Medicine and Health Sciences Commons^™

A Systematic Review Of Mental Health Of Women In Fragile And Humanitarian Settings Of The Eastern Mediterranean Region, Fauziah Rabbani, Aysha Zahidie, Amna Siddiqui, Sanam Shah, Zul Merali, Khalid Saeed, Mohamed Afifi

Brain and Mind Institute

Background: The increasing emergencies and humanitarian challenges have worsened the mental health condition of women in the Eastern Mediterranean Region.

Aim: To assess the prevalence, determinants and interventions to address mental health among women in fragile and humanitarian settings in the Eastern Mediterranean Region.

Methods: Using the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, we reviewed 59 peer-reviewed published studies (PubMed, IMEMR) and grey literature (WHO/IRIS) from January 2001 to February 2023, focusing on women's mental health in the Eastern Mediterranean Region. We then conducted a descriptive analysis of the sociodemographic characteristics.

Results: Among …

Employing Telepsychiatry Services To Assess The Prevalence And Identify Mental Health Disorders Using The Phq-9 And Gad-7 In Resource-Constrained Regions Of Dadar Mansehra, Pakistan: An Observational Cross-Sectional Study, Iffat Zafar Aga, Sara Saeed Khurram, Mahek Karim, Muhammad Muzzamil, Shahkamal Hashmi, Kashif Shafique

Medical College Documents

Objective: This study aims to measure the prevalence of mental health disorders in low-resource settings through telepsychiatry and evaluate data from Pakistan's Sehat Kahani nurse-assisted online clinics serving low-income communities. This will help to understand the magnitude and nature of the demand for contextual therapies to promote mental health. The paper will discuss the challenges faced in these settings, such as limited access to mental health facilities, stigma and opportunities telemedicine brings.
Design: An observational cross-sectional study of telepsychiatry consultations using Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7 to screen for depression and anxiety was conducted between October and December …

Workplace Violence Against Healthcare Workers In Pakistan; Call For Action, If Not Now, Then When? A Systematic Review, Syeda Tayyaba Rehan, Mishal Shan, Syed Hasan Shuja, Zayeema Khan, Hassan Ul Hussain, Rohan Kumar Ochani, Asim Shaikh, Iqbal Ratnani, Abdulqadir J. Nashwan, Salim Surani

Department of Medicine

Background: Workplace violence (WPV) is a global problem that affects healthcare workers' physical and mental health and impairs work performance. Pakistan's healthcare system is not immune to WPV, which the World Health Organization recognises as an occupational hazard.
Objectives: The primary objective of this systematic review is to determine the prevalence of physical, verbal, or other forms of WPV in healthcare workers in Pakistan. Secondary objectives include identifying the associated risk factors and perpetrators of WPV.
Methods: A systematic review of six electronic databases was conducted through August 2022. Studies were included if they met the following criteria: 1) healthcare …

Delivering Health Services During Early Days Of Covid-19 Pandemic: Perspectives Of Frontline Healthcare Workers In Kenya’S Urban Informal Settlements, Vibian Angweny, Sabina Odero, Stephen Mulupi, Derrick Ssewanyana, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development

The COVID-19 pandemic has caused widespread disruptions to health, economic and social lives globally. This qualitative study explores frontline healthcare workers’ (HCWs) experiences delivering routine care in Kenya’s informal settlements during the early phases of the pandemic, amidst stringent COVID-19 mitigation measures. Thirteen telephone interviews were conducted with facility and community-based HCWs serving three informal settlements in Nairobi and Mombasa. Data were analyzed using the framework approach. Results indicate there were widespread fears and anxieties surrounding COVID-19 and its management. Secondly, access to facility-based care at the onset of the pandemic was reported to decline, with service availability hampered by …

Health And Socioeconomic Resource Provision For Older People In South Asian Countries: Bangladesh, India, Nepal, Pakistan And Sri Lanka Evidence From Neesama, Natasha Roya Matthews, George James Porter, Mathew Varghese, Nidesh Sapkota, Murad Khan, Ammu Lukose, Stella-Maria Paddick, Malathie Dissanayake, Naila Zaman Khan, Richard Walker

Brain and Mind Institute

Background: The global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. As the number of older adults in LMICs increases, services able to effectively address their physical and mental health needs will be increasingly important.

Objective: We review the health and socioeconomic resources currently available for older people in South Asian countries, Bangladesh, India, Nepal, Pakistan and Sri Lanka, to identify gaps in available resources and assess areas for improvement.

Methods: We conducted a search of grey and published literature via Google Search, Compendex, EBSCO, JSTOR, Medline, Ovid, ProQuest databases, …

Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi

Community Health Sciences

Objectives: A dearth of qualitative studies constrains in-depth understanding of health service providers' perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.
Design: An exploratory qualitative study.
Setting: Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.
Participants: In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.
Results: …

Impact Of Biosecurity Measures, Social Pressure And Bullying On Attitudes, Perceptions, And Job Satisfaction Levels Among Healthcare Workers During The Covid-19 Pandemic: A Cross-Sectional Survey, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho-Leon, Geovanny Efraín Alvarado-Villa, Derly Madeleiny Andrade-Molina, Juan Carlos Fernandez-Cadena, Arjola Agolli, Zeynep Yukselen, Miguel Felix, Juan Carlos Gallardo Bastidas

Department of Paediatrics and Child Health

Introduction: The extent and nature of social pressure and bullying towards healthcare workers (HCWs) during the COVID-19 remains unclear. The following study identifies the effect of social pressure and bullying directed towards HCWs when using biosecurity measures during the COVID-19 pandemic; further, the impact on perceptions, attitudes and job satisfaction level is also explored.
Methodology: We conducted a cross-sectional survey-based study among 684 Ecuadorian HCWs. The survey consisted of 38 questions related to the frequency, attitudes, and perceptions of biosecurity measures during the COVID-19 pandemic. Exploratory factor analysis was performed to assess the validity of the questionnaire. Associations between variables …

The Unspoken Grief Of Multiple Stillbirths In Rural Pakistan: An Interpretative Phenomenological Study, Muhammad Asim, Sehrish Karim, Hajra Khwaja, Waqas Hameed, Sarah Saleem

Community Health Sciences

Background: Pakistan has the highest rate of stillbirth (30.6 stillbirths per 1000 total births) as compared to other South Asian countries. The psychological impact of stillbirths on bereaved women is well documented; however, there is a dearth of literature on lived experiences of women with multiple stillbirths in Pakistan.
Objective: The purpose of this research is to understand the lived experiences of women who had multiple stillbirths in Thatta, Pakistan.
Methods: An interpretative phenomenological study was conducted in district Thatta with eight women who experienced more than one stillbirth. A semi-structured in-depth interview guide was used for data collection. The …

Resilience And Its Associated Factors In Head And Neck Cancer Patients In Pakistan: An Analytical Cross-Sectional Study, Nida Zahid, Wajeeha Zahid, Wardah Khalid, Syed Iqbal Azam, Mubasher Ikram, Aneesa Hassan, Haissan Iftikhar, Shireen Shehzad Bhamani, Adnan Jabbar, Shabbir Akhtar, Moghira Siddiqui, Mohammad Sohail Awan, Nargis Asad, Khabir Ahmad

Department of Surgery

Introduction: The study aimed to assess resilience and its associated factors in head and neck cancer patients, post-treatment in a low middle income country (LMIC) such as Pakistan.
Methods: An analytical cross-sectional study was conducted from November 2019 to May 2020 among head and neck cancer patients aged at least 18 years at the largest private tertiary care hospital, in Karachi, Pakistan. Information regarding their resilience scores was collected through Wagnild and Young's Resilience scale that comprises of 14 items (RS-14). Moreover, depression and anxiety were also assessed via Hospital Anxiety and Depression Scale (HADS) and social support was assessed …

Workplace Mistreatment And Mental Health In Female Surgeons In Pakistan, Mahim Malik, Hina Inam, Russell S. Martins, Mahin B N. Janjua, Nida Zahid, Sadaf Khan, Abida K. Sattar, Shaista Khan, Adil H. Haider, Ather Enam

Section of Cardiothoracic Surgery

Background: Despite workplace mistreatment, which includes harassment, bullying and gender discrimination(GD)/bias, being serious problems for female surgeons, there are limited data from lower-middle-income countries like Pakistan. This study explored harassment and GD/bias experienced by female surgeons in Pakistan, and the effects of these experiences on mental health and well-being.
Methods: A nationwide survey was conducted between July and September 2019 in collaboration with the Association of Women Surgeons of Pakistan, an organization consisting of female surgeons and trainees in Pakistan. An anonymous online survey was emailed directly, disseminated via social media platforms (such as Facebook, Twitter and Instagram), and sent …

Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi

School of Nursing & Midwifery

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children's and adolescent's mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children's and adolescents' mental health.
Methodology: We conducted …

Impact Of The Covid-19 Pandemic On Mental Health And Well-Being Of Communities: An Exploratory Qualitative Study Protocol, Anam Shahil Feroz, Naureen Akber Ali, Noshaba Akber Ali, Ridah Feroz, Salima Nazim Meghani, Sarah Saleem

Community Health Sciences

Introduction: The COVID-19 pandemic has certainly resulted in an increased level of anxiety and fear in communities in terms of disease management and infection spread. Due to fear and social stigma linked with COVID-19, many individuals in the community hide their disease and do not access healthcare facilities in a timely manner. In addition, with the widespread use of social media, rumours, myths and inaccurate information about the virus are spreading rapidly, leading to intensified irritability, fearfulness, insomnia, oppositional behaviours and somatic complaints. Considering the relevance of all these factors, we aim to explore the perceptions and attitudes of community …

Fear Of Covid-19 Among Pregnant Women In Pakistan: A Cross-Sectional Study, Sidrah Nausheen, Shelina Bhamani, Areeba Makhdoom, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Background: The emergence of COVID-19 and its pandemic nature has exacerbated fears worldwide. Pregnant women are considered a vulnerable group during the COVID-19 pandemic because the physiological changes make them more susceptible to infections. Pregnant women are found expressing much of the fear related to their course of pregnancy, the in-utero transmission of the disease, and questions related to infection control in healthcare settings. Hence, the purpose of this paper was to explore the fears faced by pregnant women related to COVID.
Methods: It was a cross-sectional survey among 201 pregnant women attending antenatal clinics of Aga Khan University Hospital. …

Self-Reported Academic Performance In Relation To Health Behaviours Among Bahria University Students, Rehana Rehman, Amara Zafar, Aleena Mohib, Mehwish Hussain, Rabiya Ali

Department of Biological & Biomedical Sciences

Objective: To find an association between self-reported academic performance with different socio-demographic factors, health behaviours and mental health amongst university students.
Methods: This cross-sectional study was conducted at Bahria University, Karachi, from January 2012 to December 2013, and comprised university students of different disciplines. An anonymous, self-reported questionnaire was distributed among the subjects. Convenient sampling technique was used. Demographic information, including age, gender and field of study, were obtained. Depresion was evaluated via Centre for Epidemiological Studies Depression Scale. SPSS 22 was used to analyse data.
Results: Of the 813 respondents, 334(41.1%) were males and 479(58.9%) females. The mean age …

Conflict In South Asia And Its Impact On Health, Siddarth David, Rukhsana Gazi, Mohammed Shafiq Mirzazada, Chesmal Siriwardhana, Sajid Bashir Soofi, Nobhojit Roy

Department of Paediatrics and Child Health

South Asia has a large population affected by different types of protracted conflict and can provide critical insights to understand health challenges in conflict zones.
Health systems in conflict affected areas should prioritise domestic and gender-based violence, along with reproductive and sexual health services.
Mental health and psychosocial services for conflict-affected populations in South Asia need to be strengthened, and these services should be integrated into existing primary care platforms.
Building the capacity of the existing healthcare system and developing a trained local workforce can improve the access to and availability and acceptability of health services in conflict-affected communities.
Research …

Mental Health Of African Asylum-Seekers And Refugees In Hong Kong: Using The Social Determinants Of Health Framework, William Chi Wai Wong, Sealing Cheung, Heidi Yin Hai Miu, Julie Chen, Kelley Ann Loper, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

Background: Hong Kong is non-signatory to the 1951 Refugee Convention and its 1967 Protocol, and has no systematic domestic policies committed to the rights of asylum-seekers and refugees (ASRs). This creates a tenuous setting for African ASRs there. This study explored how mapped social determinates of health has impacted the mental health and wellbeing of African ASR’s in Hong Kong.

Methods: A cross-sectional survey was carried out with 374 African ASRs. The survey comprised of: (a) sociodemographics; (b) health status; (c) health behaviours; and, (d) social experiences. Associations between social determinants of health and depression screen were explored and multivariable …