Medicine and Health Sciences Commons^™

Wealth And Cardiovascular Health: A Cross-Sectional Study Of Wealth-Related Inequalities In The Awareness, Treatment And Control Of Hypertension In High-, Middle- And Low-Income Countries., Benjamin Palafox, Martin Mckee, Dina Balabanova, Khalid F. Khalid, Alvaro Jr Avezum, Ahmad Bahonar, Noorhassim Noorhassim, Jephat Chifamba, Clara K. Chow, Daniel J. Corsi, Gilles R. Dagenais, Rafael Diaz, Rajeev Gupta, Romaina Iqbal, Manmeet Kaur, Rasha Khatib, Annamarie Kruger, Iolanthe Marike Kruger, Fernando Lanas, Patricio Lopez-Jaramillo, Fu Minfan, Viswanathan Mohan, Prem K. Mony, Aytekin Oguz, Lia M. Palileo-Villanueva, Pablo Perel, Paul Poirier, Sumathy Rangarajan, Lei Rensheng, Annika Rosengren, Biju Soman, David Stuckler, S. V. Subramania, Koon Teo, Lungiswa P. Tsolekile, Andreas Wielgosz, Peng Yaguang, Karen Yeates, Mo Yongzhen, Khalid Yusoff, Rita Yusuf, Afzalhussein Yusufali, Katarzyna Zatońska, Salim Yusuf

Community Health Sciences

BACKGROUND:

Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household's ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study.

METHODS:

A cross-section of 163,397 adults aged 35 to 70 …

Antenatal Renal Pelvic Dilatation And Foetal Outcomes - Review Of Cases From A Tertiary Care Center In Karachi, Pakistan, Ruqiya Afroz, Shafia Shakoor, Muhammad Sohail Salat, Shama Munim

Woman and Child Health

Objective: To determine the incidence of antenatal renal pelvic dilatation to evaluate antenatal resolution/ progression and post-natal outcome.
Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of all women found with renal pelvic dilatation in antenatal scans between January 2011 and December 2013. A cut-off of 5mm was used to diagnose renal pelvic dilatation. Renal pelvic dilatation was categorised into three groups: mild (5-6mm in second trimester and 5-9mm in third trimester), moderate (7-10mm in second trimester and 10-15 in third) and severe (more than 10mm in second trimester and more than …

Safeguarding Maternal And Child Health In South Africa By Starting The Child Support Grant Before Birth: Design Lessons From Pregnancy Support Programmes In 27 Countries, M. F. Chersich, Stanley Luchters, D. Blaauw, F. Scorgie, E. Kern, A. Van Den Heever, H. Rees, E. Peach, S. Kharadi, S. Fonn

Population Health, East Africa

Background: Deprivation during pregnancy and the neonatal period increases maternal morbidity, reduces birth weight and impairs child development, with lifelong consequences. Many poor countries provide grants to mitigate the impact of poverty during pregnancy. South Africa (SA) offers a post-delivery Child Support Grant (CSG), which could encompass support during pregnancy, informed by lessons learnt from similar grants.

Objectives: To review design and operational features of pregnancy support programmes, highlighting features that promote their effectiveness and efficiency, and implications thereof for SA.

Methods: Systematic review of programmes providing cash or other support during pregnancy in low- and middle-income countries.

Results: Thirty-two …

Prevalence And Correlates Of Sexual And Gender-Based Violence Against Chinese Adolescent Women Who Are Involved In Commercial Sex: A Cross-Sectional Study, Xu-Dong Zhang, Sierra Myers, Hong-Juan Yang, Yun Li, Ji-Hong Li, Wei Luo, Stanley Luchters

Population Health, East Africa

Objectives: Despite the vast quantity of research among Chinese female sex workers (FSWs) to address concerns regarding HIV/sexually transmitted infection (STI) risk, there is a paucity of research on issues of sexual and gender-based violence (SGBV) and the missed opportunity for sexual and reproductive health (SRH) promotion among young FSWs. Our research aimed to assess the prevalence and correlates of SGBV among Chinese adolescent FSWs, and to explore SRH service utilisation.

Design and methods: A cross-sectional study using a one-stage cluster sampling method was employed. A semistructured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression …

Mapping The Geography Of Child Mortality: A Key Step In Addressing Disparities, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Schools Of Public Health In Low And Middle-Income Countries: An Imperative Investment For Improving The Health Of Populations?, Fauziah Rabbani, Leah Shipton, Franklin White, Iman Nuwayhid, Leslie London, Abdul Ghaffar, Bui Thi Thu Ha, Rajiv Rimal, Anwar Islam, Amirhossein Takian, Samuel Wong, Shehla Zaidi, Kausar S. Khan, Rozina Karmaliani, Imran Naeem Abbasi, Farhat Abbas

Community Health Sciences

BACKGROUND:

Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as …

Reference Ranges Of Handgrip Strength From 125,462 Healthy Adults In 21 Countries: A Prospective Urban Rural Epidemiologic (Pure) Study., Darryl P. Leong, Koon K. Teo, Sumathy Rangarajan, V. Raman Kutty, Fernando Lanas, Chen Hui, Xiang Quanyong, Qian Zhenzhen, Tang Jinhua, Romaina Iqbal

Community Health Sciences

BACKGROUND:

The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions.

METHODS:

HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged …

Sociodemographic Factors Associated With Igg And Igm Seroprevalence For Human Cytomegalovirus Infection In Adult Populations Of Pakistan: A Seroprevalence Survey, Saira Ibrahim, Anwar Ali Siddiqui, Amna Siddiqui, Waquaruddin Ahmed, Paul A. H. Moss, El Nasir Lalani

Department of Biological & Biomedical Sciences

Background: The seroprevalence of human cytomegalovirus (HCMV) infection ranges from 30 to 90 % in developed countries. Reliable estimates of HCMV seroprevalence are not available for Pakistan. This study determined the seroprevalence and sociodemographic factors associated with HCMV infection in adult populations of Karachi, Pakistan.
Methods: A seroprevalence survey was conducted on 1000 adults, including residents of two semi-urban communities, and visitors to a government and a private hospital. Questionnaire-based interviews were conducted. Sera were analysed for HCMV-specific IgG and IgM. Chi-square or Fisher’s exact test was used for comparing sociodemographic variables against seropositivity of HCMV-IgG or IgM. Multiple logistic …

Epidemiology Of Hpv Genotypes Among Hiv Positive Women In Kenya: A Systematic Review And Meta-Analysis, Sonia Menon, Aibibula Wusiman, Marie Claude Boily, Mbabazi Kariisa, Hillary Mabeya, Stanley Luchters, Frode Forland, Rodolfo Rossi, Steven Callens, Davy Vanden Broeck

Population Health, East Africa

Background: There is a scarcity of data on the distribution of human papillomavirus (HPV) genotypes in the HIV positive population and in invasive cervical cancer (ICC) in Kenya. This may be different from genotypes found in abnormal cytology. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18, and the nonavalent vaccine targeting 90% of all ICC cases, such HPV genotype distribution data are indispensable for predicting the impact of vaccination and HPV screening on prevention. Even with a successful vaccination program, vaccinated women will still require screening to detect those who will develop ICC from …

Performance Of Point-Of-Care Cd4 Testing Technologies In Resource-Constrained Settings: A Systematic Review And Meta-Analysis, Minh D. Pham, Paul A. Agius, Lorena Romero, Peter Mcglynn, David Anderson, Suzanne M. Crowe, Stanley Luchters

Population Health, East Africa

Background: Point-of-care (POC) CD4 testing increases patient accessibility to assessment of antiretroviral therapy eligibility. This review evaluates field performance in low and middle-income countries (LMICs) of currently available POC CD4 technologies.

Methods: Eight electronic databases were searched for field studies published between January 2005 and January 2015 of six POC CD4 platforms: PointCare NOW™, Alere Pima™ CD4, Daktari™ CD4 Counter, CyFlow® CD4 miniPOC, BD FACSPresto™, and MyT4™ CD4. Due to limited data availability, meta-analysis was conducted only for diagnostic performance of Pima at a threshold of 350 cells/μl, applying a bivariate multi-level random-effects modelling approach. A covariate extended model was …

Comparative Effects Of Ballooning Intracervical Catheter And Prostaglandin Pessary On Cervical Ripening, Raheela Baloch, Qamarunissa Muhabat, Fakhrunissa Waheed, Waqarunissa Ahmed

Department of Obstetrics & Gynaecology

Labor is induced to stimulate the uterine contraction in effort to have vaginal birth. Induction may be advocated to reduce fetal or neonatal morbidity and mortality. Indication of labor needs to be considered when risk and benefits analysis indicates that delivering the baby is safe option for mother or both rather than continuing the pregnancy and when there are no clear indications for caesarean section and no contraindication for vaginal delivery.

Nutritional Status And Physical Abuse Among The Children Involved In Domestic Labour In Karachi Pakistan: A Cross-Sectional Survey., Saima Zainab, Muhammad Masood Kadir

Community Health Sciences

OBJECTIVE:

To determine the prevalence of physical abuse among domestic child labours and to assess the nutritional status by calculating the Body Mass Index of children involved in domestic labour in Karachi.

METHODS:

A cross sectional study was conducted in the squatter settlements of Karachi. Questionnaire based interviews were conducted to capture physical abuse with 385 children who worked as domestic labour in the household of their employer. The ages of the children were between 10 to 14 years belonging to both genders. The children were enrolled in study by snow-ball sampling technique.

RESULTS:

The overall prevalence of physical abuse …

Comparing Effectiveness Of Active And Passive Client Follow-Up Approaches In Sustaining The Continued Use Of Long Acting Reversible Contraceptives (Larc) In Rural Punjab: A Multicentre, Non-Inferiority Trial, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque, Ghazunfer Abbas, Erik Munroe, Rebecca Harrison, Wajahat Hussain Shamsi, Ghulam Mustafa, Omar Farooq Khan

Community Health Sciences

Background: The use of long-acting reversible contraceptive (LARC) methods is very low in Pakistan with high discontinuation rates mainly attributed to method-related side effects. Mixed evidence is available on the effectiveness of different client follow-up approaches used to ensure method continuation. We compared the effectiveness of active and passive follow-up approaches in sustaining the use of LARC-and within 'active' follow-up, we further compared a telephone versus home-based approach in rural Punjab, Pakistan.
Methods: This was a 12-month multicentre non-inferiority trial conducted in twenty-two (16 rural- and 6 urban-based) franchised reproductive healthcare facilities in district Chakwal of Punjab province, between November …

Recent Strategies To Improve Community Case Management Of Diarrhea Among Children Under Five In Developing Countries, Fauziah Rabbani, Aysha Zahidie

Community Health Sciences

No abstract provided.

Availability, Affordability, And Consumption Of Fruits And Vegetables In 18 Countries Across Income Levels: Findings From The Prospective Urban Rural Epidemiology (Pure) Study., Victoria Miller, Salim Yusuf, Clara K. Chow, Mahshid Dehgha, Daniel J. Corsi, Karen Lock, Barry Popkin, Sumathy Rangarajan, Rasha Khatib, Scott A. Lear, Prem Mony, Manmeet Kaur, Viswanathan Mohan, Krishnapillai Vijayakumar, Rajeev Gupta, Annamarie Kruger, Lungiswa Tsolekile, Noushin Mohammadifard, Omar Rahman, Annika Rosengren, Alvaro Avezum, Andrés Orlandini, Noorhassim Ismail, Patricio Lopez-Jaramillo, Afzalhussein Yusufali, Kubilay Karsidag, Romaina Iqbal, Jephat Chifamba, Solange Martinez Oakley, Farnaza Ariffin, Katarzyna Zatonska, Paul Poirier, Li Wei, Bo Jian, Chen Hui, Liuxu Xu, Bai Xiulin, Koon Teo, Andrew Mente

Community Health Sciences

BACKGROUND:

Several international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability and affordability.

METHODS:

We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data from participants in these communities; we also recorded the diversity …

“A Baby Was An Added Burden”: Predictors And Consequences Of Unintended Pregnancies For Female Sex Workers In Mombasa, Kenya: A Mixed-Methods Study, Stanley Luchters, Wilkister Bosire, Amy Feng, Marlise L. Richter, Nzioki King’Ola, Frances Ampt, Marleen Temmerman, Matthew F. Chersich

Population Health, East Africa

Introduction: Female sex workers (FSW) have high rates of unintended pregnancy, sexually transmitted infections including HIV, and other adverse sexual and reproductive health outcomes. Few services for FSWs include contraception. This mixed-methods study aimed to determine the rate, predictors and consequences of unintended pregnancy among FSWs in Mombasa, Kenya.

Methods: A prospective cohort study of non-pregnant FSWs was conducted. Quantitative data were collected quarterly, including a structured questionnaire and testing for pregnancy and HIV. Predictors of unintended pregnancy were investigated using multivariate logistic regression. Qualitative data were gathered through focus group discussions and in-depth interviews with FSWs who became pregnant …

Mapping Of Research On Maternal Health Interventions In Low- And Middle-Income Countries: A Review Of 2292 Publications Between 2000 And 2012, Matthew Chersich, Duane Blaauw, Mari Dumbaugh, Loveday Penn-Kekana, Siphiwe Thwala, Leon Bijlmakers, Emily Vargas, Elinor Kern, Josephine Kavanagh, Stanley Luchters

Population Health, East Africa

Background: Progress in achieving maternal health goals and the rates of reductions in deaths from individual conditions have varied over time and across countries. Assessing whether research priorities in maternal health align with the main causes of mortality, and those factors responsible for inequitable health outcomes, such as health system performance, may help direct future research. The study thus investigated whether the research done in low- and middle-income countries (LMICs) matched the principal causes of maternal deaths in these settings.

Methods: Systematic mapping was done of maternal health interventional research in LMICs from 2000 to 2012. Articles were included on …

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 …

Obesity, An Emerging Epidemic In Pakistan-A Review Of Evidence., Sana Tanzil, Tanzil Jamali

Community Health Sciences

BACKGROUND:

In Pakistan, the disease pattern is facing a huge changeover from acute and communicable diseases to the non-communicable diseases. Moreover, an emerging epidemic of obesity is still under recognized in Pakistan. A detailed review and dissemination of the existing knowledge to determine the extent of burden of obesity can help understand this important public health issue.

METHODS:

A detailed literature review was conducted through PubMed search engines, regarding obesity burden in Pakistan. The original peer reviewed research articles, reports of WHO in English language, non-government organizations reports were included in the review. "Obesity AND Pakistan" were used as a …

Economic Burden Of Mental Illnesses In Pakistan., Ashar Muhammad Malik, Murad Moosa Khan

Community Health Sciences

BACKGROUND:

The economic consequences of mental illnesses are much more than health consequences. In Low and Middle Income Countries (LMIC) the economic impact of mental illnesses is rarely analyzed. This paper attempts to fill the gap in research on economics of mental health in LMIC. We provide economic burden of mental illness in Pakistan that can serve as an argument for reorienting health policy, resource allocation and priority settings.

AIM:

To estimate economic burden of mental illnesses in Pakistan.

METHODS:

The study used prevalence based cost of illnesses approach using bottom-up costing methodology. We used Aga Khan University Hospital, Psychiatry …

Countdown To 2015 Country Case Studies: What Can Analysis Of National Health Financing Contribute To Understanding Mdg 4 And 5 Progress?, Carlyn Mann, Courtney Ng, Nadia Akseer, Zulfiqar Ahmed Bhutta, Josephine Borghi, Tim Colbourn, Patricia Hernández-Peña, Luis Huicho, Muhammad Ashar Malik, Melisa Ashar Martinez-Alvarez, Spy Munthali, Ahmad Shah Salehi, Mekonnen Tadesse, Mohammed Yassin, Peter Berman

Community Health Sciences

Background

Countdown to 2015 (Countdown) supported countries to produce case studies that examine how and why progress was made toward the Millennium Development Goals (MDGs) 4 and 5. Analysing how health-financing data explains improvements in RMNCH outcomes was one of the components to the case studies.

Methods

This paper presents a descriptive analysis on health financing from six Countdown case studies (Afghanistan, Ethiopia, Malawi, Pakistan, Peru, and Tanzania), supplemented by additional data from global databases and country reports on macroeconomic, health financing, demographic, and RMNCH outcome data as needed. It also examines the effect of other contextual factors presented in …

Association Of Tobacco Use And Other Determinants With Pregnancy Outcomes: A Multicentre Hospital-Based Case-Control Study In Karachi, Pakistan., Shafquat Rozi, Zahid Ahmad Butt, Nida Zahid, Saba Wasim, Kashif Shafique

Community Health Sciences

OBJECTIVES:

The study aimed to identify the effects of maternal tobacco consumption during pregnancy and other factors on birth outcomes and obstetric complications in Karachi, Pakistan.

DESIGN:

A multicentre hospital-based case-control study.

SETTING:

Four leading maternity hospitals of Karachi.

PARTICIPANTS:

A random sample of 1275 women coming to the gynaecology and obstetric department of selected hospitals for delivery was interviewed within 48 hours of delivery from wards. Cases were women with adverse birth outcomes and obstetric complications, while controls were women who had normal uncomplicated delivery.

PRIMARY AND SECONDARY OUTCOME MEASURES:

Adverse birth outcomes (preterm delivery, low birth weight, stillbirth, …

Acceptability And Feasibility Of Point-Of-Care Cd4 Testing On Hiv Continuum Of Care In Low And Middle Income Countries: A Systematic Review, Minh D. Pham, Paul A. Agius, Lorena Romero, Peter Mcglynn, David Anderson, Suzanne M. Crowe, Stanley Luchters

Population Health, East Africa

Background: CD4 testing is, and will remain an important part of HIV treatment and care in low and middle income countries (LMICs). We report the findings of a systematic review assessing acceptability and feasibility of POC CD4 testing in field settings.

Methods: Electronic databases were searched for studies published in English between 2005 and 2015 that describe POC CD4 platforms. Studies conducted in LMICs and under field conditions outside a laboratory environment were eligible. Qualitative and descriptive data analysis was used to present the findings.

Results: Twelve studies were included, 11 of which were conducted in sub-Saharan countries and used …

Important Steps To Maintain The Privacy Of Patients In The Hospital, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

Women are considered as vulnerable groups in our society in spite of their defined women rights by various laws. This shows that unfortunately these laws are not implemented practically in the real life. Society is shaped by the individuals and everyone should be responsible for advocating their own rights as well as the right of others especially of the vulnerable groups within the population.

Available Interventions For Prevention Of Cotton Dust-Associated Lung Diseases Among Textile Workers, Asaad Ahmed Nafees, Zafar Fatmi

Community Health Sciences

The authors reviewed literature on interventions for cotton dust-associated lung diseases among textile workers. Internet sources (PubMed, Cochrane Library, Google and Google Scholar) were accessed and interventions were categorized into: Engineering or administrative controls, or personal protective equipment (PPE). Ten relevant articles were shortlisted, five related to engineering controls (pre-processing, bactericidal treatment of cotton, improved workplace design, machinery and dust control measures). Administrative controls may involve setting standards, environmental surveillance, periodic medical examinations, and workers training. Although specific guidelines are available regarding the use of PPEs, but there was little literature on their effectiveness. It was concluded that there is …

Inspiring Health Worker Motivation With Supportive Supervision: A Survey Of Lady Health Supervisor Motivating Factors In Rural Pakistan, Fauziah Rabbani, Leah Shipton, Wafa Aftab, Kashif Sangrasi, Shagufta Perveen, Aysha Zahidie

Community Health Sciences

BACKGROUND:

Community health worker motivation is an important consideration for improving performance and addressing maternal, newborn, and child health in low and middle-income countries. Therefore, identifying health system interventions that address motivating factors in resource-strained settings is essential. This study is part of a larger implementation research project called Nigraan, which is intervening on supportive supervision in the Lady Health Worker Programme to improve community case management of pneumonia and diarrhea in rural Pakistan. This study explored the motivation of Lady Health Supervisors, a cadre of community health workers, with particular attention to their views on supportive supervision.

METHODS:

Twenty-nine …

Peer Pressure And Family Smoking Habits Influence Smoking Uptake In Teenage Boys Attending School: Multilevel Modeling Of Survey Data., Shafquat Rozi, Sadia Mahmud, Gillian Lancaster, Nida Zahid

Community Health Sciences

Introduction:

Among young teens, about one in five smokes worldwide. Adolescents spend a considerable amount of their time in school, and the school environment is therefore important for child health practices and outcomes.

Objectives:

We aimed to investigate the impact on smoking behavior of the school environment and the personal characteristics of male teenage students attending schools in Pakistan, taking into account the survey sampling structure.

Methods:

A two-stage cluster sampling with stratification was employed, and we interviewed 772 male secondary school students. We adopted random effect and generalizing estimating equation models.

Results:

Peer pressure in particular had a strong …

Important Strategies For Effective Family Planning Counseling, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

No abstract provided.

Male Involvement In Reproductive, Maternal And Child Health: A Qualitative Study Of Policymaker And Practitioner Perspectives In The Pacific, Jessica Davis, Joseph Vyankandondera, Stanley Luchters, David Simon, Wendy Holmes

Population Health, East Africa

Background: The importance of involving men in reproductive, maternal and child health programs is increasingly recognised globally. In the Pacific region, most maternal and child health services do not actively engage expectant fathers and fathers of young children and few studies have been conducted on the challenges, benefits and opportunities for involving fathers. This study explores the attitudes and beliefs of maternal and child health policymakers and practitioners regarding the benefits, challenges, risks and approaches to increasing men's involvement in maternal and child health education and clinical services in the Pacific.

Methods: In-depth interviews were conducted with 17 senior maternal …

Use Of Smokeless Tobacco In Medical Students And Hypertension, Sumera Aziz Ali

Community Health Sciences

No abstract provided.