Medicine and Health Sciences Commons^™

"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.

Gender-Based Violence In Pakistan And Public Health Measures: A Call To Action, Azza Sarfraz, Zouina Sarfraz, Muzna Sarfraz, Zul Qarnain

Department of Paediatrics and Child Health

No abstract provided.

Prevention Of Violence Against Women And Girls: A Cost-Effectiveness Study Across 6 Low- And Middle-Income Countries, Giulia Ferrari, Sergio Torres-Rueda, Esnat Chirwa, Andrew Gibbs, Stacey Orangi, Edwine Barasa, Theresa Tawiah, Rebecca Kyerewaa Dwommoh Prah, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja

School of Nursing & Midwifery

Background: Violence against women and girls (VAWG) is a human rights violation with social, economic, and health consequences for survivors, perpetrators, and society. Robust evidence on economic, social, and health impact, plus the cost of delivery of VAWG prevention, is critical to making the case for investment, particularly in low- and middle-income countries (LMICs) where health sector resources are highly constrained. We report on the costs and health impact of VAWG prevention in 6 countries.
Methods and findings: We conducted a trial-based cost-effectiveness analysis of VAWG prevention interventions using primary data from 5 randomised controlled trials (RCTs) in sub-Saharan Africa …

Violence And Abuse Among Working Children In Urban And Suburban Areas Of Lower Sindh, Pakistan, Meesha Iqbal, Zafar Fatmi, Kausar S. Khan, Asaad Ahmed Nafees

Community Health Sciences

Background: Child labourers are exposed to an insecure environment and higher risk of violence. Violence among child labourers is an under-studied phenomenon which requires contextual assessment.
Aims: We applied Bronfenbrenner's ecological model (micro-, exo- and macro-system) to understand the interplay of individual, community, societal and policy context fuelling violence.
Methods: Focus group discussions and family ethnographies of child-labourers working in common occupational sectors of suburban areas of Sindh were carried out to gain in-depth understanding of their immediate environment and abuse (micro-system). Frequency of emotional, physical and sexual violence (5-14 years; n = 634) was also determined. Indepth interviews with …

Violence Against Healthcare Workers During The Covid-19 Pandemic: A Review Of Incidents From A Lower-Middle-Income Country, Omaima Anis Bhatti, Hareem Rauf, Namrah Aziz, Russell S. Martins, Javaid Khan

Medical College Documents

Background: Healthcare workers (HCWs) across the globe have met tremendous challenges during the COVID-19 (coronavirus disease 2019) pandemic, such as shortages of personal protective equipment, extensive work hours, and constant fear of catching the virus or transmitting it to loved ones. Adding on to the already existing burnout, an increase in incidents of violence and aggression against HCWs was seen in Pakistan and globally.
Objectives: Primarily to review cases of violence against HCWs in Pakistan, highlighting and comparing the instigating factors seen within the country and globally. Secondly, to enlist possible interventions to counter workplace violence in healthcare during a …

Types And Risk Factors Of Violence Experienced By People Living With Hiv, Pakistan: A Cross-Sectional Study, Safia Awan, Nukhba Zia, Fatima Sharif, Sharaf Ali Shah, Bushra Jamil

Department of Medicine

Background: In Pakistan, data are lacking on the violence experienced by people living with HIV.
Aims: This study determined the prevalence and risk factors of violence (physical, psychological and sexual) in people living with HIV in Karachi, Pakistan.
Methods: This was a cross-sectional study in 2016 of people living with HIV attending clinics of Bridge Consultants Foundation, a community-based care provider. Date were collected using an interview-based questionnaire. Multivariate logistic regression analysis was done to assess the risk factors for violence with adjusted odds ratios (aOR) and 95% confidence intervals (CI) presented.
Results: The sample included 250 people living with …

Brain Injury And Dementia In Pakistan: Current Perspectives, Maheen M. Adamson, Sadia Shakil, Tajwar Sultana, Muhammad Abul Hasan, Fatima Mubarak, Ather Enam, Muhammad A. Parvaz, Adeel Razi

Department of Radiology

Alzheimer's disease (AD) is the most common form of dementia, accounting for 50-75% of all cases, with a greater proportion of individuals affected at older age range. A single moderate or severe traumatic brain injury (TBI) is associated with accelerated aging and increased risk for dementia. The fastest growth in the elderly population is taking place in China, Pakistan, and their south Asian neighbors. Current clinical assessments are based on data collected from Caucasian populations from wealthy backgrounds giving rise to a "diversity" crisis in brain research. Pakistan is a lower-middle income country (LMIC) with an estimated one million people …

Gender Based Violence And Health Effects, Tazeen Saeed Ali

School of Nursing & Midwifery

Gender Based Violence (GBV) violates the basic human right of a person’s physical, sexual and emotional integrity and health ([i]) such that globally, one out of every three women is subject to some form of violence, ranging from verbal and physical abuse to emotional blackmailing and psychological torture eventually leading to futile despair and hopelessness. The ironical perception of gender equality in our society is the root cause of gender based violence, with women being more afflicted by such a form of gender discrimination than men. [i]. Ali TS, Krantz G, Gul R, Asad N, Johansson E, …

Silence In Violence: A Curse Or A Goodwill, Afsheen Hirani, Nasreen Rafiq, Shyrose Sultan, Zainish Hajani, Samreen Siraj

School of Nursing & Midwifery

Healthcare professionals face dilemmas regarding maintaining and breaching confidentiality while dealing with victims of sexual violence. The sensitivity of the cases of violence and the aim to prevent harm generates ambiguity for sound ethical and legal decision making. In Pakistan, maintaining silence is often preferred over breaking the silence. Thus, it is essential to view the risks and benefits of the conflicting positions keeping in mind the diverse perspectives and the bigger picture. Organizations, community and government can plan different strategies to put an end to this obscene game of “silence in violence”.

The Intersection Of School Corporal Punishment And Associated Factors: Baseline Results From A Randomized Controlled Trial In Pakistan, Hussain Maqbool Ahmed Khuwaja, Rozina Karmaliani Professor, Judith Mcfarlane, Rozina Somani, Saleema Gulzar, Tazeen S. Ali, Zahra Shaheen Premani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Violence against youth is a global issue; one form of youth victimization is school corporal punishment. We use baseline assessments from a cluster randomized controlled trial to examine the prevalence of school corporal punishment, by gender, and the relationship to levels of peer violence at school, parent corporal punishment, youth food security and youth academic performance and school attendance in Pakistan. Forty homogenous public schools in the urban city of Hyderabad, Pakistan were chosen for randomization into the trial evaluating a youth violence prevention intervention. 1752 6th graders, age 11-14 years, were selected as the target population. Since schools are …

Effectiveness Of Training On De-Escalation Of Violence And Management Of Aggressive Behavior Faced By Health Care Providers In A Public Sector Hospital Of Karachi, Lubna Baig, Sana Tanzil, Shiraz Shaikh, Ibrahim Hashmi, Muhammad Arslan Khan, Maciej Polkowski

Community Health Sciences

Background: Considering high burden of violence against healthcare workers in Pakistan APPNA Institute of Public Health developed a training to prevent reactive violence among healthcare providers. The purpose of this training was to equip healthcare providers with skills essential to control aggressive behaviors and prevent verbal and non-verbal violence in workplace settings. This study assesses the effectiveness of training in prevention, de-escalation and management of violence in healthcare settings.
Methods: A quasi-experimental study was conducted in October, 2016 using mixed method concurrent embedded design. The study assessed effectiveness of de-escalation trainings among health care providers working in emergency and gynecology …

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 …

Survellience System For Child Abuse: Bridging The Gap Between Actual And Hidden Cases., Maryam Pyar Ali Lakhdir, Yasmin Parpio, Salima Farooq

Community Health Sciences

The dynamics of child abuse have been recognised as a global emerging social issue which is highly associated with child humiliation. The Government of Pakistan has taken many initiatives for addressing issues regarding child abuse and neglect and has designed laws to protect children against exploitation, abuse and violence; however, most of them are not enforced at all or poorly implemented due to lack of proper definition of child abuse and related terms, and different ways of reporting child abuse cases. Most of the non-governmental organisations (NGOs) in Pakistan target extreme cases of child sexual abuse such as child rape …

Safety Netting Through The Prevention And Detection Of Child Abuse In Low And Middle Income Countries: Lessons From Pakistan, Kanwal Nayani, Muhammad Akbar Baig, Nick Brown, Asad Mian

Department of Paediatrics and Child Health

No abstract provided.

The Epidemiology Of Traumatic Event Exposure Worldwide: Results From The World Mental Health Survey Consortium, Corina Benjet, E Bromet, E G. Karam, R C. Kessler, K A. Mclaughlin, A M. Ruscio, V Shahly, D J. Stein, M Petukhova, E Hill, J Alonso, Lukoye Atwoli, B Bunting, R Bruffaerts, J M. Caldas-De-Almeida

Internal Medicine, East Africa

Background: Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs.

Method: General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. …

Twenty Years After International Conference On Population And Development: Where Are We With Adolescent Sexual And Reproductive Health And Rights?, Venkatraman Chandra-Mouli, Joar Svanemyr, Avni Amin, Helga Fogstad, Lale Say, Françoise Girard, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The International Conference on Population and Development in Cairo in 1994 laid out a bold, clear, and comprehensive definition of reproductive health and called for nations to meet the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality. In the context of the ongoing review of the International Conference on Population and Development Programme of Action and the considerations for a post-2015 development agenda, this article summarizes the findings of the articles presented in this volume and identifies key challenges and critical answers that need to be tackled in …

Determinants Of Child And Forced Marriage In Morocco: Stakeholder Perspectives On Health, Policies And Human Rights, Alexia Sabbe, Halima Oulami, Wahiba Zekraoui, Halima Hikmat, Marleen Temmerman, Els Leye

Obstetrics and Gynaecology, East Africa

Background: In Morocco, the social and legal framework surrounding sexual and reproductive health has transformed greatly in the past decade, especially with the introduction of the new Family Law or Moudawana. Yet, despite raising the minimum age of marriage for girls and stipulating equal rights in the family, child and forced marriage is widespread. The objective of this research study was to explore perspectives of a broad range of professionals on factors that contribute to the occurrence of child and forced marriage in Morocco.

Methods: A qualitative approach was used to generate both primary and secondary data for the analysis. …

The Contribution Of Emotional Partners To Sexual Risk Taking And Violence Among Female Sex Workers In Mombasa, Kenya: A Cohort Study, Stanley Luchters, Marlise L. Richter, Wilkister Bosire, Gill Nelson, Nzioki Kingola, Xu-Dong Zhang, Marleen Temmerman, Matthew F. Chersich

Population Health, East Africa

Objectives: To assess sexual risk-taking of female sex workers (FSWs) with emotional partners (boyfriends and husbands), compared to regular and casual clients. Experiences of violence and the degree of relationship control that FSWs have with emotional partners are also described.

Design: Cohort study with quarterly follow-up visit over 12-months.

Methods: Four hundred HIV-uninfected FSWs older than 16 years were recruited from their homes and guesthouses in Mombasa, Kenya. A structured questionnaire assessed participant characteristics and study outcomes at each visit, and women received risk-reduction counselling, male and female condoms, and HIV testing.

Results: Four or more …

Hidden Violence Is Silent Rape: Sexual And Gender-Based Violence In Refugees, Asylum Seekers And Undocumented Migrants In Belgium And The Netherlands, Ines Keygnaert, Nicole Vettenbu, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Although women, young people and refugees are vulnerable to sexual and gender-based violence (SGBV) worldwide, little evidence exists concerning SGBV against refugees in Europe. Using community-based participatory research, 223 in-depth interviews were conducted with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. Responses were analysed using framework analysis. The majority of the respondents were either personally victimised or knew of a close peer being victimised since their arrival in the European Union. A total of 332 experiences of SGBV were reported, mostly afflicted on them by (ex-)partners or asylum professionals. More than half of the reported violent …

Differences In Reporting Of Violence And Deliberate Self Harm Related Injuries To Health And Police Authorities, Rawalpindi, Pakistan, Umar Farooq, Mudassir Majeed, Junaid Ahmad Bhatti, Jahangir Sarwar Khan, Junaid Razzak, Muhammad Mussadiq Khan

Department of Emergency Medicine

Background:

The aim of study was to assess differences in reporting of violence and deliberate self harm (DSH) related injuries to police and emergency department (ED) in an urban town of Pakistan.

Methods/Principal Findings:

Study setting was Rawalpindi city of 1.6 million inhabitants. Incidences of violence and DSH related injuries and deaths were estimated from record linkage of police and ED data. These were then compared to reported figures in both datasets. All persons reporting violence and DSH related injury to the police station, the public hospital's ED, or both in Rawalpindi city from July 1, 2007 to June 30, …