Rural Areas Of Punjab Research Articles

Unspeakable and hidden: intimate partner sexual violence against married women in Pakistan

ABSTRACT Intimate partner sexual violence (IPSV) is a significant form of violence against women that remains largely under-researched in Pakistan, primarily due to sociocultural and religious factors. This study documents the nature and factors associated with IPSV against women in Pakistan by conducting qualitative in-depth interviews with Christian and Muslim women residing in both urban and rural areas of Punjab, Pakistan. A thematic approach was employed to analyse data gathered from seventeen participants. The findings revealed that the patriarchal nature of the society, privileged position of men within marriage, poverty and child marriages, consumption of alcohol and drugs, joint household system, legal ambiguities, and the absence of a supportive environment were contributory factors that increase the risk of sexual violence against women within intimate partnerships in the Pakistani context. It is crucial to acknowledge that sexual violence needs to be understood in the broader context of intimate partner and domestic violence. Additionally, there is a need for further research to explore the specific circumstances faced by women from diverse identity categories and to understand the multifaceted consequences of sexual violence on the physical and mental health of women.

Understanding the diabetes self-care behaviour in rural areas: Perspective of patients with type 2 diabetes mellitus and healthcare professionals.

Diabetes self-care behaviour plays a crucial role in managing the diabetes effectively and preventing complications. Patients with type 2 diabetes mellitus (T2DM) and health care professionals (HCPs) of rural areas often face unique challenges when it comes to diabetes self-care practices (SCPs). Therefore, this study aim to explore the perspectives of patients with T2DM and HCPs on diabetes SCPs. Eight focus group discussions (FGDs) among individuals with T2DM and In-depth interviews (IDIs) with 15 HCPs were conducted in rural areas of Punjab, North India. Capability, Opportunity, Motivation, and Behaviour model (COM-B) was employed for thematic framework analyses. The study participants perceived that a limited understanding of diabetes mellitus (DM), beliefs in alternative therapies, drug side effects, attitudes towards DM (psychological capability), comorbidities (physical capability), family support (social opportunity), financial and time constraints, and weather conditions (physical opportunity) contributed to lack of DM SCPs. Physicians' guidance and support were motivating them to adhere to SCPs, especially when aligned with their sense of self-efficacy (reflective motivation). HCPs constraints in providing patient-centred care are due to training limitations (psychological capability) and a lack of essential resources (physical opportunities). Participants expressed need for comprehensive diabetes care (automatic motivation) through structured diabetes education intervention to improve diabetes SCPs. The study findings indicate that various factors influence diabetes SCPs from the perspectives of both patients with T2DM and HCPs and emphasizes the need for a multi-faceted approach to improve diabetes SCPs in rural areas. Implementing a structured diabetes self-care intervention strategy in rural areas may help for preventing and mitigating the impact of diabetes-related complications in rural areas.

An intervention to improve self-care among people with diabetes mellitus: A quasi-experimental study

Abstract Background An increased self-efficacy promotes better diabetes self-care behaviours, which help in achieving glycemic targets among patients with diabetes mellitus. Methods A quasi-experimental study was conducted among patients with T2DM living in rural areas of Punjab, North India. A total of 283 in the intervention and 291 in the control arms were participated at baseline, and a total of 242 in the intervention and 237 in the control arms at endline assessments. Summary of diabetes self-care activities and diabetes management self-efficacy questionnaires were used at baseline and endline (after 6 months) surveys. Outcomes were net changes in proportion of population having diabetes self-management self-efficacy, overall diabetes self-care activities (health dietary habits, physical activity, adequate foot care, medication adherence and blood glucose monitoring) and net mean change in HbA1c. Data were analysed using per protocol analysis principle. Difference in difference analysis (DiD) using Generalized Estimating Equation model was done to adjust for confounders. p < 0.05 was considered as significant. Results There was a significant net increase in participants proportion (39%; 95% CI: 25% -52%, p < 0.001) on diabetes management self-efficacy scale. At the baseline assessment for overall self-care behaviours, only 4% of participants in the intervention arm were in the action stage and 12% were in the preparation stage; however, at the post intervention assessment, this proportion increased to 24% for action stage and 67% for preparation stage. There was a significant net increase in participants proportion (49%, 95%CI 37% -60%, p < 0.001) engaged in optimal diabetes self-care. There was a significant net decrease in mean HbA1c (-1.06%; 95%CI: -1.62 - -0.50, p < 0.001) at post intervention phase. Conclusions Diabetes self-care intervention was successful in promoting self-efficacy and self-care practices among patients with T2DM of rural areas. Key messages • Self-efficacy theory-based diabetes self-care intervention successfully improves the diabetes related self-care practices. • There is a need for a structured diabetes self-care management education programme to improve the ability of patients with T2DM who live in rural areas.

Molecular epidemiology of Bartonella species from sympatric mammals collected in urban and rural areas of Punjab, Pakistan

Bartonella can infect a variety of mammals including humans and has been detected in the Americas, Europe, Africa, and Asia. Roughly two-thirds of identified Bartonella species are found and maintained in rodent reservoirs, with some of these species linked to human infections. Rodents (N=236) were caught from the Sahiwal division of Punjab, Pakistan and tested for Bartonella using PCR targeting gltA and rpoB genes, followed by sequencing of rpoB-positive samples. Genetic relatedness to other published Bartonella spp. rpoB gene sequences were examined using BLAST and phylogenetic analysis. Overall, 7.62% (18/236) of rodents were positive for both gltA and rpoB fragments. Rattus rattus and R. norvegicus had 7.94% (12/151) and 7.05% (6/85) positivity rates for Bartonella DNA, respectively. Phylogenetic analysis revealed a close relatedness between Bartonella spp. from Pakistan to Bartonella spp. from China, Nepal, and Malaysia. This study is the first reported detection of Bartonella spp. in R. rattus and R. norvegicus from the Sahiwal area of Punjab, Pakistan.

Disposal Practices of Expired and Unused Medications Among Households in Punjab, Pakistan.

The practice of disposing expired or unused medications by different households is generally not considered and is largely neglected. The study was carried out to determine the disposal practices regarding expired and unused medications in rural areas of Punjab, Pakistan. The study was conducted by interviewing different households and students (rural areas) from different universities in Punjab, Pakistan. The sample size was 676 and the questionnaire was used for data collection. Out of 676 members, 552 (81.6%) had medications at the time of the visit. Only 14.5% (n= 80) were taking medication. Only 14.5% (n = 80) kept medication because the treatment was still in progress with the patients while 85.5% (n= 472) had medications that should be discarded. The main reasons for keeping the unused medications at home were completed treatment 34.7% (n= 164) after recovering from ailment. About 60.57% of female disposed the drugs in domestic trash while majority of male participants (48.72%) buried the drugs in the ground. Over 80% of respondents (n = 542) were unaware of the disposal methods. Almost half of the participants (n= 322) had no information about the impact of improper disposal. Statistically significant variations (p<0.001) were observed in the disposal practices depending on gender, age, education and occupation. Improper disposal of medication is a common practice in rural areas of Punjab, Pakistan. The launch of public education programs and the development of drug disposal facilities are very necessary to protect the environment and community health.

QUANTIFICATION OF HEAVY METAL RESIDUES IN FECAL MATTER OF BLUE ROCK PIGEON (COLUMBA LIVIA) IN PUNJAB

The present study was done to assess the heavy metal contamination in the excreta of Blue Rock Pigeon from rural areas of Punjab. This study was conceded out in three locations: Location I: Agronomy Farm, Punjab Agricultural University, Ludhiana, Location II: Cold Storage, Jalandhar Bypass and Location III: Cold Storage, Mullanpur. The results revealed that the levels of Arsenic (As), Chromium (Cr) and Cadmium (Cd) were greater than normal levels in excreta of pigeon from all the three locations and for Lead (Pb) it was above the toxic level at Location II and III. Lead (Pb) levels were observed to be more than thetoxic range from both the locations. Concentrations of heavy metals were higher in locations II and III because these locations are close to road and have more industrial units than location I. Therefore, pigeons excreta can be used as bioindicator for heavy metal levels.

Impacts of Television Educational Campaigns on Motivational Levels of Children and Their Families: A brief Literature Review

Television educational campaigns can have a significant impact on the motivational levels of children and their families. These campaigns aim to promote education, healthy habits, and positive values, and they often utilize engaging content, role models, and interactive elements to capture the attention of viewers. When effective, these campaigns can increase motivation to learn, adopt healthy behaviors, and make positive changes in the lives of children and families. However, it is important to note that the effects of television educational campaigns can vary depending on various factors such as the content of the campaign, the age of the child, the level of parental involvement, and the cultural background of the family. To maximize the positive impact, it is recommended that families view and engage with educational television content together and participate in discussions about the messages being conveyed. The current study will be consisting of two parts, in the first part, researcher will review the existing literature on the impacts of television educational campaigns and their impacts on the children and their families, which is the current article, in the follow-up coming article, researcher will share their own conducted study in the rural areas of Punjab, Pakistan in order to specifically pin pointing the impacts of television educational campaigns on the motivational level of children and parents in the rural areas of a developing country such as Pakistan

Cognitive Science and Learning Environment in Rural Areas of Punjab

There is a difference in the learning environment between rural and urban areas. When compared with rural areas, urban areas are always found to have better facilities with regards to learning. When it comes to academic achievements and career development, science is the most preferred field of study. Parents and students, particularly in rural areas, have developed the belief that science is the only path to a successful future career. This study explores the cognitive sciences and learning environment in rural Punjab. For this purpose, rural areas of Punjab (Sargodha, Mianwali, and Rajanpur) have been selected. The current study implies qualitative research methods, i.e., in-depth interviews. While using the purposive sampling technique, a sample size of 12 respondents (4 students, 4 parents, and 4 teachers) has been defined. Findings of the study reveal that students in rural Punjab are highly inclined to study science, but the study environment in rural Punjab is of the transmissive type. Students face challenges while studying science in a transmissive environment. According to one study, there is a need in rural Punjab for proper facilities that can help students study science in a more teacher-student friendly environment.

Exploring the Causes of Child Abuse in Punjab: Reflections from the Narratives of Child Molesters

The present qualitative study is aimed to explore the role of the lived experiences among child molesters in the urban and rural areas of Punjab, Pakistan. The purpose of this study was to find out the basic difference and reasons behind child sexual abuse in urban and rural areas. The present study also contributed to some new insights into the problem. 12 semi-structured interviews were conducted in the selected areas (Jhelum Gujrat). The content validity of the interview guide was checked through the expert opinion of the ethical committee in the field of qualitative research. The purposive sampling technique was used to include child molesters in the study. Respondents pointed out the role of their own lived experiences in child molestation. Some of them have reported that they had faced child abuse in childhood and some of them pointed out that it has happened incidentally. The study suggests that every individual has his own personal schemas of sex experiences which led them toward child molestation. There are huge socio-economic and developmental differences in child molesters of urban and rural areas.

Pattern and Correlates of Consumption Expenditure in the Rural Areas of Punjab

The pattern of consumption expenditure in the rural areas of Punjab was evaluated based on the primary data collected from the 400 sample households. The findings revealed that cultivating households spent higher per-capita expenditure on food and non-food items than non-cultivating households in rural Punjab. Step-wise regression analysis found the level of education, size of land holdings, distance from the nearest town, size of household, number of dependents, total farm workers and total non-farm workers as the statistically significant correlates, creating the difference in monthly per capita consumption expenditure among the sample rural households.

Economics of Local Cow Milk Production in Punjab

Animal husbandry, particularly dairying, was a leading supporter of the agricultural sector in the state. The present study aimed to investigate the costs and returns of local cow milk production in the Punjab state of India. About 420 dairy farmers were randomly surveyed in 2019. The total cost of local cow milk production was ?143.64 per day per local milch cow. The net returns, based on per day per animal, were found positive but negligible. However, the net returns per litre were calculated as – ?1.04 in rural Punjab. The poor management practices adopted by the dairy farmers were responsible for negative net returns from local cow milk production. The specialized dairy training courses could develop entrepreneurship among dairy farmers in rural areas of Punjab.

ORAL HEALTH LITERACY OF PATIENTS VISITING PRIVATE DENTAL HOSPITAL IN RURAL PUNJAB

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; This study aimed to explore the incidence of oral health literacy of people living in rural areas of Punjab, Pakistan. This quantitative study was crossectional in nature. Data was collected&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; from 66 dental patients coming to the dental hospital of rural areas in districts of Punjab. Descriptive&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; statistics were used to analyze data in frequencies and percentages to assess the incidence of oral health literacy among dental patients visiting the dental hospital of rural areas in Punjab, Pakistan for their dental treatment. Results revealed Oral health literacy was found at a marginal level among the majority of the participants (49.90%) followed by 38.84% participants who had an inadequate level of Oral health literacy whereas only 21.20% of participants showed adequate level. In conclusion, marginal oral health literacy was found among the dental patients visited rural area hospital for treatment.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Intimate partner violence against women in Southern Punjab, Pakistan: A phenomenological study.

Intimate Partner Violence (IPV) refers tobehavior by an intimate partner that can cause physical, sexual, or psychological harm; is a common global public health issue requiring immediate attention. IPV is the most common form of violence in rural areas of Punjab, Pakistan. This qualitative phenomenological study collected 46 in-depth interviews from married women who experienced IPV in the rural areas of South Punjab. A semi-structured interview guide was used for data collection. These women were selected through a snowball sampling technique from October 2018 to March 2019. Researchers accessed the study setting with the help of gatekeepers (Lady Health Workers and Village Heads). The interviews were audio-recorded in the local language (Saraiki) and were translated into English. The data were analyzed using the thematic inductive analysis technique. The study has presented multifaceted factors of IPV by using the socio-ecological framework in rural areas of South Punjab, Pakistan. The current study introduced culturally contextualized terminologies of "protection," "physical submissiveness," "mental delicacy," and "social security". For married women, culturally embedded terms became the primary cause of IPV. In addition, the study also highlighted some of the cultural terminologies (such as run-mureed, watta-satta, beghairat, izzat, etc.) that are ubiquitous in the local context that sometimes intensifies IPV in the family and community sphere. Furthermore, the study discussed how gender-based inequalities trigger a status quo that ultimately creates power discrimination between spouses, which perpetuates violence in the domestic context. Gender-prejudiced roles and expectations imposed by orthodoxy, misinterpretations of Islamic teachings, and dominant patriarchy can be contested through awareness campaigns among the public, and gender sensitization drives among public institutions of police and judiciary. Education and employment-based can lead to women's empowerment and help to challenge the orthodox anti-feminist societal norms and the role of kinship-based networks in the family and community sphere.

Factors Affecting Social Adjustment of The Persons with Disabilities in Rural Punjab

Persons with disabilities are the marginalized persons in the community and facing different community related issues in Punjab province of Pakistan. In Pakistan, living standard of rural community is meager and there is strong association between disability and poverty. A quantitative study was conducted on disabled persons living in rural areas of Punjab. A proportionate sample of 400 respondents was collected from three main districts of Punjab i.e., Faisalabad, Multan and Rawalpindi from November 2016 to June 2017. Level of social adjustment was measured by using a compound variable consisting of statements related to daily activities of these persons. Univariate and bivariate testing were used for data analysis. In this study, majority of the respondents thought that emotional support by non-disabled persons, family support for daily activities, community support for social wellbeing and health structure support to be a productive part of society were important factors of social adjustment for disabled persons living in rural community. Regarding socio-economic background as a whole, it was observed that majorities of the respondents were male by gender from lower class with secondary and higher secondary school education but dependent on others to fulfil their financial requirements. Regarding overall social adjustment, majority of disabled persons stated to have low level of social adjustment even with provision of both more and less health structure support, greater community support, more and less family support and greater emotional support. On the contrary, few respondents were enjoying high level of social adjustment. To provide education and increased level of awareness regarding needs of disabled persons is recommended for the non-disabled persons of the community. Disabled persons should be provided with trainings and some professional skills to live an independent life in the community. Government should implement international anti-discriminatory law to protect the rights of disabled persons.

Physical Assaults assessment concerning their pattern, severity &amp; bone of contention, in rural areas of Punjab

Background: The rural areas of Punjab have a very high prevalence of physical assault due to illiteracy, pride of cast system, related to agricultural land disputes, illegal breaches in violating the watering system of their crops, political motives of landlords in their area, and social issues related to marriages, love affairs, and illegal interference into the privacy of others. Aim: To analyze different forms of physical assaults related to their pattern, severity, and reasons behind these physical assaults keeping in view their medico-legal aspects. Methods: The data of physical assaults in medico-legal cases were collected from the peripheral rural areas of Faisalabad, Sargodha and Mianwali on specifically designed Performa. The cases were selected from these districts reported in Causality &amp; Accident departments of the district and tertiary care Hospitals during one year June 2020 to May 2021. The inclusion criteria were based on non-probability with random sampling in this retrospective study. In total 200 cases were selected for this study. Association with demographic parameters like age, sex, type of weapon used, the pattern of injury. Results: Physical Assaults had a direct association with male predominance; the age of 20 to 30 years of age, blunt weapons especially fists, kicks, and daggers, wooden sticks were used for offense as determined by the findings in this study. Various social reasons related to cast &amp; clan system, disputes of agricultural land, family issues related to inheritance, illiteracy, pride of cast system, domestic violence, illegal breaches in violating the watering system of their crops, political motives of landlords in their area and social issues related to marriages, love affairs and illegal interference into the privacy of others, were the main bone of contentions. Conclusions: Different variety of weapons used in the rural setting. Males as predominant participants of assault suggest a socially active status of men in the rural setup of Punjab where male dominance is evident. The feudal system of landlords main responsible for social injustice and exploitation of the low class, is determined in this study. There need reforms through social literacy, justice provision for all, reforms in medico legal reporting and social awareness of human rights. Keywords: Physical assaults (PA), blunt trauma, domestic violence, rural areas, and bone of contention

Frequency and Nature of Near Miss Obstetric Complications in tertiary care Hospital South Punjab

Objective: To analyze the nature of near miss obstetrical events in a tertiary care hospital of South Punjab. Study design: A Case Series. Settings: This study was carried out in labour room and intensive care unit (ICU) at Nishtar Hospital Multan. Material &amp; Methods: Study consists of near miss cases between January 1, 2020 to January 1, 2021. Near miss cases definition was based on validated disease specific criteria, including five diagnostic categories: hemorrhage, hypertensive disorders in pregnancy, dystocia, sepsis and anemia. SPSS version 23 was used for data analysis. Test of significance were applied and p value ≤0.05 was considered as significant. Results: A total of 166 patients were included in this case series. The most common surgical procedure performed was emergency hysterectomy, n=64 (60.3%). While the most common complications included sepsis and anemia, n=34 (32.1%) and n=31 (29.2%), respectively. The mean hospital stay of the patients was 5.51±2.11 days. Majority of the patients stayed for 3-5 days in hospital. Conclusions: Majority of near miss cases reported from rural areas of Punjab where socioeconomic status and literacy rate are also contributors. Anemia and sepsis were leading complications of near miss events and maternal deaths. Underlying disease process of our observation is almost same as in previous Pakistani reports. Keywords: Near miss, Obstetrical events, Anemia, Sepsis, Hemorrhage

Constraint Analysis in Adopting Mastitis Preventing Technologies in Rural Areas of Punjab, India

Constraint Analysis in Adopting Mastitis Preventing Technologies in Rural Areas of Punjab, India

Epidemiological Determinants for Mortality from Neonatal Tetanus in Punjab Province, Pakistan (2020)

Background Neonatal tetanus (NNT) is a vaccine-preventable disease that occurs at higher incidence in resource-poor countries, presumably because of low maternal immunization rates and unhygienic cord care practices. NNT remains an important cause of infant mortality in rural areas of Punjab Province. Objective This study aims to evaluate and determine the risk factors for mortality in NNT cases and to make recommendations for future strategies. Methods A descriptive study was conducted from July 6 to 14, 2021, at Directorate General Health Office Lahore. The surveillance data set for the year 2020 and clinical notes were reviewed and analyzed. Demographic information, clinical presentation progression, and outcomes were evaluated for all investigated cases, and a comparison analysis was performed between those who survived and those who died. Results Of a total of 176 reported cases, 145 (82.3%) were notified from rural areas of Punjab. The mean age was 9 days, 65 (37%) infants were females, and 111 (63%) were males. The overall mortality was 77 (43.6%), while 31 (17.6%) maternal deliveries were conducted by untrained birth attendants. In addition, 119 (67.6%) women received zero tetanus toxoid (TT) shots in their life. Clinical notes revealed that the group that survived had a significantly greater mean body weight on admission, had later onset of disease, was hospitalized early, and received tetanus immunoglobulin (TIG). The children who could not survive had significantly common clinical features, such as generalized rigidity, fever, and respiratory arrest. Conclusions The increased mortality in rural and tribal areas is suggestive of poor TT immunization coverage. Low literacy, poor socioeconomic status of families, lack of awareness regarding antenatal care, and poor hygienic deliveries conducted by untrained persons remain the main risk factors. Improvement in TT coverage, deployment of trained community midwives, and awareness sessions regarding TT vaccination in hard-to-reach areas are recommended.

Dental Trauma Management; Knowledge and Attitude of School Teachers in Rural Areas of Punjab

Objective: The purpose of study was to explore the level of knowledge and attitude in handling dental trauma among primary school teachers working in rural areas of Punjab, Pakistan. Method: This descriptive crossectional study was conducted in 47 primary government schools of different rural areas of district Narowal, Punjab, Pakistan. Collected sample size was 215 primary school teachers with minimum qualification of Bachelors in Arts. Data was collected using convenient sampling technique. SPSS version 25.0 was used for analysis and further results formation. Frequencies and Percentages were calculated for gender and qualification whereas mean and standard deviation was calculated for age. Results: Majority of participants reported that their knowledge about dealing with dental emergencies is not adequate 175(81.40%). Majority of participants were interested in having workshops on dealing with dental emergencies in school 160(74.42%). Conclusion: The knowledge and attitude of teachers towards management of dental trauma is lacking and a dire need of awareness programs and teacher training workshops has been felt after conducting this study as management of dental trauma is an important part of student safety management. Keywords: Dental Trauma, Teachers, Tooth Replantation, Tooth Avulsion

Effect of Urea-molasses Multinutrient Block Supplementation on Productive and Reproductive Performance of Rural Buffalo Farms

Background: Buffaloes (Bubalus bubalis) have an immense importance in rural economy by virtue of their high production potential as triple purpose animal. Application of scientific technologies can further lead to significant productivity enhancement in buffaloes. Hence, the study was aimed to investigate adoption and effect of urea-molasses multinutrient block (UMMB) supplementation on buffalo productivity in rural areas of Punjab, India. Methods: An expost-facto research design was employed to collect data from selected buffalo farmers (N-501) through personal interview by using pretested research instrument. Based on the response, the buffalo farms were categorized as technology adopter farms (TAF) and non-adopter farms (TNAF). The effect of UMMB supplementation on productivity was evaluated by considering various productive and reproductive parameters of buffaloes. Both parametric and non-parametric statistical tests were employed to analyse the data by using SPSS software. Result: The results indicated that the buffalo farms (36.93%; 185/501) following an additional supplementation with UMMB had significantly (p less than 0.05) higher average daily milk yield per animal and lowered values of all reproductive parameters. This has proved the viability of UMMB technology at buffalo farms in study area. The study revealed that the technology plays valuable role in buffalo productivity enhancement, hence should be recommended to the government and propagated through vigorous activities at grass-root level to improve adoption.