Pakistani Mothers Research Articles

Belief in a just world and subjective well‐being: Mothers of normal and Down syndrome children

A cross-sectional study examined the relationship between three dimensions of the belief in a just world and the subjective well-being of Pakistani mothers of normal and Down syndrome children (n = 100 each). Personal belief in a just world and two dimensions of general belief in a just world-beliefs in immanent and ultimate justice-were assessed along with four dimensions of subjective well-being: life satisfaction, mood, state anxiety, and depression. It was hypothesized that personal belief in a just world and belief in ultimate justice would be positively associated with subjective well-being for both groups of mothers. Results were obtained through moderated regression analyses. In line with our hypothesis, personal belief in a just world positively predicted life satisfaction and mood level and negatively predicted state anxiety and depression in both groups of mothers. In contrast, beliefs in immanent and ultimate justice were not consistently adaptive. In particular, the more the mothers of a Down syndrome child believed in immanent justice, the more anxiety they experienced the previous week. In addition, the more the mothers of normal children believed in ultimate justice, the more they experienced anxiety. The pattern of results persisted when controlled for mothers' education, the total number of their children and marital status. Overall, the results support the role of personal belief in a just world as a personal resource in adverse as well as normal life circumstances.

P01-205 - Maternal depression in british pakistani women and the effect on infant behaviour

ObjectiveTo investigate the effect of perinatal depression on birth weight, head circumference, length and infant behaviour in a group of Pakistani women living in the Greater Manchester area of the United Kingdom.MethodUsing a prospective cohort design British Pakistani women were screened using the Edinburgh Postnatal Depression Scale (n=714), the Life events and Difficulty Schedule was used to measure social stress and the Schedule for Clinical Assessment in Neuropsychiatry interview to confirm the diagnosis of depression. Details of birth weight and height were taken from hospital records. Physical and cognitive development of the infants using the Bayleys Scale of Infant Development (BSID-111) was assessed at 6 months postnatal.ResultsThere was no significant difference in birth weight (p=0.0948) and head circumference (p=0.75) at baseline or at 6 months between the two groups. The length of the infants of depressed mothers at 6 months was significantly less (p=0.02) than the infants of non depressed mothers. There was also a significant difference between the two groups in adaptive behaviour in leisure (p=0.043) and health & safety (p=0.049).ConclusionInfants of depressed British Pakistani mothers are not more likely to weigh less at birth or 6 months when compared to infants of non depressed mothers. However they are more likely to be shorter at 6 months and score lower on the BSID on leisure and health & safety areas of adaptive behaviour.

Ethnic density effects on maternal and infant health in the Millennium Cohort Study

Studies have suggested that members of ethnic minority groups might be healthier when they live in areas with a high concentration of people from their own ethnic group - in spite of higher levels of material deprivation typically found within such areas. We investigated the effects of area-level same-ethnic density on maternal and infant health, independent of area deprivation and individual socioeconomic status, in five ethnic minority groups. The study was a cross-sectional analysis within the UK Millennium Cohort Study and included mothers in five ethnic minority groups (Black African n=367, Bangladeshi n=369, Black Caribbean n=252, Indian n=462 and Pakistani n=868) and their 9-month-old infants. Outcome measures included: low birth weight, preterm delivery, maternal depression, self-rated health and limiting long-standing illness. Compared to those who live in areas with less than 5% of people from the same-ethnic minority population, Indian and Pakistani mothers were significantly less likely to report ever being depressed in areas with high same-ethnic density. There was a protective effect of ethnic density for limiting long-term illness among Bangladeshi mothers at 5-30% density and Pakistani mothers at all higher densities. Ethnic density was unrelated to infant outcomes and maternal self-rated health, and unrelated to any outcomes in Black African and Black Caribbean mothers and infants, possibly because no families in these groups lived at higher levels of same-ethnic density. Results were similar whether we examined smaller or larger residential areas. We conclude that, among ethnic minority mothers and infants in England, the relationship of ethnic density to health varies by ethnicity and outcome. For some measures of maternal health, in some ethnic groups, the psychosocial advantages of shared culture, social networks and social capital may override the adverse effects of material deprivation.

Ethnic disparity in stillbirth and infant mortality in Denmark 1981–2003

Objective:Ethnic minorities constitute a growing part of the Danish population but little is known about ethnic disparity in early life mortality in this population. The aim of this study was...

Decisions About Testing and Termination of Pregnancy for Different Fetal Conditions: A Qualitative Study of European White and Pakistani Mothers of Affected Children

The aim of this study is to explore reasons for and against prenatal testing and termination for a range of conditions in women from two different ethnic backgrounds. A total of 19 Pakistani and European women in West Yorkshire, UK, who either had a child with a genetic condition or had terminated a pregnancy for one, completed a questionnaire about their attitudes regarding prenatal testing and termination for 30 different fetal conditions and were interviewed about their reasons for their responses. There were more similarities than differences between the Pakistani and European white women. The most important factor in most women's decisions about termination of pregnancy was their perception of the quality of the life of a child with the genetic condition, in particular, whether the child would be "suffering." This was described as either physical suffering, as a result of medical treatment, or as emotional suffering, as a result of psychological and/or social factors. These findings highlight the need for detailed information about the potential quality of life for the child and the child's family to enable parents to make informed choices, particularly the extent to which the child is likely to suffer, the nature of such potential "suffering" and the extent to which the child could lead a "normal" life. The findings also challenge stereotypes about cultural differences in attitudes about termination of pregnancy.

A Dime a Day: The Possibilities and Limits of Private Schooling in Pakistan

This paper looks at the private schooling sector in Pakistan, a country that is seriously behind schedule in achieving the Millennium Development Goals. Using new data, the authors document the phenomenal rise of the private sector in Pakistan and show that an increasing segment of children enrolled in private schools are from rural areas and from middle-class and poorer families. The key element in their rise is their low fees - the average fee of a rural private school in Pakistan is less than a dime a day (Rs.6). They hire predominantly local, female, and moderately educated teachers who have limited alternative opportunities outside the village. Hiring these teachers at low cost allows the savings to be passed on to parents through low fees. This mechanism - the need to hire teachers with a certain demographic profile so that salary costs are minimized - defines the possibility of private schools: where they arise, fees are low. It also defines their limits. Private schools are horizontally constrained in that they arise in villages where there is a pool of secondary educated women. They are also vertically constrained in that they are unlikely to cater to the secondary levels in rural areas, at least until there is an increase in the supply of potential teachers with the required skills and educational levels.

A Dime a Day: The Possibilities and Limits of Private Schooling in Pakistan

A Dime a Day: The Possibilities and Limits of Private Schooling in Pakistan

Racial/Ethnic Differences in Breastfeeding Initiation and Continuation in the United Kingdom and Comparison With Findings in the United States

Patterns of breastfeeding vary considerably across different racial/ethnic groups; however, little is known about factors that might explain differences across and within different racial/ethnic groups. Here we examine patterns of breastfeeding initiation and continuation among a racially/ethnically diverse sample of new mothers and compare this with patterns seen in the United States. The effects of demographic, social, economic, and cultural factors on racial/ethnic differences in breastfeeding practices are assessed. The sample includes all singleton infants whose mothers participated in the first survey of the United Kingdom Millennium Cohort Study. Missing data reduced the sample to 17,474 (96%) infants with complete data. After adjustment for demographic, economic, and psychosocial factors, logistic regression models showed that Indian, Pakistani, Bangladeshi, black Caribbean, and black African mothers were more likely to initiate breastfeeding compared with white mothers. Further adjustment for a marker of cultural tradition attenuated these relationships, but all remained statistically significant, suggesting that some of the difference was a consequence of cultural factors. After adjustment for demographic, economic, and psychosocial factors, Indian, Pakistani, Bangladeshi, black Caribbean, and black African mothers were more likely to continue breastfeeding at 3 months compared with white mothers. Additional adjustment for a marker of cultural tradition attenuated the relationship for Indian, Pakistani, Bangladeshi, and black African mothers, but all remained statistically significant. Models run for breastfeeding continuation at 4 and 6 months were consistent with these results. We have shown that in the United Kingdom the highest breastfeeding rates are among black and Asian mothers, which is in stark contrast to patterns in the United States, where the lowest rate is seen among non-Hispanic black mothers. The contrasting racial/ethnic patterns of breastfeeding in the United Kingdom and United States necessitate very different public health approaches to reach national targets on breastfeeding and reduce health disparities. Those who implement future policies aimed at increasing breastfeeding rates need to pay attention to different social, economic, and cultural profiles of all racial/ethnic groups.

Maternal Education and Complementary Feeding

This study indicates the possible association between maternal education and the complementary feeding practices among representative sample of Pakistani mothers and their infants. The research team claims this sample as representativ e one, as the population of Islamabad is a heterogeneous group of people settled in Federal capital. Mothers of five hundred infants, age ranging from 6-12 month, visiting for immunization and various minor ailments were selected through convenience sampling technique from the Outpatient department of Paediatrics at Federal Government Services Hospital, Islamabad,. The data was collected by the researchers with the help of a pre-tested questionnaire, Tabulated and analyzed to find out possible association between mother's education and the prevalent complementary feeding practices. A positive relationship was found between the nutritional status of infants and educational status of mothers (P<0.001). The study revealed that the majority of Pakistani infants falling in various degrees of malnutrition belonged to the uneducated mothers. Similar relationship was observed between the educational status of respondents and the introduction of complementary foods at an appropriate age (six months) of infant s (P<0.001 It was noted that a high percentage of respondents (34.8%) who introduced complementary foods to their infants at six months age belonged to educated class. Similarly educated Pakistani mothers were more aware of the appropriate frequency of complementary feeding in every age group The study concludes that mother's education play a vital role in increasing receptivity to nutritional requirements of their infants and improved complementary feeding practices.

Lack of change in birthweights of infants by generational status among Indian, Pakistani, Bangladeshi, Black Caribbean, and Black African mothers in a British cohort study.

To test the hypothesis that an intergenerational increase would occur in birthweights of babies born to UK-born compared with overseas-born (migrant) minority women. Live singleton births to mothers present at the 1991 Census in a national longitudinal study were classified by mother's country of birth and ethnic origin as reported in the census. During 1983-2000, 52,554 White, 1788 Indian, 1538 Pakistani, 995 Bangladeshi, 300 Black Caribbean, and 299 Black African live singleton births were identified. Mean birthweights were adjusted for maternal age, socio-economic circumstances, gender, year of birth, and birth order. Adjusted mean birthweights were: 3400 g (95% CI: 3395, 3405) for infants of UK-born White mothers; 3033 g (95% CI: 2980, 3087) of UK-born Indian mothers and 3066 g (95% CI: 3034, 3097) of migrant Indian mothers; 3110 g (95% CI: 3049, 3172) of UK-born Pakistani mothers and 3123 g (95% CI: 3087, 3159) of migrant Pakistani mothers; 3026 g (95% CI: 2922, 3130) of UK-born Bangladeshi mothers and 3110 g (95% CI: 3076, 3145) of migrant Bangladeshi mothers; 3268 g (95% CI: 3177, 3359) of UK-born Black Caribbean mothers and 3238 g (95% CI: 3089, 3388) of migrant Black Caribbean mothers; and 3167 g (95% CI: 3004, 3330) of UK-born Black African mothers and 3302 g (95% CI: 3208, 3395) of migrant Black African mothers. The proportions of low birthweight infants (<2500 g), generally greater among migrant mothers than White UK-born mothers, were similar by generational status within the ethnic groups. There are no significant differences in mean birthweights of infants by generational status among mothers from these main ethnic minority groups in the UK.

A comparison of Pakistani and Caucasian mothers' perceptions of child and adolescent mental health problems

Pakistani and Caucasian mothers were both highly accurate in the identification of child and adolescent mental health problems. In a community-based vignettes study, Caucasian mothers were more likely to identify all behaviours as problematic. However, Pakistani mothers who did identify behaviours as problematic then rated them as being as (or more) serious than the Caucasian mothers. Despite this, Pakistani mothers were less likely to seek treatment from local child and adolescent mental health services.

Attitudes To and Knowledge of CAMHS: Differences Between Pakistani and White British Mothers.

Research suggests that there are differences in the problems that are referred to Child and Adolescent Mental Health Services (CAMHS) by White British and Asian families as well as differences in how these services are accessed. There is a need for more information about how different ethnic communities perceive and access CAMH services. White British or Pakistani mothers of children between 0-20 years at an urban health centre were invited to complete a study-specific questionnaire written in English (with verbal translation provided when needed). Data were collected on awareness and experience of, and willingness to use CAMH services; severity of problems before referral is considered and additional factors that influence service use. In comparison to White British mothers, Pakistani mothers were found to be less likely to consider a referral for problems judged as mild or moderate. There was no difference for severe problems. Qualitative factors that would enhance the use of CAMH services by Pakistani mothers include the availability of culture and gender matched therapists, and better access to translation facilities. The study highlights service needs and expectations of mothers of Pakistani origin, and emphasises the need for relevant, inclusive and culturally sensitive services.

Infant feeding practices of Pakistani mothers in England and Pakistan.

To investigate infant feeding practices followed by Pakistani mothers in Pakistan and in England. To establish if practices conform to current guidelines and to investigate reasons for adherence and nonadherence. Ninety mothers of weaning age children were interviewed; 45 were in England and 45 in Pakistan. A questionnaire available in English and Urdu sought to find out about the methods of milk feeding and weaning used and the advice received, together with general beliefs about weaning. Characteristics of the infants in terms of current age, gender distribution, birth order of baby and age of weaning showed no significant differences between the two groups. Thus, differences between the two groups could be attributed to cultural differences rather than any of these factors. Chi-square analysis showed that the initial method of feeding chosen was significantly different (P < 0.001, d.f. = 2) with 73% of mothers in Pakistan breast-feeding compared with 24% in England. Similar proportions of mothers in both groups commenced weaning between 3 and 4 months. Common weaning foods included rice, cereals and eggs with progression to fruit and vegetables and family food in Pakistan, and fruit, vegetables, meat and convenience foods (especially sweet options) in England. Both groups of mothers wanted more information about infant feeding practices. Mothers in Pakistan demonstrated more confidence in weaning practices than in England because of experiences with other siblings and advice from relatives. More advice from health professionals was requested and is needed by all mothers in order to improve weaning practices of the infants.

Maternal attitudes to preschool immunisations among ethnic minority groups

Objectives To explore the attitudes of ethnic minority parents to preschool immunisations, particularly first MMR (measles, mumps and rubella vaccination). Design Focus groups and semi-structured interviews with 21 Pakistani, Somali and Afro-Caribbean mothers of infants aged 16 months to 3 years. Focus groups were held in the first language of participants. Setting and Method Focus groups were held at an inner-city health centre and individual interviews in participants'own homes between November 2000 and March 2001. Results All women interviewed had a positive attitude to immunisation. They saw the diseases immunised against as dangerous and thought that their children could catch these diseases and be harmed by them. Catching infectious diseases was considered far more dangerous than immunisation. Some element of risk was accepted as inevitable within life. The three ethnic groups had different exposure to media publicity about the risks of MMR, largely linked to command of English. Pakistani women believed that health professionals gave them the best advice about childhood immunisation, but Afro-Caribbean and Somali women expressed a desire for more information from health professionals, particularly written information about immunisation which is inclusive of Black people and available in translation. Conclusions This small qualitative study suggests that ethnic minority parents perceive the benefits of childhood immunisation as greatly outweighing the risks. The parents interviewed had not been significantly affected by adverse media publicity about immunisation, and saw the immunisation programme as benign state provision in the best interests of their children.

Breast milk docosahexaenoic acid (DHA) correlates with DHA status of malnourished infants

AIMTo investigate whether low docosahexaenoic acid (22:6ω3; DHA) status of malnourished, mostly breast fed infants is a result of low ω3 fatty acid intake via breast milk.METHODSFatty acid composition of...

Conflict management of mothers and daughters belonging to individualistic and collectivistic cultural backgrounds: a comparative study

Research on the mother–daughter relationship during adolescence is mostly conducted in Western and European cultures where individualism is stressed. To examine ethnic/cultural differences and similarities in this relationship, 80 dyads of British (white) and Pakistani mothers and their adolescent daughters were studied. On the basis of the theories of cultural variability dimension and conflict face negotiation, it was hypothesized that mothers and daughters from the two cultures would use different styles of handling disagreements/conflicts. That is, Pakistani mothers and daughters would use an avoiding style, whereas British mothers and daughters would use either a dominating or compromising style, to a greater degree. It was also argued that Pakistani daughters and mothers will express more intimacy and relational harmony, will exhibit greater connectedness and mutuality and demonstrate lesser individuality and self-assertion compared to their British counterparts. However, it appeared that both the groups used an avoiding style equally, although the British group used a dominating style more than Pakistani group. As hypothesized, Pakistani mothers and daughters expressed more intimacy, relational harmony, connectedness and mutuality and lesser individuality than British mothers and daughters.

Are there intergenerational differences in the diets of young children born to first‐ and second‐generation Pakistani Muslims in Bradford, West Yorkshire, UK?

Summary Introduction: In previous reports, the diets of second‐ compared with first‐generation adults have shown greater signs of acculturation. This study aimed to assess whether this was also true amongst 3‐year‐old UK‐born children of first‐ (1G) (n=117) and second‐generation (2G) (n=109) Pakistani mothers in Bradford. Materials and methods: A random sample of mothers was selected (n=320), with generation groups matched for month of birth, sex of child and district of residence. Home‐based interviews were undertaken by multilingual female interviewers. Mother's social characteristics and infant feeding practices were examined and a 24‐h dietary recall for the child was collected. Child's position in the family was not considered in this analysis. Results: Interviews were completed for 226 mothers (117, 1G and 109, 2G). The groups varied according to educational background, linguistic ability and employment status, but analysis of dietary recall indicated more similarities between the groups than differences. For example, traditional foods were limited to midday or evening meals, snacks usually consisted of crisps and biscuits, and sweetened milk or tea was consumed at breakfast. Some differences did exist: water was more likely to be consumed by children of 1G mothers at the midday and evening meals; fish and chips were a more frequent food item among those of 2G mothers. Conclusion: Evidence of dietary transition between groups was minimal using this methodology. This may be due to the cohesive nature of the Pakistani community resulting in it evolving in unison, or because all young children may be subject to similar dietary and cultural expectations and pressures.

Mothers' perceptions of severe pneumonia in their own children: A controlled study in Pakistan

In 1992, 320 mothers were interviewed in a Rawalpindi hospital to identify which of the signs and symptoms they saw in their own children were most consistently linked with a clinical diagnosis of pneumonia as opposed to common cold. A related goal was to determine whether mothers could correctly judge the actual presence or absence of two major pneumonia signs—fast breathing and chest indrawing. The mothers were predominantly poor and 43% were illiterate. The study sample was composed of four matched groups: (1) mothers of 80 children with pneumonia, most with severe disease, interviewed after the child was referred to the ward; (2) mothers of 80 such children interviewed in the outpatient clinic prior to any discussion of the pneumonia diagnosis; (3) mothers of 80 children with common cold; and (4) mothers of 80 ‘well’ children. Results showed that when mothers were interviewed in the clinic, their perception that a child had fast breathing and/or chest indrawing was highly correlated with pneumonia (sensitivity 64%, specificity 90%). Mothers were even more likely to say that a child had these signs after the pneumonia diagnosis had been conveyed, suggesting that interaction with doctors influenced their views. Fast breathing was better recognized than chest indrawing, and accurate diagnosis of both signs was better among mothers having prior experience with childhood pneumonia. The data suggest that even in the absence of formal ARI education, a majority of Pakistani mothers attending hospitals in indigent areas can recognize these two signs in their own children. However, the seriousness of the signs and their connection with pneumonia should be stressed in education campaigns since a high percentage of children had chest indrawing (a late sign of severe disease) by the time they were brought to the hospital.

OSTEOMALACIA OF THE MOTHER AND INTRAUTERINE GROWTH

It has been suggested that vitamin D deficiency in pregnancy may affect fetal growth (BrMedJ1980;280:751-4). In the present study we measured crown-heel length of the newborn, and free calcium, phosphorous, calcidiol, calcitriol, osteocalcin and intact parathyroid hormone (PTH) in venous cord blood and in serum from 30 Pakistani and 23 Norwegian women just after delivery. Results: The Pakistani mothers had lower calcidiol levels (mean ± SD) than the Norwegians (p 5,5 pmol/l, while 43% (13/30) of the Pakistanis had. The crown-heel length of the Pakistani infants in this group were redused (p=0,01) and their mothers had lower free calcium (p=0,003), than the other Pakistani mothers. Conclusion: Biochemical signs of depressed bone mineralisation were observed in fetuses of Pakistani mothers with vitamin D deficiency. Redused intrauterine growth were observed when the mothers had both vitamin D deficiency and elevated PTH.

Are Breastfeeding Patterns in Pakistan Changing?

Prolonged breastfeeding, apart from being beneficial to the child's health, helps in keeping the binh rate low. One of the effects of malnutrition in developing countries is the Teduction in the period of lactation. In Pakistan, where the binh rate is already very high and the use of contraceptives limited, any reduction in the breastfeeding period may result in an increase of the binh rate. This study was undertaken to fmd out the recent changes in the breastfeeding pattern and their potential impact on the fertility levels in Pakistan. The data for this study is based on two National Fertility Surveys - the 1975 PakistBn Fertility Survey (PFS) and the 1979 Population, Labour Force, and Migration Survey (PLM). The estimation of the mean duration of breastfeeding is based on a measure developed by mosley (1982), given by the formula Y = BIN, where Y = estimate of duration of breastfeeding, B = total number of children currently being breastfed, N = the average number of binhs per mOhth. Taking mother's age, parity, place of residence, education, and occupation as background variables, the findings are as follows: (1) a decline of about 4 months occurs in the average length of lactation; (2) age of mother is positively associated with the duration of breastfeeding; (3) urban women have shorter periods of breastfeeding; (4) women working on farms have longer periods of breastfeeding; (5) a slight increase in fertility is due to the decline in breastfeeding and the decrease in the use of contraceptives. It is suggested that breastfeeding may be promoted among Pakistani mothers to reduce the binh rate.