Medicine and Health Sciences Commons^™

Communities, Birth Attendants And Health Facilities: A Continuum Of Emergency Maternal And Newborn Care (The Global Network's Emonc Trial), Omrana Pasha, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem, Shivaprasad S. Goudar, Fernando Althabe, Archana Patel, Fabian Esamai, Ana Garces, Elwyn Chomba, Manolo Mazariegos, Bhala Kodkany, Jose M. Belizan, Richard J. Derman, Patricia L. Hibberd, Waldemar A. Carlo, Edward A. Liechty, K. Michael Hambidge, Pierre Buekens, Dennis Wallace, Lisa Howard-Grabman, Suzanne Stalls, Marion Koso-Thomas, Alan H. Jobe, Linda L. Wright

Community Health Sciences

Background: Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes. Methods/Design: We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and …

Screening Of Hepatitis B And C Among People Visiting General Practice Clinics In A Rural District Of Sindh, Pakistan., Ameet Kumar, Saima Lalani, Asad Ali Khan Afridi, Ali Khan Khuwaja

Community Health Sciences

BACKGROUND:

Hepatitis B (HB), Hepatitis C (HC) and their risk factors are amongst the major health problems in developing countries including Pakistan. This study aimed to screen for HB and HC among people who visited General Practice clinics and also to identify the differences of screening positive cases by age and sex.

METHODS:

This was a retrospective study conducted in Tando Muhammad Khan city, one of the rural districts of Sindh. All together we reviewed 5989 laboratory reports of people for hepatitis B and C on consecutive basis from two laboratories. A pre-designed and structured perform was used to collect …

Predictors Of Obesity Among Post Graduate Trainee Doctors Working In A Tertiary Care Hospital Of Public Sector In Karachi, Pakistan, Sajid Mahmood, Muhammad Kazim Rahim Najjad, Nasir Ali, Naeem Yousuf, Yasir Hamid

Community Health Sciences

Objectives: To identify the predictors of obesity among post graduate trainee doctors working in a tertiary care hospital of public sector at Karachi, Pakistan.
Methods: A cross sectional analytical study was conducted at one of the tertiary care hospitals of public sector in Karachi. Information was collected from 117 post graduate trainee doctors via pre-tested self administered questionnaire and standard tools were used for height and weight measurement. Obesity was defined as body mass index (BMI) > or =23 by using South Asian cut-off points. SPSS version 16 was used for data analysis, and logistic regression technique was applied to come …

Situational Analysis Of Household Energy And Biomass Use And Associated Health Burden Of Indoor Air Pollution And Mitigation Efforts In Pakistan, Zafar Fatmi, Asma Rahman, Ambreen Kazi, Muhammad Masood Kadir, Nalini Sathiakumar

Community Health Sciences

Biomass fuel burning leads to high levels of suspended particulate matter and hazardous chemicals in the indoor environment in countries where it is in common use, contributing significantly to indoor air pollution (IAP). A situational analysis of household energy and biomass use and associated health effects of IAP was conducted by reviewing published and un-published literature about the situation in Pakistan. In addition to attempt to quantify the burden of ill health due to IAP, this paper also appraises the mitigation measures undertaken to avert the problem in Pakistan. Unfortunately, IAP is still not a recognized environmental hazard in Pakistan …

A Probit- Log- Skew-Normal Mixture Model For Repeated Measures Data With Excess Zeros, With Application To A Cohort Study Of Paediatric Respiratory Symptoms, Sadia Mahmud, W. Y. Wendy Lou, Neil W. Johnston

Community Health Sciences

Background: A zero-inflated continuous outcome is characterized by occurrence of "excess" zeros that more than a single distribution can explain, with the positive observations forming a skewed distribution. Mixture models are employed for regression analysis of zero-inflated data. Moreover, for repeated measures zero-inflated data the clustering structure should also be modeled for an adequate analysis. Methods: Diary of Asthma and Viral Infections Study (DAVIS) was a one year (2004) cohort study conducted at McMaster University to monitor viral infection and respiratory symptoms in children aged 5-11 years with and without asthma. Respiratory symptoms were recorded daily using either an Internet …

Knowledge And Awareness About Cervical Cancer And Its Prevention Amongst Interns And Nursing Staff In Tertiary Care Hospitals In Karachi, Pakistan., Syed Faizan Ali, Samia Ayub, Nauman Fazal Manzoor, Sidra Azim, Muneeza Afif, Nida Akhtar, Wassi Ali Jafery, Imran Tahir, Syed Farid-Ul-Hasnian, Najam Uddin

Community Health Sciences

Background and Objective: Cervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It is imperative for at least health professionals in developing countries like Pakistan to have a sound knowledge about the disease. This study was carried out to assess the knowledge and awareness about cervical cancer and its prevention amongst health professionals in tertiary care hospitals in Karachi, Pakistan.
Methods and Design: A cross-sectional, interview based survey was conducted in June, 2009. Sample of 400 was divided between the three tertiary care centers. Convenience sampling was applied …

Contracting Of Primary Health Care Services In Pakistan: Is Up-Scaling A Pragmatic Thinking, Babar Shaikh, F. Rabbani, Najibullah Safi, Zia Dawar

Community Health Sciences

Quite often, public health care systems in developing countries are struggling because of incompetence and a lack of provider responsiveness to the needs of consumers. On the contrary, the private sector dominates the system of health provision. In recent years, contracting has been experimented as an approach to ensure delivery of comprehensive public health services in an efficient, effective, superior and fair manner and has generally thrived well. The state's healthcare system in Pakistan has suffered a lot, owing to structural fragmentation, resource scarcity, inefficiency and lack of functional specificity, gender insensitivity and inaccessibility. However, partnering with the private sector …

Brain Research To Ameliorate Impaired Neurodevelopment - Home-Based Intervention Trial (Brain-Hit), Jan L. Wallander, Elizabeth Mcclure, Fred Biasini, Shivaprasad S. Goudar, Omrana Pasha, Elwyn Chomba, Darlene Shearer, Linda Wright, Vanessa Thorsten, Hrishikesh Chakraborty, Sangappa M. Dhaded, Niranjana S. Mahantshetti, Roopa M. Bellad, Zahid Abbasi, Waldemar Carlo

Community Health Sciences

Background: This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low-and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low-and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality …

A Multicentre Matched Case Control Study Of Risk Factors For Preeclampsia In Healthy Women In Pakistan., Uzma Shamsi, Juanita Hatcher, Azra Shamsi, Nadeem Zuberi, Zeeshan Qadri, Sarah Saleem

Community Health Sciences

Background: Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality world-wide. The risk for developing preeclampsia varies depending on the underlying mechanism. Because the disorder is heterogeneous, the pathogenesis can differ in women with various risk factors. Understanding these mechanisms of disease responsible for preeclampsia as well as risk assessment is still a major challenge. The aim of this study was to determine the risk factors associated with preeclampsia, in healthy women in maternity hospitals of Karachi and Rawalpindi. Methods: We conducted a hospital based matched case-control study to assess the factors associated with preeclampsia …

Potential Benefits And Perceived Need For Health Promoting Hospitals In Pakistan: A Healthcare Stakeholder's Perspective, Asif Raza Khowaja, Rozina Mistry, Ajmal Agha, Rozina Karmaliani

Community Health Sciences

OBJECTIVES: To explore perceptions of healthcare stakeholders' about health promoting hospitals, potential benefits and need in Pakistan.METHODOLOGY: A qualitative exploratory study was conducted between July-August 2007. The data was collected through key-informant (KI) interviews and focus group discussions (FGD) with purposively selected hospital administrators, healthcare providers, health policy makers, and UN-donor agency representatives. The thematic analysis was done using QSR NVivo 2.0; and nodes representing themes were generated.RESULTS: The study participants perceived health promotion, a concept synonymous to health education. Those participants with public health background were better able to relate their perceptions to a more holistic view of health …

Needle Stick Injuries Among Health Care Workers Of Public Sector Tertiary Care Hospitals Of Karachi, Mubashir Aslam, Tahir Taj, Arif Ali, Waseem Mirza, Hammad Ali, Mudassir Iqbal Dar, Nasira Badar

Community Health Sciences

OBJECTIVE: To estimate the frequency of needle stick injuries (NSI) among health care workers (nurses, student nurses and paramedical staff) in public hospitals of Karachi.STUDY DESIGN: Cross sectional, observational.PLACE AND DURATION OF STUDY: This study was conducted in three public tertiary care hospitals of Karachi, from November 2007 to January 2008.METHODOLOGY: Data was collected by structured interview-based questionnaires in Urdu and English language. Questionnaire was designed to obtain information regarding demography, work experience, hepatitis vaccination status, and occurrence of needle stick injuries with associated factors. Needle stick injury that occurred in the previous month was the defined outcome. Data was …

Knowledge, Attitudes And Practices Regarding Dengue Fever Among Adults Of High And Low Socioeconomic Groups, Madiha Syed, Taimur Saleem, Umme-Rubab Syeda, Manal Habib, Rehan Zahid, Atif Bashir, Madiha Rabbani, Madiha Khalid, Asif Iqbal, Ehsen Zawwar Rao, Shujja-Ur-Rehman, Sarah Saleem

Community Health Sciences

OBJECTIVE: To ascertain the knowledge, attitudes and practices of selected adult population in Pakistan regarding Dengue Fever.METHODS: A cross sectional survey was conducted among selected communities with different socio-economic backgrounds in Karachi, Pakistan. A sample size of 440 adults (aged 18 years and above) were interviewed using a pre-tested questionnaire regarding their knowledge, attitude and practices about dengue fever. A composite scoring system, based on the answers given in the questionnaire, was used to establish the level of awareness in the population. The division of the higher and lower socio-economic groups was based on their income and locality; both these …

Father's Support And Literacy--Factors Associated With Child Mortality In Gambat, Sindh-Pakistan, Ajmal Agha, Fozia Ajmal, Azam Iqbal, Franklin White

Community Health Sciences

Objectives: To determine Under Five Mortality Rate (U5MR) in Gambat and to identify causes of and factors associated with it.
Methods: The study was conducted in taluka Gambat of Sindh, Pakistan from December 2002 to August 2003. The sample of at least 510 mothers was needed to capture expected 1020 live births. We interviewed mothers to elicit information about live births in the past five years, under-five mortality and its cause. Additionally, the mothers were also asked about their mobility and availability of husband's support in child's rearing, other than economic support. Approval was sought from Aga Khan University's Ethical …

Landscaping Health Financing Works In Pakistan, Shehla Zaidi, Shafqat Shehzad, Asad Sayeed, Liaquat Khowaja

Community Health Sciences

No abstract provided.