Medicine and Health Sciences Commons^™

High Hiv Incidence Among Persons Who Inject Drugs In Pakistan: Greater Risk With Needle Sharing And Injecting Frequently Among The Homeless., Rab Nawaz Samo, Arshad Altaf, Ajmal Agha, Omrana Pasha, Shafquat Rozi, Ashraf Memon, Saleem Azam, Meridith Blevins, Sten Vermund, Sharaf Ali Shah

Community Health Sciences

BACKGROUND:

The incidence of HIV among persons who inject drugs (PWIDU) has fallen in many nations, likely due to successes of clean needle/syringe exchange and substance abuse treatment and service programs. However in Pakistan, prevalence rates for PWID have risen dramatically. In several cities, prevalence exceeded 20% by 2009 compared to a 2003 baseline of just 0.5%. However, no cohort study of PWID has ever been conducted.

METHODS:

We enrolled a cohort of 636 HIV seronegative PWID registered with three drop-in centers that focus on risk reduction and basic social services in Karachi. Recruitment began in 2009 (March to June) …

Bibliographic Review Of Research Publications On Access To And Use Of Medicines In Low-Income And Middle-Income Countries In The Eastern Mediterranean Region: Identifying The Research Gaps., Arash Rashidian, Nader Jahanmehr, Samer Jabbour, Shehla Zaidi, Fatemeh Soleymani, Maryam Bigdeli

Community Health Sciences

BJECTIVES:

We assessed the situation of academic publications on access to and use of medicines (ATM) in low-income and middle-income countries (LMICs) of the Eastern Mediterranean Region (EMR). We aimed to inform priority setting for research on ATM in the region.

DESIGN:

Bibliographic review of published studies.

SETTING:

LMICs in EMR.

INCLUSION CRITERIA:

Publications on ATM issues originating from or focusing on EMR LMICs covering the period 2000-2011. Publications involving multinational studies were included if at least one eligible country had been included in the study.

INFORMATION SOURCES AND DATA EXTRACTION:

We conducted comprehensive searches of the PubMed, Social Science …

Impact Of Social Franchising On Contraceptive Use When Complemented By Vouchers: A Quasi-Experimental Study In Rural Pakistan, Syed Khurram Azmat, Babar Tasneem Shaikh, Waqas Hameed, Ghulam Mustafa, Wajahat Hussain, Jamshaid Asghar, Muhammad Ishaque, Aftab Ahmed, Mohsina Bilgrami

Community Health Sciences

Background: Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society - a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in …

An Overview Of The Predictors Of Depression Among Adult Pakistani Women, Aysha Zahidie, Tanzil Jamali

Community Health Sciences

Diseases of women that are due to their gender specific roles and responsibilities result from cultural and social factors prevalent in the environs. World Health Organization has put special emphasis on research need regarding gender related factors for diseases disproportionately affecting women in developing countries. The objective of this write up was to determine the prevalence of depression and the associated risk factors among adult women in Pakistan. PubMed was searched using key words depression, risk factors, women and Pakistan. Out of 20 initially retrieved articles, 12 were directly related to depression and its risk factors among Pakistani women within …

Needle Stick Injuries--Risk And Preventive Factors: A Study Among Health Care Workers In Tertiary Care Hospitals In Pakistan., Asad Ali Khan Afridi, Ameet Kumar, Raza Sayani

Community Health Sciences

BACKGROUND:

Health care workers (HCWs) are at substantial risk of acquiring blood borne infections such as HIV, Hepatitis-B and Hepatitis-C through needle stick injuries (NSIs). This study aimed to assess the proportion of NSIs and their associated factors among HCWs and also to identify the areas in which preventive efforts might be directed to protect against this occupational hazard.

METHODOLOGY:

A cross-sectional study was conducted in two tertiary care hospitals of Pakistan representing both private and public health sector. A total of 497 HCWs (doctors and nurses) were interviewed using a structured questionnaire. Data was collected from January to May …

Research Fatigue Among Injecting Drug Users In Karachi, Pakistan, Aysha Zahidie, Arshad Altaf, Adeel Ahsan, Tanzil Jamali

Community Health Sciences

Background

Karachi is the largest metropolis of Pakistan and its economic hub attracting domestic migrants for economic opportunities. It is also the epicenter of HIV epidemic in the country. Since 2004, one pilot study and four behavioral and biological surveillance rounds have been conducted in Karachi. In addition many student research projects have also focused on key risk groups including injection drug users (IDUs). As a result of this extra ordinary exposure of same kind of questions, IDUs know how to respond to high value questions related to sharing of needles or unsafe sexual practices. The purpose of the study …

Reproductive Tract Infections Among Married Women In Peri-Urban Areas Of Karachi, Pakistan: A Population-Based Study, Neelofar Sami, Tazeen S. Ali, E. Khan

Community Health Sciences

Background: Reproductive Tract Infections (RTIs) is a major public health problem. In Pakistan, there is dearth of information about the prevalence of RTIs among women and their health seeking behavior. A study was conducted to determine the prevalence, number and types of RTIs among women residing in squatter settlements in Karachi and their health seeking behavior.
Methods: The respondents were married non-pregnant women aged 15–49 years residing in peri-urban areas of Karachi, Pakistan. The interviews with women were followed by their physical and pelvic examinations. Samples swabs collected from vagina and endocervix were tested in laboratory.
Results: Overall, 23.8% of …

Access To Essential Medicines In Pakistan: Policy And Health Systems Research Concerns., Shehla Zaidi, Maryam Bigdeli, Noureen Aleem, Arash Rashidian

Community Health Sciences

NTRODUCTION:

Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i) gaps related to access to essential medicine in Pakistan; and ii) prioritization of emerging policy and research concerns.

METHODS:

An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. …

Need For Multilevel Strategies And Enhanced Acceptance Of Contraceptive Use In Order To Combat The Spread Of Hiv/Aids In A Muslim Society: A Qualitative Study Of Young Adults In Urban Karachi, Pakistan, Syed Farid-Ul-Hasnain, Eva Johansson, Saleema A. Gulzar, Gunilla Krant

Community Health Sciences

This qualitative study explored knowledge, attitudes, beliefs and perceptions of sexual and reproductive health, focusing specifically on contraceptive use and HIV prevention among young unmarried men and women, 17-21 years, in urban Karachi, Pakistan. The main theme, identified as underlying meaning in the focus group discussions was "Societal norms and perceptions create barriers to knowledge and awareness about sexual and reproductive health matters among young adults". A knowledge gap was revealed concerning HIV/AIDS and contraceptive use among young males and females, who have to rely on media and peers for information seeking. Study participants perceived that HIV/AIDS is incurable and …

Performance And Measurement Of A Community-Based Distribution Model Of Family Planning Services In Pakistan, Syed Khurram Azmat, Shirin Ahmed, Waqas Hameed, Mohsina Bilgrami, Ayesha Khan, Adnan Ahmad Khan, Ghulam Mustafa

Community Health Sciences

Introduction: Community-based distribution (CBD) has been successfully applied to family planning (FP) services worldwide. It forms the basis for the large lady health worker (LHW) programme in Pakistan which serves a limited number of women with contraception services. Thus, the concept has seen limited application in Pakistan. We present the outcomes of a CBD model that was implemented in 49 districts across Pakistan by a non-government organization (NGO).
Methods: The Marie Stopes Society (MSS) developed a CBD model around its fixed centres and reached around half a million married women of reproductive age (MWRA) with services. The services provided included …

Social Franchising And Vouchers To Promote Long-Term Methods Of Family Planning In Rural Pakistan: A Qualitative Stocktaking With Stakeholders, Syed Khurram Azmat, Ghulam Mustafa, Waqas Hameed, Jamshaid Asghar, Aftab Ahmed, Babar T. Shaikh

Community Health Sciences

Background: The overall use of modern contraception in Pakistan is quite low, especially in rural areas. Several studies have demonstrated the effectiveness of social franchising (SF) approaches in increasing access to modern contraception and improving the quality of healthcare in resource-poor areas in Asia and Africa. Drawing on best practices in SF, the Marie Stopes Society (MSS) implemented an SF model in certain rural areas of Pakistan to increase access to affordable and quality family planning (FP) services. The model was branded as Suraj (sun) and complemented with an innovative voucher scheme for intrauterine contraceptive devices (IUCDs). This paper describes …

Impact Of Water And Sanitation And Health Education Interventions On Health And Hygiene Behaviors: A Study From A Northern Pakistani Village, Aysha Zahidie, Fauziah Rabbani

Community Health Sciences

Introduction: Water and sanitation interventions were delivered in the northern areas of Pakistan as a joint venture of the Aga Khan University and the Aga Khan Health Systems Oshikhandass Diarrhea and Dysentery Project (1989-96) followed by the Aga Khan Water, Sanitation, Health and Hygiene Studies Program (WSHHSP). Through these interventions water treatment plants, new pit latrines along with a component of health education were introduced. Objectives: To explore perceptions, knowledge and practices of inhabitants of Oshikhandass village in Gilgit related to water quality, latrine use and hand washing following the intervention. Methods: Through a cross-sectional study during June-July 2012, six …

Iud Discontinuation Rates, Switching Behavior, And User Satisfaction: Findings From A Retrospective Analysis Of A Mobile Outreach Service Program In Pakistan, Syed Khurram Azmat, Waqas Hameed, Ghulam Mustafa, Wajahat Hussain, Aftab Ahmed, Mohsina Bilgrami

Community Health Sciences

Background: In Pakistan, the uptake rate for the intrauterine device (IUD) is very low at 2.5%. The most popular modern contraceptive methods in Pakistan are female sterilization and use of condoms. The Marie Stopes Society established its mobile outreach service delivery program with the aim of increasing use of modern quality contraceptive services, including the long-term reversible IUD, by women living in hard-to-reach areas. The present study attempts to assess IUD discontinuation rates and associated factors, including switching behavior and level of satisfaction with this type of service delivery.
Methods: Using a cross-sectional approach, we contacted 681 women who had …

Asbestos Risk Assessment In Pakistan: Current Scenario And Way Forward, Adeel Ahmed Khan, Asaad Ahmed Nafees, Zafar Fatmi

Community Health Sciences

No abstract provided.