Public Health Commons^™

Assessing The Governance Of The Health Policy-Making Process Using A New Governance Tool: The Case Of Lebanon, Rasha Hamra, Sameen Siddiqi, Emma Carmel, Walid Ammar

Community Health Sciences

Background: In the international agenda, it has become common to assert that the assessment of health system governance using a practical tool is crucial. This approach can help us better understand how health systems are being steered as well as to identify gaps in the decision-making process and their causes. The authors developed a new assessment tool, the Health Policymaking Governance Guidance Tool (HP-GGT), that was designed to be conceptually sound and practical. This tool enables policy-makers and stakeholders to systematically review and assess health system governance at policy-making level. This article presents first use of the HP-GGT in Lebanon, …

Factors Affecting The Utilization Of Antenatal Care Among Married Women Of Reproductive Age In The Rural Thatta, Pakistan: Findings From A Community-Based Case-Control Study, Sumera Aziz Ali, Savera Aziz Ali, Anam Feroz, Sarah Saleem, Zafar Fatmi, Muhammad Masood Kadir

Community Health Sciences

Background: There are differences in antenatal care (ANC) utilization between urban and rural areas of Pakistan. Although multiple factors have been studied affecting the utilization of general health care services, the effect of road network distance particularly on the utilization of ANC has not been assessed. Therefore, this study aimed to determine the association between road network distance from a health care facility and utilization of the ANC among women of reproductive age in Thatta Pakistan.
Methods: A community-based case-control study was conducted in district Thatta, Pakistan. Women who did not utilize ANC services during their last pregnancy were considered …

Impact Of Conflict On Maternal And Child Health Service Delivery: A Country Case Study Of Afghanistan, Mohammed Shafiq Mirzazada, Zahra Ali Padhani, Sultana Jabeen, Malika Fatima, Arjumand Rizvi, Uzair Ansari, Jai K. Das, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: Since decades, the health system of Afghanistan has been in disarray due to ongoing conflict. We aimed to explore the direct effects of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing these services.
Method: We conducted a quantitative analysis of secondary data on RMNCAH&N indicators and undertook a supportive qualitative study to help understand processes and contextual factors. For quantitative analysis, we stratified the various provinces of Afghanistan into minimal-, moderate- and severe conflict categories based on battle-related deaths from Uppsala Conflict Data Program (UCDP) and …

Prelacteal Feeding Practices In Pakistan: A Mixed-Methods Study, Muhammad Asim, Zarak Husain Ahmed, Mark D. Hayward, Elizabeth M. Widen

Community Health Sciences

Background: Prelacteal feeding, the feeding a newborn substances or liquids before breastfeeding, is a common cultural practice in Pakistan, but is associated with neonatal morbidity and mortality because it delays early initiation of breastfeeding. In this study, we sought to examine the social and cultural factors associated with prelacteal feeding in Pakistan.
Methods: This mixed-method study used data from the Pakistan Demographic and Health Survey (PDHS) 2012-13. Findings from the survey were complemented by qualitative interviews with mothers and healthcare providers. In a subset of PDHS dyads (n = 1361) with children (0-23 months), descriptive statistics and bivariate and multivariable …

School Health Education Program In Pakistan (Shepp)-A Threefold Health Education Feasibility Trial In Schoolchildren From A Lower-Middle-Income Country, Aysha Almas, Romaina Iqbal, Sania Sabir, Abdul Ghani, Khawar Kazmi

Department of Medicine

Background: The school environment plays an essential role in promoting health education and physical activity for children and adolescence, and they are more likely to adapt it into their adulthood. School health education program has been endorsed and emphasized by the World Health Organization has not been implemented in true spirit in Pakistan yet. We aim to test feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardiometabolic risk factors by including BP, BMI, and waist circumference.
Methods: It is a parallel-group feasibility intervention trial. It is being conducted in two …

Intergrowth-21st Project International Inter-Nda Standards For Child Development At 2 Years Of Age: An International Prospective Population-Based Study, Michelle Fernandes, José Villar, Alan Stein, Eleonora Staines Urias, Cutberto Garza, Cesar G. Victora, Fernando C. Barros, Enrico Bertino, Manorama Purwar, Maria Carvalho, Zulfiqar Ahmed Bhutta

Woman and Child Health

Objectives: To describe the construction of the international INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) standards for child development at 2 years by reporting the cognitive, language, motor and behaviour outcomes in optimally healthy and nourished children in the INTERGROWTH-21st Project.
Design: Population-based cohort study, the INTERGROWTH-21st Project.
Setting: Brazil, India, Italy, Kenya and the UK.
Participants: 1181 children prospectively recruited from early fetal life according to the prescriptive WHO approach, and confirmed to be at low risk of adverse perinatal and postnatal outcomes.
Primary measures: Scaled INTER-NDA domain scores for cognition, language, fine and gross motor skills and behaviour; vision outcomes measured …

Prevalence And Risk Factors Associated With Hiv/Hepatitis B And Hiv/Hepatitis C Co-Infections Among People Who Inject Drugs In Mozambique, Cynthia Semá Baltazar, Makini Boothe, Timothy Kellogg, Paulino Ricardo, Isabel Sathane, Erika Fazito, Henry F. Raymond, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Background: There is scare information about HIV co-infections with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) among People Who Inject Drugs (PWID) in Mozambique. This information is critical to ensure the treatment necessary to decrease the progression of liver disease and the transmission of both HIV and hepatitis. We assess the prevalence of HIV, HBV and HCV co-infections as well as associated risk factors among PWID.

Methods: The first Bio-Behavioral Surveillance Survey was conducted in 2013-2014 among persons who self-reported to have ever injected drugs. Using respondent-driven sampling, PWID aged 18 years and older were recruited …

Associations Of Outdoor Fine Particulate Air Pollution And Cardiovascular Disease In 157 436 Individuals From 21 High-Income, Middle-Income, And Low-Income Countries (Pure): A Prospective Cohort Study, Perry Hystad, Andrew Larkin, Sumathy Rangarajan, Khalid F. Alhabib, Álvaro Avezum, Kevser Burcu Tumerdem Calik, Jephat Chifamba, Antonio Dans, Rafael Diaz, Romaina Iqbal

Community Health Sciences

Background: Most studies of long-term exposure to outdoor fine particulate matter (PM2·5) and cardiovascular disease are from high-income countries with relatively low PM2·5 concentrations. It is unclear whether risks are similar in low-income and middle-income countries (LMICs) and how outdoor PM2·5 contributes to the global burden of cardiovascular disease. In our analysis of the Prospective Urban and Rural Epidemiology (PURE) study, we aimed to investigate the association between long-term exposure to PM2·5 concentrations and cardiovascular disease in a large cohort of adults from 21 high-income, middle-income, and low-income countries.
Methods: In this multinational, prospective cohort study, we studied 157 436 …

Determinants Of Occupational Hazards Knowledge And Safety Practices Among Textile Workers In Karachi, Pakistan: A Cross Sectional Study, Natasha Shaukat, Hasan Nawaz Tahir, Tanzil Jamali, Mohammed Moizul Hassan, Asaad Ahmed Nafees

Community Health Sciences

Objective: To determine the factors associated with good knowledge and safe practices regarding occupational hazards among textile workers.
Methods: The cross-sectional study was conducted in Karachi from September 2015 to February 2016, and comprised male workers from seven textile mills. A 45-item structured questionnaire was developed and pretested in Urdu, the local language. One part of the questionnaire comprised 31 items related to good knowledge, and the other part comprised 14 items related to safe practices. Data was analysed using SPSS 19.
Results: Of the 300 subjects, 123(41%) were aged 18-27 years, 183(63%) were educated, 184(61.3%) worked more than eight …

Correlates Of Health-Related Quality Of Life Among Adults Receiving Combination Antiretroviral Therapy In Coastal Kenya, Moses K. Nyongesa, Paul Mwangi, Stanley Wanjala, Agnes M. Mutua, Hans M. Koot, Pim Cuijpers, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Health-related quality of life (HRQoL) is an important metric of perceived wellbeing in people living with HIV/AIDS (PLWHA). However, research on HRQoL among PLWHA in sub-Saharan Africa is limited. This study investigates factors associated with HRQoL among PLWHA in Kilifi, coast of Kenya.

Methods: Between February and April 2018, 450 adults living with HIV and on combined antiretroviral therapy (cART) between 18 to 60 years were sequentially recruited from an HIV-specialized clinic. The Functional Assessment of HIV Infection (FAHI) questionnaire, previously adapted for assessing HRQoL in this setting, was slightly modified and administered to participants alongside other …

A Systematic Review Of Epidemiological Patterns And Proposed Interventions To Address Pediatric Burns In Nigeria, Srikanta Banerjee, Constance Shumba

School of Nursing & Midwifery, East Africa

Background: Unintentional injuries from burns comprise a significant proportion of public health morbidity in Nigeria. In order to understand the type and impact of burns on youth in Low-and-Middle-Income countries, the epidemiology of burns must be adequately assessed.

Methods: This review describes the epidemiological patterns of burn occurrences in the pediatric populations and pro- poses interventions using the Haddon Matrix to address injuries in specific populations in Nigeria. A literature search was conducted using the Proquest, CINAHL, and PubMed databases at the Johns Hopkins University library (January 1, 1990 to August 14, 2018), on burns or thermal injury …

Patient Delay In Breast Cancer Diagnosis In Two Hospitals In Karachi, Pakistan: Preventive And Life-Saving Measures Needed, Uzma Shamsi, Shaista Khan, Syed Iqbal Azam, Shaheryar Usman, Amir Maqbool, Tiffany Gill, Romaina Iqbal, David Callen

Department of Surgery Docs

Purpose: Patients with breast cancer in Pakistan commonly present with advanced disease. The objectives of this study were to evaluate the frequency and length of delays in seeking medical consultation and to assess the factors associated with them.
Methods: Four hundred ninety-nine patients with newly diagnosed breast cancer were enrolled and interviewed over the period from February 2015 to August 2017. Information on sociodemographic factors, delay to medical consultation, stage of breast cancer at presentation, and tumor characteristics of the breast cancer were collected through face-to-face interviews and medical file review.
Results: The mean (standard deviation) age of patients with …

Male Involvement Interventions And Improved Couples’ Emotional Relationships In Tanzania And Zimbabwe: ‘When We Are Walking Together, I Feel Happy’, Liz Comrie-Thomson, Webster Mavhu, Christina Makungu, Quamrun Nahar, Rasheda Khan, Jessica Davis, Erica Stillo, Saadya Hamdani, Stanley Luchters, Cathy Vaughan

Population Health, East Africa

Male involvement in maternal and child health is recognised as a valuable strategy to improve care-seeking and uptake of optimal home care practices for women and children in low- and middle-income settings. However, the specific mechanisms by which involving men can lead to observed behaviour change are not well substantiated. A qualitative study conducted to explore men’s and women’s experiences of male involvement interventions in Tanzania and Zimbabwe found that, for some women and men, the interventions had fostered more loving partner relationships. Both male and female participants identified these changes as profoundly meaningful and highly valued. Our findings illustrate …

Cohort Profile: The Kaloleni/Rabai Community Health And Demographic Surveillance System, Anthony Ngugi, Rachel Odhiambo, Felix Agoi, Amyn Lakhani, James Orwa, Jerim Obure, David Mang’Ong’O, Stanley Luchters, Catherine Munywoki, Anisa Omar, Marleen Temmerman

Population Health, East Africa

Why was the cohort set up?In many resource-constrained settings, availability of reli-able vital statistics and health information is limited bylack of proper system for civil registration and health infor-mation. This is further limited by the fact that the majorityof population health events, such as births, morbidity andmortality, occur outside the reach of these systems. In par-ticular, obtaining credible data from rural and remote ge-ographies can be even more constrained. The developmentof population-based surveillance systems in resource-constrained countries to monitor demographic and healthevents in these countries has as its basis the limited capac-ity of civil registration and health information systems.Locally rooted …

C'Est Vraiment Compliqué: A Case Study On The Delivery Of Maternal And Child Health And Nutrition Interventions In The Conflict-Affected Regions Of Mali, Anushka Ataullahjan, Michelle F. Gaffey, Moctar Tounkara, Samba Diarra, Seydou Doumbia, Zulfiqar Ahmed Bhutta, Diego G. Bassani

Woman and Child Health

Background: Mali is currently in the midst of ongoing conflicts which involve jihadist groups, rebels, and the state. This conflict has primarily centered in the North of the country. Humanitarian actors delivering services in these geographies must navigate the complex environment created by conflict. This study aimed to understand how humanitarian actors make decisions around health service delivery within this context.
Methods: The current case-study utilized a mixed methods approach and focused on Mopti, Mali's fifth administrative region and fourth largest in population. Latent content analysis was used to analyze interview transcripts guided by our research objectives and new concepts …

Understanding The Factors Affecting The Humanitarian Health And Nutrition Response For Women And Children In Somalia Since 2000: A Case Study, Zahra Ahmed, Anushka Ataullahjan, Michelle F. Gaffey, Mohamed Osman, Chantal Umutoni, Zulfiqar Ahmed Bhutta, Abdirisak A. Dalmar

Woman and Child Health

Background: Somalia has been ravaged by more than two decades of armed conflict causing immense damage to the country's infrastructure and mass displacement and suffering among its people. An influx of humanitarian actors has sought to provide basic services, including health services for women and children, throughout the conflict. This study aimed to better understand the humanitarian health response for women and children in Somalia since 2000.
Methods: The study utilized a mixed-methods design. We collated intervention coverage data from publically available large-scale household surveys and we conducted 32 interviews with representatives from government, UN agencies, NGOs, and health facility …

Impact Of Conflict On Maternal And Child Health Service Delivery - How And How Not: A Country Case Study Of Conflict Affected Areas Of Pakistan, Jai K. Das, Zahra Ali Padhani, Sultana Jabeen, Arjumand Rizvi, Uzair Ansari, Malika Fatima, Ghulam Akbar, Wardah Ahmed, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: In conflict affected countries, healthcare delivery remains a huge concern. Pakistan is one country engulfed with conflict spanning various areas and time spans. We aimed to explore the effect of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing the prioritization and implementation in conflict affected areas of Pakistan (Balochistan and FATA).
Method: We conducted a secondary quantitative and a primary qualitative analysis. For the quantitative analysis, we stratified the various districts/agencies of Balochistan and FATA into the conflict categories of minimal-, moderate- and severe based on …

Investigating The Delivery Of Health And Nutrition Interventions For Women And Children In Conflict Settings: A Collection Of Case Studies From The Branch Consortium, Anushka Ataullahjan, Michelle F. Gaffey, Samira Sami, Neha S. Singh, Hannah Tappis, Robert E. Black, Karl Blanchet, Ties Boerma, Ana Langer, Paul B. Spiegel, Ronald J. Waldman, Paul H. Wise, Zulfiqar Ahmed Bhutta

Woman and Child Health

Globally, the number of people affected by conflict is the highest in history, and continues to steadily increase. There is currently a pressing need to better understand how to deliver critical health interventions to women and children affected by conflict. The compendium of articles presented in this Conflict and Health Collection brings together a range of case studies recently undertaken by the BRANCH Consortium (Bridging Research & Action in Conflict Settings for the Health of Women and Children). These case studies describe how humanitarian actors navigate and negotiate the multiple obstacles and forces that challenge the delivery of health and …

Substantial And Sustained Reduction In Under-5 Mortality, Diarrhea, And Pneumonia In Oshikhandass, Pakistan: Evidence From Two Longitudinal Cohort Studies 15 Years Apart, C L. Hansen, B J J. Mccormick, Iqbal Azam Syed, K Ahmed, J M. Baker, E Hussain, A Jahan, A F. Jamison, N Samji, Oshikhandass Diarrhea And Pneumonia Project, Anita K. M. Zaidi, Ahmed Jan

Community Health Sciences

Background: Oshikhandass is a rural village in northern Pakistan where a 1989-1991 verbal autopsy study showed that diarrhea and pneumonia were the top causes of under-5 mortality. Intensive surveillance, active community health education and child health interventions were delivered in 1989-1996; here we assess improvements in under-5 mortality, diarrhea, and pneumonia over this period and 15 years later.
Methods: Two prospective open-cohort studies in Oshikhandass from 1989 to 1996 (Study 1) and 2011-2014 (Study 2) enrolled all children under age 60 months. Study staff trained using WHO guidelines, conducted weekly household surveillance and promoted knowledge on causes and management of …

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 …

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 …

Community Stakeholders' Views On Reducing Violence Against Women In Pakistan, Tazeen S. Ali, Rozina Karmaliani Professor, Hussain Maqbool Ahmed Khuwaja, Nasim Zahid Shah, Zahid Hyder Wadani, Saher Aijaz, Asli Kulane

School of Nursing & Midwifery

Background: Nearly half of the women experience violence across their lifespan in all the provinces of Pakistan at an alarming rate. Despite knowing the prevalence, there has been meager progress in developing strategies to combat violence at individual, family, or community level. Many interventions suggested in other countries have been pilot tested but the effects of those interventions had been limited. Therefore, the aim of this study is to understand the voices of stakeholders to reduce Violence Against Women (VAW) and to explore the possible community-based strategies that could be implemented in Pakistan.
Methods: A total of 14 Key Informant …

Immunity And Field Efficacy Of Type 2-Containing Polio Vaccines After Cessation Of Trivalent Oral Polio Vaccine: A Population-Based Serological Study In Pakistan, Arie Voorman, Atif Habib, Imtiaz Hussain, Rana Muhammad Safdar, Jamal A. Ahmed, William C. Weldon, Imran Ahmed, Muhammad Umer, Jeffrey Partridge, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: In Pakistan and other countries using oral polio vaccine (OPV), immunity to type 2 poliovirus is now maintained by a single dose of inactivated polio vaccine (IPV) in routine immunization, supplemented in outbreak settings by monovalent OPV type 2 (mOPV2) and IPV. While well-studied in clinical trials, population protection against poliovirus type 2 achieved in routine and outbreak settings is generally unknown.
Methods: We conducted two phases of a population-based serological survey of 7940 children aged 6-11 months old, between November 2016 and October 2017 from 13 polio high-risk locations in Pakistan.
Results: Type 2 seroprevalence was 50% among …

Prevalence Of Hypertension And Its Risk Factors Among Cotton Textile Workers In Low- And Middle-Income Countries: A Protocol For A Systematic Review, Naureen Akber Ali, Anam Shahil Feroz

School of Nursing & Midwifery

Background: Cotton workers are exposed to various hazards in the textile industry that might result in different ailments including hypertension (HTN). However, few attempts have been made to systematically review the prevalence of hypertension and its risk factor among cotton textile workers in low-and middle-income countries (LMICs). The objective of this study will be to evaluate the prevalence of hypertension and its risk factors among adult cotton textile workers in low- and middle-income countries.
Methods: We designed and registered a study protocol for a systematic review of descriptive epidemiology data. We will include observational studies (e.g., cross-sectional, cohort, surveys) on …

Polycystic Ovary Syndrome, Subfertility And Vitamin D Deficiency, Arfa Azhar, Fatima Abid, Rehana Rehman

Department of Biological & Biomedical Sciences

Polycystic ovarian syndrome (PCOS) is the most common endocrine female disorder, affecting 4-18% women of reproductive age. The prevalence of PCOS in South Asian women, especially in Pakistani women, is much higher (52%) as compared to white population (20 - 25% in UK). In Pakistan, vitamin D status displays 31.2% vitamin D insufficiency, 53.5% vitamin D deficiency, and 15.3% normal vitamin D values. Vitamin D deficiency, though very common in the general population, is even more prevalent in PCOS patients, seen in approximately 67-85%, which further correlates to their related comorbidities. A lot of researches have to be directed to …

Intimate Partner Violence Against Women In Pakistan: A Review Of Qualitative Research, Tazeen S. Ali, Rida Farhan, Michelle Ayub

Community Health Sciences

Objective: To consolidate research data and provide an insight into areas that need further research regarding intimate partner violence.
Methods: The review targeted qualitative research-based studies done in the English language and conducted in Pakistan from 2008 to 2018 regarding intimate partner violence against women. A thorough search of Google Scholar and PubMed databases was done. Data from each selected article was extracted using a data-extraction template.
Results: Of the 2,479 results, 21(0.8%) articles were selected along with 4(0.16%) texts from grey literature. An in-depth analysis led to six broad categories: experiences/perspectives of married women facing intimate partner violence; perspectives …

Do Recipients Of Cash Transfer Scheme Make The Right Decisions On Household Food Expenditure? A Study From A Rural District In Pakistan, Aminah Jahangir, Shehla Zaidi, Jai K. Das, Shifa Habib

Community Health Sciences

Objective: To assess spending by beneficiaries of Benazir Income Support Programme on monthly food commodities, and contribution of the cash grant programme on purchase of nutritious foods.
Methods: The descriptive cross-sectional survey of households enrolled in the Benazir Income Support Programme was conducted during July and August, 2013, in Matiari district of the Sindh province of Pakistan. Monthly household food expenditure on food commodities and use of the cash grant on type of food purchased was assessed through structured interviews of the beneficiaries. Results were computed in 2013 Pak rupees and converted to 2018 United States dollar. Women beneficiaries were …

Chloroquine Administration In Breastfeeding Mothers Associates With Increased Hiv-1 Plasma Viral Loads, William A. Paxton, Marloes A. Naarding, Ferdinand Wnm Wnm Wit, Nienke J. Veldhuijzen, Matthew F. Chersich, Brigitte Kankindi Kankindi, Rene Douma A. Douma, Samuel Tuyizere, Suzanne Jurriaans, Stanley Luchters

Population Health, East Africa

Chloroquine (CQ) and Hydroxychloroquine (HCQ) have been proposed to be effective at treating COVID-19 patients. We, and others, have previously reported on the capacity of CQ to reduce HIV-1 replication in vitro. We tested CQ administration in post-partum mothers on influencing HIV-1 viral loads in human milk as a means of lowering mother to child transmission. A Phase I/II, randomized, placebo-controlled study to evaluate chloroquine administration to reduce HIV-1 RNA levels in human milk: the CHARGE study. Thirty HIV-1 positive pregnant Rwandese women (CQ n = 20; placebo n = 10) were enrolled in a 16-week study, with the treatment …

Associations Of Sickness Absence For Pain In The Low Back, Neck And Shoulders With Wider Propensity To Pain, David Coggon, Georgia Ntani, Karen Walker-Bone, Vanda E. Felli, Raul Harari, Lope H. Barrero, Sarah A. Felknor, Marianela Rojas, Anna Cattrell, Muhammad Masood Kadir

Community Health Sciences

Objectives: To explore the association of sickness absence ascribed to pain at specific anatomical sites with wider propensity to musculoskeletal pain.
Methods: As part of the CUPID (Cultural and Psychosocial Influences on Disability) study, potential risk factors for sickness absence from musculoskeletal pain were determined for 11 922 participants from 45 occupational groups in 18 countries. After approximately 14 months, 9119 (78%) provided follow-up information about sickness in the past month because of musculoskeletal pain, including 8610 who were still in the same job. Associations with absence for pain at specific anatomical sites were assessed by logistic regression and summarised …

Delivering Trauma And Rehabilitation Interventions To Women And Children In Conflict Settings: A Systematic Review, Reena P. Jain, Sarah Meteke, Michelle F. Gaffey, Mahdis Kamali, Mariella Munyuzangabo, Daina Als, Shailja Shah, Fahad J. Siddiqui, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: In recent years, more than 120 million people each year have needed urgent humanitarian assistance and protection. Armed conflict has profoundly negative consequences in communities. Destruction of civilian infrastructure impacts access to basic health services and complicates widespread emergency responses. The number of conflicts occurring is increasing, lasting longer and affecting more people today than a decade ago. The number of children living in conflict zones has been steadily increasing since the year 2000, increasing the need for health services and resources. This review systematically synthesised the indexed and grey literature reporting on the delivery of trauma and rehabilitation …