Rural Sindh Research Articles

A REVIEW OF EDUCATIONAL PROBLEMS IN RURAL AREAS OF SINDH WITH ROLE OF PRIVATE NGOs

Purpose: No country can fulfill its objectives without a well-educated labor force, and that is why education is such an important part of national growth and development. Education is a strong weapon for social transformation, but depriving it of fundamental necessities shows that it has failed. This study has been carried out just to know the education concerns of rural areas of Sindh with the important role of NGOs plays in a country's growth for the development of its citizens' moral, social, and cultural creativity. Methodology: The literature review has been done in the formation of this study while the approach taken in this literature review was motivated by the work of Suikkala and Leino-Kilpi (2001) and Evans (2002). The Google search engine and the Google Scholar database were used to discover articles and books published between January 1999 and January 2022. Only works first published in English were considered. Findings: Physical distance to school, teacher hiring in rural area, spotty internet access, poverty and non-entrepreneurial teachers are the challenges of the education system. Conclusion: Problems of education in rural areas exist not only in Pakistan but throughout the world while supporting role of private NGOs is the dire need of education system in rural Sindh

Dyslexia: emotional and psychological effects in relationship with the social behaviour of caretakers in Sindh, Pakistan

This qualitative study focuses on the socio-emotional and psychological aspects of children with learning disabilities starting from an early age. It includes the perception and behaviour of caretakers (parents and teachers). The paper contains first-hand information collected through semi-structured interviews of 12 parents who are also primary school teachers at a public school in Taluka Matli, rural Sindh, Pakistan. The study concludes that teachers’ knowledge regarding learning disabilities is minimal, and they lack professional training to deal with such students. It also provides evidence that teachers and parents practice corporal punishment, which ultimately affects the lives of children with learning disabilities. The study presents a case study of a child with learning disorders on his father’s account, which highlights other aspects of a learning disorder. This paper also focuses on the possible adverse effects of parental behaviour in Pakistani society concerning corporal punishment as social behaviour. It may help parents and teachers to identify the characteristics of learning disabilities like dyslexia or ADHD from a very early stage of childhood.

Role of Lacosamide in Diabetic Neuropathy: An Experience at Tertiary Care Hospital in Rural Sindh

Background: Lacosamide is a relatively newer drug for treatment of chronic diabetic painful neuropathy (CDPN). Objective: To analyse the effectiveness and safety of lacosamide in patients with diabetic neuropathy. Study Design: Randomized controlled clinical trial. Duration and Place of Study: This study was conducted at department of neurology, Khairpur Medical College, Khairpur Mir’s, during from the period Oct 2021 to March 2022. Methodology: Ninety-two patients of either gender, age 20-60 years, known case of diabetes mellitus for minimally 5 years having pain intensity in the range of 4-9 on 11-point (0–10) numerical rating scale & HbA1c value 6.1%-10% were included and assigned randomly (Lacosamide = 46 & Placebo = 46) after taking a valid informed/ written consent. Lacosamide 400 mg/ day was given upto 20 weeks which initially increased from baseline at rate of 100 mg per week. The primary outcome variable was changes from baseline in average pain scores. Results: The mean age of lacosamide group was 40.26±11.33 while in placebo group was 41.30±10.46 years. The mean Pretrial Pain Score measured on NRS of lacosamide group was 6.59±1.95 which decreased to 3.39±1.94 and in placebo group was 6.71±1.89 which decreased to 6.35±1.52 by the end of maintenance phase (20 weeks; p<0.0001). Adverse events (59%) of the patients experience adverse events at least for 1 time. Common side-effects included headache (11% vs. 31%), dizziness (09% vs. 11%), nausea (15% vs. 8%), and diarrhea (8% vs. 19%) with lacosamide and placebo group respectively each (p<0.0001). Conclusion: Lacosamide is a safe and effective drug and achieved in pain relief and may be prescribed as routine treatment of chronic diabetic painful neuropathy. Keywords: Diabetes mellitus, Pain, Chronic diabetic painful neuropathy, Lacosamide, Numerical rating scale

Assessment of knowledge and attitude of healthcare professionals regarding the use of telemedicine: A cross-sectional study from rural areas of Sindh, Pakistan.

Telemedicine has proved its significance in the healthcare system, especially during the coronavirus disease 2019 (COVID-19) pandemic as it assists in the provision of early and effective healthcare to those in distant areas. This study aimed to assess the knowledge and attitude of healthcare professionals toward the use of telemedicine in the rural areas of Sindh, Pakistan. The cross-sectional study was conducted with 212 healthcare professionals including physicians, consultants, surgeons, residents, dentists, and house officers working in public sector hospitals. The face-to-face method was used for data collection. Chi-square test and logistic regression analysis were applied to find the association between different variables and knowledge and practice of telemedicine using SPSS V 24. The knowledge of participants regarding the usability of telemedicine and various tools used for the provision of medical services (video consultations, conferencing, use of applications, software, and online groups) was good. A total of 52.2% of participants showed agreement when they were questioned about being aware of online healthcare service provision. In this study, 52.8% of the participants practiced telemedicine by delivering healthcare services through online consultations. The majority of the participants were surgeons (25.9%), residents (23.1%), and physicians (18.9%). The internet (42.4%) and public media (25.9%) were the major sources of information for telemedicine. A total of 70.5% of participants suggested that strategies and efforts should be directed toward the enhanced implementation of telemedicine. Training in telemedicine as a source of information [OR = 13.02 (95% CI = 3.9-43.6), p < 0.001)] and awareness regarding the effect of telemedicine in healthcare quality [OR = 10.25 (95% CI = 2.9-35.4), p < 0.001)] remained the predicting factors for the practice of telemedicine among healthcare workers using multivariate regression analysis. Telemedicine has technologically revolutionized the medical sciences worldwide. The awareness level and usage of telemedicine were good among healthcare professionals in rural Sindh. Telemedicine should be utilized to provide quality healthcare in underprivileged areas by investing in infrastructure and education.

Violence against health care workers in rural areas of Sindh, Pakistan.

To determine the magnitude of violence against healthcare workers in a rural setting, and the consequences of this violence on their personal and professional lives. The descriptive, quantitative, cross-sectional study was conducted in 4 rural districts of the Sindh province of Pakistan from February to December 2019, and comprised healthcare workers, including doctors, nurses, support staff and field workers. Data was collected using a structured questionnaire. Data was analysed using SPSS 22. Of the 1622 subjects, 929(57.3%) were males and 693(42.7%) were females. The overall mean age was 35.55+/-10.05 years. The largest cluster was that of doctors 396(24.4%), followed by technicians 202(12.5%). Overall, 522(32.2%) subjects had a professional experience of 1-5 years. Violence at workplace in any form was experienced by 693(42.7%) subjects. Verbal violence had been experienced by 396(24.4%) subjects, while 228(14.1%) had witnessed it. The corresponding numbers for physical violence were 122(7.5%) and 22(1.4%). Verbal violence was more prevalent compared to physical violence (p<0.01). The major effect was that the healthcare workers remained alert 537(33.1%), felt frustrated 524(32.3%) and disturbed 503(31%). Also, 272(16.8%) subjects were planning to migrate or quit the profession. Violence was found to be a significant issue in rural Sindh.

Addressing women’s climate change awareness in Sindh, Pakistan: an empirical study of rural and urban women

ABSTRACT Understanding climate change through knowledge and researching its level of awareness are critical for building resilience in vulnerable populations. Climate change comprehension is not a gender-neutral construct. The purpose of this paper is to investigate women’s perceptions of climate change in both rural and urban Sindh, Pakistan, as it is one of the ten most vulnerable countries to climate change. This study also looks into the sources of local women’s climate change awareness and knowledge. The study employed a mixed methodology approach, with 400 women from urban and rural areas polled for quantitative data and subject/field experts interviewed to validate the findings using informed opinion. According to the study’s findings, women in Sindh, Pakistan, are aware of climate change, but their sources of awareness are secondary, and their knowledge is based on personal experience. Therefore, the study recommends robust government initiatives to raise climate change awareness among women across the country.

Occurrence of Seropositivity of Toxoplasma gondii, Cytomegalovirus, and Rubella Infections in Pregnant Women

Aim: To assess the seropositivity for Toxoplasma gondii, Rubella virus, and Cytomegalovirus among pregnant females in Hyderabad, Sindh, Pakistan Methodology: A prospective study was undertaken at the Department of Gynecology and Obstetrics, Bahria University of Health Sciences, Karachi, Pakistan between March 2020 to June 2021. All women with confirmed pregnancies were eligible to participate in the study. Women with ectopic pregnancy or women who were not receiving prenatal care at our center were excluded. All participants underwent assessment for antibody Titres for Toxoplasmosis, Rubella, and CMV. Blood specimens of participating women were obtained in aseptic conditions for laboratory investigations. The IgM and IgG antibodies for Toxoplasma gondii, Rubella, and CMV along with IgG antibodies for CMV and Toxoplasma gondii were assessed comprehensively. Seropositivity was stratified with respect to age groups. Results: A total of 336 women with a mean age of 26.88 ± 3.77 years were included. The rate of seropositivity for anti-Toxoplasma IgM, anti-Rubella IgM, and anti-CMV IgM was 1.2%, 0.6%, and 2.7%, consecutively. A total of four (1.2%) cases were positive for anti-Toxoplasma IgM. 126(37.5%) women were positive for Anti-Toxoplasma IgG. For the three positive cases of both IgM and IgG, avidity test showed high avidity. Overall, one case for toxoplasma gondii was detected. Two women were positive for anti-Rubella IgM only (positive cases). Overall, 291 (86.6%) individuals were positive for Rubella IgG. Overall, two cases of Rubella were detected in our study. All nine positive cases of anti-CMV IgM antibodies were also positive for anti-CMV IgG. For these nine cases, anti-CMV IgG avidity was reported which turned out to be intermediary or high. Overall, we did not detect a case of CMV in our study. Conclusion: We found high levels of IgG antibodies for Rubella and CMV, indicating past infection/immunity. The present study highlighted the seroprevalence rate of Toxoplasma gondii, CMV, and Rubella in a cohort of pregnant women from Sindh. However, this rate could be under-reported as many women do not avail of antenatal services during pregnancy, especially from rural Sindh, Pakistan. Nevertheless, this study adds to the current literature. Furthermore, it is recommended to regularly screen pregnant females for these infections. Keywords: Cytomegalovirus, rubella, seroprevalence, torch infections, toxoplasma gondii

The Perception, Understanding and Incidence of Pedophilia, The Reasons of its Prevalence, The Problems and the Consequences of this Social Crime in Rural Sindh: A Sociological Analysis

The objective of the study was to find out and determine the types of child sexual abuse, temptations used by the abusers to seduce the victim, the impact of child sexual abuse on the victims, and the impact of child sexual abuse on the family of the victims. The study was conducted using mixed methods i.e. Qualitative and Quantitative. This was a six months study. The qualitative study was conducted first. Based on the findings of the qualitative study Quantitative study was done through a field survey. For the qualitative study police officials and Casualty Medical Officers (CMO) were interviewed in depth. For quantitative research Parents of victims or the victims themselves with the consent of their parents were interviewed. Qualitative data was analyzed using the Theme, subtheme, and remarks while the quantitative data were analyzed using SPSS (26 versions) and Excel software applications. Most of the children appeared to be innocent and the minor children considered the act vulgar and indecent. The more grown-up ones considered it unethical and were having some guilt. Similar feelings were shared by the parents about the child. Society is very much aware of crime but they are more sensitive to girls than boys. To some extent, they are ignorant too and that is the reason crime is increasing. They became frightened, depressed, lonely, and aloof. The parents became depressed and also suspicious of the social environment. They became secretive in their talk and behavior. Abusers tempted the victims with sex stories, jokes pornographic materials (photos and videos), and by showing their sex organs.

Are school leaders working as instructional leaders? Exploration of school leadership practices in rural Pakistan

School Leadership is widely acknowledged as a prime determiner of school improvement. Among the various leadership models, Instructional Leadership (IL) is considered as having greater impact upon the school, teachers, and student achievement. Consequently, an increasing attention has been paid to IL across the globe. However, we lack any empirical evidence regarding how IL unfolds in rural contexts characterized by many challenges. Hence, this research explores IL practices in a secondary school in rural Sindh, Pakistan. Data are collected from school leaders and teachers through focused group and semi-structured interviews, observations of leadership practices and document analysis. The findings of the study revealed that school leaders played restricted role as instructional leaders (ILs). Their priorities were more administrative and managerial related tasks rather than student achievement, teachers’ professional development (PD) and creating learning culture as suggested in educational literature. The outcomes of this research provoke thoughts in relation to school leadership in the developing world especially in rural contexts having significant implications for policy makers, educational reformers and school leaders.

Analysing Gendered Otherness of Women in Rural Sindh Through The Selected Fictional Stories

This study is based on the textual analysis of the short stories; The Wedding of Sundri (2008) and Pirani (2006). The study applies the theory of Gendered Otherness by Simon de Beauvoir. This theory highlights women`s position as others, partial and secondary to men. There is no existence of women without the association of men, while, man is the dominant, powerful and decision maker. He takes all decisions of women’s lives. It is in fact the man who makes the life of woman meaningful and purposeful. The findings of the research correspond to the theory that in rural Sindh women are suffering from gendered otherness. They are partial and secondary to men. Women cannot take the decisions of their lives’ as that of Sundri and Pirani. The marital decision of Sundri and Pirani is decided by their fathers without their consent. Women tolerate the violence of men at their home just like Naseema. Due to gendered otherness women are suppressed and marginalized. They never develop the habit of self-expression like Sebhagi and her sister. Women never built self- recognition and identity within the society.

Inter-regional socioeconomic disparity levels within rural Sindh

The purpose of this study is to investigate the existence of socioeconomic disparity levels in rural Sindh. Determining the reasons behind such disparity is not the scope of this research. Previous studies reflected that compared to lower Sindh, upper Sindh has performed better as per socioeconomic indicators such as health and literacy rate, the Multidimensional Poverty Index (MPI) calculated shows no such pattern on a closer look. Even though the MPI values for upper Sindh district are lower in comparison to lower Sindh, the intensity of poverty in upper Sindh is extreme. Pakistan Social and Living Standard Measurement (PSLM) household survey questionnaire was used to calculate the MPI of various districts selected through a stratified sampling technique. The results show the MPI values for districts in lower Sindh reflect a greater incidence of poverty compared to upper Sindh. However, the intensity of deprivation in upper Sindh is higher. For instance, the MPI value recorded for Qambar, an upper Sindh district was 0.091 and the intensity of poverty recorded was 0.67.

Triad of minimal antenatal care, pre-eclampsia and dementia in rural women: A deep insight and call for awareness.

Pre-eclampsia, a prominent gestational hypertensive disorder, affects around 2-8% of pregnancies and is the dominating cause of late- life maternal morbidities worldwide. Frequent signs of this disorder such as proteinuria, hypertension, and thrombocytopenia, are detected by physicians during the routine antenatal checkups of expectant women. Pre-eclampsia, if left untreated, delineates with complications like central nervous system dysfunction, microangiopathies, thromboembolism, and cerebrovascular accidents in later life of women.[1] Vascular dementia is noticed as one of the late-life complications in women with a history of preeclampsia. Two cohort analyses disclosed a significantly increased risk of vascular dementia in later life of women with a history of preeclampsia. [2,3] Incidence of vascular dementia was noticed as being thrice more common in these women when compared to the non-pre-eclamptic ones. [2] Like all over the world, high percentage of pre-eclampsia cases are also rampant in the rural areas of Pakistan. An analysis from Sukkar, rural Sindh, Pakistan, showed that Preeclampsia and eclampsia cases in a tertiary care hospital accounted for 112 (5.56%) of total 2012 deliveries. Out of these cases, 6.45% were unbooked, depicting the negligence of antenatal care, and 5.8% were found linked to low education levels. [4] The extensive urban-rural gap in the utilization of antenatal care can be determined by the fact that according to reports, 70% of women in the lower quantile of South Asia undergo labor at home in comparison 40% of them deliver without any professional assistance. In Southeast Asia, only 17.7% of lower area women were recorded to use public maternity facilities.[5] A survey from Interior Sindh of Pakistan reported that most rural women have no access to maternity centres within 10km of their living. The authors further stated that the rural residents believed that medical interventions could pose a threat to pregnancy so they preferred untrained midwives over proper maternity centre visits, which could be one of the prime reasons for undiagnosed gestational disorders in these women.[6] Lack of antenatal care utilization could be due to paucity of awareness amongst rural women or the dearth of maternity centres in such underdeveloped areas. Together these factors presented as the key attributes to vascular dementia favouring pre-eclampsia. In rural areas, where barriers to healthcare services and socioeconomic inequality already prevail, this untended rise is a red flag situation. Respective Governments should channel efforts in expanding the accessible maternity setups in these poorly facilitated areas. --Continue

Factors associated with home delivery in rural Sindh, Pakistan: results from the global network birth registry

BackgroundAccording to global estimates for 2017, nearly 295,000 maternal deaths occurred worldwide. Thus, approximately 810 women die every day due to pregnancy-related complications. This burden of maternal deaths in LMICs is primarily due to poor healthcare service utilization, as indicated by relatively low rates of institutional deliveries and skilled-birth attendance (SBA). We conducted this study with an aim to assess the factors associated with home delivery and its subsequent effect on the pregnancy outcome in rural Sindh, Pakistan.MethodsData for this study were taken from The Global Network’s Maternal Newborn Health Registry (MNHR), which is a prospective, population-based observational cohort study. Registry data for 2018–2019 for District Thatta, Pakistan was retrieved for the analysis. Multivariable logistic regression models were used to determine the effect of each independent variable on the place of delivery by including all predictors and covariates. Results of the regression analyses are presented with crude odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals (CIs).ResultsA total of 4649 women were included in the study, of these, 1286 (27.7%) women had delivered at home. Of those who delivered at home, a larger proportion was illiterate (90%), had a BMI of less than 18.5 kg/m2 (26.0%), had parity of 3 or more (48.1%), and had a history of pregnancy loss as compared to women who had institutional delivery. In addition, two-thirds of women (63.4%) who had delivered at home had less than 4 ANC visits, whereas 15.6% did not receive any ANC. On multivariable logistic regression we found that home delivery was significantly associated with being illiterate (aOR = 1.60; [95% CI: 1.34, 2.04]), having high parity (aOR = 1.91; [95% CI: 1.58, 2.32]), and no ANC visit (aOR = 14.8; [95% CI: 10.2, 21.5]).ConclusionsMore than a quarter of our study sample women delivered at home. These women were illiterate, multiparous, and did not receive antenatal care during pregnancy. It is essential to conduct extensive educational interventions for the women and their family members regarding the potential benefits of delivering in a safe and skilled environment. Moreover, the provision of comprehensive and quality antenatal care should be ensured as it improves the mothers' health-seeking behavior and helps them make informed decisions about their health and well-being.

Frequency of Intestinal Parasitic Infestation among Children from Tertiary Care Center in Rural Sindh

Aims: To determine the frequency of parasitic infestation among children in our setup.&#x0D; Study Design: Observational study&#x0D; Place and Duration of Study: This study was conducted at the department of Pediatric Medicine and Department of Pathology, Suleman Roshan Medical College and Hospital, Tando Adam, Pakistan from 17th October 2020 to 30th May 2021.&#x0D; Methods: A total of 2412 consecutive patients aged between 5 to 12 years, who attended the outpatient department for the complain of abdominal pain, diarrhea or dysentery, the clinically anemic cases, patients having history of occult blood (black stools) were included in the study. The demographic and clinical details of all the cases were collected on a structured proforma designed for the study. All the patients were investigated for stool examination. The patients already having negative stool report for parasite were excluded from the study. Microscopic examination of the fecal smear in normal saline was performed for the detection of any helminth or protozoal infection. The data collected was statistically analyzed and the results were tabulated.&#x0D; Results: 1316 (54.6%) samples were found positive for helminth or protozoal infection, and 1490 parasites were detected from a total of 2412 stool specimens collected and analyzed. Majority of the children were female 1344 (55.7%). The highest parasitosis (70.3%) was more common among 9-10 years age group. Abdominal pain was the main presenting complaint. The Entamoeba histolytica was most common protozoa in both male and female (24.6%), while helminthic infection like Ascaris lumbricoides was most common parasite detected in 47.2% of samples but more prevalent in male cases.&#x0D; Conclusion: The present study reveals a high frequency of parasitosis in our setup. Entamoeba histolytica was the commonest protozoa and Ascaris lumbricoides was the most frequent helminthic infection, abdominal pain being the main presenting complaint.

English

Pakistan is an agriculture based economy and the main economic activity in Sindh province is farming, which is a capital intensive business. For diversified and efficient agricultural production, agricultural investment is important. Despite the importance of the modern technological practices, most farmers are still practicing subsistence agriculture. The lack of capital is the one of the major constraints in increasing investment in farming. The main focus of this article is to examine rice farmer’s investment and the income under credit constraints in rural Sindh, Pakistan. For this research an endogenous switching regression model was employed to conclude the problem of selection bias and endogeneity of credit constraints. In order to achieve the results from visible and invisible factors average treatment effect was utilized. The results revealed that more than half of farmers (65.0 percent) from the total sample are hampered by supply-side (34.0 percent) and demand-side (31.0 percent) credit constraints. Importantly, the results have significant implications that agricultural investment and income can be increased up to 7.3 and 5.1 percent, if there are no credit constraints. Therefore, it is suggested that investment in agriculture can be increased if there is no or minimized credit constraints, which can ultimately increase the farmers’ income in the country

Socio-Economic Impact of the Interest-Free Community Investment Fund: A Case Study of Rural Sindh, Pakistan

This study aims to measure the impact of an intervention, the Community Investment Fund (CIF), on the socio-economic life of rural women. CIF is a community-managed fund aimed at improving the living standards of women by empowering them to undertake income-generating projects to become financially more stable and self-governed in the Khairpur, Shikarpur, Kandhkot-Kashmore and Jacobabad districts of Sindh, Pakistan. This study used a quasi-experimental design approach that involved two groups, i.e., the treatment group (beneficiaries) and control group (non-beneficiaries). The sample size of this study was 708 respondents including the treatment and control group. The results of comparison of mean indicate that there is a significant difference between treatment and control group in terms of socio-demographic variables (including monthly income and consumption, saving amount, total asset value, an asset purchased value and household diet) and women empowerment’s indicators, thereby suggesting that CIF has resulted in women empowerment. Concerning the results of the poverty scorecard, the higher graduation of beneficiaries (treatment group) asserts that the intervention of CIF has also a positive impact on targeted beneficiaries. In particular, the findings indicate that 72% of beneficiaries (treatment group) have graduated from one poverty band to another higher band compared to 59.4% of non-beneficiaries (control group) in poverty score. In addition, the findings of the logistic regression analysis confirmed that participation in the CIF program empowers women beneficiaries. This study will support policymakers to further improve CIF so that it can become more effective and sustainable.

Effect of a Youth Led Early Childhood Care and Education Programme on Children's Development and Learning: A Stepped-Wedge Cluster-Randomised Implementation Trial in Rural Sindh, Pakistan

Effect of a Youth Led Early Childhood Care and Education Programme on Children's Development and Learning: A Stepped-Wedge Cluster-Randomised Implementation Trial in Rural Sindh, Pakistan

“Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

“Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

Food Taboos and Cultural Beliefs among Pregnant Mothers in Rural Sindh

Food Taboos and Cultural Beliefs among Pregnant Mothers in Rural Sindh