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Articles 31 - 60 of 103
Full-Text Articles in Maternal and Child Health
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 …
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 …
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 …
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 …
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 …
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 …
Evaluating The Effect Of Care Around Labor And Delivery Practices On Early Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Archana B. Patel, Elizabeth M. Simmon, Sowmya R. Rao, Janet Moore, Tracy L. Nolen, Robert L. Goldenberg, Shivaprasad S. Goudar, Manjunath S. Somannavar, Sarah Saleem, Farnaz Naqvi
Evaluating The Effect Of Care Around Labor And Delivery Practices On Early Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Archana B. Patel, Elizabeth M. Simmon, Sowmya R. Rao, Janet Moore, Tracy L. Nolen, Robert L. Goldenberg, Shivaprasad S. Goudar, Manjunath S. Somannavar, Sarah Saleem, Farnaz Naqvi
Community Health Sciences
Background: Neonatal deaths in first 28-days of life represent 47% of all deaths under the age of five years globally and are a focus of the United Nation's (UN's) Sustainable Development Goals. Pregnant women are delivering in facilities but that does not indicate quality of care during delivery and the postpartum period. The World Health Organization's Essential Newborn Care (ENC) package reduces neonatal mortality, but lacks a simple and valid composite index that measures its effectiveness.
Methods: Data on 5 intra-partum and 3 post-partum practices (indicators) recommended as part of ENC, routinely collected in NICHD's Global Network's (GN) Maternal Newborn …
Reports From The Nichd Global Network's Maternal And Newborn Health Registry: Supplement Introduction, Robert L. Goldenberg, Shivaprasad S. Goudar, Sarah Saleem, Patricia L. Hibberd, Jorge E. Tolosa, Marion Koso-Thomas, Elizabeth M. Mcclure, Global Network Investigators
Reports From The Nichd Global Network's Maternal And Newborn Health Registry: Supplement Introduction, Robert L. Goldenberg, Shivaprasad S. Goudar, Sarah Saleem, Patricia L. Hibberd, Jorge E. Tolosa, Marion Koso-Thomas, Elizabeth M. Mcclure, Global Network Investigators
Community Health Sciences
No abstract provided.
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 …
Use Of Smokeless Tobacco Before Conception And Its Relationship With Maternal And Fetal Outcomes Of Pregnancy In Thatta, Pakistan: Findings From Women First Study, Sumera Aziz Ali, Umber S. Khan, Farina Abrejo, Brandi Vollmer, Sarah Saleem, Michael K. Hambidge, Nancy F. Krebs, Jamie E. Westcott, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha
Use Of Smokeless Tobacco Before Conception And Its Relationship With Maternal And Fetal Outcomes Of Pregnancy In Thatta, Pakistan: Findings From Women First Study, Sumera Aziz Ali, Umber S. Khan, Farina Abrejo, Brandi Vollmer, Sarah Saleem, Michael K. Hambidge, Nancy F. Krebs, Jamie E. Westcott, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha
Community Health Sciences
Introduction: Smokeless tobacco (SLT) consumption during pregnancy has adverse consequences for the mother and fetus. We aimed to investigate the effects of maternal pre-pregnancy SLT consumption on maternal and fetal outcomes in the district of Thatta, Pakistan.
Methods: We conducted a secondary data analysis of an individual randomized controlled trial of preconception maternal nutrition. Study participants were women of reproductive age residing in the district of Thatta, Pakistan. Participants were asked questions regarding the usage of commonly consumed SLT known as gutka (exposure variable). Study outcomes included maternal anemia, miscarriage, preterm births, stillbirths, and low birth weight. We performed a …
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 …
A Comparison Of Mits Counseling And Informed Consent Processes In Pakistan, India, Bangladesh, Kenya, And Ethiopia, Anam Shahil Feroz, Christina Paganelli, Milka Bunei, Beza Eshetu, Shahana Parveen, Sayyeda Reza, Chaitali Sanji, Shiyam Sunder Tikmani, Shivaprasad S. Goudar, Sarah Saleem
A Comparison Of Mits Counseling And Informed Consent Processes In Pakistan, India, Bangladesh, Kenya, And Ethiopia, Anam Shahil Feroz, Christina Paganelli, Milka Bunei, Beza Eshetu, Shahana Parveen, Sayyeda Reza, Chaitali Sanji, Shiyam Sunder Tikmani, Shivaprasad S. Goudar, Sarah Saleem
Community Health Sciences
Globally, more than 5 million stillbirths and neonatal deaths occur annually. For many, the cause of death (CoD) is unknown. Minimally invasive tissue sampling (MITS) has been increasingly used in postmortem examinations for ascertaining the CoD in stillbirths and neonates. Our study compared the counseling and consent methods used in MITS projects in five countries in Africa and south Asia. Key informant interviews were conducted with researchers to describe the characteristics and backgrounds of counselors, the environment and timing of consent and perceived facilitators and barriers encountered during the consent process. Counselors at all sites had backgrounds in social science, …
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 …
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 …
Prelacteal Feeding Practices In Pakistan: A Mixed-Methods Study, Muhammad Asim, Zarak Husain Ahmed, Mark D. Hayward, Elizabeth M. Widen
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 …
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
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 …
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 …
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
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 …
Mainstreaming Nutrition Services: Stabilization Centers And Outpatient Therapeutic Program Centers, Ashar Muhammad Malik
Mainstreaming Nutrition Services: Stabilization Centers And Outpatient Therapeutic Program Centers, Ashar Muhammad Malik
Community Health Sciences
No abstract provided.
A Study Protocol For An Mhealth, Multi-Centre Randomized Control Trial To Promote Use Of Postpartum Contraception Amongst Rural Women In Punjab, Pakistan, Xaher Gul, Waqas Hameed, Sharmeen Hussain, Ishaque Sheikh, Junaid-Ur-Rehman Siddiqui
A Study Protocol For An Mhealth, Multi-Centre Randomized Control Trial To Promote Use Of Postpartum Contraception Amongst Rural Women In Punjab, Pakistan, Xaher Gul, Waqas Hameed, Sharmeen Hussain, Ishaque Sheikh, Junaid-Ur-Rehman Siddiqui
Community Health Sciences
Background: Provision of family planning services during the immediate post-partum phase is considered effective and cost-efficient for promoting healthy timing and spacing of pregnancies. This research aims to test the effectiveness of mobile phone-based interventions in promoting use of postpartum contraception. Moreover, it will also test the non-inferiority of text and voice messages compared to interactive phone-based counselling.
Methods: A three-arm, 10-month, multicentre, randomized controlled trial will be conducted at 15 social franchise (SF) health facilities in Punjab province of Pakistan. Pregnant women aged 15-44 years who are in their first or second trimester and have a mobile phone for …
Polyhydramnios Among Women In A Cluster-Randomized Trial Of Ultrasound During Prenatal Care Within Five Low And Low-Middle Income Countries: A Secondary Analysis Of The First Look Study, Melissa Bauserman, Robert Nathan, Adrien Lokangaka, Elizabeth M. Mcclure, Janet Moore, Daniel Ishoso, Antoinette Tshefu, Lester Figueroa, Sarah Saleem, Waseem Mirza
Polyhydramnios Among Women In A Cluster-Randomized Trial Of Ultrasound During Prenatal Care Within Five Low And Low-Middle Income Countries: A Secondary Analysis Of The First Look Study, Melissa Bauserman, Robert Nathan, Adrien Lokangaka, Elizabeth M. Mcclure, Janet Moore, Daniel Ishoso, Antoinette Tshefu, Lester Figueroa, Sarah Saleem, Waseem Mirza
Community Health Sciences
Background: In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes.
Methods: We performed a secondary analysis of the First Look Study, a multi-national, cluster-randomized trial of ultrasound during prenatal care. We evaluated all women enrolled from Guatemala, Pakistan, Zambia, Kenya and the Democratic Republic of Congo (DRC) who received an examination by prenatal ultrasound. We used pairwise site …
Pregnant Women In Four Low-Middle Income Countries Have A High Prevalence Of Inadequate Dietary Intakes That Are Improved By Dietary Diversity, Rebecca L. Lander, K Michael Hambidge, Jamie E. Westcott, Gabriela Tejeda, Tshilenge S. Diba, Shivanand C. Mastiholi, Umber S. Khan, Ana Garcés, Sumera Aziz Ali, Sarah Saleem, On Behalf Of The Women First Preconception Nutrition Trial Group
Pregnant Women In Four Low-Middle Income Countries Have A High Prevalence Of Inadequate Dietary Intakes That Are Improved By Dietary Diversity, Rebecca L. Lander, K Michael Hambidge, Jamie E. Westcott, Gabriela Tejeda, Tshilenge S. Diba, Shivanand C. Mastiholi, Umber S. Khan, Ana Garcés, Sumera Aziz Ali, Sarah Saleem, On Behalf Of The Women First Preconception Nutrition Trial Group
Community Health Sciences
Background: Up-to-date dietary data are required to understand the diverse nutritional challenges of pregnant women living in low-middle income countries (LMIC). To that end, dietary data were collected from 1st trimester pregnant women in rural areas of Guatemala, India, Pakistan, and Democratic Republic of the Congo (DRC) participating in a maternal lipid-based nutrient supplement (LNS) Randomized Controlled Trial to examine dietary diversity (DD), usual group energy and nutrient intakes, and prevalence of inadequate dietary intakes.
Methods: Two 24-h dietary recalls were conducted in ~240 pregnant women/site (total n = 966) prior to 12-week gestation. Adequate DD was assessed, i.e., ≥5 …
Challenges Of Implementing An Individual Randomized Controlled Trial (Women First: Preconception Maternal Nutrition Study) In A Rural Study Site: A Case Study From Pakistan, Sumera Aziz Ali, Umber S. Khan, Farina Abrejo, Sarah Saleem, Michael K. Hambidge, Nancy F. Krebs, Jamie E. Westcott, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha
Challenges Of Implementing An Individual Randomized Controlled Trial (Women First: Preconception Maternal Nutrition Study) In A Rural Study Site: A Case Study From Pakistan, Sumera Aziz Ali, Umber S. Khan, Farina Abrejo, Sarah Saleem, Michael K. Hambidge, Nancy F. Krebs, Jamie E. Westcott, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha
Community Health Sciences
Persistent global disparities in maternal and neonatal outcomes associated with poor maternal nutrition provided the genesis of the Women First (WF) study, an individually randomized controlled trial on preconceptional maternal nutrition. This article describes the challenges that arose in implementing this trial related to nutrition or diet of the mother, in District Thatta-Pakistan. During different phases of the study, we encountered problems in identifying the eligible participants, taking consent from couples, randomizing participants in different arms, conducting biweekly follow-up visits on time, ensuring compliance to the intervention, and measuring the primary outcome within the 24 hours of birth. Each challenge …