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Articles 1 - 30 of 34
Full-Text Articles in Public Health
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 …
Association Of Parity With Birthweight And Neonatal Death In Five Sites: The Global Network's Maternal Newborn Health Registry Study, Ana Garces, Wilton Perez, Margo S. Harrison, Kay S. Hwang, Tracy L. Nolen, Robert L. Goldenberg, Archana B. Patel, Patricia L. Hibberd, Adrien Lokangaka, Sarah Saleem
Association Of Parity With Birthweight And Neonatal Death In Five Sites: The Global Network's Maternal Newborn Health Registry Study, Ana Garces, Wilton Perez, Margo S. Harrison, Kay S. Hwang, Tracy L. Nolen, Robert L. Goldenberg, Archana B. Patel, Patricia L. Hibberd, Adrien Lokangaka, Sarah Saleem
Community Health Sciences
Background: Nulliparity has been associated with lower birth weight (BW) and other adverse pregnancy outcomes, with most of the data coming from high-income countries. In this study, we examined birth weight for gestational age z-scores and neonatal (28-day) mortality in a large prospective cohort of women dated by first trimester ultrasound from multiple sites in low and middle-income countries.
Methods: Pregnant women were recruited during the first trimester of pregnancy and followed through 6 weeks postpartum from Maternal Newborn Health Registry (MNHR) sites in the Democratic Republic of Congo (DRC), Guatemala, Belagavi and Nagpur, India, and Pakistan from 2017 and …
Gender Variations In Neonatal And Early Infant Mortality In India And Pakistan: A Secondary Analysis From The Global Network Maternal Newborn Health Registry, Zubair H. Aghai, Shivaprasad S. Goudar, Archana Patel, Sarah Saleem, Sangappa M. Dhaded, Avinash Kavi, Parth Lalakia, Farnaz Naqvi, Patricia L. Hibberd, Elizabeth M. Mcclure
Gender Variations In Neonatal And Early Infant Mortality In India And Pakistan: A Secondary Analysis From The Global Network Maternal Newborn Health Registry, Zubair H. Aghai, Shivaprasad S. Goudar, Archana Patel, Sarah Saleem, Sangappa M. Dhaded, Avinash Kavi, Parth Lalakia, Farnaz Naqvi, Patricia L. Hibberd, Elizabeth M. Mcclure
Community Health Sciences
Background: To determine the gender differences in neonatal mortality, stillbirths, and perinatal mortality in south Asia using the Global Network data from the Maternal Newborn Health Registry.
Methods: This study is a secondary analysis of prospectively collected data from the three south Asian sites of the Global Network. The maternal and neonatal demographic, clinical characteristics, rates of stillbirths, early neonatal mortality (1-7 days), late neonatal mortality (8-28 days), mortality between 29-42 days and the number of infants hospitalized after birth were compared between the male and female infants.
Results: Between 2010 and 2018, 297,509 births [154,790 males (52.03%) and 142,719 …
Regional Trends In Birth Weight In Low- And Middle-Income Countries 2013-2018, Irene Marete, Osayame Ekhaguere, Carla M. Bann, Sherri L. Bucher, Paul Nyongesa, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar
Regional Trends In Birth Weight In Low- And Middle-Income Countries 2013-2018, Irene Marete, Osayame Ekhaguere, Carla M. Bann, Sherri L. Bucher, Paul Nyongesa, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar
Community Health Sciences
Background: Birth weight (BW) is a strong predictor of neonatal outcomes. The purpose of this study was to compare BWs between global regions (south Asia, sub-Saharan Africa, Central America) prospectively and to determine if trends exist in BW over time using the population-based maternal and newborn registry (MNHR) of the Global Network for Women'sand Children's Health Research (Global Network).
Methods: The MNHR is a prospective observational population-based registryof six research sites participating in the Global Network (2013-2018), within five low- and middle-income countries (Kenya, Zambia, India, Pakistan, and Guatemala) in threeglobal regions (sub-Saharan Af rica, south Asia, Central America). The …
Institutional Deliveries And Stillbirth And Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Shivaprasad S. Goudar, Norman Goco, Manjunath S. Somannavar, Avinash Kavi, Sunil S. Vernekar, Antoinette Tshefu, Elwyn Chomba, Ana L. Garces, Sarah Saleem, Farnaz Naqvi
Institutional Deliveries And Stillbirth And Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Shivaprasad S. Goudar, Norman Goco, Manjunath S. Somannavar, Avinash Kavi, Sunil S. Vernekar, Antoinette Tshefu, Elwyn Chomba, Ana L. Garces, Sarah Saleem, Farnaz Naqvi
Community Health Sciences
Background: Few studies have shown how the move toward institutional delivery in low and middle-income countries (LMIC) impacts stillbirth and newborn mortality.
Objectives: The study evaluated trends in institutional delivery in research sites in Belagavi and Nagpur India, Guatemala, Kenya, Pakistan, and Zambia from 2010 to 2018 and compared them to changes in the rates of neonatal mortality and stillbirth.
Methods: We analyzed data from a nine-year interval captured in the Global Network (GN) Maternal Newborn Health Registry (MNHR). Mortality rates were estimated from generalized estimating equations controlling for within-cluster correlation. Cluster-level analyses were performed to assess the association between …
Development Of The Global Network For Women's And Children's Health Research's Socioeconomic Status Index For Use In The Network's Sites In Low And Lower Middle-Income Countries, Archana B. Patel, Carla M. Bann, Ana L. Garces, Nancy F. Krebs, Adrien Lokangaka, Antoinette Tshefu, Carl L. Bose, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar
Development Of The Global Network For Women's And Children's Health Research's Socioeconomic Status Index For Use In The Network's Sites In Low And Lower Middle-Income Countries, Archana B. Patel, Carla M. Bann, Ana L. Garces, Nancy F. Krebs, Adrien Lokangaka, Antoinette Tshefu, Carl L. Bose, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar
Community Health Sciences
Background: Socioeconomic status (SES) is an important determinant of health globally and an important explanatory variable to assess causality in epidemiological research. The 10th Sustainable Development Goal is to reduce disparities in SES that impact health outcomes globally. It is easier to study SES in high-income countries because household income is representative of the SES. However, it is well recognized that income is poorly reported in low- and middle- income countries (LMIC) and is an unreliable indicator of SES. Therefore, there is a need for a robust index that will help to discriminate the SES of rural households in a …
Rates And Risk Factors For Preterm Birth And Low Birthweight In The Global Network Sites In Six Low- And Low Middle-Income Countries, Yamini V. Pusdekar, Archana B. Patel, Kunal G. Kurhe, Savita R. Bhargav, Vanessa Thorsten, Ana Garces, Robert L. Goldenberg, Shivaprasad S. Goudar, Sarah Saleem, Fabian Esamai
Rates And Risk Factors For Preterm Birth And Low Birthweight In The Global Network Sites In Six Low- And Low Middle-Income Countries, Yamini V. Pusdekar, Archana B. Patel, Kunal G. Kurhe, Savita R. Bhargav, Vanessa Thorsten, Ana Garces, Robert L. Goldenberg, Shivaprasad S. Goudar, Sarah Saleem, Fabian Esamai
Community Health Sciences
Background: Preterm birth continues to be a major public health problem contributing to 75% of the neonatal mortality worldwide. Low birth weight (LBW) is an important but imperfect surrogate for prematurity when accurate assessment of gestational age is not possible. While there is overlap between preterm birth and LBW newborns, those that are both premature and LBW are at the highest risk of adverse neonatal outcomes. Understanding the epidemiology of preterm birth and LBW is important for prevention and improved care for at risk newborns, but in many countries, data are sparse and incomplete.
Methods: We conducted data analyses using …
Cesarean Birth In The Global Network For Women's And Children's Health Research: Trends In Utilization, Risk Factors, And Subgroups With High Cesarean Birth Rates, Margo S. Harrison, Ana L. Garces, Shivaprasad S. Goudar, Sarah Saleem, Janet L. Moore, Fabian Esamai, Archana B. Patel, Elwyn Chomba, Carl L. Bose, Edward A. Liechty
Cesarean Birth In The Global Network For Women's And Children's Health Research: Trends In Utilization, Risk Factors, And Subgroups With High Cesarean Birth Rates, Margo S. Harrison, Ana L. Garces, Shivaprasad S. Goudar, Sarah Saleem, Janet L. Moore, Fabian Esamai, Archana B. Patel, Elwyn Chomba, Carl L. Bose, Edward A. Liechty
Community Health Sciences
Background: The objectives of this analysis were to document trends in and risk factors associated with the cesarean birth rate in low- and middle-income country sites participating in the Global Network for Women's and Children's Health Research (Global Network).
Methods: This is a secondary analysis of a prospective, population-based study of home and facility births conducted in the Global Network sites.
Results: Cesarean birth rates increased uniformly across all sites between 2010 and 2018. Across all sites in multivariable analyses, women younger than age twenty had a reduced risk of cesarean birth (RR 0.9 [0.9, 0.9]) and women over 35 …
Maternal Mortality In Six Low And Lower-Middle Income Countries From 2010 To 2018: Risk Factors And Trends, Melissa Bauserman, Vanessa R. Thorsten, Tracy L. Nolen, Jackie Patterson, Adrien Lokangaka, Antoinette Tshefu, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Saleem Jessani
Maternal Mortality In Six Low And Lower-Middle Income Countries From 2010 To 2018: Risk Factors And Trends, Melissa Bauserman, Vanessa R. Thorsten, Tracy L. Nolen, Jackie Patterson, Adrien Lokangaka, Antoinette Tshefu, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Saleem Jessani
Community Health Sciences
Background: Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time.
Methods: We analyzed data from women enrolled in the NICHD Global Network for Women's and Children's Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative …
The Relationship Between Birth Intervals And Adverse Maternal And Neonatal Outcomes In Six Low And Lower-Middle Income Countries, Melissa Bauserman, Kayla Nowak, Tracy L. Nolen, Jackie Patterson, Adrien Lokangaka, Antoinette Tshefu, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Saleem Jessani
The Relationship Between Birth Intervals And Adverse Maternal And Neonatal Outcomes In Six Low And Lower-Middle Income Countries, Melissa Bauserman, Kayla Nowak, Tracy L. Nolen, Jackie Patterson, Adrien Lokangaka, Antoinette Tshefu, Archana B. Patel, Patricia L. Hibberd, Sarah Saleem, Saleem Jessani
Community Health Sciences
Background: Due to high fertility rates in some low and lower-middle income countries, the interval between pregnancies can be short, which may lead to adverse maternal and neonatal outcomes.
Methods: We analyzed data from women enrolled in the NICHD Global Network Maternal Newborn Health Registry (MNHR) from 2013 through 2018. We report maternal characteristics and outcomes in relationship to the inter-delivery interval (IDI, time from previous delivery [live or stillborn] to the delivery of the index birth), by category of 6-17 months (short), 18-36 months (reference), 37-60 months, and 61-180 months (long). We used non-parametric tests for maternal characteristics, and …
Stillbirth 2010-2018: A Prospective, Population-Based, Multi-Country Study From The Global Network, Elizabeth M. Mcclure, Sarah Saleem, Shivaprasad S. Gouda, Ana Garces, Ryan Whitworth, Fabian Esamai, Archana B. Patel, Shiyam Sunder Tikmani, Musaku Mwenechanya, Elwyn Chomba
Stillbirth 2010-2018: A Prospective, Population-Based, Multi-Country Study From The Global Network, Elizabeth M. Mcclure, Sarah Saleem, Shivaprasad S. Gouda, Ana Garces, Ryan Whitworth, Fabian Esamai, Archana B. Patel, Shiyam Sunder Tikmani, Musaku Mwenechanya, Elwyn Chomba
Community Health Sciences
Background: Stillbirth rates are high and represent a substantial proportion of the under-5 mortality in low and middle-income countries (LMIC). In LMIC, where nearly 98% of stillbirths worldwide occur, few population-based studies have documented cause of stillbirths or the trends in rate of stillbirth over time.
Methods: We undertook a prospective, population-based multi-country research study of all pregnant women in defined geographic areas across 7 sites in low-resource settings (Kenya, Zambia, Democratic Republic of Congo, India, Pakistan, and Guatemala). Staff collected demographic and health care characteristics with outcomes obtained at delivery. Cause of stillbirth was assigned by algorithm.
Results: From …
Neonatal Deaths In Infants Born Weighing ≥ 2500 G In Low And Middle-Income Countries, Sarah Saleem, Farnaz Naqvi, Elizabeth M. Mcclure, Kayla J. Nowak, Shiyam Sunder Tikmani, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Tracy L. Nolen, Sameen Siddiqi
Neonatal Deaths In Infants Born Weighing ≥ 2500 G In Low And Middle-Income Countries, Sarah Saleem, Farnaz Naqvi, Elizabeth M. Mcclure, Kayla J. Nowak, Shiyam Sunder Tikmani, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Tracy L. Nolen, Sameen Siddiqi
Community Health Sciences
Background: Babies born weighing ≥ 2500 g account for more than 80% of the births in most resource-limited locations and for nearly 50% of the 28-day neonatal deaths. In contrast, in high-resource settings, 28-day neonatal mortality among this group represents only a small fraction of the neonatal deaths. Yet mortality risks for birth weight of ≥ 2500 g is limited. Knowledge regarding the factors associated with mortality in these babies will help in identifying interventions that can reduce mortality.
Methods: The Global Network's Maternal Newborn Health Registry (MNHR) is a prospective, population-based observational study that includes all pregnant women and …
The Global Network Maternal Newborn Health Registry: A Multi-Country, Community-Based Registry Of Pregnancy Outcomes, Elizabeth M. Mcclure, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Shivaprasad S. Goudar, Sarah Saleem, Fabian Esamai, Archana Patel, Elwyn Chomba, Adrien Lokangaka
The Global Network Maternal Newborn Health Registry: A Multi-Country, Community-Based Registry Of Pregnancy Outcomes, Elizabeth M. Mcclure, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Shivaprasad S. Goudar, Sarah Saleem, Fabian Esamai, Archana Patel, Elwyn Chomba, Adrien Lokangaka
Community Health Sciences
Background: The Global Network for Women's and Children's Health Research (Global Network) conducts clinical trials in resource-limited countries through partnerships among U.S. investigators, international investigators based in in low and middle-income countries (LMICs) and a central data coordinating center. The Global Network's objectives include evaluating low-cost, sustainable interventions to improve women's and children's health in LMICs. Accurate reporting of births, stillbirths, neonatal deaths, maternal mortality, and measures of obstetric and neonatal care is critical to determine strategies for improving pregnancy outcomes. In response to this need, the Global Network developed the Maternal Newborn Health Registry (MNHR), a prospective, population-based registry …
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 - …
Looking Beyond The Numbers: Quality Assurance Procedures In The Global Network For Women's And Children's Health Research Maternal Newborn Health Registry, Ana Garces, Emily Macguire, Holly L. Franklin, Norma Alfaro, Gustavo Arroyo, Lester Figueroa, Shivaprasad S. Goudar, Sarah Saleem, Fabian Esama, Archana Patel
Looking Beyond The Numbers: Quality Assurance Procedures In The Global Network For Women's And Children's Health Research Maternal Newborn Health Registry, Ana Garces, Emily Macguire, Holly L. Franklin, Norma Alfaro, Gustavo Arroyo, Lester Figueroa, Shivaprasad S. Goudar, Sarah Saleem, Fabian Esama, Archana Patel
Community Health Sciences
Background: Quality assurance (QA) is a process that should be an integral part of research to protect the rights and safety of study participants and to reduce the likelihood that the results are affected by bias in data collection. Most QA plans include processes related to study preparation and regulatory compliance, data collection, data analysis and publication of study results. However, little detailed information is available on the specific procedures associated with QA processes to ensure high-quality data in multi-site studies.
Methods: The Global Network for Women's and Children's Health Maternal Newborn Health Registy (MNHR) is a prospective population-based registry …
Lifetime Risk Of Diabetes In Metropolitan Cities In India, Shammi Luhar, Dimple Kondal, Rebecca Jones, Ranjit M. Anjana, Shivani A. Patel, Sanjay Kinra, Lynda Clarke, Mohammed K. Ali, Dorairaj Prabhakaran, Muhammad Masood Kadir
Lifetime Risk Of Diabetes In Metropolitan Cities In India, Shammi Luhar, Dimple Kondal, Rebecca Jones, Ranjit M. Anjana, Shivani A. Patel, Sanjay Kinra, Lynda Clarke, Mohammed K. Ali, Dorairaj Prabhakaran, Muhammad Masood Kadir
Community Health Sciences
Aims/hypothesis: We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI.
Methods: A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010-2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by …
Predictive Modeling For Perinatal Mortality In Resource-Limited Settings, Vivek V. Shukla, Barry Eggleston, Namasivayam Ambalavanan, Elizabeth M. Mcclure, Musaku Mwenechanya, Elwyn Chomba, Carl Bose, Melissa Bauserman, Antoinette Tshefu, Sarah Saleem
Predictive Modeling For Perinatal Mortality In Resource-Limited Settings, Vivek V. Shukla, Barry Eggleston, Namasivayam Ambalavanan, Elizabeth M. Mcclure, Musaku Mwenechanya, Elwyn Chomba, Carl Bose, Melissa Bauserman, Antoinette Tshefu, Sarah Saleem
Community Health Sciences
Importance: The overwhelming majority of fetal and neonatal deaths occur in low- and middle-income countries. Fetal and neonatal risk assessment tools may be useful to predict the risk of death.
Objective: To develop risk prediction models for intrapartum stillbirth and neonatal death.
Design, setting, and participants: This cohort study used data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Global Network for Women's and Children's Health Research population-based vital registry, including clinical sites in South Asia (India and Pakistan), Africa (Democratic Republic of Congo, Zambia, and Kenya), and Latin America (Guatemala). A total of 502 …
Air Pollution And Non Communicable Diseases, Zafar Fatmi, Shafaq Mahmood, Zainab Samad, Mohammad Wasay
Air Pollution And Non Communicable Diseases, Zafar Fatmi, Shafaq Mahmood, Zainab Samad, Mohammad Wasay
Community Health Sciences
No abstract provided.
Healthcare Utilisation And Expenditure Patterns For Cardio-Metabolic Diseases In South Asian Cities: The Carrs Study, Priti Gupta, Kalpana Singh, Roopa Shivashankar, Kavita Singh, Ajay Vamadevan, V Mohan, Muhammad Masood Kadir, Nikhil Tandon, K M. Narayan, Dorairaj Prabhakaran, Mohammed K. Ali
Healthcare Utilisation And Expenditure Patterns For Cardio-Metabolic Diseases In South Asian Cities: The Carrs Study, Priti Gupta, Kalpana Singh, Roopa Shivashankar, Kavita Singh, Ajay Vamadevan, V Mohan, Muhammad Masood Kadir, Nikhil Tandon, K M. Narayan, Dorairaj Prabhakaran, Mohammed K. Ali
Community Health Sciences
Objective: To estimate average annual expenditures per person, total economic burden and distress health financing associated with the treatment of five cardio-metabolic diseases (CMDs-hypertension, diabetes, heart disease (angina, myocardial infarction and heart failure), stroke and chronic kidney disease) in three metropolitan cities in South Asia.
Design: Cross-sectional surveys.
Setting: We analysed community-based baseline data from the Centre for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study collected in 2010-2011 representing Chennai and New Delhi (India), and Karachi (Pakistan).
Participants: We used data from non-pregnant adults (≥20 years) from the aforementioned cities that responded to a cost-of-illness questionnaire. We estimated health …
Prevalence And Determinants Of Anemia Among Women Of Reproductive Age In Thatta Pakistan: Findings From A Cross-Sectional Study, Sumera Aziz Ali, Zahid Abbasi, Babar Shahid, Ghazal Moin, K Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Elizabeth M. Mcclure, Robert L. Goldenberg, Sarah Saleem
Prevalence And Determinants Of Anemia Among Women Of Reproductive Age In Thatta Pakistan: Findings From A Cross-Sectional Study, Sumera Aziz Ali, Zahid Abbasi, Babar Shahid, Ghazal Moin, K Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Elizabeth M. Mcclure, Robert L. Goldenberg, Sarah Saleem
Community Health Sciences
Background: Anemia is a major public health concern among women of reproductive age leading to high maternal mortality in low- and middle-income countries. Of the prior studies conducted in Pakistan, most focused on large urban areas and did not explore the determinants of anemia among women of reproductive age (WRA) across socio-demographic, dietary, reproductive, and biological domains. Thus, we aimed to study the prevalence and determinants of anemia among WRA in rural Pakistan.
Methods: We conducted a cross-sectional study in the Thatta district of Pakistan from September 2018 to January 2019 and enrolled 150 non-pregnant, married women. Data collectors administered …
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 …
Operability, Usefulness, And Task-Technology Fit Of An Mhealth App For Delivering Primary Health Care Services By Community Health Workers In Underserved Areas Of Pakistan And Afghanistan: Qualitative Study, Shehla Zaidi, Abdul Momin Kazi, Atif Riaz, Ammarah Ali, Rabia Najmi Taha, Rawshan Jabeen, Umerdad Khudadad, Saleem Sayani
Operability, Usefulness, And Task-Technology Fit Of An Mhealth App For Delivering Primary Health Care Services By Community Health Workers In Underserved Areas Of Pakistan And Afghanistan: Qualitative Study, Shehla Zaidi, Abdul Momin Kazi, Atif Riaz, Ammarah Ali, Rabia Najmi Taha, Rawshan Jabeen, Umerdad Khudadad, Saleem Sayani
Community Health Sciences
Background: The recent proliferation of digital health technology in low- and middle-income countries has made it possible for community health workers (CHWs) to use mobile health (mHealth) to perform tasks such as data collection and training. Although most studies focus on the prospect of digital apps to motivate and connect CHW, only a few have captured end-user experiences with mobile-based apps. We examined the experience of frontline health workers with a move towards digitalized real-time data to record maternal and childcare services in remote areas of Afghanistan and Pakistan.
Objective: Our study aimed to explore CHW perceptions on the operability …
Food Supplements To Reduce Stunting In Pakistan: A Process Evaluation Of Community Dynamics Shaping Uptake, Shehla Zaidi, Jai K. Das, Gul Nawaz Khan, Rabia Najmi Taha, Mashal Murad Shah, Sajid Bashir Soofi
Food Supplements To Reduce Stunting In Pakistan: A Process Evaluation Of Community Dynamics Shaping Uptake, Shehla Zaidi, Jai K. Das, Gul Nawaz Khan, Rabia Najmi Taha, Mashal Murad Shah, Sajid Bashir Soofi
Community Health Sciences
Background: There is an increasing interest in use of food supplements to prevent childhood stunting, however the evidence on the process indicators is scarce. We in this study explore the barriers to the effective implementation of food supplementation programs and the possible mitigation strategies which can guide the design of future programs.
Methods: We undertook a process evaluation of a stunting prevention food supplementation pilot program in rural Pakistan that distributed Wheat Soy Blend (WSB) to pregnant & lactating women, and Lipid-based Nutrient Supplement (LNS) and micronutrient powder (MNP) to < 5 years children. We used a mixed methods approach through a quantitative survey of 800 households and conducted 18 focused group discussion (FGDs) (with male and female caregivers), 4 FGDs (with Community Health Workers (CHWs)) and 22 key informant interviews (with district stakeholders) to evaluate the community side factors affecting uptake through five parameters: value, acceptability, receipt of supplement, usage and correct dosage.
Results: The findings show that proportionately few beneficiaries consumed the …
Perceptions Of Stakeholders About The Role Of Health System In Suicide Prevention In Ghizer, Gilgit-Baltistan, Pakistan, Anila Anjum, Tazeen S. Ali, Nousheen Pradhan, Murad M. Khan Dr., Rozina Karmaliani Professor
Perceptions Of Stakeholders About The Role Of Health System In Suicide Prevention In Ghizer, Gilgit-Baltistan, Pakistan, Anila Anjum, Tazeen S. Ali, Nousheen Pradhan, Murad M. Khan Dr., Rozina Karmaliani Professor
Community Health Sciences
Background: Suicide is a serious global public health problem, with more than 800,000 people dying by suicide worldwide every year. 79% of suicides happen in Low and Middle-Income Countries (LMICs), where lack of national suicide prevention programs coupled with inadequate MH facilities for early identification and treatment of mental disorders add to seriousness of the problems. Although there is paucity of research, studies suggest that the rate of suicide in district Ghizer, Gilgit-Baltistan (GB), in northern Pakistan may be higher compared to rest of the country.
Methods: This study aimed to explore the perceptions of stakeholders about the role of …
Compliance Of Smokeless Tobacco Supply Chain Actors And Products With Tobacco Control Laws In Bangladesh, India And Pakistan: Protocol For A Multicentre Sequential Mixed-Methods Study, Zohaib Khan, Rumana Huque, Aziz Sheikh, Anne Readshaw, Jappe Eckhardt, Cath Jackson, Mona Kanaan, Romaina Iqbal, Zohaib Akhter, Javaid Khan
Compliance Of Smokeless Tobacco Supply Chain Actors And Products With Tobacco Control Laws In Bangladesh, India And Pakistan: Protocol For A Multicentre Sequential Mixed-Methods Study, Zohaib Khan, Rumana Huque, Aziz Sheikh, Anne Readshaw, Jappe Eckhardt, Cath Jackson, Mona Kanaan, Romaina Iqbal, Zohaib Akhter, Javaid Khan
Community Health Sciences
Introduction: South Asia is home to more than 300 million smokeless tobacco (ST) users. Bangladesh, India and Pakistan as signatories to the Framework Convention for Tobacco Control (FCTC) have developed policies aimed at curbing the use of tobacco. The objective of this study is to assess the compliance of ST point-of-sale (POS) vendors and the supply chain with the articles of the FCTC and specifically with national tobacco control laws. We also aim to assess disparities in compliance with tobacco control laws between ST and smoked tobacco products.
Methods and analysis: The study will be carried out at two sites …
Perceptions And Experiences Of Men And Women Towards Acceptability And Use Of Contraceptives In Underserved Areas Of Karachi, Pakistan: A Midline Qualitative Assessment Of Sukh Initiative, Karachi Pakistan, Sarah Saleem, Narjis Rizvi, Anam Feroz, Sayyeda Reza, Saleem Jessani, Farina Abrejo
Perceptions And Experiences Of Men And Women Towards Acceptability And Use Of Contraceptives In Underserved Areas Of Karachi, Pakistan: A Midline Qualitative Assessment Of Sukh Initiative, Karachi Pakistan, Sarah Saleem, Narjis Rizvi, Anam Feroz, Sayyeda Reza, Saleem Jessani, Farina Abrejo
Community Health Sciences
Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.
Methods: A qualitative study was conducted at ten …
Risk Factors For Postpartum Sepsis: A Nested Case-Control Study, Samina Bakhtawar, Sana Sheikh, Rahat Qureshi, Zahra Hoodbhoy, Beth Payne, Iqbal Azam Syed, Peter Von Dadelszen, Laura Magee
Risk Factors For Postpartum Sepsis: A Nested Case-Control Study, Samina Bakhtawar, Sana Sheikh, Rahat Qureshi, Zahra Hoodbhoy, Beth Payne, Iqbal Azam Syed, Peter Von Dadelszen, Laura Magee
Community Health Sciences
Background: The Majority (99%) of maternal deaths occur in low and middle-income countries. The three most important causes of maternal deaths in these regions are postpartum hemorrhage, pre-eclampsia and puerperal sepsis. There are several diagnostic criteria used to identify sepsis and one of the commonly used criteria is systematic inflammatory response syndrome (SIRS). However, these criteria require laboratory investigations that may not be feasible in resource-constrained settings. Therefore, this study aimed to develop a model based on risk factors and clinical signs and symptoms that can identify sepsis early among postpartum women.
Methods: A case-control study was nested in an …
Estimation Of The Burden Of Out-Of-Hospital Traumatic Cardiac Arrest In Karachi, Pakistan, Using A Cross-Sectional Capture-Recapture Analysis, Minaz Mawani, Syed Iqbal Azam, Muhammad Masood Kadir, Zainab Samad, Junaid Abdul Razzak
Estimation Of The Burden Of Out-Of-Hospital Traumatic Cardiac Arrest In Karachi, Pakistan, Using A Cross-Sectional Capture-Recapture Analysis, Minaz Mawani, Syed Iqbal Azam, Muhammad Masood Kadir, Zainab Samad, Junaid Abdul Razzak
Community Health Sciences
Background: The burden of trauma-related-out-of-hospital cardiac arrest (OHCA) in developing countries like Pakistan remains largely unexplored due to a lack of organized pre-hospital systems. In order to estimate the burden, we used a two-sample capture-recapture method which has been used in several domains to estimate difficult-to-count populations.
Methods: We obtained 3-month data from two sources: Records of two major EMS (emergency medical services) systems and five major hospitals providing coverage to the city's population. All adults with traumatic OHCA were included. Information on variables such as name, age, gender, date and time of arrest, cause of arrest, and destination hospital …
Lifestyle Changes And Glycemic Control In Type 1 Diabetes Mellitus: A Trial Protocol With Factorial Design Approach, Sobia Sawani, Amna Siddiqui, Syed Iqbal Azam, Khadija N Humayun, Asma Ahmed, Aysha Habib, Sabahat Naz, Mayera Tufail, Romaina Iqbal
Lifestyle Changes And Glycemic Control In Type 1 Diabetes Mellitus: A Trial Protocol With Factorial Design Approach, Sobia Sawani, Amna Siddiqui, Syed Iqbal Azam, Khadija N Humayun, Asma Ahmed, Aysha Habib, Sabahat Naz, Mayera Tufail, Romaina Iqbal
Community Health Sciences
Background: Type 1 diabetes (T1D) has been increasing globally over the past three decades. Self-monitoring of blood glucose is a challenge in both developed as well as developing countries. Self-management guidelines include maintaining logbooks for blood glucose, physical activity, and dietary intake that affect glycated hemoglobin (HbA1c) and a multitude of life-threatening acute complications. Innovative, cost-effective interventions along with beneficial lifestyle modifications can improve home-based self-monitoring of blood glucose in T1D patients. The overall objective of this study is to evaluate the relationship between maintaining log books for blood glucose levels, reinforcement by e-messages, and/or daily step count and changes …
School-Based Interventions To Promote Personal And Environmental Hygiene Practices Among Children In Pakistan: Protocol For A Mixed Methods Study, Nousheen Pradhan, Waliyah Mughis, Tazeen S. Ali, Maleeha Naseem, Rozina Karmaliani Professor
School-Based Interventions To Promote Personal And Environmental Hygiene Practices Among Children In Pakistan: Protocol For A Mixed Methods Study, Nousheen Pradhan, Waliyah Mughis, Tazeen S. Ali, Maleeha Naseem, Rozina Karmaliani Professor
Community Health Sciences
Background: Poor personal hygiene and inadequate sanitation practices among young children leads to communicable diseases. There remains a gap in the holistic assessment of school children's hygiene literacy, practices and effectiveness of school-based hygiene interventions in Pakistan. Therefore, a school-based intervention protocol has been designed to promote personal and environmental hygiene practices for primary school children. Towards improving children's hygiene behaviors, the study will also focus on enhancing mothers' hygiene knowledge and practices.
Methods: Using quasi-experimental design with mixed methods data collection approaches, this study will be conducted in schools located in an urban squatter settlements in Pakistan. To assess …