Involvement of Community in Health Systems Management: An Experience from Sindh, Province of Pakistan

Summary The community is the ultimate barometer of success or failure of an intervention. Involvement of community members in health care programmes, decision?making, evaluation and implementation is a major means for achieving the necessary fit between the programme and its beneficiaries. The World Bank?funded Family Health Project was launched in Sindh Province of Pakistan, in 1992. It aims to strengthen the existing health system and improve the health status of the population. To achieve sustainable results, FHP focused on engaging community participation. Village Health Committees were formed at Basic Health Unit and Rural Health Centre levels under an Area Focus Approach. Village Health Committee members were trained to understand the basic concept of FHP, be able to identify factors which affect the health of the community, and suggest local methods for combating these problems. The Village Health Committee's main objective was to ensure community participation, improve utilisation of outreach health services, improve accountability of the service providers through community involvement, and decentralisation of power at the community level. This article reflects on the experience of the FHP in implementing these objectives

A Socio Religious Analysis of Suicides and its Impact on Economic Development

The aim of this paper is to gaining deeper insight into the reasons and consequences of condemned suicidal act from the socio-religious point of view and its impact on the economic development of a society. The condemned act of suicide and problems relating to it, keeping in view the available facts and figures is analysed in view of social and religious beliefs in the known religions of the world. Suicide is a serious public social problem. It is one of the important problems. Different reports on the causes and consequences of suicide have presented an extremely grim picture. It has threatened the life itself. The people resorted to suicides in huge numbers since last decade. Accordingly, the problem of suicide and other related matters may be viewed in terms of the role performance failure of the social & religious systems concerned and the social entities in their environment. Analogously, the problem may be interpreted in terms of the mal-functions of relationships based role on the reciprocity of expectations amongst the interacting social systems.Suicidal, Economics, Socio-religious, Beliefs, Rituals, problems, Reasons, Consequences, Role-Performance, Interaction.

Women's rights in the light of Islam

Before Islam, women lived a life of total oppression. They had no rights. They were looked down upon. The Arabs themselves used to treat women badly. Women were also deprived of their basic rights. Woman was considered a bad thing. It was considered ominous. Men had the right to choose the best things for themselves and set aside the worst kind of things for women. Prior to Islam, the polytheists of Arabia used to bury their daughter alive as soon as they were born for fear of maintaining their honor and dignity and not bowing down to anyone. Women were treated worse than animals and they had no respect whatsoever. There were rituals in the name of marriage which made woman a useless thing. The woman did not have any kind of honor, chastity or respect. Islam has given women a dignified life. Islam gave respect to women in society, gave them their true identity, gave them their rights, gave them equal respect and dignity and gave them equal status with men. Islam has removed the curse of perpetual curse on women and made them sacred. This article deals with the pre-Islamic status of women and the respect and dignity that Islam has given them

An Investigation into the Role of Local Government in Enhancing the Public Participation in Sindh, Pakistan: Policy and Practice in Service Delivery

It is generally recognised that the primary role of the decentralise local governance is to establish closer relationship between rural communities and the governing authorities in local development. In Pakistan, the system of local governments has always been introduced by the non-democratic forces. The decentralised governments have often been discontinued by the civilian governments of Pakistan. This study has sought to examine the role of the decentralised local governance in initiating the local community participation in local development in the province of Sindh, Pakistan. This thesis responds the questions about the initiatives taken by the local government authorities and the genuine local community participation in local community development programs. It further explores the main barriers to local public participation in the local policy making and implementation in Sindh. The findings suggest that the challenges to participation have been ever increasing. The military establishment’s hold on the central state policies has weakened the public empowering national laws. Furthermore, the local government’s role to initiate meaningful local community involvement in development projects of the decentralised local governance has been engrossed by the hold of feudal lords, corruption, favouritism, and the attitude of indifference on the part of provincial and national governments. Thus, it is argued that, in such dominant military state and feudal lords’ system, there is no positive link between the local government reforms and the democratic participation in the local decision-making. Based on these findings, a realistic model for participation is introduced and relevant implications are considered

Karo Kari : the murder of honour in Sindh Pakistan : an ethnographic study

This paper aims to discuss the wider context, in which honour murders occur, the social structures which contribute to the occurrence and perpetuation of the practice of honour murders. An ethnographic fieldwork was conducted in Jacobabad Sindh, Pakistan. The study found that honour murders were not solely driven by customs and traditions, but also by a feudal culture, male-dominated social structures, the complicit role of state institutions and law enforcement agencies and a web of vested interests. Therefore, honour murders may be prevented by reducing the influence and interference of feudal lords on state institutions, in particular law enforcement agencies, and by promoting education that challenges a patriarchal and feudal mind-set in the community

Laparoscopic-assisted percutaneous endoscopic gastrostomy tube insertion in the immediate post-partum period for head and neck cancer

Abstract Percutaneous endoscopic gastrostomy (PEG) tube placement serves as a well-tolerated and efficacious technique for long-term enteral access in patients with medical conditions precluding oral food intake. The nutritional optimisation of patients with oral cancer is mostly achieved via PEG tube placement. However, certain special situations, such as pregnancy and the immediatepost-partum period, may render the placement of PEG tubes to be a challenge. A 28-year-old pregnant female patient presented to us with the diagnosis of squamous cell carcinoma of the tongue during her third trimester. Definitive surgical resection was planned post-delivery along with simultaneous PEG tube placement. Immediately following delivery via an elective Caesarean section, she successfully underwent laparoscopic-assisted PEG tube placement. A gravid uterus or an immediately post-partum distended uterus poses significant difficulties whilst attempting PEG insertion. However, laparoscopic-assisted PEG insertion in a controlled setting may make the process safer to perform

Discovery of Remarkable New Ant Species of the Genus Pseudolasius Emery (Hymenoptera: Formicidae) From Western Ghats of India

Pseudolasius zamrood sp. n., is described based upon the worker and the sexual caste. The new species marks the first record of the genus from South India and represents only the seventh species of the genus to be reported from India. The species appears distinct with its extremely reduced eyes. The new species is closest to P. typhlos Wheeler, 1912 from Philippines. However the new species has truncated anterior clypeal margin at the middle lobe, scapes relatively short and propodeum has relatively narrow dorsum in lateral vie

EUS-FNA for the Diagnosis of Retroperitoneal Primitive Neuroectodermal Tumor

Primitive neuroectodermal tumor (PNET) is a rare “small round blue cell tumor” that is diagnosed by open biopsy or percutaneous biopsy of the lesion under radiologic guidance. In this case report, we present a novel approach to the diagnosis of a retroperitoneal PNET by endoscopic ultrasound- (EUS-) guided fine needle aspiration (FNA). A 35-year-old man presented with the history of left-sided flank pain and swelling of 3-weeks duration. Computerized tomography (CT) scan of his abdomen revealed a 12.8 × 13 × 12.5 cm cystic and solid mass arising from the retroperitoneum and displacing the third and fourth portions of the duodenum. He underwent EUS which revealed a well-circumscribed heterogeneous mass abutting the inferior portion of the stomach. EUS-FNA of the mass revealed malignant cells consistent with primitive neuroectodermal tumor (PNET)/Ewing's sarcoma. EUS-guided FNA is an appropriate technique for diagnosing retroperitoneal PNET/Ewing's sarcoma

THE ETHICAL ANALYSIS OF ADAPTATION OF RANDOMIZED CONTROLLED TRIAL APPROACH IN THE FIELD OF IMPACT EVALUATION FOR HUMANITARIAN PROJECTS

Conducting and communicating research is a responsible intellectual job. A researcher would go analysing immense literature and would search for valid evidence. Prior to narrating an authentic statement. Correspondingly while selecting a method for study it is vital to opt for an approach that is ethically suitable in a defined context. While applied on a set of a populace, generally denoted to as a sample and/or universe. Therefore, social research would be a more laborious task. Hence, the social context is ever-changing in terms of time and space. Diverse methods of social research are being invented yearly. To compete with consistently changing social phenomena and needs of evidence. Operational research, evaluation, and screen monitoring are the most prominent approaches of modern social research. Hence, these naïve approaches of social research would undergo learning and adaptation. Community development projects and retrospective studies thereof are also being synthesized, with existing methods of social research. An identical practice is an adaptation of the Randomized Controlled Trial hereinafter (RCT) approach to conduct impact evaluations of humanitarian and development projects. Hitherto, RCT was being widely used by health researchers as a clinical research approach. Hence, an adaptation of this clinical research approach for field studies, particularly for the evaluation of humanitarian projects. Those are being implemented to provide survival support to vulnerable communities. It would require this approach to undergo some ethical adaptations. This research paper is developed to commence a wider literary discourse on requisite ethical adaptations for RCT to use in the evaluation of humanitarian projects. This research paper brings the findings from desk and field. To discuss key questions; where and how we can use RCT, and what ethical adaptations are necessary not to be forgone? This discourse is established on the usefulness of RCT, ethics of social research, ethics of evaluation, and humanitarian principles. The overarching purpose of this research paper is to facilitate the adaptation of RCT in the field of impact evaluation. While considering the ethical principles of the development sector and evaluation. Article visualizations

Attitudes of Foreign Language Teaching Assistants Towards Teaching of English in Pakistani Context

This study aims to examine the attitudes of Foreign Language Teaching Assistants towards the teaching of English in the context of Pakistan. Its importance lies in the fact that it will make the teachers aware of uniquely effective teaching methods. Almost all stakeholders may get benefits from it. The research utilized interview tools. Semi-structured interviews were discussed among the respondents. The results show that the Pakistani teacher assistants view English favorably. They consider it absolutely necessary for employment purpose and professional development. Therefore, they opt for positive attitudes towards teaching English language along with culture in ELT Classrooms. The results also showed that Teaching Assistants after coming back from training, continue to celebrate the value of their own culture too. In the end, the research suggests measures necessary to formulate effective language teaching policies. Keywords: Attitudes, English Language, Teaching Assistants, Pakistan. DOI: 10.7176/JLLL/78-03 Publication date: April 30th 202