Community Health Commons^™

Public Private Mix Model In Enhancing Tuberculosis Case Detection In District Thatta, Sindh, Pakistan, Jameel Ahmed, Mubashir Ahmed, A Laghari, Wasdev Lohana, Sajid Ali, Zafar Fatmi

Community Health Sciences

To enhance the TB case detection through Public Private Mix (PPM) model by involving private practitioners in collaboration with National TB Control Program, (NTP) in district Thatta. Private practitioners (PPs) of district Thatta involved in treatment of TB cases were requested to participate in the study. All consenting physicians were provided with training on Directly Observed Treatment Short course (DOTS) module. In addition to routine cases, TB cases diagnosed by private practitioners through sputum microscopy were also registered with the district TB control program and medicines were provided by NTP. After intervention of PPM-DOTS change in Case Detection Rate (CDR) …

The Health Seeking Behaviour Of Elderly Population In A Poor-Urban Community Of Karachi, Pakistan, Abdullah Ladha, Romaisa Shamim Khan, Awais Amjad Malik, Sana Farooq Khan, Beenish Khan, Irum Nawaz Khan, Samiullah, Waleed Tallat Kayani, Sarah Saleem

Community Health Sciences

OBJECTIVES: To presents socio-demographic characteristics and health seeking behaviour of elderly and to determine frequency of Diabetes Mellitus and Hypertension in elderly population of a poor peri-urban community in Karachi, Pakistan.

METHODS: A cross-sectional study was conducted, targeting population aged 65 or above. A total of 438 respondents were interviewed after taking informed consent, between November 2005 and December 2005. Frequencies and Chi square values were calculated for different variables using SPSS 13.0.

RESULTS: Total population surveyed comprised of 438 elderly, 158 (36%) women and 280 (63.9%) men. Mean age for the population was 71.44 +/- 7.74. A total of …

General Practitioner's Knowledge Regarding The Diagnosis And Drug Therapy For Acute Myocardial Infarction, Zaman Shah, Munsif Ali, Islam Hussain, Saadia Zohra Farooqui, Anita Naushir Akbar Ali, Ailia Welayat Ali, Fazal Manzoor Arain, Salman Saleem Allana, Shadmeen Rafique Aarabi, Salman Fasih Khan, Mansoor Arif, Saad Siddique, Majid Shafiq, Amyn B Lakhani

Community Health Sciences

OBJECTIVE: To assess the general practitioners (GP) knowledge regarding the diagnosis and initial drug therapy for acute myocardial infarction (AMI).

METHODS: A questionnaire-based survey was conducted in randomly selected GPs of Karachi. Doctors working in community as GPs who were registered medical practitioners having a Bachelor of Medicine & Bachelor of Surgery degree were included in the study. Doctors working at tertiary care facilities or having a post graduate degree or post graduate training in a specialty other than family medicine were excluded from the study.

RESULTS: A total of 186 GPs participated in our study. GPs who studied research …

Knowledge And Practices Regarding Cigarette Smoking Among Adult Women In A Rural District Of Sindh, Pakistan, Sajid Ali, Naseem Ara, Arif Ali, Beena Ali, Muhammad Masood Kadir

Community Health Sciences

OBJECTIVE: To determine the prevalence of cigarette smoking and to obtain information on socio-demographic factors and attitude regarding cigarette smoking among adult women in a rural district of Sindh Province, Pakistan.

METHODS: A cross sectional community based survey was done in a rural district of Sindh province of Pakistan using a two stage cluster sampling design. A pre tested questionnaire was used to interview 502 adult women (aged 18- 60 years) from the study site. The study was approved by the ethical research committee and informed consent was taken from participants.

RESULTS: A total of 502 women were interviewed for …

Social Health Insurance: Can We Ever Make A Case For Pakistan, Farina G Abrejo, Babar Tasneem Shaikh

Community Health Sciences

Social Health Insurance has been used as an approach to increase efficiency of healthcare system and consumer satisfaction in provision of healthcare services. Many developed countries have successfully planned and implemented insurance models which provide almost universal coverage and addresses issues of equity. The phenomenon is established however, developing countries especially Eastern Mediterranean region is still struggling to present one successful model of social health insurance which can be compared with European or Scandinavian countries. Pakistan likewise faces huge challenges in public sector healthcare provision and considerable proportion of population prefers to go to private sector. Quality of care, access …

Self-Medication Amongst University Students Of Karachi: Prevalence, Knowledge And Attitudes, Syed Nabeel Zafar, Reema Syed, Sana Waqar, Akbar Jaleel Zubairi, Talha Vaqar, Mehrine Shaikh, Wajeeha Yousaf, Saman Shahid, Sarah Saleem

Community Health Sciences

OBJECTIVE: To determine the prevalence, attitude and knowledge of self-medication amongst university students of Karachi, Pakistan.

METHODS: This cross-sectional, study was conducted from Jan-Feb 2007. A convenience sample was taken from 2 medical and 2 non-medical universities of the city of Karachi, Pakistan. Data was analyzed using SPSS v 14 and associations were tested using the Chi square test.

RESULTS: Of the 572 participants (mean age=21 +/- 1.8 years, Male: Female ratio=1:1.5), 295 were medical and 277 were non-medical students. The prevalence of self-medication was 76%. Forty three percent students stated that they alter the regimen of prescribed medicines while …

Incidence, Patterns And Severity Of Reported Unintentional Injuries In Pakistan For Persons Five Years And Older: Results Of The National Health Survey Of Pakistan 1990–94, Zafar Fatmi, Wilbur C. Hadden, Junaid A. Razzak, Huma Qureshi, Adnan A. Hyder, Gregory Pappas

Community Health Sciences

Background

National level estimates of injuries are not readily available for developing countries. This study estimated the annual incidence, patterns and severity of unintentional injuries among persons over five years of age in Pakistan.

Methods

National Health Survey of Pakistan (NHSP 1990–94) is a nationally representative survey of the household. Through a two-stage stratified design, 18, 315 persons over 5 years of age were interviewed to estimate the overall annual incidence, patterns and severity of unintentional injuries for males and females in urban and rural areas over the preceding one year. Weighted estimates were computed adjusting for complex survey design …

Eight Key Household Practices Of Integrated Management Of Childhood Illnesses (Imci) Amongst Mothers Of Children Aged 6 To 59 Months In Gambat, Sindh, Pakistan, Ajmal Agha, Muhammad Younus, Muhammed Masood Kadir, Sajid Ali, Zafar Fatmi

Community Health Sciences

Objective:

To determine Knowledge, Attitudes and Practices (KAP) regarding eight key integrated management of childhood illness (IMCI) suggested practices and the association of these key practices with stunting as outcome.

Methods:

Sampling proportionate to sub-population sizes was employed to ensure representation from all the Union Councils of taluka Gambat-Sindh.

Results:

Low female education and mobility show the status of child's first care provider in a typical rural community. Few women knew about giving more food to a child suffering from diarrhoea. Moreover, very few exclusively breastfed their children for first 4-6 months, got their children completely immunized, washed hands before …

Knowledge And Beliefs Of Adolescents Regarding Sexually Transmitted Infections And Hiv/Aids In A Rural District In Pakistan, Hafsa Raheel, Franklin White, Muhammad Masood Kadir, Zafar Fatmi

Community Health Sciences

Objective:

To assess the knowledge and beliefs of adolescents (15-19 years girls and boys) regarding sexually transmitted infections (STIs) and HIV/AIDS.

Methods:

A community based cross-sectional survey was conducted in October 2002 in a rural district (Mirpurkhas) of Sindh province, Pakistan.

Results:

A total of 428 adolescent girls and boys were interviewed. Only 44% correctly named at least one STI, while 55% knew at least two modes of transmission for HIV/AIDS. Adolescents with education greater than or equal to secondary level, those who were able to read the newspaper, possessed electricity in their homes and were allowed to meet their …

Resource Allocation Within The National Aids Control Program Of Pakistan: A Qualitative Assessment Of Decision Maker's Opinions, Sara Husain, Masood Kadir, Zafar Fatmi

Community Health Sciences

Background:

Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program.

Methods:

A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to …

Social Environment And Depression Among Pregnant Women In Urban Areas Of Pakistan: Importance Of Social Relations., Ambreen Kazi, Zafar Fatmi, Juanita Hatcher, Muhammad Masood Kadir, Unaiza Niaz, Gail A. Wasserman

Community Health Sciences

Aspects of the social environment, including social conditions (socio-economic status, household situations, chronic illnesses) and social relations (attitude and behaviors of relations) are major determinants of depression among women. This study evaluates the relative power of social relations and social conditions in predicting depression among pregnant women in Pakistan. In the qualitative phase of the study, social environmental determinants were identified through literature search, and experts' opinions from psychologists, psychiatrists, gynecologists, sociologists and researchers. Along with this, 79 in-depth interviews were conducted with pregnant women drawn from six hospitals (public and private) and two communities in Karachi, Pakistan. Identified determinants …

Socio-Demographic Correlates Of Betel, Areca And Smokeless Tobacco Use As A High Risk Behavior For Head And Neck Cancers In A Squatter Settlement Of Karachi, Pakistan, Samia Mazahir, Rabia Malik, Maria Maqsood, Kanwal Aliraza Merchant, Farida Malik, Atif Majeed, Zafar Fatmi, Muhammad Rizwanulhaq Khawaja, Shehzad Ghaffar

Community Health Sciences

Background

Head and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of …

Socio-Economic And Demographic Factors Associated With Injecting Drug Use Among Drug Users In Karachi, Pakistan, A. Agha, S. Parviz, M. Younus, Zafar Fatmi

Community Health Sciences

Objective: To identify the socio-economic and demographic factors associated with injecting drug users (IDUs) in Karachi.

Methods: We recruited 242 IDUs (taking drugs through sub-dermal routes) and 231 non-IDUs (taking drugs other than sub-dermal routes) from February through June 1996. IDUs were interviewed regarding sociodemographic factors, economic condition, and social network (marital status, living with spouse). In addition, information regarding location of drug users within the city (districts of Karachi) and current history of sexually transmitted diseases (STDs) were gathered. Moreover, blood samples were also obtained for HIV testing

.Results: Multivariate analysis showed that the income generation via illegal …

Utility Of Participatory Rural Appraisal For Health Needs Assessment And Planning., M. A. Mahmood, Kausar S. Khan, Muhammad Masood Kadir, S. Ali, R. Tunio, N. Barney

Community Health Sciences

BACKGROUND:

While poverty and lack of life opportunities are root causes of a high burden of disease and infant and maternal mortality, inadequate health care contributes heavily. Often those who are left without care are those who need it most. Existing health services are managed without taking into account acceptance and need perspectives. This further reduces the effectiveness of and equity in health care. In order to guide the planning of reproductive health services by a national NGO, health needs were assessed in a district in Sindh using a combination of participatory rural appraisal (PRA) and qualitative and quantitative research …