Health Problem In Pakistan Research Articles

Postoperative Outcomes of Breast Cancer Surgery in Tertiary Care Units in Pakistan: A Cross-Sectional Study

Background: Breast cancer is a serious health problem in Pakistan and has high incidence and mortality rate. This paper seeks to compare and contrast surgical care and patient management by analyzing postoperative results of breast cancer operations in tertiary health care centers of Pakistan. Methods: It was a cross-sectional study designed in tertiary care unit of Nishtar hospital Multan where medical records of female breast cancer patients who underwent surgery between January 2024 to June 2024 were analyzed. The demographic data, surgical procedures, postoperative morbidities, hospital stays, and readmission rates data were analyzed using multivariate statistics. Results: In total 300 patients were selected in the study. The rate of developing post-operative complications was 20%, and the most frequent of them were infections (12%). The mean days to recovery including those who were discharged and stayed at home was twenty-one days with a readmission ratio of fifteen percent. Specific factors that were found to have a significant influence on the outcomes consisted of age, comorbidities as well as the surgical method used with the latter having a (p ≤ 0.01). Conclusion: This finding of study stated that the postoperative outcomes of breast cancer surgeries in Pakistani tertiary care units were determined by patients’ characteristics, medical co morbidities, and surgical procedures. Implementing standard of care and making available better surgical modalities can improve the patient care and post-surgical care maybe reduced the rate of further complications among breast cancer patients.

Economic costs of perinatal depression and anxiety in a lower middle income country: Pakistan

BackgroundWomen's mental health during the perinatal period is a major public health problem in Pakistan. Many challenges and competing priorities prevent progress to address the large treatment gap.AimTo quantify the long-term impacts of untreated perinatal depression and anxiety in economic terms, thus highlighting its overall burden based on country-specific evidence. MethodsCost estimates were generated for a hypothetical cohort of women giving birth in 2017, and their children. Women and children experiencing adverse events linked to perinatal mental health problems were modelled over 40 years. Costs assigned to adverse events included were those linked to losses in quantity and quality-of-life, productivity, and healthcare-related expenditure. Present values were derived using a discount rate of 3 %. Data were taken from published cohort studies, as well as from sources of population, economic and health indicators. ResultsThe total costs were $16.5 billion for the cohort and $2680 per woman giving birth. The by far largest proportion referred to quality-of-life losses ($15.8 billion). Productivity losses and out-of-pocket expenditure made up only a small proportion of the costs, due to low wages and market prices. When the costs of maternal suicide were included, total costs increased to $16.6 billion. LimitationsImportant evidence gaps prevented the inclusion of all cost consequences linked to perinatal mental health problems. ConclusionsTotal national costs are much higher compared with those in other, higher middle-income countries, reflecting the excessive disease burden. This study is an important first step to inform resource allocations.

Lived Experiences of Suicide-Bereaved Siblings in Pakistan: A Qualitative Approach

The perspective of siblings who are suicide-bereaved in Pakistan denote a rather underexplored but significant part of mental wellbeing. This qualitative research reconnoiters the feeling of people whose siblings have been lost in the event of a suicide while also aiming to bring light to the different facets of the grieving journey that they have navigated through. Using techniques of thematic analysis, data was collected using semi-structured interviews involving 8 participants who were siblings and belonging to a wide range of backgrounds, each of them offering a different and unique viewpoint that was shaped by their experiences and backgrounds. The analysis discovered seven predominant themes, each of which contained several subthemes. From these, a universal and main aspect of the bereavement process was emotional distress which was interlinked with coping mechanisms and resilience portrayed by siblings while undergoing that journey of grief. Furthermore, posttraumatic growth as a phenomenon came forth as an intricate interconnection of transformation of the individual due to huge loss. The research also revealed the extensive effect of stigmatization in Pakistani society regarding suicide. Nevertheless, the significance of Environmental Reward, complexities of stressed relationships and social support dynamics came forth as important features that shaped the experience of bereavement. The discoveries highlight the need for specialized interventions and support services that cater to individualized needs of individuals in Pakistan who are suicide bereaved. By identifying and authenticating their experiences, officials involved in making policies and mental health professionals can nurture a more effective and sympathetic method for helping those who are currently experiencing loss of a sibling due to suicide. This research contributes important discernments to the increasing literature on the topic of bereavement and emphasizes the importance of cultural bound and contextual helping strategies for catering mental health problems in Pakistan.

Public Awareness and Behavioral Patterns During Smog

Smog is also an alarming signal for health problems in Pakistan especially in the city Lahore. Objective: To find out how the general public feels about smog. Methods: The study was conducted by surveying Lahore residents who drive. This was a survey-based study which included 100 subjects using any vehicle as a mode of transportation. Results: Generally, 2% people used cycle, motorbike 62%, car 13% and public transport 23% but during smog people shifted from bike to public transport and rate of car users were also increased from 13% to 25%. In this survey, 58% of the people came to know about smog through TV channels. Most of the respondents had the symptoms of chest tightness, eye irritation, breathing difficulty. This study revealed that 85% of vehicle users took preventive measures such as kept themselves hydrated (18%), worn mask (58%) and driven less (9%); which kept them away from hospitals during smog. Conclusions: It was anticipated that motor bike, car and public transport users had more knowledge about the causes of smog but none of cycle user was aware that sulfur and nitrogen compounds were the cause of smog (p<0.001). Thus, Pakistan needs to implement future countermeasures for smog.

Regional and National Trends in Consumption of Antimicrobials in Pakistan; Pre and Post-COVID (2019-2021).

Efforts to combat antimicrobial resistance, a growing public health problem in Pakistan, have been hampered by the lack of high-quality national and provincial-level antimicrobial consumption data. The singular objective of this retrospective study was to measure antimicrobial consumption over 3 years between 2019 and 2021. The study was designed to estimate antimicrobial consumption at National and Regional levels. Antimicrobial consumption data was collected by IQVIA covering 110 districts of Pakistan in which 88% of sales are census (accurate sales collected directly from distributors), whereas 12% of sales (sales of 300 pharmacies) are projected on the national level. To determine the usage for 3 consecutive years, the consumption of antibiotics was calculated as defined daily doses (DDD) of antibiotics per 1000 inhabitants per day (DID). The results of our study demonstrated a steep increase in the consumption of antimicrobials from 2019 to 2021. An increase in consumption of most classes of antibiotics was observed both nationally and Regionally. Quinolones, penicillins (co-amoxiclav), macrolides, and third-generation cephalosporins remained the most frequently used antibiotics nationally. A 40% increase in intravenous use of antimicrobials was observed between 2019 and 2021 at the national level. Moxifloxacin, Levofloxacin, Ciprofloxacin, and linezolid were the most commonly used intravenous antibiotics. Region 7 (Peshawar) demonstrated the highest consumption, followed by Region 1 (Karachi) and Region 6 (Faisalabad). Among the most commonly used antibiotics, the use of third-generation cephalosporin (cefixime), quinolones, penicillins (amoxicillin + clavulanic acid), and macrolides (azithromycin) was most noticeable in all regions, particularly in those with the higher consumption of antibiotics. Although the increase in consumption of all antibiotics is concerning, the steep increase in the use of watch and reserve category antibiotics during the study period calls for immediate actions to limit and regulate their usage.

Detection of KatG Mutation in MDR Mycobacterium Tuberculosis Isolates by PCR-RFLP and DNA Sequencing

Objective: Tuberculosis (TB) is among the widespread and rapidly growing infections in the world. Furthermore, TB is one of the major public health problems in Pakistan as every year 48,000 Pakistani dies due to this infection. Pakistan ranks fifth among high burden countries worldwide. As the TB has become most threatening because of the epidemics of human immune deficiency virus (HIV), Covid-19 and the emergence of multi-drug resistance (MDR) strains of Mycobacterium tuberculosis (M. tb). This study was aimed to understand the genetic mechanism of drug resistance in local TB isolates. Methodology: For the genetic studies of INH resistance, KatG (encoding catalase peroxidase) hotspot region was amplified through PCR followed by RFLP and sequencing. Results: The study of PCR-RFLP showed that forty-five out eighty INH resistant M. tb strains had mutations in KatG (codon 315) which is 56.2% of all cases. Sequencing results revealed that this is substitution mutation; AGC to ACC (Ser315Thr). Conclusion: It may be concluded that majority of INH resistance is due to the mutation in the codon 315 of KatG in local isolates. Furthermore, PCR-RFLP technique could be considered as a reliable method for the early detection of KatG mutations in MDR-TB. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 804-808

FREQUENCY OF IRON DEFICIENCY ANAEMIA AND ITS ASSOCIATION WITH PERSISTENT DIARRHOEA, LOW WEIGHT AND PARASITIC INFESTATION IN CHILDREN VISITING TEHSIL HEADQUARTER HOSPITAL DASKA.

Iron deficiency anemia (IDA) is a common health problem in Pakistan among younger children. Persistent diarrhea, one of the major causes of malnutrition in children especially under two years of age contributed to IDA resulting in increased mortality and morbidity in developing countries. The incidence and mortality is especially high during infancy in the absences of breast feeding. Number of factors effect prevalence of IDA in this age group, important ones, are low socio-economic status, low weight, worm infestation and persistent diarrhea.

Frequency of Iron Deficiency Anemia Among Children a Multi-Center Study

Background: Anaemia, marked by abnormally low levels of haemoglobin and often caused by an absence of iron, remains a severe public health problem in Pakistan. Studies have yet to be done on the prevalence of iron deficiency anaemia in children, making it essential to research the Khyber Pakhtunkhwa region to understand better how widespread this ailment is amongst the region's pediatric populations. Objective: Determine the prevalence of iron deficiency anaemia in anaemic newborns between 6 and 66 months. Materials and Methods: This multi-center study was conducted between February 2022 and February 2023 at the Hayatabad Medical Complex pediatric department in Peshawar. The 180 enrolled children's basic demographic information, including age, gender, and weight, were collected. Operational guidelines for automated analysis of iron deficiency anaemia collected venous whole blood samples.

Suicides by pesticide ingestion in Pakistan and the impact of pesticide regulation

IntroductionSuicide is a major public health problem in Pakistan, accounting to approximately 19,331 deaths every year. Many are due to consumption of acutely toxic pesticides; however, there is a lack of national suicide data, limiting knowledge and potential for intervention. In this paper, we aimed to review the literature on pesticide self-poisoning in Pakistan to identify the most problematic pesticides in relation to national pesticide regulations.MethodsInformation on the currently registered and banned pesticides was obtained from Ministry of National Food Security and Research while data on pesticide import and use was extracted from FAOSTAT. We searched the following sources for articles and research papers on poisoning in Pakistan: Cumulative Index to Nursing and Allied Health (CINAHL), Google Scholar, Applied Social Sciences Index and s (ASSIA), Excerpta Medica (EMBASE), National Library of Medicine’s MEDLINE (PUBMED), PS102YCHINFO and Pakmedinet.com using the search terms ‘self-poisoning’, ‘deliberate self-harm’, ‘suicide’, ‘methods and means of suicide’, ‘organophosphate’, ‘wheat pill’, ‘aluminium phosphide’, ‘acute poisoning’, OR ‘pesticides’, AND ‘Pakistan’.ResultsAs of May 2021, 382 pesticide active ingredients (substances) were registered in Pakistan, of which five were WHO hazard class Ia (extremely hazardous) and 17 WHO hazard class Ib (highly hazardous). Twenty-six pesticides, four formulations, and seven non-registered pesticides had been banned, of which two were WHO class Ia and five Ib. We identified 106 hospital-level studies of poisoning conducted in Pakistan, of which 23 did not mention self-poisoning cases and one reported no suicidal poisoning cases. We found no community or forensic medicine studies. Of 52,323 poisoning cases identified in these papers, 24,546 [47%] were due to pesticides. The most commonly identified pesticide classes were organophosphorus (OP) insecticides (13,816 cases, 56%) and the fumigant aluminium phosphide (3 g 56% tablets, often termed ‘wheat pills’; 686 cases, 2.7%). Few studies identified the particular pesticides involved or the resulting case fatality.ConclusionWe found pesticide poisoning to be a major cause of poisoning in Pakistan, with OP insecticides and the fumigant aluminium phosphide the main pesticides identified. Withdrawal of Class I pesticides (as proposed to occur nationally in 2022) and high concentration aluminium phosphide tablets should rapidly reduce suicidal deaths by reducing the case fatality for low-intention poisoning cases. National cause of death data and forensic toxicology laboratory data identifying the pesticides responsible for deaths will be important to assess impacts of the proposed national ban.

Frequency of Iron Deficiency Anemia and Its Association with Persistent Diarrhea, Weight and Parasitic Infestation in Children, 1-2 Years of Age in Semi-Rural Area of District Sialkot, Pakistan

Iron deficiency anemia (IDA) is a common health problem in Pakistan and persistent diarrhea under two years of age is one of its major reasons. Objectives: To determine the frequency of IDA among children 1-2 years of age and to find its association with persistent diarrhea and parasitic infestation. Methods: In this hospital-based study, 345 children 1-2 years of age visiting OPD of Tehsil Headquarter Hospital, with persistent diarrhea were included. Socio-demographic characteristics of children and their parents collected with the questionnaire while total body iron stores determined by checking Hemoglobin (Hb), Serum Ferritin and Total Iron Binding Capacity (TIBC) in the blood while parasitic infestation was determined by Ova and Cyst in the stool samples. Chi-square test was used to test association. Results: Out of total children, 55.9% children were bottle fed, weaning was started among 97.7% children at the age of 6 months, 44.9% had weight <8 kg, 53.0% children were anemic, had TIBC >450 µg/dl and serum ferritin level <7 ng/ml. The association of IDA with age, gender, mode of feeding, food allergies and vaccination history were significant while it was insignificant with persistent diarrhea and parasitic infestation. Conclusions: Study concluded that IDA was very frequent among children in less than 2 years of age and among contributing factors, lack of beast-feeding and diarrhea are important. Correlation was significant between IDA with age and feeding mode while association was insignificant with persistent diarrhea and parasitic infestation

Exploring the beliefs and experiences with regard to COVID-19 vaccine hesitancy and acceptance in a slum of Karachi, Pakistan.

The COVID-19-related misinformation and vaccine hesitancy is a widespread global concern and a recognized public health problem in Pakistan. The current research sought to explore the beliefs and experiences with regard to COVID-19, including vaccine hesitancy and acceptance, in a slum of Karachi, Pakistan. This study used an interpretivist epistemological approach for data collection and employed in-depth interviews (IDIs) and focus group discussions (FGDs) to explore the themes of interest. IDIs and FDGs were conducted in the local language (Pashtu) and Urdu, using semi-structured interview guides. A hybrid thematic analysis approach (use of both inductive and deductive coding) was used to analyze the data. We identified two key themes: the first related to vaccine hesitancy and refusal and included the role of personal belief systems, vaccine mistrust and public perceptions in hesitancy; the second related to vaccine acceptance and included knowledge and awareness about the vaccine and trusted sources of information. Religious beliefs and cultural norms influenced attitudes toward COVID-19 and vaccination. This study also found that awareness about the COVID-19 vaccine in this sample was influenced by sex, educational status and socioeconomic status. Participants with good health literacy and those from healthcare backgrounds were more likely to share views that indicated vaccine acceptance. The findings of this study are being used to co-design a comprehensive intervention to dispel COVID-19 misinformation and vaccine hesitancy across a range of stakeholders such as youths, community leaders, family members, faith leaders, schools and community-based local organizations in Pakistan.

A dyadic approach to depression, resilience and quality of life on marital adjustment among infertile couples in Karachi, Pakistan: A cross-sectional study.

Infertility is a major reproductive health problem in Pakistan. It has the potential to cause serious negative impact on a couple's marital life and psychological health. This study aimed to assess the factors associated with maladjustment among infertile couples. An analytical cross-sectional design was employed. Validated scales were used to assess marital adjustment, depression, resilience and quality of life among infertile couples. Purposive sampling was employed to enrol 334 infertile couples from a private infertility medical centre, of Karachi, Pakistan. Among couples, marital adjustment scores were comparable, but resilience and quality of life were significantly low among wives whereas depression was significantly high among wives compared with husbands. Wives' marital adjustment was positively correlated with husband's resilience and quality of life and negatively related with his depression. After employing adjusted actor-partner interdependence modelling, wives' own depression and resilience had significant effect on their marital adjustment and their partner's resilience, depression and quality of life did not have any impact on their outcome. On the contrary, wives' resilience had a significant effect in increasing the marital adjustment of their husband. This study highlights the need to promote psychological support (resilience building skills) or couples' therapy to all those couples undergoing infertility treatment.

Meningococcaemia In Children-An Under Recognized Public Health Problem In Pakistan.

Meningococcaemia is a serious bacterial disease caused by Neisseria meningitidis resulting in septicaemia and meningitis in previously well individuals and is associated with serious consequences including mortality. As the data from our region is scarce, the study was conducted with an aim to highlight the disease manifestations and outcomes so that appropriate interventions are devised. A descriptive study was conducted in Paediatrics A Unit from 1st March 2020 to 30th September 2021 after approval of institutional review board. Children admitted with features of meningococcaemia in the form of fever and typical petechial purpuric rash were included in the study. A total of 46 patients with meningococcaemia were included in the study. Of these, 24 (52.2%) were male. Majority of the patients 22 (47.8%) were in the age group of 1 year to five years, Major complications were meningitis in 39 (84.8%), septic shock in 26 (56.5%) and purpura fulminans in 12 (26.1%) patients. Mortality was documented in 6 (13%) patients. Outcome was associated with age. (p= 0.039). There was a significant difference in outcome in patients with prolonged PT/APTT (p=0.031), purpura fulminans (p=0.000) and septic shock (p=0.021). Meningococcaemia is prevalent in our region in paediatric population. The disease has a fulminant course with a myriad of complications and potentially fatal outcomes especially in children under one year of age.

Antibiotics prescribing practices for sore throat in a sub-urban primary care clinic

<p><strong>Background and Objective:</strong> Antimicrobial resistance (AMR) is one of the serious health problems in Pakistan. Excessive use of antibiotics during pandemics has aggravated AMR; hence, rational use in the future is even more important to consider and implement. Clinical audits on antibiotic prescribing in general practice can help improve antimicrobial stewardship. This study was designed as an audit to evaluate if the antibiotics prescribed for Streptococcus pharyngitis at a sub-urban primary care center in Pakistan were in line with the standard and latest guidelines.<br /><strong>Methods:</strong> A retrospective audit was carried out at the primary care center located at Nainsukh, Lahore, Pakistan during 1 month period. Both adult and pediatric patients (above 3 years of age) presenting with upper respiratory tract infections were included in the study. A total of 48 consultation cards were identified using International Classification of Diseases 10 coding. The antibiotic prescribing practice of primary care physicians was evaluated against the Modified Centor Criteria (MCC) which was used as a standard. A score of ≤3 required no antibiotic whereas a score of ≥ 3 needed a same-day antibiotic prescription for sore throat.<br /><strong>Results:</strong> There were 28 (58.3%) patients presenting with MCC of ≤3 and were not given antibiotics. Antibiotic prescriptions issued on the day of presentation were n = 20; however, only n = 7 (35%) met the standard criteria, i.e., MCC score of ≥3 and among these patients, penicillin remained the first choice with 71% patients receiving amoxicillin, while 28% received co-amoxiclav.<br /><strong>Conclusion:</strong> Antibiotic stewardship is lacking among general physicians working at the sub-urban primary health care center in Lahore city. Clinical audits, as a part of clinical governance, may help improving the quality of care provided to the community by the regional primary health care physicians.</p>

O01 Trends in antimicrobial resistance amongst pathogens isolated from blood and cerebrospinal fluid cultures in Pakistan (2011–15): a retrospective cross-sectional study

BackgroundWhile antimicrobial resistance (AMR) continues to be a major public health problem in Pakistan, data regarding trends of resistance among pathogenic bacteria remain scarce, with few studies presenting long-term trends in AMR. This study was therefore designed to analyse long-term AMR trends at a national level in Pakistan.MethodsWe report here results of a comprehensive analysis of resistance among pathogens isolated from blood and CSF, between 2011 and 2015. Susceptibility data were obtained from a local laboratory with collection points all across Pakistan (Chughtai Laboratory). Resistance proportions to most commonly used antimicrobials were calculated for each pathogen over a period of 5 years.ResultsWhile Acinetobacter species demonstrated highest resistance rates to all tested antimicrobials, a sharp increase in carbapenem resistance was the most noticeable (50%–95%) between 2011 and 2015. Our results also highlight the presence of third and fourth generation cephalosporins resistance in Salmonella enterica serovar Typhi in Pakistan. Interestingly, where a rise in AMR was being observed in some major invasive pathogens, decreasing resistance trends were observed in Staphylococcus aureus to commonly used antimicrobials.ConclusionsOverall pathogens isolated from blood and CSF between 2011 and 2015 showed an increase in resistance towards commonly used antimicrobials.

Analyzing the Mediating Role of Food Insecurity between Economic Factors and Child Health in Pakistan: An Application of Haye’s Logistic Model

This study tends to assess the critical selected economic factors intervening the child health problems in Pakistan. Child health problem is of great concern and became even more important after the United Nation’s Sustainable Development Goals vision of Global Social, Economics, and Environmental sustainability. This study analyses the data of the Pakistan Household Integrated Economic Survey (HIES) 2018-19, which is the latest available data in the current year, 2022. A total frequency of 24809 households are included in the study sample and are inquired about their economic proceeding of life and their child's health problems. Child health is a derived factor that is not obviously directly affected by its socio-economic determinants. Unlike the previous studies, this study follows an indirect analysis while explaining child health determinants. Hayes' process of mediation is applied to see the role of global food insecurity in the households in the country and its implication on the child health ratio in Pakistan. This study implies a significant negative role in asset poverty. Food insecurity on the child health in Pakistan, meaning that if a household is food insecure, that will lead to a high risk of child adverse health problems and vice-versa. Moreover, there are some direct effects of asset poverty on the child's health as they assess the fiat source of finance for the household after a liquid form of monetary assets.

Food handlers: an important reservoir of protozoans and helminth parasites of public health importance.

Food handlers plays a primary role in the transmission of pathogenically important protozoans and helminth parasites. This study was aimed to evaluate the prevalence of intestinal pathogenic protozoans and helminth parasites among food handlers in and around University of Malakand, Lower Dir, Pakistan. Stool samples were collected from 642 food handlers (all of male) in a cross-sectional study from January to November, 2017. Wet Mount Techniques and concentration methods by using salt and formol-ether solutions. Three hundred and eighty four cases (59.8%) were found infected with one more parasites. Most of the individuals were found infected with helminth (47.6%) as compared to intestinal protozoans (0.93%). Seventy two cases (11.2%) of the cases presented mixed infection with both intestinal protozoan and helminth parasites. The order of prevalence for intestinal helminth was Ancylostoma duodenale (n = 258, 40.1%), followed by Taeniasa ginata (n=96, 14.9%) Ascaris lumbricoides (n = 54, 8.40%) and Trichuris trichura (n=30, 4.60%). For intestinal protozoa, Entamoeba histolytica/dispar (n = 36, 5.64%) was the only protozoan detected. Mono-parasitism was higher than poly-parasitism. Family size income and education level were the factors significantly (P<0.05) associated in the parasites prevalence. Current research showed that IPIs are primarily the foodborne pathogens still an important public health problem in Pakistan. Effective control programs on parasitic diseases transfer and their associated factors are recommended.

Prevalence and Potential Determinants of Aggregate Anthropometric Failure among Pakistani Children: Findings from a Community Health Survey.

Malnutrition among children is an important public health problem in Pakistan. Conventional indicators (stunting, wasting and underweight) are well known. However, there is a need for aggregate indicators in this perspective. The goal of this study is to assess the prevalence and trends of malnutrition among Pakistani children under the age of five using the so-called composite index of anthropometric failure (CIAF), a tool for calculating the whole aggregate burden of malnutrition. The data were extracted from the Pakistan Demographic and Health Survey 2012–2013. Mothers’ education and socioeconomic statuses (SES) were assessed as important factors in malnutrition. Chi-squared analysis was used to check the bivariate association, and multiple logistic regression was used to identify the significant correlates of child malnutrition. Moreover, multiple correspondence analysis (MCA) was applied to strengthen the use of CIAF as an outcome variable. The study looked at 3071 children under the age of five, with 52.2% of them falling into the CIAF. Children of educated mothers had 43% fewer odds of being malnourished (OR (Odd Ratio) = 0.57, 95% CI (Confidence Interval) = 0.44–0.73). Additionally, a decreasing trend in malnutrition was found with increasing SES. There is a need to improve maternal education. Such programs focusing on increasing women’s autonomy in making home decisions should be established. Furthermore, long-term interventions for improving home SES and effective nutritional methods should be examined. For policymakers, the use of CIAF is suggested since it provides an estimate of the entire burden of undernutrition.

Impact evaluation of the efficacy of different doses of vitamin D supplementation during pregnancy on pregnancy and birth outcomes: a randomised, controlled, dose comparison trial in Pakistan

BackgroundVitamin D deficiency during pregnancy is a public health problem in Pakistan and is prevalent among most women of reproductive age in the country. Vitamin D supplementation during pregnancy is...

COMMUNITY PARTICIPATION IN PREVENTION OF COMMUNICABLE DISEASES IN RURAL AREAS OF PAKISTAN: A REVIEW OF LITERATURE

BACKGROUND: There is huge burden of both communicable and non-communicable diseases in healthcare systems. Community engagement is the diverse beneficial relationship between community stakeholders, primary healthcare system and professionals over a wide variety of tasks, their role and participation in decision making for enhancing community health. OBJECTIVES: This paper focuses to present the use of Ladder of Community Participation as a framework to integrate community health problems in Pakistan. Additional focus is on local issues and the integration of the model according to socio-politico-economic structure of Pakistan METHODS: Research articles were reviewed from PubMed, Medline, EBSCO, and CINAHL. Different key words such as “community engagement”, “community participation”, “communicable diseases”, “Ladder framework”, were used along with focus on the most recent and human based studies. After thorough review of the abstracts, selected researches were used to integrate the concept of community engagement in prevention of communicable diseases. REVIEW: Review of the literature showed that local healthcare services alone cannot make sufficient efforts to uplift the health status of the communities. Community based collaborative interventions are often cost effective, sustainable and effective in managing outbreaks and other communicable diseases. It is imperative to engage the local communities and its stakeholders for an informative, collaborative and success oriented approach. Moreover, educating the community stakeholders for on-going basis can be an asset to the public health initiatives in the community. The ladder of community participation presented in this paper guides the public health workers and community stakeholders for step-wise integration of community and its resources in different programs about communicable disease prevention. CONCLUSION: This ladder presents a continuum of different approaches, which will help in planning program management, feasibility assessment, evaluating ongoing interventions along with modification, and expanding community engagement approaches.