Medicine and Health Sciences Commons^™

In The Name Of Riwaj: An Ethnographic Study To Explore The Notion Of Women Empowerment Among Bisp Recipients In Rural Sakhro-Sindh, Pakistan, Qurratulain Nasiruddin, Rozina Karmaliani, Nasim Zahid Shah, Tazeen Saeed Ali

School of Nursing & Midwifery

Women empowerment is a national agenda for Pakistan and, one of its manifestations is the nationwide cash transfer program namely Benazir Income Support Programme (BISP). With the help of Bourdieu methodological paradigm of “habitus” this paper analyses empowerment among BISP recipients in their social settings where various social actors such as her husband and wadera of the village dominate her agency but, at the same time, women herself submits her agency to these social actors under the veil of riwaj (social customs). This ethnographic study reveals that the performance of submission among women follows an inner drive for conformation to …

"Women Are Again Unsafe": Preventing Violence And Poor Maternal Outcomes During Current Floods In Pakistan, Sarmad Muhammad Soomar, Abir Arefin, Salman Muhammad Soomar

School of Nursing & Midwifery

No abstract provided.

Perpetuation Of Gender Discrimination In Pakistani Society: Results From A Scoping Review And Qualitative Study Conducted In Three Provinces Of Pakistan, Tazeen Saeed Ali, Shahnaz Shahid Ali, Sanober Nadeem, Zahid Memon, Sajid Bashir Soofi, Falak Madhani, Yasmin Karim, Shah Mohammad, Zulfiqar Ahmed Bhutta

School of Nursing & Midwifery

Background: Gender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender discrimination. The aim of this study is to assess the factors that influence gender discrimination in Pakistan, and its impact on women's life.
Methods: A mixed method approach was used in the study in which a systematic review was done in phase one to explore the themes on gender discrimination, and qualitative interviews were conducted in phase two to explore the perception of people regarding gender discrimination. The qualitative interviews (in-depth interviews and …

Urinary Incontinence: Understanding The Silent Plight Of Women, Yasmin Nadeem Parpio, Anmol Minaz, Sonia Ijaz Haider

School of Nursing & Midwifery

Urinary incontinence (UI) is defined as the complaint of involuntary loss of urine. UI affects both men and women but is more common in women. It has been identified as a World Health Organization priority. The burden related to UI at local, national, and global levels is huge and its impact in terms of physical, social, mental, and financial aspects makes it a concerning issue. However, there exist several barriers in terms of knowledge and attitude in seeking healthcare among women experiencing UI. This calls upon a multi-disciplinary approach involving professionals from different disciplines and tackling it with collaborative and …

Levels And Predictors Of Self-Care Among Patients With Hypertension In Pakistan, Khairulnissa Ajani, Ambreen Gowani, Raisa B. Gul, Pammla Petrucka

School of Nursing & Midwifery

Background: Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan.
Methods: This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban …

Intimate Partner Violence Against Women: A Comprehensive Depiction Of Pakistani Literature, Tazeen Saeed Ali, Rozina Karmaliani, Rida Farhan, Syeda Hussain, Fatima Jawad

School of Nursing & Midwifery

Background: Intimate partner violence against women is a significant problem in Pakistan associated with an alarming set of mental health issues.
Aims: To identify the prevalence of intimate partner violence in Pakistan and the causes, health effects and coping strategies used by women.
Methods: A comprehensive search based on the identified keywords was conducted using Google Scholar and PubMed. Relevant literature was also searched and included. Abstracts were then shortlisted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, and 25 studies were selected. Quantitative studies on intimate partner violence were included in the review. The review comprises …

Mental Health Challenges And Psycho-Social Interventions Amid Covid-19 Pandemic: A Call To Action For Pakistan, Salima Farooq, Saima Sachwani, Sonia Ijaz Haider, Sajid Abrar Iqbal, Yasmin Parpio, Humera Saeed

School of Nursing & Midwifery

The increase in death and spread-related coronavirus (COVID-19) has shifted the world focus to the containment of the disease by emphasising measures to prevent spread in the general population. Such a complex, threatening, and unprecedented situation has left the psycho-social wellbeing needs of general public unaddressed. This paper aims to review the current COVID-19 scenario and its effects on the psycho-social wellbeing of people; and an attempt to shed some light on the aforementioned questions. Furthermore, the review will propose some recommendations for overcoming the mental illness issues, during and after the COVID-19 outbreak. We extracted information from reliable published …

Insight Into Covid-19 Responses And Initiatives From Pakistan, Salima Farooq, Sonia Ijaz Haider, Saima Sachwani, Yasmin Parpio

School of Nursing & Midwifery

The coronavirus pandemic is a rapidly evolving outbreak that has tremendously distressed people worldwide. The paper aims to present some key rapid responses and initiatives to COVID-19 undertaken in Pakistan. The information has been gathered by reviewing material and documents pertinent to COVID-19 in the context of Pakistan. The incidences of COVID-19 cases are gradually increasing; however, the case fatality rate is relatively lower in Pakistan as compared to developed countries. The government has taken massive actions, in terms of lockdowns, quarantine homes, testing facilities, closure of schools, and mass gatherings at places, to combat COVID-19. However, the measures seem …

Exploring The Experiences Of The Older Adults Who Are Brought To Live In Shelter Homes In Karachi, Pakistan: A Qualitative Study, Laila Akber Cassum, Keith Cash, Waris Qidwai Dr, Samina Vertejee

School of Nursing & Midwifery

Background: The traditional joint family system in a culturally diverse Pakistani society shows great respect and care for older population by the families and their generations. However, in the recent years the phenomenon of population ageing in Pakistan is rapidly increasing due to demographic shift influencing life expectancy, along with changes in socio-cultural values. This transition has resulted in institutionalization of the elderly as an emerging shelter alternative. The aim of this study was to explore the experiences of the elderly people and to identify the reason which compelled them to reside in these shelter homes.
Method: A …

Factors Associated With Postoperative Pain Among Patients After Cardiac Surgery In The Tertiary Care Teaching Hospital Of Karachi, Pakistan, Sineer Micah, Rubina Barolia, Yasmin Parpio, Santosh Kumar, Hasanat Sharif

School of Nursing & Midwifery

Background: Pain is the subjective feeling of an individual, which affects the overall recovery of patients after cardiac surgery. Postoperative pain is the most inadequately managed symptom of cardiac surgery. Subsequently, there are many factors that can either hinder or facilitate pain management, including patients' beliefs, cultural values, physiological features, hospital policies, and healthcare providers' knowledge and beliefs. The purpose of this research was to identify factors associated with postoperative pain and its management, after cardiac surgery, among patients in a tertiary care hospital in Karachi, Pakistan.
Methods: Quantitative correlational study design was employed to attain the study purpose. Data …

Dose-Response Of Cotton Dust Exposure With Lung Function Among Textile Workers: Multitex Study In Karachi, Pakistan, Naureen Akber Ali, Asaad Ahmed Nafees, Zafar Fatmi, Iqbal Azam Syed

School of Nursing & Midwifery

Background: Cotton dust exposure among textile mill workers lead to impaired lung function. However, only few studies have investigated the dose-response relationship between cotton dust and lung function.
Objective: To determine the dose-response relationship between cotton dust exposure and lung function among textile workers.
Methods: This cross-sectional survey was conducted from January to March 2016 and included 303 adult male textile workers from spinning and weaving sections of 5 mills in Karachi, Pakistan. We collected data through a translated version of the American Thoracic Society respiratory questionnaire (ATS-DLD-78A) and using spirometry. Mill-level airborne cotton dust was measured …

Risk Factors Of Cardiovascular Disease And Its Recommendations In Pakistani Context., Rubina Barolia, Amber Hussain Sayani

School of Nursing & Midwifery

Cardiovascular diseases possess a major cause for fatality and disability the world over. Since last several decades, the rates of cardiovascular diseases-related deaths have decreased in a number of high-income countries but increased in low- and middle-income countries with around 80% of the burden. Despite the seriousness of cardiovascular diseases in low- and middle-income countries, minimal attention is given to the prevention of cardiovascular diseases risk factors in South Asia, particularly in Pakistan. In addition, economic and political instability is accelerating the rates of cardiovascular diseases in the country. Practical efforts are required to enhance the understanding of cardiovascular diseases …

Peer Violence Perpetration And Victimization: Prevalence, Associated Factors And Pathways Among 1752 Sixth Grade Boys And Girls In Schools In Pakistan, Rozina Karmaliani Professor, Judith Mcfarlane, Rozina Somani, Hussain Maqbool Ahmed Khuwaja, Shireen Shehzad Bhamani, Tazeen Saeed Ali, Saleema A. Gulzar, Yasmeen Hassan Somani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Background: Child peer violence is a global problem and seriously impacts health and education. There are few research studies available in Pakistan, or South Asia. We describe the prevalence of peer violence, associations, and pathways between socio-economic status, school performance, gender attitudes and violence at home.
Methods: 1752 children were recruited into a cluster randomized controlled trial conducted on 40 fairly homogeneous public schools (20 for girls and 20 for boys), in Hyderabad, Pakistan. This was ranging from 20-65 children per school. All children were interviewed with questionnaires at baseline.
Results: Few children had no experience of peer violence in …

Preventing Peer Violence Against Children: Methods And Baseline Data Of A Cluster Randomized Controlled Trial In Pakistan, Judith Mc Farlane, Rozina Karmaliani Professor, Hussain Maqbool Ahmed Khuwaja, Saleema A. Gulzar, Rozina Somani, Tazeen Saeed Ali, Yasmeen Hassan Somani, Shireen Shehzad Bhamani, Ryan D. Krone, Rene M. Paulson, Atta Muhammad, Rachel Jewke

School of Nursing & Midwifery

Background: Violence against and among children is a global public health problem that annually affects 50% of youth worldwide with major impacts on child development, education, and health including increased probability of major causes of morbidity and mortality in adulthood. It is also associated with the experience of and perpetration of later violence against women. The aim of this article is to describe the intervention, study design, methods, and baseline findings of a cluster randomized controlled trial underway in Pakistan to evaluate a school-based play intervention aiming to reduce peer violence and enhance mental health.
Methods: A cluster randomized controlled …

Exploring The Impact Of Gender Inequities On The Promotion Of Cardiovascular Health Of Women In Pakistan, Rubina Barolia, Alexander M. Clark, Gina M. Higginbottom

School of Nursing & Midwifery

Cardiovascular disease exerts an enormous burden on women's health. The intake of a healthy diet may reduce this burden. However, social norms and economic constraints are often factors that restrain women from paying attention to their diet. Underpinned by critical realism, this study explores how gender/sex influences decision-making regarding food consumption among women of low socioeconomic status (SES). The study was carried out at two cardiac facilities in Karachi, Pakistan, on 24 participants (male and female from different ethnic backgrounds), who had received health education. Using an interpretive descriptive approach, the study identified major barriers to a healthy diet: proscribed …

Integration Of Health Promotion Into Nursing Practice: A Case Study In Pakistan., Muneerah Vastani, Rozina Karmaliani Professor, Pammla M. Petrucka

School of Nursing & Midwifery

The purpose of this study was to understand the concept of health promotion and perceptions related to the integration of health promotion in nursing practice in Pakistan. The study utilized the qualitative single case study approach to explore and describe the concept of health promotion, its significance and ways to integrate health promotion strategies in nursing practice. The data were collected from three different sources; focus group discussion among final year Post-RN BScN students, key informant interviews of practicing nurses, faculty, and MScN students, as well as a document review of the Post-RN BScN curriculum. Data analysis included a content …

Association Of Depression And Life Satisfaction With Low Resilience Among Married Women Of Karachi, Pakistan, Shireen Shehzad, Nida Zahid, Iqbal Azam Syed, Nargis Asad, Rozina Karmaliani Professor, Omrana Pasha

School of Nursing & Midwifery

Background:

The concept of resilience is very crucial in promoting positive psychological well-being. However, this construct was never looked among married women of Karachi, Pakistan. Therefore, this study aimed to assess the prevalence and the associated risk factors of resilience in Pakistan.

Methods:

It was a cross-sectional survey, using the Wagnild Resilience Scale (RS) to assess resilience, Beck Depression Inventory II (BDI-II) for measuring depression and Trait Wellbeing Inventory for determining Life Satisfaction. Systematic sampling was employed to enroll 636 participants of aged 20 to 40 years living in two urban squatter settlements of Karachi, Pakistan. Prevalence ratio was computed …

Are We Empowered? A Qualitative Approach To Unfold The Experiences Of Female Nurses In Pakistan, Saleema A. Gulzar, Rozina Karmaliani, Nasreen Lalani, Qurratulain Nasiruddin

School of Nursing & Midwifery

The disparity of men and women in certain societies, such as Pakistan, is a growing concern. The disparity, unchanging mind-set, and definitions rooted in traditions do not free individuals from the socially bound gender identities. In such circumstances, educational institutions can become a way of transforming social structures. Considering female nurses in Pakistan as a case study, this paper explores the notion of “empowerment” and the factors responsible for empowerment or disempowerment of female nurses. The study also evaluates the role of a leading nursing institution in Pakistan namely the Aga Khan University- School of Nursing and Midwifery (AKUSONAM) in …

Polio - An Endemic Disease In Pakistan: Literature Review, Savera Aziz Ali, Nadir Suhail, Hunaina Hadi, Mohsina Hussain, Marium Manji, Jaweria Bano, Abdul Salam, Sajida Naseer, Sumera Aziz Ali

School of Nursing & Midwifery

Poliomyelitis is a highly contagious and incurable disease, which mainly affects children under five years of age leading to irreversible paralysis and possibly death. For decades, both private and government organizations have been putting efforts through their partnership to eradicate polio completely from the different parts of the globe and as a result of those efforts there are left only three countries which are currently polio endemic. Since Pakistan is one of those three countries which still remain polio endemic along with Afghanistan and Nigeria, it is significant to address this issue and work on the preventive measures to control …

Lifetime Prevalence Of Emotional/Psychological Abuse Among Qualified Female Healthcare Providers., Azmat Jehan Khan, Rozina Karmaliani Professor, Tazeen Saeed Ali, Nargis Asad, Farhana Madhani

School of Nursing & Midwifery

The purpose of this study was to determine the lifetime prevalence of emotional/psychological abuse among married female healthcare providers in tertiary care hospitals in Karachi, Pakistan. A descriptive cross-sectional study was conducted in a sample of 350 married female nurses and doctors, recruited from three tertiary healthcare hospitals (one public and two private). This study used the self-administered modified truncated WHO multi-country questionnaire. Descriptive and univariate analysis was performed. Of the total sample of 350 female married healthcare providers, 97.7% (n = 342) were reported with one or more forms of domestic violence at some point in their married life, …

The Impact Of Caring For Children With Mental Retardation On Families As Perceived By Mothers In Karachi, Pakistan., Arusa Lakhani, Irma Gavino, Aisha Yousafzai

School of Nursing & Midwifery

OBJECTIVE:

To assess how families perceive the positive and negative impacts of caring for a child with mental retardation.

METHODS:

The quantitative descriptive study was conducted from January to August 2007 and comprised 54 families attending a private day-care centre for children with special needs in Karachi, Pakistan. The Kansas Inventory of Parental Perceptions was used to assess mothers' perceptions on the impact of caring for a child with mental retardation. Positive contributions, social comparisons with others, understanding of disability and perception of control were assessed. SPSS 16 was used for statistical analysis.

RESULTS:

Mothers reported positive contribution to family …

Dowry Practices And Their Negative Consequences From A Female Perspective In Karachi, Pakistan —A Qualitative Study, Tazeen Saeed Ali, Gunnhildur Árnadóttir, Asli Kulane

School of Nursing & Midwifery

Aim:

To assess the pattern, demand and opinion of dowry among women in urban Karachi, Pakistan and their perceived negative consequences of dowry. Setting: Pakistan is a low income country, predominantly Muslim, with around 190 million inhabitants. Karachi is the biggest city with roughly 13 million inhabitants.

Method:

Qualitative study, using content analysis of five focus group discussions with women. Results: The theme “Dowry practices and their consequences” emerged, along with five categories and 14 subcategories, describing the “burden of dowry”, “dowry in society”, “dowry problems created by parents-in-law”, “negative consequences of dowry practice” and “good intentions”.

Conclusion:

Problems due …

Experience Of Nurses With Using Ehealth In Gilgit-Baltistan, Pakistan: A Qualitative Study In Primary And Secondary Healthcare, Saleema A. Gulzar, Shariq Khoja, Afroz Sajwani

School of Nursing & Midwifery

Background: To improve the quality of health care in remote parts of Pakistan, a research project was initiated in the mountainous region of Gilgit-Baltistan using information and communication technology to improve patient care and support continuing education of health providers (eHealth). This paper describes the experience of nurses in using eHealth in their routine practices.
Methods: All health centres of Gilgit-Baltistan, Pakistan using eHealth as part of this study, were taken as a single case. These include four primary healthcare centres, three secondary care centres and one medical centre. In-depth interviews were conducted using semi-structured interview guide to study nurses' …

Malnutrition In Young Pakistani Children, Shela Akbar Ali Hirani

School of Nursing & Midwifery

Background: Pakistan is a developing country with the second highest infant and child mortality rate in South Asia. In this region, malnutrition underlies much of the high infant and under five child morbidity and mortality rates. Although struggle to tackle the issue of malnutrition among young Pakistani children has been going on since many decades, till yet a realistic solution for this growing problem has not been found.

Objective: This paper aims at reviewing literature to analyse the biological, maternal, socio-cultural, environmental, and politico-economical determinants of malnutrition among young children in Pakistan so that need based interventions can …

Coronary Artery Bypass Grafting: Quality Of Life Of Patients In Karachi, Rozina Barolia, Fauziya Ali, Salma Jaffar

School of Nursing & Midwifery

In the Third World, cardiac Patients often suffer not only from the nature of their illnesses, but also the insufficiency of the facilities available. Although the effectiveness of coronary artery bypass grafting (CABG) is being evaluated in terms of mortality, complications or recurrence of symptoms, empirical studies assessing the change in Patients' quality of life (QOL) after CABG within the Pakistani cultural context are lacking.
Aims: The aims of the present study are to assess and compare the change in health-related quality of life before and 1 month after CABG and to assess the differences in QOL with respect to …

Development Of Students' Critical Thinking: The Educators' Ability To Use Questioning Skills In The Baccalaureate Programmes In Nursing In Pakistan, Tanveer Saeed, Shehla Khan, Azra Ahmed, Raisa Gul, Shanaz Hussein Cassum, Yasmin Parpio

School of Nursing & Midwifery

Objective: To enhance the Critical Thinking skills of educators associated with the nursing baccalaureate programmes in Pakistan. By focusing on the type and level of questions asked by the educators.
Methods: Ninety-one faculty members from 14 out of 17 schools participated in the study. Data on the faculty's questioning skills was obtained through classroom observations and field notes. The duration of the observations was 45-60 minutes. Using Bloom's Taxonomy for cognitive thinking, questions were categorised into high and low categories.
Results: Most of the questions (68.9 %) asked by the participants were of lower levels, while some (5.37 %) were …

Violence Permeating Daily Life: A Qualitative Study Investigating Perspectives On Violence Among Women In Karachi, Pakistan, Tazeen S. Ali, Gunilla Krantz, Ingrid Mogren

School of Nursing & Midwifery

Background: This study explored how married women perceive situations which create family conflicts and lead to different forms of violence in urban Pakistan. In addition, it examines perceptions of consequences of violence, their adverse health effects, and how women resist violence within marital life.

Methods: Five focus group discussions were conducted with 28 women in Karachi. Purposive sampling, aiming for variety in age, employment status, education, and socioeconomic status, was employed. The focus group discussions were conducted in Urdu and translated into English. Manifest and latent content analysis were applied.

Results: One major theme emerged during the analysis, …

Gender Roles And Their Influence On Life Prospects For Women In Urban Karachi, Pakistan: A Qualitative Study, Tazeen S. Ali, Gunilla Krantz, Raisa Gul, Nargis Asad, Eva Johansson, Ingrid Mogren

School of Nursing & Midwifery

BACKGROUND: Pakistan is a patriarchal society where men are the primary authority figures and women are subordinate. This has serious implications on women's and men's life prospects.
OBJECTIVE: The aim was to explore current gender roles in urban Pakistan, how these are reproduced and maintained and influence men's and women's life circumstances.
DESIGN: Five focus group discussions were conducted, including 28 women representing employed, unemployed, educated and uneducated women from different socio-economic strata. Manifest and latent content analyses were applied.
FINDINGS: TWO MAJOR THEMES EMERGED DURING ANALYSIS: 'Reiteration of gender roles' and 'Agents of change'. The first theme included perceptions …

The Association Between Parity, Infant Gender, Higher Level Of Paternal Education And Preterm Birth In Pakistan: A Cohort Study, Kiran Shaikh, Shahirose Sadrudin Premji, Marianne S. Rose, Ambreen Kazi, Shaneela Khowaja, Suzanne Tough

School of Nursing & Midwifery

Background:

High rates of antenatal depression and preterm birth have been reported in Pakistan. Self reported maternal stress and depression have been associated with preterm birth, however findings are inconsistent. Cortisol is a biological marker of stress and depression, and its measurement may assist in understanding the influence of self reported maternal stress and depression on preterm birth.

Methods:

In a prospective cohort study pregnant women between 28 to 30 weeks of gestation from the Aga Khan Hospital for Women and Children completed the A-Z Stress Scale and the Centre for Epidemiology Studies Depression Scale to assess stress and depression …

A Silent Storm: Hepatitis C In Pakistan, Noureen Jiwani, Raisa B. Gul

School of Nursing & Midwifery

No abstract provided.