Health Services Research Commons^™

Health-Related Quality Of Life Variations By Sociodemographic Factors And Chronic Conditions In Three Metropolitan Cities Of South Asia: The Carrs Study, Kavita Singh, Dimple Kondal, Roopa Shivashankar, Mohammed K. Ali, Rajendra Pradeepa, Vamadevan S. Ajay, Viswanathan Mohan, Muhammad Masood Kadir, Mark Daniel Sullivan, Nikhil Tandon, K M Venkat Narayan, Dorairaj Prabhakaran

Community Health Sciences

Objectives: Health-related quality of life (HRQOL) is a key indicator of health. However, HRQOL data from representative populations in South Asia are lacking. This study aims to describe HRQOL overall, by age, gender and socioeconomic status, and examine the associations between selected chronic conditions and HRQOL in adults from three urban cities in South Asia.
Methods: We used data from 16 287 adults aged ≥20 years from the baseline survey of the Centre for Cardiometabolic Risk Reduction in South Asia cohort (2010-2011). HRQOL was measured using the European Quality of Life Five Dimension-Visual Analogue Scale (EQ5D-VAS), which measures health status …

Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

Countdown To 2015 Country Case Studies: What Can Analysis Of National Health Financing Contribute To Understanding Mdg 4 And 5 Progress?, Carlyn Mann, Courtney Ng, Nadia Akseer, Zulfiqar Ahmed Bhutta, Josephine Borghi, Tim Colbourn, Patricia Hernández-Peña, Luis Huicho, Muhammad Ashar Malik, Melisa Ashar Martinez-Alvarez, Spy Munthali, Ahmad Shah Salehi, Mekonnen Tadesse, Mohammed Yassin, Peter Berman

Community Health Sciences

Background

Countdown to 2015 (Countdown) supported countries to produce case studies that examine how and why progress was made toward the Millennium Development Goals (MDGs) 4 and 5. Analysing how health-financing data explains improvements in RMNCH outcomes was one of the components to the case studies.

Methods

This paper presents a descriptive analysis on health financing from six Countdown case studies (Afghanistan, Ethiopia, Malawi, Pakistan, Peru, and Tanzania), supplemented by additional data from global databases and country reports on macroeconomic, health financing, demographic, and RMNCH outcome data as needed. It also examines the effect of other contextual factors presented in …

Continuation Rates And Reasons For Discontinuation Of Intra-Uterine Device In Three Provinces Of Pakistan: Results Of A 24-Month Prospective Client Follow-Up, Waqas Hameed, Syed Khurram Azmat, Muhammad Ishaque, Wajahat Hussain, Erik Munroe, Ghulam Mustafa, Omar Farooq Khan, Ghazunfer Abbas, Safdar Ali, Qaiser Jamshaid Asghar

Community Health Sciences

Background: Long-acting reversible contraceptives, such as the intrauterine device (IUD), remain underutilised in Pakistan with high discontinuation rates. Based on a 24-month prospective client follow-up (nested within a larger quasi-experimental study), this paper presents the comparison of two intervention models, one using private mid-level providers branded as "Suraj" and the other using community midwives (CMWs) of Maternal Newborn and Child Health Programme, for method continuation among IUD users. Moreover, determinants of IUD continuation and the reasons for discontinuation, and switching behaviour were studied within each arm.
Methods: A total of 1,163 IUD users, 824 from Suraj and 339 from the …

Perceived Barriers To Utilizing Maternal And Neonatal Health Services In Contracted-Out Versus Government-Managed Health Facilities In The Rural Districts Of Pakistan, Atif Riaz, Shehla Zaidi, Asif Raza Khowaja

Community Health Sciences

Background: A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted).

Methods: A community-based qualitative exploratory study was conducted between April to September 2012 at two …

Integration Of Non-Communicable Diseases Into Primary Health Care: A Snapshot From Eastern Mediterranean Region, Shehla Zaidi, Abdul Latif Khan, Aftab Ali Mukhi, Yousuf Memon, Slim Slama, Samer Jabbour

Community Health Sciences

No abstract provided.

Provider Cost Analysis Supports Results-Based Contracting Out Of Maternal And Newborn Health Services: An Evidence-Based Policy Perspective, Peter Hatcher, Shiraz Shaikh, Hassan Fazli, Shehla Zaidi, Atif Riaz

Community Health Sciences

Background

There is dearth of evidence on provider cost of contracted out services particularly for Maternal and Newborn Health (MNH). The evidence base is weak for policy makers to estimate resources required for scaling up contracting. This paper ascertains provider unit costs and expenditure distribution at contracted out government primary health centers to inform the development of optimal resource envelopes for contracting out MNH services.

Methods

This is a case study of provider costs of MNH services at two government Rural Health Centers (RHCs) contracted out to a non-governmental organization in Pakistan. It reports on four selected Basic Emergency Obstetrical …

How To Write An Introduction And Methods Of A Systematic Review Of Literature, Ashar Muhammad Malik

Community Health Sciences

No abstract provided.

Bibliographic Review Of Research Publications On Access To And Use Of Medicines In Low-Income And Middle-Income Countries In The Eastern Mediterranean Region: Identifying The Research Gaps., Arash Rashidian, Nader Jahanmehr, Samer Jabbour, Shehla Zaidi, Fatemeh Soleymani, Maryam Bigdeli

Community Health Sciences

BJECTIVES:

We assessed the situation of academic publications on access to and use of medicines (ATM) in low-income and middle-income countries (LMICs) of the Eastern Mediterranean Region (EMR). We aimed to inform priority setting for research on ATM in the region.

DESIGN:

Bibliographic review of published studies.

SETTING:

LMICs in EMR.

INCLUSION CRITERIA:

Publications on ATM issues originating from or focusing on EMR LMICs covering the period 2000-2011. Publications involving multinational studies were included if at least one eligible country had been included in the study.

INFORMATION SOURCES AND DATA EXTRACTION:

We conducted comprehensive searches of the PubMed, Social Science …

Access To Essential Medicines In Pakistan: Policy And Health Systems Research Concerns., Shehla Zaidi, Maryam Bigdeli, Noureen Aleem, Arash Rashidian

Community Health Sciences

NTRODUCTION:

Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i) gaps related to access to essential medicine in Pakistan; and ii) prioritization of emerging policy and research concerns.

METHODS:

An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. …

Determinants Of Patient's Satisfaction With Health Care System In Pakistan: A Critical Review, Maliha Naseer, Aysha Zahidie, Babar Tasneem Shaikh

Community Health Sciences

Patient satisfaction with health care services is considered an important factor of quality health care. Although research on patient satisfaction has become standard in many developed country, in countries such as Pakistan the concept of patient satisfaction is still relatively neglected. This study aimed to find out the determinants of patient satisfaction from existing literature in Pakistan.The literature search was carried out by using the database of Medscape, Medline, PakMedinet and PubMed, without any language restriction using MeSH words as “patient satisfaction AND health care system in Pakistan” and “Determinants of patient satisfaction AND Pakistan”. Twenty-one articles were found which …

Role And Contribution Of Private Sector In Moving Towards Universal Health Coverage In The Eastern Mediterranean Region, Shehla Zaidi, Atif Riaz, Ali Thaver, Aftab Mukhi, Latif Afzal Khan

Community Health Sciences

No abstract provided.

Access To Essential Medicines: In Pakistan Identifying Policy Research And Concerns, Shehla Zaidi, Noureen Nishtar

Community Health Sciences

The fundamental importance of ensuring access to medicines, particularly for the poor, is reflected in MDG 8 however remains poor in many low and middle income countries (LMICs). Country specific evidence on access to medicines is weak in LMICs and research has rarely been from an integrated health systems perspective. This study used an evidence based approach to identify key priority concerns and emerging research questions related to access to medicines in Pakistan. WHO’s Access to Medicine Framework was used as the conceptual basis for data collection on rational usage, affordability, financing and health systems. Methods involved a systematic desk …

Knowledge And Attitudes About Health Research Amongst A Group Of Pakistani Medical Students, Hassan Khan, Muhammad Rizwanulhaq Khawaja, Abdul Waheed, Muhammad Ameen Rauf, Zafar Fatmi

Community Health Sciences

Background

Health research training is an important part of medical education. This study was conducted to assess the level of knowledge and attitudes regarding health research in a group of Pakistani medical students at Aga Khan University, Karachi.

Methods

It was a cross-sectional pilot study conducted among a group of Pakistani medical students. Through stratified random sampling, a pre-tested, structured and validated questionnaire was administered to 220 medical students. Knowledge and attitudes were recorded on a scale (graduated in percentages).

Results

Mean scores of students were 49.0% on knowledge scale and 53.7% on attitude scale. Both knowledge and attitudes improved …