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  • 1
    Online Resource
    Online Resource
    Health Services Academy ; 2019
    In:  Pakistan Journal of Public Health Vol. 9, No. 1 ( 2019-07-13), p. 07-11
    In: Pakistan Journal of Public Health, Health Services Academy, Vol. 9, No. 1 ( 2019-07-13), p. 07-11
    Abstract: Background: Rapid urbanization has led to emergence of squatter settlements with poor infrastructure and compromised basic amenities. These conditions expose vulnerable groups like women and children to serious health risks. This paper presents the status of maternal and child health in a squatter settlement of Karachi.Methods: Health and Demographic Surveillance System was established in Sultanabad, a squatter settlement of Karachi. Households were eligible to be enrolled if there was a married woman of 15-49 years of age. Data on socio-demographic, maternal and child health indicators was collected during a round of surveillance using a structured questionnaire adapted from Measure Demographic and Health Survey Phase III and Pakistan Demographic and Health Survey 2012-13. Analysis was done using SPSS version 19. Results: A total of 730 women completed the interview. Among them 87% women sought antenatal care during last pregnancy and 79% of the women delivered in a facility. Contraceptive prevalence rate was 32%. Proportion of children exclusively breast fed till six months of age was 63%. Almost 86% children of 12-23 months were fully immunized. Prevalence of stunting among children under five was 40%. Conclusion: In Sultanabad, maternal and child health indicators were relatively better as compared to national statistics. However in the presence of available health facilities, the low contraceptive prevalence and high proportion of stunted children in the community is alarming. This requires urgent attention primarily addressing social determinants of health within the local context.
    Type of Medium: Online Resource
    ISSN: 2226-7018 , 2225-0891
    Language: Unknown
    Publisher: Health Services Academy
    Publication Date: 2019
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  • 2
    Online Resource
    Online Resource
    University of Technology, Sydney (UTS) ; 2017
    In:  Gateways: International Journal of Community Research and Engagement Vol. 10 ( 2017-06-22)
    In: Gateways: International Journal of Community Research and Engagement, University of Technology, Sydney (UTS), Vol. 10 ( 2017-06-22)
    Abstract: In the megacity of Karachi, which has a population of more than 24 million, more than 9.2 million people (approximately 40 per cent) live in squatter settlements. Communities here are characterised by low socioeconomic settings, crowded living conditions, inadequate water and sanitation facilities, and poor health-related behaviours. Such conditions create an environment favourable to the spread of communicable diseases like tuberculosis (TB), hepatitis and dengue. Since 1985, the Department of Community Health Sciences at the Aga Khan University, Karachi, Pakistan has run the Urban Health Program (UHP), a community-campus partnership operating in these disadvantaged squatter settlements. Recent explosive increases in the spread of dengue, hepatitis and TB, however, necessitated special attention and activities on a scale and pace that was greater than could be accommodated as part of UHP’s core work. Thus, having an already well-established collaborative model with social accountability measures in place, a dedicated mass awareness program was initiated over the course of one year, from mid 2015: the AGAHI project. This article describes AGAHI’s innovative, low-cost, collaborative activities conducted in partnership with two squatter communities, Sultanabad and Rehri Goth, to build health awareness, improved care-seeking and compliance to treatment. Activities ranged from school sessions, role plays and awareness walks to laneway meetings, training of health care workers, door-to-door campaigns and collaboration with local religious leaders, public sector groups and NGOs. Building on the collaborative work of the UHP, in just 12 months AGAHI was able to conduct 80 health awareness sessions with 4000 participants. Moreover, high-risk and vulnerable populations were identified and referred for further treatment. A comparative cross-sectional survey afterwards revealed a significant increase in knowledge among Sultanabad residents as compared to the neighbouring settlement of Hijrat Colony. As a result, this article suggests that the need for and efficacy of targeted health awareness campaigns against the major infectious diseases of poverty cannot be overemphasised. By adopting community-based participatory models, couched in a framework of social accountability, activities that are low cost, innovative and scientifically robust hold real potential for improving health awareness in vulnerable megacities like Karachi.
    Type of Medium: Online Resource
    ISSN: 1836-3393
    Language: Unknown
    Publisher: University of Technology, Sydney (UTS)
    Publication Date: 2017
    detail.hit.zdb_id: 2482422-7
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  • 3
    In: Health Policy and Planning, Oxford University Press (OUP), Vol. 35, No. 5 ( 2020-06-01), p. 503-521
    Abstract: We assessed the technical content of sugar, salt and trans-fats policies in six countries in relation to the World Health Organization ‘Best Buys’ guidelines for the prevention and control of non-communicable diseases (NCDs). National research teams identified policies and strategies related to promoting healthy diets and restricting unhealthy consumption, including national legislation, development plans and strategies and health sector-related policies and plans. We identified relevant text in relation to the issuing agency, overarching aims, goals, targets and timeframes, specific policy measures and actions, accountability systems, budgets, responsiveness to inequitable vulnerabilities across population groups (including gender) and human rights. We captured findings in a ‘policy cube’ incorporating three dimensions: policy comprehensiveness, political salience and effectiveness of means of implementation, and equity/rights. We compared diet-related NCD policies to human immunodeficiency virus policies in relation to rights, gender and health equity. All six countries have made high-level commitments to address NCDs, but dietary NCDs policies vary and tend to be underdeveloped in terms of the specificity of targets and means of achieving them. There is patchwork reference to internationally recognized, evidence-informed technical interventions and a tendency to focus on interventions that will encounter least resistance, e.g. behaviour change communication in contrast to addressing food reformulation, taxation, subsidies and promotion/marketing. Policies are frequently at the lower end of the authoritativeness spectrum and have few identified budgetary commitments or clear accountability mechanisms. Of concern is the limited recognition of equity and rights-based approaches. Healthy diet policies in these countries do not match the severity of the NCDs burden nor are they designed in such a way that government action will focus on the most critical dietary drivers and population groups at risk. We propose a series of recommendations to expand policy cubes in each of the countries by re-orienting diet-related policies so as to ensure healthy diets for all.
    Type of Medium: Online Resource
    ISSN: 0268-1080 , 1460-2237
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1484858-2
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  • 4
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Journal for Healthcare Quality Vol. 29, No. 5 ( 2007-09), p. 21-34
    In: Journal for Healthcare Quality, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 5 ( 2007-09), p. 21-34
    Type of Medium: Online Resource
    ISSN: 1062-2551
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
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  • 5
    In: Human Resources for Health, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2021-12)
    Abstract: Lack of programmatic support and supervision is one of the underlying reasons of the poor performance of Pakistan’s Lady Health Worker Program (LHWP). This study describes the findings and potential for scale-up of a supportive supervision intervention in two districts of Pakistan for improving LHWs skills for integrated community case management (iCCM) of childhood diarrhea and pneumonia. Methods The intervention comprised an enhanced supervision training to lady health supervisors (LHSs) and written feedback to LHWs by LHSs, implemented in Districts Badin and Mirpur Khas (MPK). Clinical skills of LHWs and LHSs and supervision skills of LHSs were assessed before, during, and after the intervention using structured tools. Results LHSs’ practice of providing written feedback improved between pre- and mid-intervention assessments in both trials (0% to 88% in Badin and 25% to 75% in MPK) in the study arm. Similarly, supervisory performance of study arm LHSs was better than that in the comparison arm in reviewing the treatment suggested by workers’ (94% vs 13% in MPK and 94% vs 69% in Badin) during endline skills assessment in both trials. There were improvements in LHWs’ skills for iCCM of childhood diarrhea and pneumonia in both districts. In intervention arm, LHWs’ performance for correctly assessing for dehydration (28% to 92% in Badin and 74% to 96% in MPK), and measuring the respiratory rate correctly (12% to 44% in Badin and 46% to 79% in MPK) improved between baseline and endline assessments in both trials. Furthermore, study arm LHWs performed better than those in comparison arm in classifying diarrhea correctly during post-intervention skills assessment (68% vs 40% in Badin and 96% vs 83% in MPK). Conclusion Supportive supervision including written feedback and frequent supervisor contact could improve the performance of community-based workers in managing diarrhea and pneumonia among children. Positive lessons for provincial scale-up can be drawn. Trial registration Both trials are registered with the ‘Australian New Zealand Clinical Trials Registry’. Registration numbers: Nigraan Trial: ACTRN1261300126170; Nigraan Plus: ACTRN12617000309381.
    Type of Medium: Online Resource
    ISSN: 1478-4491
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2126923-3
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  • 6
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  Human Resources for Health Vol. 20, No. 1 ( 2022-12)
    In: Human Resources for Health, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2022-12)
    Abstract: Healthcare workers (HCWs) have found themselves and their families more susceptible to contracting COVID-19. This puts them at a higher risk of psychological distress, which may compromise patient care. In this study, we aim to explore the risk perceptions and psychological distress between HCWs and non-healthcare workers (NHCWs) in Pakistan. Methods A cross-sectional study was conducted using an online self-administered questionnaire. Psychological distress was assessed through The Hospital Anxiety and Depression Scale (HADS). Comparisons were made between HCWs (front/backend, students/graduates) and NHCWs related to risk perceptions and stress levels related to COVID-19. Following tests for normality (Shapiro–Wilk test), variables that fulfilled the normality assumption were compared using the independent samples t -test, while for other variables Mann–Whitney U -test was employed. Pearson Chi-square test was used to compare categorical data. Multiple logistic regression techniques examined the association of participant age, gender, household income, and the presence of COVID-19 symptoms with depression and anxiety levels. Results Data from 1406 respondents (507 HCWs and 899 NHCWs) were analyzed. No significant difference was observed between HCWs and NHCWs’ perception of susceptibility and severity towards COVID-19. While healthcare graduates perceived themselves (80% graduates vs 66% students, p -value 0.011) and their family (82% graduates vs 67% students, p -value 0.008) to be more susceptible to COVID-19, they were less likely to experience depression than students. Frontline HCWs involved in direct patient care perceived themselves (83% frontline vs. 70% backend, p -value 0.003) and their family (84% frontline vs. 72% backend, p -value 0.006) as more susceptible to COVID-19 than backend healthcare professionals. Over half of the respondents were anxious (54% HCWs and 55% NHCWs). Female gender, younger age, lower income, and having COVID-19 related symptoms had a significant effect on the anxiety levels of both HCWs and NHCWs. Conclusion Frontline HCWs, young people, women, and individuals with lower income were at a higher risk of psychological distress due to the pandemic. Government policies should thus be directed at ensuring the mental well-being of frontline HCWs and improving their satisfaction to strengthen the health care delivery system. The findings suggest the need to provide mental health support for health workers.
    Type of Medium: Online Resource
    ISSN: 1478-4491
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2126923-3
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  • 7
    Online Resource
    Online Resource
    Emerald ; 2015
    In:  International Journal of Health Care Quality Assurance Vol. 28, No. 5 ( 2015-6-8), p. 520-531
    In: International Journal of Health Care Quality Assurance, Emerald, Vol. 28, No. 5 ( 2015-6-8), p. 520-531
    Abstract: – The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework. Design/methodology/approach – Using a cross-sectional study design, two rural health centers (RHCs) contracted out to Aga Khan Health Service, Pakistan were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson χ 2, Fisher’s Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities. Findings – Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients’ inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p =0.006). Practical implications – The study shows that contracting out initiatives have the potential to improve MNH care. Originality/value – This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.
    Type of Medium: Online Resource
    ISSN: 0952-6862
    Language: English
    Publisher: Emerald
    Publication Date: 2015
    detail.hit.zdb_id: 2010023-1
    SSG: 3,2
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  • 8
    Online Resource
    Online Resource
    Scitechnol Biosoft Pvt. Ltd. ; 2016
    In:  Health Systems and Policy Research Vol. 3, No. 3 ( 2016)
    In: Health Systems and Policy Research, Scitechnol Biosoft Pvt. Ltd., Vol. 3, No. 3 ( 2016)
    Type of Medium: Online Resource
    ISSN: 2254-9137
    Language: Unknown
    Publisher: Scitechnol Biosoft Pvt. Ltd.
    Publication Date: 2016
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  • 9
    Online Resource
    Online Resource
    Elsevier BV ; 2006
    In:  Accident Analysis & Prevention Vol. 38, No. 3 ( 2006-05), p. 526-531
    In: Accident Analysis & Prevention, Elsevier BV, Vol. 38, No. 3 ( 2006-05), p. 526-531
    Type of Medium: Online Resource
    ISSN: 0001-4575
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2006
    detail.hit.zdb_id: 1498752-1
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  • 10
    In: Acta Paediatrica, Wiley, Vol. 107, No. S471 ( 2018-12), p. 63-71
    Abstract: To assess the effect of enhanced supportive supervision of lady health workers ( LHW s) by lady health supervisors on integrated community case management of childhood pneumonia and diarrhoea. Methods A total of thirty‐four supervisors were randomly assigned to intervention and comparison arms. The intervention included enhanced training of supervisors on supervisory skills and written feedback to LHW s by supervisors. The performance of both cadres was assessed three times. Household surveys judged caregiver practices. Results Intervention arm LHW s performed better than those in the comparison arm in assessing dehydration (92% [n = 25] vs 64% [n = 25] ) and in classifying diarrhoea correctly (68% [n = 25] vs 40% [n = 25] ). The two arms differed little in correct disease classification for pneumonia (44% [n = 25] vs 40% [n = 25] ). Supervisory performance of intervention arm supervisors was better than that in the comparison arm in correcting the workers’ clinical examination skills (64% [n = 25] vs 40% [n = 25] ) and more frequent feedback. In the household survey, only 18% (n = 2182) intervention and 23% (n = 2197) comparison arm caregivers considered LHW s capable of providing diarrhoea and pneumonia care. Commodities for integrated community case management were not regularly available to workers. Conclusion Supportive supervision can improve community case management performance. Support through refresher training, logistics and commodities is essential.
    Type of Medium: Online Resource
    ISSN: 0803-5253 , 1651-2227
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1492629-5
    detail.hit.zdb_id: 1501466-6
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