Digital Commons Network^™

Safety Handbook - Faculty And Staff

University press releases and calendars

No abstract provided.

High Achievers Awards 2014

University anniversary celebration materials

No abstract provided.

What Is Midwifery Work In Low And Middle-Income Countries? A Systematic Review To Enhance Midwifery Practices In Resource-Constrained Contexts, Qorinah Estiningtyas Sakilah Adnani, Ela Nurfitriyani, S. Tr. Keb, Niken Bayu Argaheni, Rufidah Maulina, Victor Abiola Adepoju, Maeve O’Connell

Journal of Asian Midwives (JAM)

Background: Midwifery plays a crucial role in enhancing maternal and newborn health outcomes in low- and middle-income countries (LMIC). This systematic review aims to provide a comprehensive and evidence-based evaluation of midwifery practice in LMIC, beyond specific outcomes and interventions.
Methods: A systematic literature search was conducted using electronic databases including PubMed, Embassy, Scopus, Web of Science, and CINAHL, covering the period from 2019 to 2023. The search strategy employed predefined keywords and Medical Subject Headings (MeSH) terms related to midwives, maternal health, newborn health, and LMIC. The findings were analyzed using a narrative synthesis approach to identify key …

A Child With Severe Pneumonia Cannot Feed, Causing Malnutrition: Exploring Health Worker And Caregiver Perspectives And Practices For Mitigating Malnutrition Among Children With Severe Pneumonia, A Case Of Uganda, Damalie Nalwanga, Robert Opoka, Andrew Sentoogo Ssemata, Lawrence Kakooza, Andrew Kiggwe, Victor Musiime, Sarah Kiguli

Paediatrics and Child Health, East Africa

Background: Severe pneumonia remains the leading cause of morbidity and mortality among children worldwide. Severe pneumonia causes death during hospitalization, and survivors are prone to malnutrition after discharge from the hospital. The World Health Organization and United Nations International Children’s Fund recommend ‘continued’ feeding following a severe pneumonia illness without specific recommendations on nutritional support. This recommendation could influence health workers’ and caregivers’ nutritional practices. This study aimed to explore the perspectives and practices of health workers and caregivers for mitigating malnutrition among children with severe pneumonia.

Methods: We conducted a cross-sectional qualitative study between June and November 2021 among …

The Aga Khan Health Services - International Newsletter No. 23, Aga Khan University

The Aga Khan Health Services Archives

• $ 125,000 Aga Khan Foundation Grant for Better Health Communications

• Contractor Hands Over Buildings

• Dental Health Workshop for School Teachers in Nairobi

• Health Crusade Launched by Nairobi Committee

• First Lady Hospital Administrator

• Hospitals in the Muslim Near East A Historical Overview

• Carbohydrates Versus Protein Controversy

• Dr. John H. Bryant

• Child to Child’ Workshop in India

• George Purvis to Co-ordinate Hospital Services in Asia and Africa

• Hospitals in the Muslim Near East

• Free Eye Clinic in Arusha

• Health Centres Inaugurated in Sind and Northern Pakistan

• Britain Donates …

The Evaluation Of Anti-Factor Xa Levels In Hospitalised Patients Receiving Low Molecular Weight Heparin (Lmwh): A Prospective Study, Tandzile Thandwayinkosi Simelane

Master of Medicine in Clinical Pathology

Background 

Patients admitted to the hospital have been reported to have coagulation abnormalities due to various factors including immobilisation, preexisting disease, and current illness. The overall incidence of venous thromboembolism (VTE) in critically ill patients varies from 15% to well over 50%, even with the use of prophylactic measures in most patients. Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are the recommended drugs for VTE prophylaxis in inpatient care. Although not standardly recommended, the laboratory can offer monitoring of anti-Factor Xa using the gold standard method of chromogenic anti-Factor X assay. The anti-Factor Xa levels are notably affected …

Knowledge, Attitudes, And Practices Of Healthcare Workers Regarding Early Childhood Development: A Mixed-Methods Study At Secondary Care Maternal And Child Care Hospitals In Karachi, Pakistan, Sarosh Hirani, Shelina Bhamani, Hajra Malik, Samira Lakhani, Adeeb Kanji, Khairunnissa Hooda

Journal of Asian Midwives (JAM)

Introduction: Early childhood development (ECD) is a critical period that lays the foundation for a child's future growth and overall well-being. Healthcare settings play a significant role in shaping these developmental outcomes. However, there is limited research evaluating healthcare professionals' knowledge, attitude, and practices on ECD in Pakistan. This study aims to assess the awareness, attitudes, and practices of healthcare providers working in secondary hospitals regarding ECD.
Methods: A sequential explanatory mixed-methods approach was used. The study initially recruited healthcare workers, including physicians, nurses, trainees, and midwives from two secondary care hospitals. Participants completed the Caregiver Knowledge of Child Development …

Development And Validation Of Risk Assessment Tools For Hypertensive Disorder In Pregnancy, Vanitha K, Hepsibah Sharmil, Vijayalakshmi Kandasamy

Journal of Asian Midwives (JAM)

Aims and Background: Hypertensive disorders in pregnancy (HDP) have significant impact on both mothers and newborns leading to complications such as Eclampsia, Preterm delivery, Renal and cardiac problems, Intra Uterine Growth Retardation (IUGR) and Intra Uterine Fetal Death (IUFD). Early screening of hypertensive disorders in pregnancy is essential in the prevention and management of these complications. This research study aims to develop and validate a risk assessment tool for hypertensive disorders in pregnancy.
Materials and methods: A mixed-method research was carried out from December 2023 to December 2024 consisting of two steps. Step one involved the development of …

Contribution Of Maternal Adherence To The Effect Of Multiple Micronutrient Supplementation During Pregnancy: A Systematic Review And Individual Participant Data Meta-Analysis, Emily R. Smith, Filomena Gomes, Seth Adu-Afarwuah, Victor M. Aguayo, Shams El Arifeen, Zulfiqar Ahmed Bhutta, Ellen C. Caniglia, Parul Christian, Arjumand Rizvi, Sajid Bashir Soofi

Centre of Excellence in Women and Child Health

Multiple micronutrient supplements (MMS) in pregnancy reduces risk of infant low birthweight (LBW) and improves other maternal and infant outcomes compared with iron and folic acid (IFA) supplements alone. However, the impact of timing of initiation and adherence on the MMS effectiveness in real-world programs remains unclear. To address this, we conducted a 2-stage individual participant data meta-analysis that included 15 randomized trials (61,204 pregnant women) and assessed whether the relative effect of MMS differed by the following: adherence alone; adherence in combination with gestational age at initiation; and the total number of tablets taken. We also evaluated the observational …

Vitamin D Status And Risk For Breast Cancer In Kenya, Ronald Wasike, Victor Mobegi, Esther Maina, Francis Makokha, Robert Armstrong, Annastacia Mbithi

General Surgery, East Africa

Background: Vitamin D plays a critical role in bone metabolism, calcium regulation, and various cellular processes, including those linked to cancer. The biologically active form, 1,25-dihydroxyvitamin D [1,25(OH)2D], works through the Vitamin D Receptor (VDR). Polymorphisms in VDR and related genes have been associated with cancer risk, including breast cancer. This case-control study aimed to investigate the relationship between serum vitamin D levels and breast cancer among Kenyan women.

Methods: Serum 25-hydroxyvitamin D [25(OH)D] levels were measured in 112 breast cancer patients and 106 controls using electrochemiluminescence.

Results: Results indicated that 81.2% of participants had deficient or insufficient vitamin D …

Institute For Global Health And Development : Issue 11 - July 2025, Institute For Global Health And Development

IGHD Newsletters

• Climate Change, Water, And the Way Forward
• Dr. Zulfiqar Bhutta Joins Global Panel on CGTN America For World Health Day 2025
• IGHD Welcomes New Associate Faculty Members
• Dr. Zulfiqar A. Bhutta Named American Society For Nutrition (ASN) Distinguished Fellow 2025
• IGHD’s Dr. Ammad Qazi Delivers Keynote Address at AKU Climate Change Event
• New IGHD Research Project to Develop Sustainable Health Infrastructure in LMICS

CLIMATE CHANGE, WATER, AND THE WAY FORWARD

The Aga Khan University's Economic Impacts In Pakistan

University press releases and calendars

No abstract provided.

The Aga Khan School Of Nursing

University press releases and calendars

No abstract provided.

The Aga Khan Health Services

University press releases and calendars

No abstract provided.

Anemia: An Uncommon Cause Of Cerebral Venous Sinus Thrombosis, Iqra Athar, Afrah Malik, Neelma Naz Khattak, Tashfain Shifa, Zukhruf Zayian

Pakistan Journal of Neurological Sciences (PJNS)

Cerebral venous sinus thrombosis (CVST) is a multifactorial illness seen more commonly in females as compared to males. Its diagnosis is often delayed due to variable clinical presentations. It is now identified more often due to advancements in neuroimaging modalities. We present an uncommon case of CVST caused by anemia in a 23-year-old female. Our patient presented with complaints of headache since the past two days and left sided hemiplegia since past one day. Later on during her hospital stay she developed generalized tonic clonic seizures. MRI and MRV brain with contrast revealed right cerebral venous (vein of Trolard) thrombosis. …

Exploring Early Childhood Development Programming In Kenya’S Arid And Semi-Arid Lands, Phyllis Magoma, Amina Abubakar, Martha Kaniala, Barack Aoko, Moses Wesala, Joyce Marangu, Susan Nyamanya, Margaret Kabue, Anil Khamis, Esther Chongwo

Institute for Human Development, East Africa

Background: Promoting high-quality early childhood development (ECD) is vital for individuals’ physical and social well-being and yields significant societal returns. However, children in marginalised regions like Kenya’s arid and semi-arid lands (ASALs) face significant barriers to accessing quality ECD services.

Aim: This study aimed to document existing ECD services in Kenya’s ASAL areas, including their availability, types and key characteristics; identify gaps in their provision and propose solutions to enhance access and quality. Setting: This qualitative study was conducted in 10 ASAL counties in Kenya.

Methods: Using purposive and snowball sampling techniques, 103 key informants, including pre-primary …

Supplementation With Ready-To-Use Therapeutic Food Has No Effect On Adverse Outcomes Among Undernourished Children Aged 6–59 Months With Severe Pneumonia, Damalie Nalwanga, Elisa Giallongo, Victor Musiime, Sarah Kiguli, Peter Olupot-Olupot, Florence Alaroker, Robert Opoka, Abner Tagoola, Mainga Hamaluba, Christabel Mogaka

Paediatrics and Child Health, East Africa

Objectives: To investigate the effect of supplementation with ready-to-use therapeutic food (RUTF) on adverse outcomes among undernourished children aged 6–59 months with severe pneumonia.

Methods: This secondary analysis of the COAST-Nutrition (ISRCTN10829073) included children hospitalized for severe pneumonia in Uganda and Kenya. Undernutrition was defined as having either a weight-for-age z score, height-for-age z score, or weight-for-height/length z score below the median of the WHO reference population (< 0) or mid-upper arm circumference (MUAC) below 13.5 cm. Participants were randomized to receive 1 sachet of RUTF daily for 8 weeks in addition to the usual diet (intervention) or usual diet alone (control). The primary composite outcome for adverse events was any one of mortality, re-admission, or deterioration of nutritional status by day 90 of follow-up.

Results: Of 846 main trial participants, 741 (88%) met the inclusion criteria (intervention: 374 versus control: 367). Of 687 (93%) participants in whom the primary outcome was assessed, 370 …

Down Syndrome In Africa: Challenges, Opportunities, And Future Directions, Eimear Mcglinchey, Salina Tewolde, Amanda He, Juan Fortea, Lingani Mbakile-Mahlanza, Ayda Tefera, Emmanuel Epenge, Jason Hassenstab, Rachel Maina, Zul Merali

Brain and Mind Institute

INTRODUCTION: As life expectancy improves for people with Down syndrome (DS) in Africa, the risk of developing DS-associated Alzheimer’s disease (DSAD) will rise. There is a pressing need to plan for this emerging challenge, particularly in the context of existing health and social disparities.

METHODS: This work emerged from a pan-African collaboration, including discussions at the Brain Ageing and Dementia in Low- and Middle-Income Countries conference held in Nairobi in 2024, where stakeholders identified regional priorities for DS and dementia care.

RESULTS: Limited epidemiological, cognitive, biomarker data, delayed diagnoses, and gaps in specialized services may impact access …

The Impact Of Implementing The Women's Reproductive Rights Agenda On Climate Change, Marleen Temmerman, Emilie Peeters, Celine Delacroix, Malachi Arunda, Sara Khalid, Claudia Hanson, Samuel Ojong

Centre of Excellence in Women and Child Health

The 1994 International Conference on Population and Development (ICPD) established sexual and reproductive health and rights (SRHR) as foundational to sustainable development. Thirty years later, advancing women's reproductive rights (WRR), encompassing agency, decision-making autonomy, and universal access to family planning—remains critical not only for health and gender equity but also for mitigating environmental degradation. By reducing unintended pregnancies and empowering women to align childbearing with personal and ecological capacity, WRR alleviates ecological stressors such as deforestation while enhancing health resilience in climate-vulnerable communities. Yet, despite well-documented linkages between population dynamics and environmental change, contemporary climate policies and funding mechanisms persistently …

The Aga Khan University's Economic Impacts In Pakistan

University press releases and calendars

No abstract provided.

Aga Khan University Medical Centre

University press releases and calendars

No abstract provided.

Building The Vision

Vision and mission statements

No abstract provided.

Championing Sustainable Development In Academic Libraries: Insights From East Africa, Arnold Mwanzu, Joseph Mwangi

Book Chapters / Conference Papers

Sustainable development has become a global priority. The United Nations (UN) member states have endorsed the Sustainable Development Goals (SDGs) to transform the world by 2030 into a sustainable society. This chapter reports on academic libraries’ initiatives in East Africa, including Kenya, Uganda, Tanzania and Rwanda, which were explored through interviews and focus groups with librarians from East African university libraries. Library efforts can be assigned to the five priority action areas: advancing policy, transforming learning environments, building the capacity of educators, empowering and mobilising youth, and accelerating local-level action, as envisioned under UNESCO’s Education for Sustainable Development (ESD) framework …

Managing Refractory Epilepsy In A Resource Limited Setting—Doing More With Less, Ruta Yardi, Kurupath Radhakrishnan, Pauline Samia, Janet Wilson, Amza Ali

Paediatrics and Child Health, East Africa

Drug-resistant epilepsy (DRE) disproportionately affects individuals in low- and middle-income countries (LMIC), where access to affordable and effective care remains a significant challenge. Patients with DRE face high healthcare costs, inadequate access to epilepsy surgery, and limited availability of trained professionals. This review explores a multifaceted approach to managing DRE in resource-constrained settings. Key strategies include rational polypharmacy with cost-effective antiseizure medications (ASM), implementation of dietary therapies like the ketogenic diet, and cost-conscious presurgical evaluations. Enhancing emergency care systems, particularly for conditions like status epilepticus, is critical, as is the development of standardized diagnostic and treatment protocols and training programs …

Small For Gestational Age Sub-Groups Have Differential Morbidity, Growth And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Méndez, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, James A. Berkley

Paediatrics and Child Health, East Africa

Background :Small for Gestational Age (SGA) is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birth weight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterise distinct SGA sub-groups and assess their neonatal and early childhood health trajectories.

Objectives: To refine the classification of SGA by identifying sub-groups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.

Study Design: Prospective Cohort Study. In six …

Labour Companionship And Respectful Treatment Of Women During Childbirth: A Cross-Sectional Study Across 16 Hospitals In Benin, Malawi, Tanzania And Uganda, Soha El-Halabi, Kristi Sidney Annerstedt, Christian Agossou, Fadhlun Al-Beity, Andrea B. Pembe, Phillip Wanduru, Bianca Kandeya, Jean-Paul Dossou, Helle Molsted-Alvesson, Claudia Hanson

Centre of Excellence in Women and Child Health

Introduction: Evidence suggests that women value and benefit from having a labour companion during childbirth. However, the applicability of the evidence to low-income and lower-middle-income countries is limited and varies. Thus, we assessed the association between the presence of labour companions and mistreatment in 16 hospitals of Benin, Malawi, Tanzania and Uganda.

Methods: We conducted a cross-sectional survey using a validated questionnaire administered to women at discharge after birth between December 2021 and March 2024. The main outcomes were factor-weighted respectful treatment score and its subscores on maintained respect and dignity, privacy and maintained confidentiality and no physical and verbal …

Pregnancy Care Integrating Translational Science, Everywhere (Precise): A Prospective Cohort Study Of African Pregnant And Non-Pregnant Women To Investigate Placental Disorders – Cohort Profile, Rachel Craik, Joseph Akuze, Marie-Laure Volvert, Hannah Blencowe, Moses Mukhanya, Angela Koech, Grace Mwashigadi, Marleen Temmerman, Marvin Ochieng, Emily Mwadime

Centre of Excellence in Women and Child Health

Purpose: The Pregnancies' Care Integrating translational Science, Everywhere Network was established to investigate specific placental disorders (pregnancy hypertension, preterm birth, fetal growth restriction and stillbirth) in sub-Saharan Africa. We created a repository of clinical and social data with associated biological samples from pregnant and non-pregnant women. Alongside this, local infrastructure and expertise in the field of maternal and child health research were enhanced.

Participants: Pregnant women were recruited in participating health facilities in The Gambia, Kenya and Mozambique at their first antenatal visit or at the time a placental disorder was diagnosed (Kenya and The Gambia only). Follow-up study …

Improving Nutrition Outcomes Through Enhanced Allocative Efficiency Of Investments In 24 High Risk Counties In Kenya: An Optima Nutrition Modelling Study, Morris Ogero, Nick Scott, Veronica Kirogo, Anthony Ngugi

Population Health, East Africa

Introduction ;Undernutrition remains a significant global challenge, severely impacting children’s development and growth. To address this, the Sustainable Development Goals target a substantial reduction in stunting and wasting by 2025. Achieving these goals requires scaling up evidence-based nutritional interventions; however, limited budgets pose challenges in funding all necessary programs. To assist policymakers in making informed decisions, the World Bank developed the Optima Nutrition Modelling tool, which optimizes the allocation of nutrition investments. Kenya, with its high prevalence of stunting, was the focus of this study. Using the Optima Nutrition model, we aimed to (1) assess the impact of scaling up …

Quality Of Perinatal Care: Experiences Of Clients And Providers In Three District Hospitals Of Western Uganda– A Mixed Methods Study, Mercy Muwema, Joaniter Nankabirwa, Dan K. Kaye, Gorrette Nalwadda, Joanita Nangendo, Gloria Odei Obeng-Amoako, Jean Claude Nkurunziza, Wilson Mwanja, Elizabeth N. Ekong, Joan N. Kalyango, Grace Edwards, Emmanuel Otieno, Robert Basaza

School of Nursing & Midwifery, East Africa

Background: It is anticipated that closing the quality gap through provision of effective antenatal, intrapartum and postnatal care for mothers and newborns in facilities will reduce morbidity and mortality. Mothers’ and health care providers’ experiences play a vital role in achieving quality care during the perinatal periods.

Purpose: To assess the health care providers’ (HCPs) and clients’ experiences on quality of perinatal care at three district hospitals in Bunyoro region, Western Uganda.

Methods: A convergent parallel mixed methods study design was utilized to explore experiences of 1) mothers as they sought antenatal, intrapartum, and postnatal care; and 2) …

The Aga Khan Health Services - International Newsletter No. 22, Aga Khan University

The Aga Khan Health Services Archives

• Her Highness Inaugurates Extension of Kisumu Hospital

• Medical and Nursing Student Survey Reveals Health Oddity in Orangi

• Student Survey Reveals Health Oddity

• Appointments at Aga Khan University and Hospital

• School of Nursing Graduates 49% of Karachi Nurses

• Continuing Education Workshops for Lady Health Visitors

• Pakistan Burmah Shell

• Hospitals in the Muslim Near East A Historical Overview

• Good Luck Corporation

• Dr. Dan Kasege

• Aga Khan Health Services Co-Sponsors Conference on Diarrhoeal Diseases

• UNICEF Assists Dar-es-Salaam Hospital

• Nutrition Campaign Launched in U.K.

• Blood Donor Clinic in Toronto

• …