Women's Health Commons^™

Incidence And Outcome Of Small For Gestational Age Fetuses: An Experience From A Secondary Care Hospital, Riffat Bano, Nousheen Asim, Ammara Mushtaq, Mehreen Adhi, Noureen Afzal

Department of Obstetrics & Gynaecology

The objective of the study was to determine the frequency and outcome of Small for Gestational Age (SGA) foetuses, and its association with the mode of delivery, foetal birthweight, maternal age and gestational age. It was a hospital-based descriptive study, conducted at Aga Khan Hospital for Women, Karachi, from January 2009 to December 2010. Mode of deliveries, foetal birthweight, maternal age and gestational age of SGA foetuses were recorded and analszed. Of a total of 6024 deliveries during the study period, 722(11.98%) had SGA foetuses. Maternal age in such cased ranged between 20-40 years in 588(81.44%), while 406(56.23%) of these …

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 …

Assessment Of Competence For Caesarean Section With Global Rating Scale, Rahat Najam Qureshi, Syeda Kauser Ali

Department for Educational Development

Objective: To establish as reliable and valid the nine-point global rating scale for assessing residents\' independent performance of Caesarean Section.

Methods: The validation study was conducted at the Department of Obstetrics and Gynaecology, Aga Khan University Hospital, from April to December 2008, and comprised 15 residents during 40 Caesarean Sections over 9 months. Independently two evaluators rated each procedure and the difficulty of each case.

Results: The observations per faculty ranged from 1-8 (mean 4.07± 2.56). The Year 4 residents were observed the most i.e. 32 (40%), followed by Year 3, 30 (37.5%); Year 2; 14 (17.5%); and Year 1, …

The Relationship Between Prenatal Stress, Depression, Cortisol And Preterm Birth: A Review, Kiran Shaikh, Shahirose Premji, Khurshid Khowaja, Suzanne Tough, Ambreen Kazi, Shaneela Khowaj

School of Nursing & Midwifery

Preterm birth is one of the most common adverse pregnancy outcomes. Maternal risk factors such as stress and depression have been associated with preterm birth. Preterm infants are at a higher risk of poor growth and neuro developmental outcomes. The objective of this paper is to examine the relationship between maternal stress, depression, cortisol level, and preterm birth. Preterm birth is one of the most common adverse pregnancy outcomes with a global prevalence of 9.6% and one of the major contributors to infant mortality and morbidity. The association between psychosocial stress and preterm birth, although examined for more than 25 …

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 …

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 …

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 …

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 …

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 …

Accessibility Of Antenatal Services At Primary Healthcare Facilities In Punjab, Pakistan, Muhammad Ashraf Majrooh, Seema Hasnain, Javaid Akram, Arif Siddiqui, Fatimah Shah, Zahid Memon

Centre of Excellence in Women and Child Health

Introduction: Almost one-fifth of the world\'s population constitutes women of reproductive age who are repeatedly exposed to pregnancy and childbearing. Many are often at high risk of illness and mortality during pregnancy and require maternal healthcare services for early detection of complications. More than 0.5 million women die every year worldwide due to pregnancy-related complications. Almost 0.03 million of them are in Pakistan. Maternal healthcare in Pakistan is poor and results in high rates of morbidity and mortality. This paper evaluates the accessibility of antenatal care (ANC) services in primary healthcare settings in the Punjab province of Pakistan during the …

Global Epidemiology Of Invasive Meningococcal Disease, Rabab Z. Jafri, Syed Asad Ali, Nancy E. Messonnier, Carol Tevi-Benissan, David Durrheim, Juhani Eskola, Florence Fermon, Keith P. Klugman, Mary Ramsay, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Neisseria meningitidis is one of the leading causes of bacterial meningitis globally and can also cause sepsis, pneumonia, and other manifestations. In countries with high endemic rates, the disease burden places an immense strain on the public health system. The worldwide epidemiology of invasive meningococcal disease (IMD) varies markedly by region and over time. This review summarizes the burden of IMD in different countries and identifies the highest-incidence countries where routine preventive programs against Neisseria meningitidis would be most beneficial in providing protection. Available epidemiological data from the past 20years in World Health Organization and European Centre for Disease Prevention …

Silent Uterine Rupture Of Scarred Uterus--An Unusual Presentation As Amniocele, Aisha Syed Wali, Tahira Naru

Department of Obstetrics & Gynaecology

Obstetricians should be aware of the possibility of silent rupture of scarred uterus. Ultrasound has an important role in the diagnosis of silent uterine rupture. A case of silent uterine rupture with foetal demise, that remained undiagnosed for many weeks, is described.