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Full-Text Articles in Social and Behavioral Sciences

Perpetuation Of Gender Discrimination In Pakistani Society: Results From A Scoping Review And Qualitative Study Conducted In Three Provinces Of Pakistan, Tazeen Saeed Ali, Shahnaz Shahid Ali, Sanober Nadeem, Zahid Memon, Sajid Bashir Soofi, Falak Madhani, Yasmin Karim, Shah Mohammad, Zulfiqar Ahmed Bhutta Dec 2022

Perpetuation Of Gender Discrimination In Pakistani Society: Results From A Scoping Review And Qualitative Study Conducted In Three Provinces Of Pakistan, Tazeen Saeed Ali, Shahnaz Shahid Ali, Sanober Nadeem, Zahid Memon, Sajid Bashir Soofi, Falak Madhani, Yasmin Karim, Shah Mohammad, Zulfiqar Ahmed Bhutta

School of Nursing & Midwifery

Background: Gender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender discrimination. The aim of this study is to assess the factors that influence gender discrimination in Pakistan, and its impact on women's life.
Methods: A mixed method approach was used in the study in which a systematic review was done in phase one to explore the themes on gender discrimination, and qualitative interviews were conducted in phase two to explore the perception of people regarding gender discrimination. The qualitative interviews (in-depth interviews and …


Psychometric Properties Of The Sindhi Version Of The Mood And Feelings Questionnaire (Mfq) In A Sample Of Early Adolescents Living In Rural Pakistan, Janavi Shetty, Florence Perquier, Susan C. Campisi, Yaqub Wasan, Madison Aitken, Daphne J. Korczak, Suneeta Monga, Sajid Bashir Soofi, Peter Szatmari, Zulfiqar Ahmed Bhutta Nov 2022

Psychometric Properties Of The Sindhi Version Of The Mood And Feelings Questionnaire (Mfq) In A Sample Of Early Adolescents Living In Rural Pakistan, Janavi Shetty, Florence Perquier, Susan C. Campisi, Yaqub Wasan, Madison Aitken, Daphne J. Korczak, Suneeta Monga, Sajid Bashir Soofi, Peter Szatmari, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

There is a need for reliable and valid screening tools that assess depressive symptoms in adolescents in Pakistan. To address this need, the present study examined the psychometric properties and factor structure of a Sindhi-translated and adapted version of the child-report Mood and Feelings Questionnaire (MFQ-C) and the Short Mood and Feelings Questionnaire (SMFQ-C) in a community sample of adolescents living in Matiari, Pakistan. Questionnaires were translated into Sindhi and administered by study psychologists to 1350 participants (52.3% female) 9.0 to 15.9 years old. Measurement structure was examined using confirmatory factor analysis. Internal consistency was estimated, and convergent and divergent …


Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi Nov 2022

Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi

Community Health Sciences

Objectives: A dearth of qualitative studies constrains in-depth understanding of health service providers' perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.
Design: An exploratory qualitative study.
Setting: Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.
Participants: In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.
Results: …


Impact Of A Multifaceted Intervention On Physicians' Knowledge, Attitudes And Practices In Relation To Pharmaceutical Incentivisation: Protocol For A Randomised Control Trial, Muhammad Naveed Noor, Mishal Khan, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Sabeen Sharif Khan, Iqbal Azam, Sadia Shakoor, Rumina Hasan Nov 2022

Impact Of A Multifaceted Intervention On Physicians' Knowledge, Attitudes And Practices In Relation To Pharmaceutical Incentivisation: Protocol For A Randomised Control Trial, Muhammad Naveed Noor, Mishal Khan, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Sabeen Sharif Khan, Iqbal Azam, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Introduction: In settings where the private sector constitutes a larger part of the health system, profit-gathering can take primacy over patients' well-being. In their interactions with pharmaceutical companies, private general practitioners (GPs) can experience the conflict of interest (COI), a situation whereby the impartiality of GPs' professional decision making may be influenced by secondary interests such as financial gains from prescribing specific pharmaceutical brands.
Methods and analysis: This study is a randomised controlled trial to assess the impact of a multifaceted intervention on GPs' medical practice. The study sample consists of 419 registered GPs who own/work in private clinics and …


Covid-19, Nutrition, And Gender: An Evidence-Informed Approach To Gender-Responsive Policies And Programs, Anna Kalbarczyk, Noora-Lisa Aberman, Bregje S M Van Asperen, Rosemary Morgan, Zulfiqar Ahmed Bhutta, Bianca Carducci, Rebecca Heidkamp, Saskia Osendarp, Neha Kumar, Anna Lartey Nov 2022

Covid-19, Nutrition, And Gender: An Evidence-Informed Approach To Gender-Responsive Policies And Programs, Anna Kalbarczyk, Noora-Lisa Aberman, Bregje S M Van Asperen, Rosemary Morgan, Zulfiqar Ahmed Bhutta, Bianca Carducci, Rebecca Heidkamp, Saskia Osendarp, Neha Kumar, Anna Lartey

Department of Paediatrics and Child Health

In addition to the direct health impacts of COVID-19, government and household mitigation measures have triggered negative indirect economic, educational, and food and health system impacts, hitting low-and middle-income countries the hardest and disproportionately affecting women and girls. We conducted a gender focused analysis on five critical and interwoven crises that have emerged because of the COVID-19 crisis and exacerbated malnutrition and food insecurity. These include restricted mobility and isolation; reduced income; food insecurity; reduced access to essential health and nutrition services; and school closures. Our approach included a theoretical gender analysis, targeted review of the literature, and a visual …


Intimate-Partner Violence And Its Association With Symptoms Of Depression, Perceived Health, And Quality Of Life In The Himalayan Mountain Villages Of Gilgit Baltistan, Gul Nowshad, Neelum Jahan, Nasim Zahid Shah, Nasloon Ali, Tazeen Saeed Ali, Sartaj Alam, Ambreen Khan, Mohammad Afzal Mahmood, Malika Saba, Syed M. Shah Sep 2022

Intimate-Partner Violence And Its Association With Symptoms Of Depression, Perceived Health, And Quality Of Life In The Himalayan Mountain Villages Of Gilgit Baltistan, Gul Nowshad, Neelum Jahan, Nasim Zahid Shah, Nasloon Ali, Tazeen Saeed Ali, Sartaj Alam, Ambreen Khan, Mohammad Afzal Mahmood, Malika Saba, Syed M. Shah

Centre of Excellence in Women and Child Health

Study objectives: We aimed to estimate the prevalence of intimate partner violence (IPV) and associated risk factors in married women in rural villages of Gilgit Baltistan in Pakistan.
Methods: A cross-sectional design to assess the magnitude and factors associated with IPV in a random sample of 789 married women aged 18-49 years. A World Health Organization screening instrument was used to assess the presence of IPV in the previous 12 months. A locally validated instrument was adopted to identify self-reported symptoms of major depression according to the DSM IV. Trained nurses obtained socio-demographic and reproductive history through structured interviews. Bivariate …


Heterogeneity In The Prevalence Of Premature Hypertension Among Asian American Populations Compared With White Individuals: A National Health Interview Survey Study, Sina Kianoush, Mahmoud Al Rifai, Anwar T. Merchant, Xiaoming Jia, Zainab Samad, Aneil Bhalla, Ayesha Khan, Dongshan Zhu, Salim S. Virani Sep 2022

Heterogeneity In The Prevalence Of Premature Hypertension Among Asian American Populations Compared With White Individuals: A National Health Interview Survey Study, Sina Kianoush, Mahmoud Al Rifai, Anwar T. Merchant, Xiaoming Jia, Zainab Samad, Aneil Bhalla, Ayesha Khan, Dongshan Zhu, Salim S. Virani

Section of Cardiology

Background: Differences in prevalence of risk factors such as hypertension may explain heterogeneity in cardiovascular risk across Asian American populations.
Methods: We used National Health Interview Survey (NHIS) data from 2006 to 2018 among White, Chinese, Asian Indian, Filipino, and 'other Asians' (Japanese, Korean, and Vietnamese). Unadjusted and adjusted odds ratios (aOR) with 95% confidence intervals were reported using logistic regression models for the association between race and self-reported premature hypertension (age old). Models were adjusted for sex, education, body mass index, smoking status, diabetes, and coronary heart disease.
Results: We studied 99,864 participants with history of hypertension (mean age, …


Hypertension In Women: A South-Asian Perspective, Fatima Farrukh, Amin Abbasi, Misbah Jawed, Aysha Almas, Tazeen Jafar, Salim S. Virani, Zainab Samad Aug 2022

Hypertension In Women: A South-Asian Perspective, Fatima Farrukh, Amin Abbasi, Misbah Jawed, Aysha Almas, Tazeen Jafar, Salim S. Virani, Zainab Samad

Medical College Documents

Introduction: Hypertension is an important contributor to cardiovascular disease related morbidity and mortality. Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in both men and women.
Materials and methods: Numerous databases, i.e., PubMed, ScienceDirect, etc., were searched using keywords to identify relevant studies to our narrative review. The findings from the most pertinent articles were summarized and integrated into our narrative review on hypertension in women.
Results: The pathophysiology of essential hypertension is still being delineated in both men and women; there are multiple sex specific factors in association with the …


Narrative Synthesis Systematic Review Of Pakistani Women's Health Outcomes From Primary Care Interventions, Sara Rizvi Jafree, Qaisar Khalid Mahmood, Sohail Mujahid, Muhammad Asim, Jane Barlow Aug 2022

Narrative Synthesis Systematic Review Of Pakistani Women's Health Outcomes From Primary Care Interventions, Sara Rizvi Jafree, Qaisar Khalid Mahmood, Sohail Mujahid, Muhammad Asim, Jane Barlow

Community Health Sciences

Objective: Women living in Pakistan have complex health problems including infectious and non-communicable diseases, accident and injuries, and mental health problems. While a majority of these women rely on primary healthcare services for all of their healthcare needs, there has to date been no overview of the extent of their effectiveness. The objective of this review was to (1) synthesise the available evidence regarding the effectiveness of primary care based interventions aimed at improving women's mental and physical health and (2) identify the factors that promote effectiveness for women's health outcomes.
Methods: Five academic databases were searched, including PubMed, BMC …


Implementation Evaluation Of A Leadership Development Intervention For Improved Family Experience In A Private Paediatric Care Hospital, Pakistan, Muneera A. Rasheed, Ayesha Hussain, Amin Hashwani, Johannes T. Kedzierski, Babar S. Hasan Jul 2022

Implementation Evaluation Of A Leadership Development Intervention For Improved Family Experience In A Private Paediatric Care Hospital, Pakistan, Muneera A. Rasheed, Ayesha Hussain, Amin Hashwani, Johannes T. Kedzierski, Babar S. Hasan

Department of Paediatrics and Child Health

Background: A study from a tertiary care center in Pakistan demonstrated that a leadership development intervention led to improved family experience of care outcomes. The objective of the current paper is to assess the implementation of this intervention and identify barriers and facilitators to inform sustainability and scalability.
Methods: A working group designed the intervention using a theory-of-change model to strengthen leadership development to achieve greater employee engagement. The interventions included: i) purpose and vision through purpose-driven leadership skills trainings; ii) engaging managers via on-the-job mentorship programme for managers, iii) employee voice i.e., facilitation of upward communication to hear the …


Measuring Contraceptive Method Mix, Prevalence, And Demand Satisfied By Age And Marital Status In 204 Countries And Territories, 1970-2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Annie Haakenstad, Olivia Angelino, Caleb M S Irvine, Zulfiqar Ahmed Bhutta, Kelly Bienhoff, Corinne Bintz, Kate Causey, M Ashworth Dirac, Nancy Fullman, Emmanuela Gakidou Jul 2022

Measuring Contraceptive Method Mix, Prevalence, And Demand Satisfied By Age And Marital Status In 204 Countries And Territories, 1970-2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Annie Haakenstad, Olivia Angelino, Caleb M S Irvine, Zulfiqar Ahmed Bhutta, Kelly Bienhoff, Corinne Bintz, Kate Causey, M Ashworth Dirac, Nancy Fullman, Emmanuela Gakidou

Department of Paediatrics and Child Health

Background: Meeting the contraceptive needs of women of reproductive age is beneficial for the health of women and children, and the economic and social empowerment of women. Higher rates of contraceptive coverage have been linked to the availability of a more diverse range of contraceptive methods. We present estimates of the contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), demand satisfied, and the method of contraception used for both partnered and unpartnered women for 5-year age groups in 204 countries and territories between 1970 and 2019.
Methods: We used 1162 population-based surveys capturing contraceptive use among women between 1970 …


Determinants Of Domestic Violence Among Women Of Reproductive Age (15-49 Years) In Quetta, Balochistan-A Mixed-Method Protocol, Salman Muhammad Soomar, Sarmad Muhammad Soomar May 2022

Determinants Of Domestic Violence Among Women Of Reproductive Age (15-49 Years) In Quetta, Balochistan-A Mixed-Method Protocol, Salman Muhammad Soomar, Sarmad Muhammad Soomar

Department of Emergency Medicine

Background: Worldwide, domestic violence (DV) is a cause of death and disability among women aged 15-49 years. In Pakistan, DV appears in different forms, and only 3.2% of women report any DV. There are various factors associated with DV against women. The data are sparse for the Balochistan province due to the under-reporting and scattered population. This research study aims to determine the factors associated with DV and the types of violence among women of reproductive age. Also, to understand the perspective of community leaders and healthcare workers (HCWs) for developing interventions for DV prevention against women of reproductive age …


Maximising Access To Timely Trauma Care Across Population Of Karachi And Its Districts: A Geospatial Approach To Develop A Trauma Care Network, Muhammad Nabeel Ashraf, Mohammad Salman Khalil, Ahwaz Akhtar, Lubna Samad, Asad Latif Apr 2022

Maximising Access To Timely Trauma Care Across Population Of Karachi And Its Districts: A Geospatial Approach To Develop A Trauma Care Network, Muhammad Nabeel Ashraf, Mohammad Salman Khalil, Ahwaz Akhtar, Lubna Samad, Asad Latif

Department of Anaesthesia

Objectives: To develop and propose a cost-effective trauma care network for Karachi, Pakistan, by calculating maximum timely trauma care (TTC) coverage achieved with the addition of potential designated private and public level 1 and level 2 trauma centres (TCs).
Setting: A lower middle-income country metropolis, Karachi is Pakistan's largest city with a population of 16 million and a total of 56 hospitals as per government registry data.
Participants: 41 potential TCs selected using a two-level, contextually-relevant TC designation criteria adapted from various international guidelines.
Primary and secondary outcome measures: Maximum TTC coverage achievable with the addition of potential TCs. Proposed …


Prevention Of Violence Against Women And Girls: A Cost-Effectiveness Study Across 6 Low- And Middle-Income Countries, Giulia Ferrari, Sergio Torres-Rueda, Esnat Chirwa, Andrew Gibbs, Stacey Orangi, Edwine Barasa, Theresa Tawiah, Rebecca Kyerewaa Dwommoh Prah, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja Mar 2022

Prevention Of Violence Against Women And Girls: A Cost-Effectiveness Study Across 6 Low- And Middle-Income Countries, Giulia Ferrari, Sergio Torres-Rueda, Esnat Chirwa, Andrew Gibbs, Stacey Orangi, Edwine Barasa, Theresa Tawiah, Rebecca Kyerewaa Dwommoh Prah, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja

School of Nursing & Midwifery

Background: Violence against women and girls (VAWG) is a human rights violation with social, economic, and health consequences for survivors, perpetrators, and society. Robust evidence on economic, social, and health impact, plus the cost of delivery of VAWG prevention, is critical to making the case for investment, particularly in low- and middle-income countries (LMICs) where health sector resources are highly constrained. We report on the costs and health impact of VAWG prevention in 6 countries.
Methods and findings: We conducted a trial-based cost-effectiveness analysis of VAWG prevention interventions using primary data from 5 randomised controlled trials (RCTs) in sub-Saharan Africa …


Self-Medication Practices In Medical Students During The Covid-19 Pandemic: A Cross-Sectional Analysis, Farah Yasmin, Muhammad Sohaib Asghar, Unaiza Naeem, Hala Najeeb, Hamza Nauman, Muhammad Nadeem Ahsan, Abdullah Khan Khattak Mar 2022

Self-Medication Practices In Medical Students During The Covid-19 Pandemic: A Cross-Sectional Analysis, Farah Yasmin, Muhammad Sohaib Asghar, Unaiza Naeem, Hala Najeeb, Hamza Nauman, Muhammad Nadeem Ahsan, Abdullah Khan Khattak

Medical College Documents

Background and objectives: During the pandemic, the growing influence of social media, accessibility of over-the-counter medications, and fear of contracting the virus may have led to self-medication practices among the general public. Medical students are prone to such practices due to relevant background knowledge, and access to drugs. This study was carried out to determine and analyze the prevalence of self-medication practices among medical students in Pakistan.
Materials and methods: This descriptive, cross-sectional study was conducted online in which the participants were asked about the general demographics, their self-medication practices and the reasons to use. All participants were currently enrolled …


Institute For Global Health And Development : Issue 2 - March 2022, Institute For Global Health And Development Mar 2022

Institute For Global Health And Development : Issue 2 - March 2022, Institute For Global Health And Development

IGHD Newsletter

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Inclusive, Supportive And Dignified Maternity Care (Sdmc)-Development And Feasibility Assessment Of An Intervention Package For Public Health Systems: A Study Protocol, Bilal Iqbal Avan, Waqas Hameed, Bushra Khan, Muhammad Asim, Sarah Saleem, Sameen Siddiqi Feb 2022

Inclusive, Supportive And Dignified Maternity Care (Sdmc)-Development And Feasibility Assessment Of An Intervention Package For Public Health Systems: A Study Protocol, Bilal Iqbal Avan, Waqas Hameed, Bushra Khan, Muhammad Asim, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Introduction: Mistreatment, discrimination, and poor psycho-social support during childbirth at health facilities are common in lower- and middle-income countries. Despite a policy directive from the World Health Organisation (WHO), no operational model exists that effectively demonstrates incorporation of these guidelines in routine facility-based maternity services. This early-phase implementation research aims to develop, implement, and test the feasibility of a service-delivery strategy to promote the culture of supportive and dignified maternity care (SDMC) at public health facilities.
Methods: Guided by human-centred design approach, the implementation of this study will be divided into two phases: development of intervention, and implementing and testing …