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Articles 1 - 30 of 127
Full-Text Articles in Medicine and Health Sciences
The Causes Of Preterm Neonatal Deaths In India And Pakistan (Purpose): A Prospective Cohort Study, Sangappa M. Dhaded, Sarah Saleem, Shivaprasad S. Goudar, Shiyam Sunder Tikmani, Kay Hwang, Gowdar Guruprasad, Gayathri H. Aradhya, Varun B. Kusagur, Sana Roujani, Sayyeda Reza
The Causes Of Preterm Neonatal Deaths In India And Pakistan (Purpose): A Prospective Cohort Study, Sangappa M. Dhaded, Sarah Saleem, Shivaprasad S. Goudar, Shiyam Sunder Tikmani, Kay Hwang, Gowdar Guruprasad, Gayathri H. Aradhya, Varun B. Kusagur, Sana Roujani, Sayyeda Reza
Community Health Sciences
Background: Preterm birth remains the major cause of neonatal death worldwide. South Asia contributes disproportionately to deaths among preterm births worldwide, yet few population-based studies have assessed the underlying causes of deaths. Novel evaluations, including histological and bacteriological assessments of placental and fetal tissues, facilitate more precise determination of the underlying causes of preterm deaths. We sought to assess underlying and contributing causes of preterm neonatal deaths in India and Pakistan.
Methods: The project to understand and research preterm pregnancy outcomes and stillbirths in South Asia (PURPOSe) was a prospective cohort study done in three hospitals in Davangere, India, and …
Time For Reintroducing Hpv Vaccine In Pakistan For Primary Prevention Of Cervical Cancer, Uzma Shamsi, Afshan Anwar, Zainab Samad
Time For Reintroducing Hpv Vaccine In Pakistan For Primary Prevention Of Cervical Cancer, Uzma Shamsi, Afshan Anwar, Zainab Samad
Community Health Sciences
No abstract provided.
Are Women With Disabilities Less Likely To Utilize Essential Maternal And Reproductive Health Services?-A Secondary Analysis Of Pakistan Demographic Health Survey, Shafaq Mahmood, Waqas Hameed, Sameen Siddiqi
Are Women With Disabilities Less Likely To Utilize Essential Maternal And Reproductive Health Services?-A Secondary Analysis Of Pakistan Demographic Health Survey, Shafaq Mahmood, Waqas Hameed, Sameen Siddiqi
Community Health Sciences
Background: People with disabilities deal with widespread exclusion from healthcare services, including sexual and reproductive health (SRH) rights. Studies analyzing the relationship between disability and key SRH utilization outcomes have often reported mixed findings. In Pakistan, very little to no literature is available on this topic, therefore we aim to determine inequalities in the utilization of essential maternal and reproductive health services between women with and without disabilities in Pakistan.
Methods: This was a secondary analysis of Pakistan Demographic Health Survey 2017-18 performed on a weighted sample of 6,711 women aged 15-49 years with a live birth in the 5 …
Estimating The Pre- And Post-Diagnosis Costs Of Tuberculosis For Adults In Pakistan: Household Economic Impact And Costs Mitigating Strategies, Shama Razzaq, Aysha Zahidie, Zafar Fatmi
Estimating The Pre- And Post-Diagnosis Costs Of Tuberculosis For Adults In Pakistan: Household Economic Impact And Costs Mitigating Strategies, Shama Razzaq, Aysha Zahidie, Zafar Fatmi
Community Health Sciences
Background: Despite free tuberculosis (TB) care in Pakistan, patients still have to bear high costs, which push them into poverty. This study estimated the pre- and post-diagnosis costs households bear for TB care, and investigated coping mechanisms among adults ≥ 18 years in Karachi, Pakistan.
Methods: We conducted a cross-sectional study comprising of 516 TB patients identified with completion of at least one month intensive treatment from four public sector health facilities from two institutes in Karachi, Pakistan. A standardized questionnaire to estimate patient's costs was administered. The study outcomes were direct medical and non-medical costs, and indirect costs. The …
Factors Associated With Home Delivery In Rural Sindh, Pakistan: Results From The Global Network Birth Registry, Afreen Sadia, Shafaq Mahmood, Farnaz Naqvi, Seemab Naqvi, Zahid Soomro, Sarah Saleem
Factors Associated With Home Delivery In Rural Sindh, Pakistan: Results From The Global Network Birth Registry, Afreen Sadia, Shafaq Mahmood, Farnaz Naqvi, Seemab Naqvi, Zahid Soomro, Sarah Saleem
Community Health Sciences
Background: According to global estimates for 2017, nearly 295,000 maternal deaths occurred worldwide. Thus, approximately 810 women die every day due to pregnancy-related complications. This burden of maternal deaths in LMICs is primarily due to poor healthcare service utilization, as indicated by relatively low rates of institutional deliveries and skilled-birth attendance (SBA). We conducted this study with an aim to assess the factors associated with home delivery and its subsequent effect on the pregnancy outcome in rural Sindh, Pakistan.
Methods: Data for this study were taken from The Global Network's Maternal Newborn Health Registry (MNHR), which is a prospective, population-based …
Understanding The Needs Of A Mobile Phone-Based Telemonitoring Program For Pregnant Women At High Risk For Pre-Eclampsia: Interpretive Qualitative Description Study, Anam Shahil Feroz, Kristina De Vera, Nadia D. Bragagnolo, Sarah Saleem, Zulfiqar Ahmed Bhutta, Emily Seto
Understanding The Needs Of A Mobile Phone-Based Telemonitoring Program For Pregnant Women At High Risk For Pre-Eclampsia: Interpretive Qualitative Description Study, Anam Shahil Feroz, Kristina De Vera, Nadia D. Bragagnolo, Sarah Saleem, Zulfiqar Ahmed Bhutta, Emily Seto
Community Health Sciences
Background: Lack of early risk detection, diagnosis, and treatment of pregnant women at high risk for pre-eclampsia can result in high maternal mortality and morbidity not only in Pakistan but also in other low- to middle-income countries (LMICs). A potential tool for supporting pregnant women at high risk for pre-eclampsia for early detection is telemonitoring (TM). However, there is a limited body of evidence on end-user needs and preferences to inform the design of the TM programs for pregnant women at high risk for pre-eclampsia, specifically in LMICs such as Pakistan.
Objective: This study aims to explore the needs of …
Human Papillomavirus Associated Prevention: Knowledge, Attitudes, And Perceived Risks Among Men Who Have Sex With Men And Transgender Women In Pakistan: A Qualitative Study, Muslima Ejaz, Anna Mia Ekström, Alyan Ahmed, Aymen Haroon, Dania Ali, Tazeen Saeed Ali, Mariano Salazar
Human Papillomavirus Associated Prevention: Knowledge, Attitudes, And Perceived Risks Among Men Who Have Sex With Men And Transgender Women In Pakistan: A Qualitative Study, Muslima Ejaz, Anna Mia Ekström, Alyan Ahmed, Aymen Haroon, Dania Ali, Tazeen Saeed Ali, Mariano Salazar
Community Health Sciences
Objectives: Men who have sex with men (MSM) and transgender individuals are at higher risk of genital warts and anal cancer due to sexually transmitted human papillomavirus infection. This study explores MSM and transgender women's perceptions of Human papillomavirus (HPV) infection and HPV prevention strategies (screening and vaccination) in Pakistan.
Design: A qualitative study using focus group discussions (FGD) with self-identified MSM, male sex workers and transgender women were conducted between March 2019 to August 2019 in Karachi, Pakistan.
Methods: Participants were recruited from community-based organization (CBO) working for MSM and transgender women. A total of 38 men and 10 …
Quality Of Care Assessment For Small And Sick Newborns And Young Infants In Pakistan: Findings From A Cross-Sectional Study, Nousheen Pradhan, Sumera Aziz Ali, Sana Roujani, Ammarah Ali, Syed Shujaat Hussain, Samia Rizwan, Shabina Ariff, Sarah Saleem, Sameen Siddiqi
Quality Of Care Assessment For Small And Sick Newborns And Young Infants In Pakistan: Findings From A Cross-Sectional Study, Nousheen Pradhan, Sumera Aziz Ali, Sana Roujani, Ammarah Ali, Syed Shujaat Hussain, Samia Rizwan, Shabina Ariff, Sarah Saleem, Sameen Siddiqi
Community Health Sciences
Introduction: Pakistan is facing a challenging situation in terms of high newborn mortality rate. Securing pregnancy and delivery care may not bring a substantial reduction in neonatal mortality, unless coupled with the provision of quality inpatient care for small and sick newborns and young infants (NYIs). We undertook this study to assess the availability and quality of newborn care services provided and the readiness of inpatient care for NYIs in Pakistan.
Methods: We conducted a cross-sectional study across Pakistan from February to June 2019, using a purposive sample of 61% (23) of the 38 sick newborn care units at public …
The Impact Of Disease Control Measures On The Spread Of Covid-19 In The Province Of Sindh, Pakistan, Bilal Ahmed Usmani, Mustafain Ali, Muhammad Abul Hasan, Amna Rehana Siddiqui, Sameen Siddiqi, Aaron Guanliang Lim, Saad Ahmed Qazi
The Impact Of Disease Control Measures On The Spread Of Covid-19 In The Province Of Sindh, Pakistan, Bilal Ahmed Usmani, Mustafain Ali, Muhammad Abul Hasan, Amna Rehana Siddiqui, Sameen Siddiqi, Aaron Guanliang Lim, Saad Ahmed Qazi
Community Health Sciences
The province of Sindh reported the first COVID-19 case in Pakistan on 26th February 2020. The Government of Sindh has employed numerous control measures to limit its spread. However, for low-and middle-income countries such as Pakistan, the management protocols for controlling a pandemic are not always as definitive as they would be in other developed nations. Given the dire socio-economic conditions of Sindh, continuation of province-wise lockdowns may inadvertently cause a potential economic breakdown. By using a data driven SEIR modelling framework, this paper describes the evolution of the epidemic projections because of government control measures. The data from reported …
Human Papillomavirus-Associated Anal Squamous Intraepithelial Lesions In Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Karachi Pakistan: Implications For Screening And Prevention, Muslima Ejaz, Muhammad Mubarak, Tazeen Saeed Ali, Sören Andersson, Anna Mia Ekström
Human Papillomavirus-Associated Anal Squamous Intraepithelial Lesions In Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Karachi Pakistan: Implications For Screening And Prevention, Muslima Ejaz, Muhammad Mubarak, Tazeen Saeed Ali, Sören Andersson, Anna Mia Ekström
Community Health Sciences
Background: Anal squamous intraepithelial lesions (ASIL), strongly related to human papilloma virus (HPV) infection, is more prevalent among men who have sex with men (MSM). However, no such data are available for Pakistan yet, and neither HPV vaccination nor anal-cytology screening is implemented in Pakistan. The purpose of this first ever study was to assess the prevalence of HPV-related anal cytological abnormalities among MSM and transgender women living with and without HIV infection in Pakistan.
Methods: We conducted a cross-sectional study from March 2016 to November 2017 at sexual health centers run by the Perwaaz Trust and the National AIDS …
Unintended Pregnancy And The Associated Factors Among Pregnant Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Narjis Rizvi, Sarah Saleem
Unintended Pregnancy And The Associated Factors Among Pregnant Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Narjis Rizvi, Sarah Saleem
Community Health Sciences
Objective: Unintended pregnancy has become a substantially growing reproductive health concern in South Asian region. The objective of this survey was to assess the magnitude of unintended pregnancy along with its correlates among currently pregnant women residing in Karachi.
Methods: A community based, multistage, cross-sectional study was carried out among 612 currently pregnant women from squatter settlements of Karachi, inquiring for "unintended pregnancy", outcome of interest. Multivariable logistic analysis was done using SPSS v.19 to determine associated factors.
Results: Of 612 pregnant women interviewed, 168(27.4%) reported their pregnancies as unintended. The multivariable regression identified a high likelihood of unintended pregnancy …
Financing Mechanisms Applied For Successful Universal Health Coverage In Malaysia, Thailand And Singapore - Lessons For Pakistan, Rawshan Jabeen, Unaib Rabbani, Nazish Abbas
Financing Mechanisms Applied For Successful Universal Health Coverage In Malaysia, Thailand And Singapore - Lessons For Pakistan, Rawshan Jabeen, Unaib Rabbani, Nazish Abbas
Community Health Sciences
Universal health coverage is a global agenda and, currently for Pakistan, achieving this goal is a challenge because of a number of constraints. The current narrative review was planned to describe an overview of the provision of health insurance in Malaysia, Thailand and Singapore that have achieved universal health coverage, and to propose a roadmap for Pakistan. Literature search was conducted on Google Scholar and PubMed databases as well as on the World Bank website to retrieve relevant articles. The three studied countries achieved universal health coverage by gradually increasing allocation for health and through various mechanisms, such as health …
Desire To Limiting Child Birth And The Associated Determinants Among Married Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Sumera Aziz Ali, Zahid Abbasi, Sarah Saleem
Desire To Limiting Child Birth And The Associated Determinants Among Married Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Sumera Aziz Ali, Zahid Abbasi, Sarah Saleem
Community Health Sciences
Objective: High rates of population growth negatively influence the social and economic development of a country. This study aimed to determine the women's desire to limiting child birth in future (fertility intention) and its determinants among Pakistani women of reproductive age resident of Karachi.
Methods: A community-based, multistage cross-sectional study was carried out among residents of the squatter settlements in Karachi. The were 4,485 married residents, and currently non-pregnant females of 18 to 49 years old. Framework adapted has been based on "Pullum 1980" to operationalize the outcome of determining the desire to limiting childbearing and the factors related with …
Overcoming The Challenges Of Community-Engaged Emergency Referrals In A Rural District Of Pakistan, Imran Naeem Abbasi, Sameen Siddiqi
Overcoming The Challenges Of Community-Engaged Emergency Referrals In A Rural District Of Pakistan, Imran Naeem Abbasi, Sameen Siddiqi
Community Health Sciences
A functional referral system for addressing health emergencies requires coordinated efforts by health system's stakeholders and the community. Using the Rural Health Programme (RHP) Thatta as a platform provided by an academic institution, district health system stakeholders and the community of Mirpur Sakro, taluka of Thatta, were engaged to strengthen the referral system for health emergencies through active community engagement. Through consultations with stakeholders, a referral system plan was developed with community volunteers from each village as focal persons for transportation, referring patients to health facilities and maintaining referral documentation. The stakeholders' experience and perceptions about the referral system were …
Spatiotemporal Variation And Socioeconomic Factors Of Financial Hardships Of Out-Of-Pocket Health Expenditure In Pakistan, Muhammad Ashar Malik, Iqbal Azam Syed, Amir Khan, Faisal Rifaq, Kinza Chaudhary
Spatiotemporal Variation And Socioeconomic Factors Of Financial Hardships Of Out-Of-Pocket Health Expenditure In Pakistan, Muhammad Ashar Malik, Iqbal Azam Syed, Amir Khan, Faisal Rifaq, Kinza Chaudhary
Community Health Sciences
Background: Financial hardships of out-of-pocket health expenditure (OPHE) is a growing concern for health policy makers in many low and middle-income countries. Spatiotemporal variation between Pakistan's four provinces over 2001-2015 is discussed, which would help comparing existing health services delivery and financial risk protection plans.
Aims: In this paper, we estimate financial hardship of OPHE in Pakistan.
Methods: We use the data sets of the household integrated economic surveys 2001-02, 2005-06, 2010-11 and 2015-16. We estimate OPHE share in household total and non-subsistence expenditure, catastrophic headcount at the threshold of OPHE ≥ 10% of total expenditure or OPHE ≥ 25% …
Covid-19 Vaccination In Sindh Province, Pakistan: A Modelling Study Of Health Impact And Cost-Effectiveness, Carl A B. Pearson, Fiammetta Bozzani, Simon R. Procter, Nicholas G. Davies, Maryam Huda, Henning Tarp Jensen, Marcus Keogh-Brown, Muhammad Khalid, Sedona Sweeney, Sergio Torres-Rueda
Covid-19 Vaccination In Sindh Province, Pakistan: A Modelling Study Of Health Impact And Cost-Effectiveness, Carl A B. Pearson, Fiammetta Bozzani, Simon R. Procter, Nicholas G. Davies, Maryam Huda, Henning Tarp Jensen, Marcus Keogh-Brown, Muhammad Khalid, Sedona Sweeney, Sergio Torres-Rueda
Community Health Sciences
Background: Multiple Coronavirus Disease 2019 (COVID-19) vaccines appear to be safe and efficacious, but only high-income countries have the resources to procure sufficient vaccine doses for most of their eligible populations. The World Health Organization has published guidelines for vaccine prioritisation, but most vaccine impact projections have focused on high-income countries, and few incorporate economic considerations. To address this evidence gap, we projected the health and economic impact of different vaccination scenarios in Sindh Province, Pakistan (population: 48 million).
Methods and findings: We fitted a compartmental transmission model to COVID-19 cases and deaths in Sindh from 30 April to 15 …
Quality Of Inpatient Care Of Small And Sick Newborns In Pakistan: Perceptions Of Key Stakeholders, Nousheen Pradhan, Ammarah Ali, Sana Roujani, Sumera Aziz Ali, Samia Rizwan, Sarah Saleem, Sameen Siddiqi
Quality Of Inpatient Care Of Small And Sick Newborns In Pakistan: Perceptions Of Key Stakeholders, Nousheen Pradhan, Ammarah Ali, Sana Roujani, Sumera Aziz Ali, Samia Rizwan, Sarah Saleem, Sameen Siddiqi
Community Health Sciences
Background: In LMICs including Pakistan, neonatal health and survival is a critical challenge, and therefore improving the quality of facility-based newborn care services is instrumental in averting newborn mortality. This paper presents the perceptions of the key stakeholders in the public sector to explore factors influencing the care of small and sick newborns and young infants in inpatient care settings across Pakistan.
Methods: This exploratory study was part of a larger study assessing the situation of newborn and young infant in-patient care provided across all four provinces and administrative regions of Pakistan. We conducted 43 interviews. Thirty interviews were conducted …
Longitudinal Association Between Parental-To-Child-Maltreatment And Self-Reported Generalized Anxiety Disorder Symptoms In Pakistani Adolescents, Maryam Pyar Ali Lakhdir, Ghazal Peerwani, Salman Muhammad Soomar, Apsara Ali, Salima Farooq, Naureen Akber Ali, Asif Khaliq, Muhammad Masood Kadir, Syed Iqbal Azam
Longitudinal Association Between Parental-To-Child-Maltreatment And Self-Reported Generalized Anxiety Disorder Symptoms In Pakistani Adolescents, Maryam Pyar Ali Lakhdir, Ghazal Peerwani, Salman Muhammad Soomar, Apsara Ali, Salima Farooq, Naureen Akber Ali, Asif Khaliq, Muhammad Masood Kadir, Syed Iqbal Azam
Community Health Sciences
Background: Parent-to-child maltreatment is considered one of the risk factors for Generalized Anxiety Disorder (GAD) symptoms, but this hypothesis has not been adequately tested in Pakistani settings.
Aim: This study aimed to examine the association between parent-to-child maltreatment and the risk of developing GAD symptoms among adolescents.
Methods: The association of none to rare, occasionally, and frequently parent-to-child maltreatment with the incidence of GAD symptoms was investigated in a sample of 800 adolescents aged 11-17 years who were followed for two years. Parent-to-child maltreatment was assessed using ICAST-C (International child abuse screening tool). GAD Symptoms were determined by SCARED (Screen …
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
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 …
Fears And Barriers: Problems In Breast Cancer Diagnosis And Treatment In Pakistan, Sidra Saeed, Muhammad Asim, Malik Muhammad Sohail
Fears And Barriers: Problems In Breast Cancer Diagnosis And Treatment In Pakistan, Sidra Saeed, Muhammad Asim, Malik Muhammad Sohail
Community Health Sciences
Background: Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers. There is a dearth of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Punjab, Pakistan. Addressing this gap, this qualitative study sought to identify and explore the barriers that hinder women from seeking timely screening and treatment.
Methods: In this process 45 women (age = 18-50 years) with breast cancer were purposively sampled and interviewed from the Punjab Institute of Nuclear Medicine (PINUM) hospital, Faisalabad, Pakistan.
Results: An inductive approach was …
Budget Impact And Cost-Effectiveness Analyses Of The Cobra-Bps Multicomponent Hypertension Management Programme In Rural Communities In Bangladesh, Pakistan, And Sri Lanka, Eric A. Finkelstein, Anirudh Krishnan, Aliya Naheed, Imtiaz Jehan, H Asita De Silva, Mihir Gandhi, Ching Wee Lim, Jehanzeb Khan, Samina Hirani, Tazeen H. Jafar
Budget Impact And Cost-Effectiveness Analyses Of The Cobra-Bps Multicomponent Hypertension Management Programme In Rural Communities In Bangladesh, Pakistan, And Sri Lanka, Eric A. Finkelstein, Anirudh Krishnan, Aliya Naheed, Imtiaz Jehan, H Asita De Silva, Mihir Gandhi, Ching Wee Lim, Jehanzeb Khan, Samina Hirani, Tazeen H. Jafar
Community Health Sciences
Background: COBRA-BPS (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan, Sri Lanka), a multi-component hypertension management programme that is led by community health workers, has been shown to be efficacious at reducing systolic blood pressure in rural communities in Bangladesh, Pakistan, and Sri Lanka. In this study, we aimed to assess the budget required to scale up the programme and the incremental cost-effectiveness ratios.
Methods: In a cluster-randomised trial of COBRA-BPS, individuals aged 40 years or older with hypertension who lived in 30 rural communities in Bangladesh, Pakistan, and Sri Lanka were deemed eligible for inclusion. Costs were quantified prospectively …
Health Services Utilization And Out-Of-Pocket (Oop) Expenditures In Public And Private Facilities In Pakistan: An Empirical Analysis Of The 2013-14 Oop Health Expenditure Survey, F Khalid, W Raza, D R. Hotchkiss, R H. Soelaeman
Health Services Utilization And Out-Of-Pocket (Oop) Expenditures In Public And Private Facilities In Pakistan: An Empirical Analysis Of The 2013-14 Oop Health Expenditure Survey, F Khalid, W Raza, D R. Hotchkiss, R H. Soelaeman
Community Health Sciences
Background: As low- and middle-income countries progress toward Universal Health Coverage, there is an increasing focus on measuring out-of-pocket (OOP) expenditure and health services utilization within countries. While there have been several reforms to improve health services coverage and financial protection in Pakistan, there is limited empirical research comparing OOP expenditure and health services utilization between public and private facilities and exploring their determinants, a knowledge gap addressed in this study.
Methods: We used data from 2013 to 14 OOP Health Expenditure Survey, a population-based household survey carried out for Pakistan's National Health Accounts. The analysis included 7969 encounters from …
A Surrogate Frax Model For Pakistan, G Naureen, H Johansson, Romaina Iqbal, Lena Jafri, Aysha Habib Khan, Masood Umer, E Liu, L Vandenput, M Lorentzon, N C. Harvey, E V. Mccloskey, J A. Kanis
A Surrogate Frax Model For Pakistan, G Naureen, H Johansson, Romaina Iqbal, Lena Jafri, Aysha Habib Khan, Masood Umer, E Liu, L Vandenput, M Lorentzon, N C. Harvey, E V. Mccloskey, J A. Kanis
Community Health Sciences
A surrogate FRAX® model for Pakistan has been constructed using age-specific hip fracture rates for Indians living in Singapore and age-specific mortality rates from Pakistan.
Introduction: FRAX models are frequently requested for countries with little or no data on the incidence of hip fracture. In such circumstances, the International Society for Clinical Densitometry and International Osteoporosis Foundation have recommended the development of a surrogate FRAX model, based on country-specific mortality data but using fracture data from a country, usually within the region, where fracture rates are considered to be representative of the index country.
Objective: This paper describes the development …
Why Are The Pakistani Maternal, Fetal And Newborn Outcomes So Poor Compared To Other Low And Middle-Income Countries?, Aleha Aziz, Sarah Saleem, Tracy L. Nolen, Nousheen Akber Pradhan, Elizabeth M. Mcclure, Saleem Jessani, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Sameen Siddiqi
Why Are The Pakistani Maternal, Fetal And Newborn Outcomes So Poor Compared To Other Low And Middle-Income Countries?, Aleha Aziz, Sarah Saleem, Tracy L. Nolen, Nousheen Akber Pradhan, Elizabeth M. Mcclure, Saleem Jessani, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Sameen Siddiqi
Community Health Sciences
Background: Pakistan has among the poorest pregnancy outcomes worldwide, significantly worse than many other low-resource countries. The reasons for these differences are not clear. In this study, we compared pregnancy outcomes in Pakistan to other low-resource countries and explored factors that might help explain these differences.
Methods: The Global Network (GN) Maternal Newborn Health Registry (MNHR) is a prospective, population-based observational study that includes all pregnant women and their pregnancy outcomes in defined geographic communities in six low-middle income countries (India, Pakistan, Democratic Republic of Congo, Guatemala, Kenya, Zambia). Study staff enroll women in early pregnancy and follow-up soon after …
Knowledge, Attitudes And Practices Towards Covid-19 Among Pakistani Residents: Information Access And Low Literacy Vulnerabilities, Zafar Fatmi, Shafaq Mahmood, Waqas Hameed, Ibtisam Qazi, Muhammad Siddiqui, Anny Dhanwani, Sameen Siddiqi
Knowledge, Attitudes And Practices Towards Covid-19 Among Pakistani Residents: Information Access And Low Literacy Vulnerabilities, Zafar Fatmi, Shafaq Mahmood, Waqas Hameed, Ibtisam Qazi, Muhammad Siddiqui, Anny Dhanwani, Sameen Siddiqi
Community Health Sciences
Background: Coronavirus disease (COVID-19) has accentuated the need for speedy access to information. Digital divide and socio-demographic disparity create an information hiatus and therefore unhealthy practices with regard to dealing with COVID-19, particularly in low- and middle-income countries.
Aims: We assessed knowledge, attitudes, practices and their determinants regarding COVID-19 in Pakistan during March-April 2020.
Methods: 905 adults ≥18 years (males and females) participated: 403 from a web-based survey; 365 from an urban survey; and 137 from a rural survey. Frequency of adequate knowledge, attitudes and practices for the three populations was determined based on available global guidelines. Multivariable logistic regression …
Hemoglobin Concentrations And Adverse Birth Outcomes In South Asian Pregnant Women: Findings From A Prospective Maternal And Neonatal Health Registry, Sumera Aziz Ali, Shiyam Sunder Tikmani, Sarah Saleem, Archana B. Patel, Patricia L. Hibberd, Shivaprasad S. Goudar, Sangappa Dhaded, Richard J. Derman, Janet L. Moore, Elizabeth M. Mcclure, Robert L. Goldenberg
Hemoglobin Concentrations And Adverse Birth Outcomes In South Asian Pregnant Women: Findings From A Prospective Maternal And Neonatal Health Registry, Sumera Aziz Ali, Shiyam Sunder Tikmani, Sarah Saleem, Archana B. Patel, Patricia L. Hibberd, Shivaprasad S. Goudar, Sangappa Dhaded, Richard J. Derman, Janet L. Moore, Elizabeth M. Mcclure, Robert L. Goldenberg
Community Health Sciences
Background: While the relationship between hemoglobin (Hb) concentrations and pregnancy outcomes has been studied often, most reports have focused on a specific Hb cutoff used to define anemia. Fewer studies have evaluated pregnancy outcomes across the entire range of Hb values. Moreover, to date, most studies of the relationship of Hb concentrations to pregnancy outcomes have been done in high-income countries. Thus, we have sought to determine the relationship between the range of maternal Hb concentrations and adverse birth outcomes among South Asian pregnant women.
Methods: For this study, we used data collected from two South Asian countries (Pakistan - …
Measuring Service Quality And Assessing Its Relationship To Contraceptive Discontinuation: A Prospective Cohort Study In Pakistan And Uganda, Karen T. Chang, Nirali M. Chakraborty, Amanda M. Kalamar, Waqas Hameed, Ben Bellows, Karen A. Grépin, Agha Xaher Gul, Sarah E K. Bradley, Lynn M. Atuyambe, Dominic Montagu
Measuring Service Quality And Assessing Its Relationship To Contraceptive Discontinuation: A Prospective Cohort Study In Pakistan And Uganda, Karen T. Chang, Nirali M. Chakraborty, Amanda M. Kalamar, Waqas Hameed, Ben Bellows, Karen A. Grépin, Agha Xaher Gul, Sarah E K. Bradley, Lynn M. Atuyambe, Dominic Montagu
Community Health Sciences
Background: The quality of contraceptive counseling that women receive from their provider can influence their future contraceptive continuation. We examined (1) whether the quality of contraceptive service provision could be measured in a consistent way by using existing tools from 2 large-scale social franchises, and (2) whether facility quality measures based on these tools were consistently associated with contraceptive discontinuation.
Methods: We linked existing, routinely collected facility audit data from social franchise clinics in Pakistan and Uganda with client data. Clients were women aged 15-49 who initiated a modern, reversible contraceptive method from a sampled clinic. Consented participants completed an …
Malnutrition And Food Insecurity In Child Labourers In Sindh, Pakistan: A Cross-Sectional Study, Meesha Iqbal, Zafar Fatmi, Kausar S. Khan, Yusra Jumani, Neelma Amjad, Asaad Ahmed Nafees
Malnutrition And Food Insecurity In Child Labourers In Sindh, Pakistan: A Cross-Sectional Study, Meesha Iqbal, Zafar Fatmi, Kausar S. Khan, Yusra Jumani, Neelma Amjad, Asaad Ahmed Nafees
Community Health Sciences
Background: Child labour is common in low- and middle-income countries. Although child labour is widespread in Pakistan, no data are available on the health of child labourers.
Aims: This study aimed to assess the food security, food intake and nutritional status of child labourers aged 5-14 years working in lower Sindh, Pakistan.
Methods: Child labourers aged 5-14 years working in agriculture, manufacturing industry, hotels and restaurants, domestic work and migrant child labourers working in vegetable markets were recruited using a respondent-driven sampling technique. Sociodemographic and nutrition information was obtained by an interviewer questionnaire. The children's height and weight were measured …
Brucellosis In Pakistan: A Neglected Zoonotic Disease, Meesha Iqbal, Zafar Fatmi, Mumtaz Ali Khan
Brucellosis In Pakistan: A Neglected Zoonotic Disease, Meesha Iqbal, Zafar Fatmi, Mumtaz Ali Khan
Community Health Sciences
Brucellosis is a zoonotic disease; endemic but neglected in the South Asian countries including Pakistan. It causes economic loss to the livestock sector and leads to systemic infection in humans. Brucellosis was neglected in Pakistan since long. According to the Staged Tool for the Elimination of Brucellosis (STEB), Pakistan carries a grim landscape of the disease with no structured control activities. This article describes the five-year national brucellosis control strategic plan (2018-2023) formulated by the government of Pakistan using the one-health approach for the prevention and control of disease across the country. The plan incorporates components of surveillance, research, diagnostic …
Recommendations: Putting An End To Child Labour In Pakistan!, Meesha Iqbal, Zafar Fatmi, Kausar S. Khan, Asaad Ahmed Nafees, Neelma Amjad
Recommendations: Putting An End To Child Labour In Pakistan!, Meesha Iqbal, Zafar Fatmi, Kausar S. Khan, Asaad Ahmed Nafees, Neelma Amjad
Community Health Sciences
Child labour is rampant in Pakistan since ages. Laws, policies, programmes and strategies to eliminate child labour have been in place with little gain. Implementation of laws and sustainability of programmes offer barriers to eliminate the menace. We recommend a new approach of regulating child labour as a strategy to eliminate it in the longer run. Model districts with drop-in-centres offering free education to the working children should be constructed. The key stakeholders should unite on a common platform to formulate guidelines defining the nature and duration of work for children in various sectors such that they have sufficient time …