, intrapartum, and postpartum) in Bunyoro region, Uganda. Results from this study provide valuable information on the perinatal care services and highlight areas of improvement for better perinatal outcomes.

Methods: A cross sectional survey was conducted among postpartum mothers attending care at three district hospitals in Bunyoro. Following consent, a questionnaire was …

Knowledge And Practices Regarding Standard Precautions For Infection Control Among Nurses Working At A Public, Tertiary Care Hospital Islamabad, Pakistan, Samina Yasmeen, Tazeen Saeed Ali, Wardah Khalid, Zohra Kurji, Shair Muhammad Hazara, Shahzad Bashir

School of Nursing & Midwifery

Introduction: To protect patients and healthcare providers from healthcare-associated infections (HAIs), standard precautions have been promoted universally. Nurses are the forefront force in patient care; therefore, evidence-based and up to date knowledge and practices can play a vital role in helping nurses apply standard precautions (SPs).
Methods: The analytical cross-sectional study design was used. Through purposive sampling, the data were collected from 320 nurses, via, a self-administered questionnaire, from April to May 2017, from a public tertiary level hospital in Islamabad. The validity and reliability of each section was established. Mean and standard deviation were computed for continuous variables’ whereas; …

Effects Of Integrating Family Planning With Maternal, Newborn, And Child Health Services On Uptake Of Voluntary Modern Contraceptive Methods In Rural Pakistan: Protocol For A Quasi-Experimental Study, Zahid Memon, Sophie Reale, Wardah Ahmed, Rachael Spencer, Talib Hussain Lashari, Zulfiqar Ahmed Bhutta, Hora Soltani

Centre of Excellence in Women and Child Health

Background: The uptake of modern contraceptive methods (MCMs) remains low, with 25% of women reporting their use in Pakistan. The overarching interventions covering service delivery platforms at facility and community levels necessitate the integration of family planning (FP) with maternal, newborn, and child health (MNCH) services.
Objective: The main aim of this study is to evaluate the impact of an integrated FP-MNCH service delivery model to increase coverage of MCMs in rural Pakistan. Moreover, we aim to measure the level of effectiveness of interventions regarding the uptake of MCMs.
Methods: A quasi-experimental, sequential, mixed methods study design with pre- and …

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 …

Effectiveness Of Implementation Of Standard Clinical Pathway Through Healthcare Professionals Among Acute Myocardial Infarction Patients Undergoing Angiography / Angioplasty In A Public Tertiary Care Hospital, Karachi, Shahzad Bashir, Sarfraz Masih, Rubina Barolia, Muhammad Nawaz Lashari, Iram Amin

School of Nursing & Midwifery

Objective: To assess the effect of acute myocardial infarction standard clinical pathway among acute myocardial infarction patients on length of stay in public tertiary care setting.
Methods: The quasi-experimental non-randomised study was conducted at the Department of Cardiology, Dr Ruth Pfau Civil Hospital, Karachi, from September to December 2018, and comprised acute myocardial infarction patients. Those admitted before the implementation of acute myocardial infarction standard clinical pathway formed the control group, while those admitted after the implementation were in the intervention group. Acute myocardial infarction standard clinical pathway was implemented and the interventional clinical practices of healthcare professionals, including cardiologists, …

The Nine-Item Internet Gaming Disorder Scale (Igds9-Sf): Its Psychometric Properties Among Sri Lankan Students And Measurement Invariance Across Sri Lanka, Turkey, Australia, And The Usa, Amira Mohammed Ali, Rasmieh Al-Amer, Maha Atout, Tazeen Saeed Ali, Ayman M Hamdan Mansour, Haitham Khatatbeh, Abdulmajeed A. Alkhamees, Amin Omar Hendawy

School of Nursing & Midwifery

The prevalence of internet gaming disorders (IGD) is considerably high among youth, especially with the social isolation imposed by the ongoing COVID-19 pandemic. IGD adversely affects mental health, quality of life, and academic performance. The Internet Gaming Disorder Scale (IGDS9-SF) is designed to detect IGD according to DSM-IV diagnostic criteria. However, inconsistent results are reported on its capacity to diagnose IGD evenly across different cultures. To ensure the suitability of the IGDS9-SF as a global measure of IGD, this study examined the psychometric properties of the IGDS9-SF in a sample of Sri Lankan university students (N = 322, mean age …

Bilateral Retractile Testis: A Possible Risk Factor For Male Infertility, Syed Intesar Burni, Shazia R. Khan, Fareena Khalil Ahmed, Sameera Ali Rizvi, Tazeen Saeed Ali

School of Nursing & Midwifery

Healthy youth is an asset and strength for economic and social growth of any society. Developmental changes during puberty of youngsters need proper guidance to avoid future physical, physiological and psychological ailments. Bilateral Retractile Testis (BRT) is a health problem if remains unnoticed till adolescence can lead to tribulations. BRT may affect testicular parenchyma and spermatogenesis. Cremasteric muscles (muscles attached with testes) pull the testes up into groin so it randomly moves up and down and do not reside in its natural pouch always. It has been a controversial issue in male infertility as retraction may affect infertility.
Objective: To …