Medicine and Health Sciences Commons^™

Operability, Usefulness, And Task-Technology Fit Of An Mhealth App For Delivering Primary Health Care Services By Community Health Workers In Underserved Areas Of Pakistan And Afghanistan: Qualitative Study, Shehla Zaidi, Abdul Momin Kazi, Atif Riaz, Ammarah Ali, Rabia Najmi Taha, Rawshan Jabeen, Umerdad Khudadad, Saleem Sayani

Community Health Sciences

Background: The recent proliferation of digital health technology in low- and middle-income countries has made it possible for community health workers (CHWs) to use mobile health (mHealth) to perform tasks such as data collection and training. Although most studies focus on the prospect of digital apps to motivate and connect CHW, only a few have captured end-user experiences with mobile-based apps. We examined the experience of frontline health workers with a move towards digitalized real-time data to record maternal and childcare services in remote areas of Afghanistan and Pakistan.
Objective: Our study aimed to explore CHW perceptions on the operability …

Food Supplements To Reduce Stunting In Pakistan: A Process Evaluation Of Community Dynamics Shaping Uptake, Shehla Zaidi, Jai K. Das, Gul Nawaz Khan, Rabia Najmi Taha, Mashal Murad Shah, Sajid Bashir Soofi

Community Health Sciences

Background: There is an increasing interest in use of food supplements to prevent childhood stunting, however the evidence on the process indicators is scarce. We in this study explore the barriers to the effective implementation of food supplementation programs and the possible mitigation strategies which can guide the design of future programs.
Methods: We undertook a process evaluation of a stunting prevention food supplementation pilot program in rural Pakistan that distributed Wheat Soy Blend (WSB) to pregnant & lactating women, and Lipid-based Nutrient Supplement (LNS) and micronutrient powder (MNP) to < 5 years children. We used a mixed methods approach through a quantitative survey of 800 households and conducted 18 focused group discussion (FGDs) (with male and female caregivers), 4 FGDs (with Community Health Workers (CHWs)) and 22 key informant interviews (with district stakeholders) to evaluate the community side factors affecting uptake through five parameters: value, acceptability, receipt of supplement, usage and correct dosage.
Results: The findings show that proportionately few beneficiaries consumed the …

What Influences Family Planning In Rural Pakistan: Franchised Service Provider And Community Health Worker Perspective, Waqas Hameed, Junaid-Ur-Rehman Siddiqui, Muhammad Ishaque, Sharmeen Hussain, Xaher Gul, Hina Najmi, Shehla Noorani, Ghulam Mustafa, Asma Balal

Community Health Sciences

Background: Pakistan has a low modern contraceptive prevalence rate, 26%, leading family planning (FP) programmes to explore partnerships with local private providers to improve access to quality FP services. This study aims to understand the socio-cultural and organizational factors that influence delivery of quality family planning services.
Methods: This qualitative study was conducted with private service providers and community health workers (CHW) in Marie Stopes Society's (MSS) social franchise network. A total of 31 providers and 28 CHWs from Sindh, Punjab, and Khyber Pakhtunkhwa provinces of Pakistan were purposively selected for in-depth interviews. The study used thematic content analysis to …

Quality Of Care Of Treatment For Uncomplicated Severe Acute Malnutrition Provided By Lady Health Workers In Pakistan, Eleanor Rogers, Muhammad Ali, Shahid Fazal, Deepak Kumar, Saul Guerrero, Imtiaz Hussain, Sajid Bashir Soofi, Jose Luis Alvarez Morán

Department of Paediatrics and Child Health

Objective: To assess the quality of care provided by lady health workers (LHW) managing cases of uncomplicated severe acute malnutrition (SAM) in the community.
Design: Cross-sectional quality-of-care study.
Setting: The feasibility of the implementation of screening and treatment for uncomplicated SAM in the community by LHW was tested in Sindh Province, Pakistan. An observational, clinical prospective multicentre cohort study compared the LHW-delivered care with the existing outpatient health facility model.
Subjects: LHW implementing treatment for uncomplicated SAM in the community.
Results: Oedema was diagnosed conducted correctly for 87·5 % of children; weight and mid upper-arm circumference were measured correctly for …

Potential For Task-Sharing To Lady Health Workers For Identification And Emergency Management Of Pre-Eclampsia At Community Level In Pakistan, Rehana A. Salam, Rahat Najam Qureshi, Sana Sheikh, Asif Raza Khowaja, Diane Sawchuck, Marianne Vidler, Peter Von Dadelszen, Shujaat Zaidi, Zulfiqar Bhutta

Department of Paediatrics and Child Health

Background: An estimated 276 Pakistani women die for every 100,000 live births; with eclampsia accounting for about 10% of these deaths. Community health workers contribute to the existing health system in Pakistan under the banner of the Lady Health Worker (LHW) Programme and are responsible to provide a comprehensive package of antenatal services. However, there is a need to increase focus on early identification and prompt diagnosis of pre-eclampsia in community settings, since women with mild pre-eclampsia often present without symptoms. This study aims to explore the potential for task-sharing to LHWs for the community-level management of pre-eclampsia and eclampsia …

Health Workers’ Perspectives, Knowledge And Skills Regarding Community Case Management Of Childhood Diarrhoea And Pneumonia: A Qualitative Inquiry For An Implementation Research Project “Nigraan” In District Badin, Sindh, Pakistan, Fauziah Rabbani, Shagufta Perveen, Wafa Aftab, Aysha Zahidie, Kashif Sangrasi, Shamim Ahmad Qazi Ahmad Qazi

Community Health Sciences

BACKGROUND:

Pakistan's Lady Health Worker Programme aims to provide care to children sick with pneumonia and diarrhoea, which continues to cause 27 % under-five mortality in Pakistan. The quality of supervision received by Lady Health Workers (LHWs) in the programme influence their knowledge and skills, in turn impacting their ability to provide care.

METHODS:

This study is part of an implementation research project titled "Nigraan" (an Urdu word meaning supervisor), and explores LHW and Lady Health Supervisor (LHS) perspectives regarding the role of supervision in improving LHWs performance and motivation in district Badin, Sindh, Pakistan. Their knowledge and skills regarding …

Effect Of Provision Of An Integrated Neonatal Survival Kit And Early Cognitive Stimulation Package By Community Health Workers On Developmental Outcomes Of Infants In Kwale County, Kenya: Study Protocol For A Cluster Randomized Trial, Lisa G. Pell, Diego G. Bassani, Lucy Nyaga, Isaac Njagi, Catherine Wanjiku, Thulasi Thiruchselvam, William Macharia, Ripudaman S. Minhas, Patricia Kitsao-Wekulo, Amyn Lakhani, Zulfiqar Ahmed Bhutta, Robert Armstrong, Shaun K. Morris

Paediatrics and Child Health, East Africa

Background: Each year, more than 200 million children under the age of 5 years, almost all in low- and middle-income countries (LMICs), fail to achieve their developmental potential. Risk factors for compromised development often coexist and include inadequate cognitive stimulation, poverty, nutritional deficiencies, infection and complications of being born low birthweight and/or premature. Moreover, many of these risk factors are closely associated with newborn morbidity and mortality. As compromised development has significant implications on human capital, inexpensive and scalable interventions are urgently needed to promote neurodevelopment and reduce risk factors for impaired development.

Method/Design: This cluster randomized trial aims at …

Commonly Cited Incentives In The Community Implementation Of The Emergency Maternal And Newborn Care Study In Western Kenya, Peter Gisore, B. Rono, J. Nekesa-Mangeni, C. Tenge, E. Shipala, H. Mabeya, D. Odhiambo, K. Otieno, S. Bucher, C. Makokha, E. Liechty, F. Esamai

Paediatrics and Child Health, East Africa

Background: Mortality of mothers and newborns is an important public health problem in low-income countries. In the rural setting, implementation of community based education and mobilization are strategies that have sought to reduce these mortalities. Frequently such approaches rely on volunteers within each community.

Objective: To assess the perceptions of the community volunteers in rural Kenya as they implemented the EmONC program and to identify the incentives that could result in their sustained engagement in the project.

Method: A community-based cross sectional survey was administered to all volunteers involved in the study. Data were collected using a self-administered supervision tool …

Community Based Weighing Of Newborns And Use Of Mobile Phones By Village Elders In Rural Settings In Kenya: A Decentralised Approach To Health Care Provision, Peter Gisore, Evelyn Shipala, Kevin Otieno, Betsy Rono, Irene Marete, Constance Tenge, Hillary Mabeya, Sherri Bucher, Janet Moore, Edward Liechty, Fabian Esamai

Paediatrics and Child Health, East Africa

Background: Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH) Registry Study of the Global Network for Women and Children’s Health study area in Kenya revealed that up to 70% of newborns did …