Medicine and Health Sciences Commons^™

Are Pre-School Girls More Likely To Be Under-Nourished In Rural Thatta, Pakistan?-A Cross-Sectional Study., Rozina Nuruddin, Wilbur C. Hadden

Community Health Sciences

BACKGROUND:

Pakistan ranks third lowest on a global gender index (2013) and 13(th) highest on the prevalence of underweight among under-five children (2010). Through this population-based study, we examined gender differentials in the prevalence of stunting, wasting and under-weight defined by World Health Organization (WHO) Growth Standard among rural pre-school Pakistani children.

METHODS:

We performed secondary analysis of data collected through a cross-sectional survey of Thatta district during 1992-93. Prevalence ratios were calculated for 1051 children aged 0-35 months from 95 randomly selected villages of rural Pakistan using a clustered adjusted log binomial model. Level 1 variables included child and …

Family Planning Knowledge, Attitudes, And Practices Among Married Men And Women In Rural Areas Of Pakistan: Findings From A Qualitative Need Assessment Study, Ghulam Mustafa, Syed Khurram Azmat, Waqas Hameed, Safdar Ali, Muhammad Ishaque, Wajahat Hussain, Aftab Ahmed, Erik Munroe

Community Health Sciences

This paper presents the findings of a qualitative assessment aimed at exploring knowledge, attitudes, and practices regarding family planning and factors that influence the need for and use of modern contraceptives. A descriptive exploratory study was conducted with married women and men aged between 15 and 40. Overall, 24 focus group discussions were conducted with male and female participants in three provinces of Pakistan. The findings reveal that the majority knew about some modern contraceptive methods, but the overall contraceptive use was very low. Knowledge and use of any contraceptive method were particularly low. Reasons for not using family planning …

Low Prevalence Of Asthma Among Textile Workers In Karachi, Pakistan, Sana Tanzil, Asaad A. Nafees

Community Health Sciences

Objective: To determine the prevalence of asthma in textile workers through post-bronchodilator spirometry and to compare the differences in prevalence based on different criteria used to assess asthma.
Methods: The cross-sectional study was conducted between July and December 2013 in Karachi, Pakistan, and comprised workers from15 textile mills in the city and its outskirts. Asthma and associated respiratory symptoms were assessed using the American Thoracic Society Division of Lung Diseases Questionnaire, and post-bronchodilator spirometry. SPSS 19 was used for statistical analysis.
Results: Among the 372 workers in the study, asthma was found in 19(5%) as diagnosed on post-bronchodilator spirometry. The …

Assessing Predictors Of Contraceptive Use And Demand For Family Planning Services In Underserved Areas Of Punjab Province In Pakistan: Results Of A Cross-Sectional Baseline Survey, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Waqas Hameed, Omar Farooq Khan, Ghazunfer Abbas, Marleen Temmerman, Erik Munroe

Community Health Sciences

Background: Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed.
Method: A cross-sectional baseline household survey …

Comparing Lung Function Of Textile Workers With The Healthy Pakistani Population, Unaib Rabbani, Asaad Ahmed Nafees

Community Health Sciences

Background: The purpose of this study was to compare lung function of textile workers with healthy Pakistani population, compare predicted values based on the European Respiratory Society (ERS) equations with those based on the Pakistani equations, and to develop predictor equations for textile workers in Pakistan.
Methods: This was a secondary analysis of data from two previous surveys where lung function of textile workers was compared with healthy Pakistani men. Spirometry was performed according to the American Thoracic Society guidelines. Independent sample t-test was used to compare the lung function parameters and multivariate linear regression was used to develop predictor …

Comparing Effectiveness Of Two Client Follow-Up Approaches In Sustaining The Use Of Long Acting Reversible Contraceptives (Larc) Among The Underserved In Rural Punjab, Pakistan: A Study Protocol And Participants' Profile, Syed Khurram Azmat, Waqas Hameed, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Omar Farooq Khan, Ghazunfer Abbas, Erik Munroe

Community Health Sciences

Background: Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of …

Engaging The Missing Link: Evidence From Falah For Involving Men In Family Planning In Pakistan—Meeting Report, Seemin Ashfaq, Farooq Ahmed

Reproductive Health

The Population Council Pakistan, as part of the Evidence Project, synthesized evidence from both national and international sources and developed a set of research documents highlighting the importance of involving men in family planning efforts in Pakistan. This report outlines the findings of these important publications shared at the National Consultative Meeting which was held to provide evidence-based recommendations to major stakeholders who are directly involved in shaping population and health policies and programs. The aim of the meeting was to stimulate thinking and build consensus on a renewed male engagement strategy as part of the Plan of Action to …

Reducing Maternal And Child Mortality In Balochistan: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This brief explains why FP must be prioritized in Balochistan, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 41 percent of maternal deaths, 35 percent of infant deaths, and 74 percent of young child deaths. FP’s wider health benefits include reduced …

Low Use And High Discontinuation Of Modern Contraceptives In Pakistan: Reasons And Policy Recommendations, Population Council

Reproductive Health

According to the latest Pakistan Demographic and Health Survey, 20 percent of married women of reproductive age have unmet need for contraception. Moreover, the country’s contraceptive prevalence rate (CPR), for modern and traditional methods combined, is only 35 percent—one of the lowest CPRs in the region. In addition to the problem of nonuse, the country is finding it difficult to keep current contraceptive users onboard: compared to other developing countries, Pakistan has the highest rate of discontinuation of contraceptive use. Thus, while there has been an overall increase in the use of contraceptives—modern and traditional—there is a large difference between …

Using The Community Informant Based (Made-In And Made-For) Methodology For Estimating Mmr In Punjab, Ali M. Mir, Saleem Shaikh, Mumraiz Khan, Irfan Masood

Reproductive Health

Pakistan is one of the six countries that account for more than 50 percent of the world’s maternal deaths. Each year, there are nearly 14,000 pregnancy-related deaths. Although maternal mortality has fallen from 533 per 100,000 live births in 1990–91 to 276 in 2006–07, Pakistan has not been able to achieve its Millennium Development Goal target of reducing maternal mortality to 140 per 100,000 live births by 2015. Planners require a method that can provide reliable subnational estimates easily, cost effectively. and with greater regularity. The Research and Advocacy Fund offered support to the Government of Pakistan to assess the …

Prospects For Economic Growth In Sindh Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq

Reproductive Health

Sindh is currently undergoing a demographic transition from high fertility and high mortality to lower fertility and mortality. The resulting bulge in its working-age population means the province is poised to reap a “demographic dividend.” By 2050, Sindh’s per capita income will be 191 percent higher than today’s levels if there is no decline in fertility, but 426 percent higher if fertility declines rapidly. The scale and effectiveness of efforts to reduce fertility levels in Sindh will determine whether per capita income in the province grows by 328 percent or 426 percent by 2050. The possible demographic dividend of a …

Gender-Biased Sex Selection In South Asia: The Situation And Promising Approaches To Restore Balance, Population Council

Poverty, Gender, and Youth

This project summary indicates that sex ratios at birth in South Asia vary considerably. While the sex ratios at birth in Bangladesh and Pakistan have been normal at the country level (103 and 102.5 males per 100 females, respectively), Nepal is showing signs of disturbed sex ratios at birth, with a sex ratio of 106 males per 100 females, and the situation in India is particularly adverse, with a sex ratio at birth of 110 males per 100 females. In all of these countries, preconditions for a deterioration of the sex ratio at birth are evident. Preferences are expressed for …

Unveiling The Consensus: Putting People First In Pakistan's Development Agenda, Government Of Pakistan, Unfpa, Population Council

Poverty, Gender, and Youth

This document contains the consensus from the Population Summit held in Islamabad, Pakistan, November 5–6, 2015. To date, an enduring commitment to a sound and adequate population welfare program has eluded Pakistan, leaving millions of couples who want to wait before having their next child or who consider that they have enough children, without good access to family planning. However, in the wake of devolution, in part through efforts of donors and civil society for awareness building, advocacy, and dialogue, opinion among all major stakeholders is coalescing around the need to address Pakistan’s alarming maternal and child health indicators through …

Family Planning Through The Lens Of Men: Readiness, Preferences, And Challenges, Iram Kamran, Zeba Tasneem, Tahira Parveen, Rehan M. Niazi

Reproductive Health

Family planning (FP) is urgently needed in Pakistan but progress remains slow. In its 2002 Population Policy, the country pledged to reduce its total fertility rate to 2.2 by 2020; at the London Summit in 2012, it committed to increase the contraceptive prevalence rate (CPR) to 55 percent by the same year. Despite important achievements, Pakistan’s current CPR is only 35 percent, the total fertility rate is 3.8, and 20 percent of married couples of reproductive age express unmet need for FP. FP programming has largely been directed at women, and husbands have been regarded, at best, as interested bystanders. …

The Availability And Quality Of Family Planning Services Across Eight Districts In Pakistan: The Potential And The Constraints, Gul Rashida, Iram Kamran, Khan Muhammad, Rehan M. Niazi, Tahira Parveen

Reproductive Health

This report forms part of a multipronged investigation to determine why, despite evident unmet need for family planning, contraceptive prevalence especially for modern methods remains so low in Pakistan. The research, conducted by the Population Council with the support of the Research and Advocacy Fund, consists of four component studies: 1) review of relevant academic, program, and policy literature; 2) a qualitative study of perspectives of men, women, and service providers in the country on family planning; 3) a situation analysis of contraceptive quality, supply, and access factors at health facilities; and 4) an examination of supply issues affecting the …

Engaging The Missing Link: Evidence From Falah For Involving Men In Family Planning In Pakistan—Case Study, Seemin Ashfaq, Maqsood Sadiq

Reproductive Health

This report describes FALAH’s experience of engaging men in its target communities, which bears out the finding of recent studies that Pakistani men are ready, indeed eager, to be involved directly in family planning. Implementation of the FALAH approach to male engagement in 20 districts across Pakistan’s four provinces shows that male engagement can be implemented on a large scale and that it can be synchronized with interventions that target women together with men, as is the case with interactive theatre, or separately, as with the male and female falahi workers. The findings from this case study are relevant for …

Reducing Maternal And Child Mortality In Punjab: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Punjab’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 45 percent of maternal deaths, 26 percent of infant deaths, and 76 percent of young child deaths. FP’s wider health …

Prospects For Economic Growth In Balochistan Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq

Reproductive Health

Balochistan is currently undergoing a demographic transition from a situation of high fertility and high mortality to one of lower fertility and mortality. The resulting bulge in its working-age population means the province is poised to reap a “demographic dividend.” By 2050, Balochistan’s per capita income will be 165 percent higher than today’s levels if there is no decline in fertility, but 388 percent higher if fertility declines rapidly. The scale and effectiveness of efforts to reduce fertility levels in Balochistan will determine whether per capita income in the province grows by 295 percent or by 388 percent by 2050. …

Reducing Maternal And Child Mortality In Sindh: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why FP must be prioritized in Sindh, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. Evidence shows that FP is one of the most powerful tools at the government’s disposal for a rapid reduction in maternal, infant, and child mortality. FP’s wider health benefits include reduced anemia among women; lower …

Prospects For Economic Growth In Punjab Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq

Reproductive Health

Punjab is currently undergoing a demographic transition from a situation of high fertility and high mortality to one of lower fertility and mortality. The resulting bulge in its working-age population means the province is poised to reap a “demographic dividend.” By 2050, Punjab’s per capita income will be 210 percent higher than today’s levels if there is no decline in fertility, but 431 percent higher if fertility declines rapidly. The scale and effectiveness of efforts to reduce fertility levels in Punjab will determine whether per capita income in the province grows by 333 percent or by 431 percent by 2050. …

Investigating The Low Patterns Of Modern Contraceptive Use In Pakistan, Iram Kamran, Zeba Tasneem, Tahira Parveen, Yasmin Zehra Zaidi

Reproductive Health

This report documents the study “Investigating the Low Patterns of Modern Contraceptive Use in Pakistan” conducted by the Population Council Pakistan in 2014 as part of an extensive research project to determine why use of modern contraceptives in the country remains so low despite large unmet need. The family planning (FP) scenario in Pakistan has changed significantly in recent years, and it is now recognized that the reasons most often cited for unmet need require reappraisal, with qualitative research required for a deeper understanding of the attributes, experiences, reservations, and preferences that women, men, and service providers associate with specific …

Reducing Maternal And Child Mortality In Khyber Pakhtunkhwa: The Untapped Potential Of Family Planning, Zeba Sathar, Maqsood Sadiq, Seemin Ashfaq

Reproductive Health

Family Planning (FP) is recognized as a necessary tool for faster fertility decline leading to accelerated economic development. However, its unique and potent role in preserving mother and child health is less well understood. This Population Council/Evidence Project policy brief explains why family planning must be prioritized in Khyber Pakhtunkhwa, Pakistan’s health strategy as a key intervention for reducing maternal, infant, and under-five mortality in the province. By fulfilling the existing unmet need for birth spacing and limiting, it is possible to prevent 37 percent of maternal deaths and 57 percent of infant deaths. FP’s wider health benefits include reduced …

Prospects For Economic Growth In Khyber Pakhtunkhwa Under Alternative Demographic Scenarios: The Case For A Rapid Fertility Decline, David E. Bloom, Zeba Sathar, Maqsood Sadiq

Reproductive Health

Khyber Pakhtunkhwa (KP) is currently undergoing a demographic transition from a situation of high fertility and high mortality to one of lower fertility and mortality. The resulting bulge in its working-age population means the province is poised to reap a “demographic dividend.” By 2050, KP’s per capita income will be 167 percent higher than today’s levels if there is no decline in fertility, but 412 percent higher if fertility declines rapidly. The scale and effectiveness of efforts to reduce fertility levels in KP will determine whether per capita income in the province grows by 316 percent or by 412 percent …

Reasons For Low Modern Contraceptive Use—Insights From Pakistan And Neighboring Countries, Batool Zaidi, Sabahat Hussain

Reproductive Health

This literature review forms part of an extensive research project to determine why, despite evident demand, contraceptive prevalence remains so low in Pakistan, especially for modern methods. The research has been conducted by the Population Council with the support of the Research and Advocacy Fund (RAF) and comprises four component studies: review of relevant academic, program, and policy literature; qualitative study of perspectives of men, women, and service providers in the country on family planning; situation analysis of contraceptive quality, supply, and access factors at health facilities; and examination of supply-chain issues affecting the availability of contraceptives. This review presents …

Evidence Of Son Preference And Resulting Demographic And Health Outcomes In Pakistan, Zeba Sathar, Gul Rashida, Sabahat Hussain, Anushe Hassan

Poverty, Gender, and Youth

Pakistan has a highly patriarchal society. Consequently, the desire for sons is a dominant and widely prevalent cultural value that is reinforced by feudal kinship systems that permeate many parts of the country. While reliance on sons is stronger in rural areas because of agricultural work and the tying of land ownership with male inheritance, even in other areas boys are seen to be important in carrying on the family name and taking care of parents in old age. On the other hand, daughters are seen as an expense and an economic burden in both rural and urban areas. A …

Bridging Evidence, Policy, And Practice To Strengthen Health Systems For Improved Maternal And Newborn Health In Pakistan, Atsumi Hirose, Sarah Hall, Zahid Memon, Julia Hussein

Centre of Excellence in Women and Child Health

Policy and decision making should be based on evidence, but translating evidence into policy and practice is often sporadic and slow. It is recognised that the relationship between research and policy uptake is complex and that dissemination of research findings is necessary, but insufficient, for policy uptake. Political, social, and economic context, use of (credible) data and dialogues between and across networks of researchers and policymakers play important roles in evidence uptake. Advocacy is the process of mobilising political and public opinions to achieve specific aims and its role is crucial in mobilising key actors to push for policy uptake. …

Knowledge, Attitude And Practices Regarding Respiratory Symptoms Among Textile Workers Of Karachi, Pakistan: A Cross-Sectional Survey, Aneeta Khoso, Asaad Ahmed Nafees

Community Health Sciences

Objectives: To determine the prevalence and predictors of good knowledge, appropriate attitude and appropriate protective practices regarding respiratory symptoms among textile workers, and to determine the association of knowledge, attitude and practices with respiratory symptoms.
Methods: The cross-sectional study was conducted in 2009 and comprised male workers from 15 textile mills in and around Karachi. A structured and pre-tested questionnaire was used which included questions to explore the knowledge, attitude and practices regarding respiratory symptoms. SPSS 19 was used for statistical analysis.
Results: The study had a sample size of 372 and found prevalence of good knowledge to be in …