Effect of lipid-based nutrient supplement - medium quantity on reduction of stunting in children 6-23 Months of age in Sindh, Pakistan: A cluster randomized controlled trial (OR25-06-19)

Objectives: We evaluated the effectiveness of a locally produced lipid-based nutrient supplement - medium-quantity (LNS-MQ) known as Wawamum to prevent stunting in children 6–23 months of age in Thatta and Sujawal districts of Sindh province, Pakistan. Methods: A cluster randomized controlled trial was conducted and a total of 870 children between 6–18 months old were enrolled. Children in the intervention group received 50 grams/day of Wawamum for 6 months, while children in the control group received standard government health services, not including Wawamum. The primary outcome was stunting risk reduction among children 6–23 months of age. Results: Children who received Wawamum were found to have a significantly reduced risk of stunting (RR = 0.91, 95% CI; 0.88– 0.94, P \u3c 0.001) and wasting (RR = 0.78, 95% CI; 0.67–0.92, p0.004) as compared to children who received the standard government health services. A non-significant impact was observed on underweight (RR = 0.94, 95% CI; 0.85–1.04, p-0.241) in the intervention group compared to the control group. Statistically significant reduction in anaemia in the intervention group was also found as compared to the control group (RR = 0.97, 95% CI; 0.94–0.99, p-0.008). The reduction in risk of severe anaemia was even more evident (RR = 0.45, 95% CI; 0.28–0.99, p-0.002) in the intervention group than in the control group. The mean compliance of Wawamum was 60.3% among children. Conclusions: The study confirmed the plausibility of achieving nutrition gains in the short-term with a locally produced LNS-MQ, known as Wawamum, through the primary health care system. The risk of stunting and wasting was reduced by 9% and 22%, respectively. The statistically significant reduction in risk of stunting, wasting and anaemia among children 6–23 months of age showed that an immediate improvement in these nutrition indicators is indeed possible. This approach can be scaled up in similar settings to achieve positive outcomes for nutrition and health. Funding Sources: World Health Organization

Role of Human Resources Management in the Effectiveness of Business Process Reengineering

The main idea of the paper to presents a model with the discussion of Human resources management role with line extent of Management competency, team working, effective communication, IT and Organizational structure and there impact on the effectiveness of Business Process Reengineering. The article suggest that the use of HRM with the implementation of the BPR find the better results and support the organizational better performance Keywords: human Resources Management, business process Reengineering, Organizational performanc

The role of TQM and BPR in executing quality improvement: a comparative study

In order to sustain a competitive edge in this global manufacturing era, enterprises need to adopt appropriate improvement schemes. This article examines a detailed study of quality improvement tools mostly used in the organizations. As this is the conceptual paper, the paper focuses on two important quality improvement techniques, BPR (Business Process Reengineering) and TQM (Total quality management). Both the approaches clinch the same thoughts and objectives for organizational enhancement but the difference lies in terms of means used by each technique, the risk, time frame and the magnitude of change expected from each of these programs. In order to attain this comparison, the article first defines and explains each of the approaches for the in depth understanding of the difference as well as similarities between these two. The articles (related to the comparison of these two improvement tools) of almost last 15 years are gathered and studied in detail and then conclusion is drawn based on the findings of different previous articles. The methodology used primarily is literature review as well as the case study method also helps in gathering the data. The study concludes that even though both the approaches intend to enhance organizational competence, they are relatively different both theoretically as well as practically and each of the approach is suitable for different situation depending upon the needs and requirements of the organization. Keywords: Competitive edge, TQM, BP

Economics of Wheat Production in Mohmand Agency, Khyber Pakhtunkhwa, Pakistan

The central theme of this research endeavour was to compute the cost and net returns of wheat crop. This study has also highlighted the significant variables contributing in wheat productivity. The study universe was two focused villages namely Malok-Korona and Peer-Qila of Ekaghund Tehsil, Mohmand Agency. The proportional allocation sampling technique was used to get the required sample size of 70 respondents. However, 26 respondents from Malok-Korona and 44 respondents from Peer-Qila were interviewed through face to face interview technique. The marked findings of this study divulge that vast majority of the farmers (61.43%) were using certified seed and the study area was predominantly dependent upon rainfall as reported by 60 % of the respondents. It is further revealed that the mean cost of production incurred by the sampled growers was estimated as Rs. 30,000 per acre. Income trend observed by 70 per cent of the respondent through wheat crop was found Rs.40000 per acre. The average income of farmers through wheat crop was Rs.35286 per acre. The estimated results of regression analysis corroborate the expected sign of the majority of coefficient of explanatory variables. Among explanatory variables seed, irrigation and labor days were significant while urea and FYM were found insignificant for crop yield. The study recommends that attempts for awareness, supply of loans, inputs like fertilizer, pesticide, apt agriculture approaches, demonstration plots and training programs should be made available to farmers for higher wheat production in Mohmand Agency

DESIGN AND OPERATION OF MICROGRID

The need for new generation systems has motivated the development of microgrids. This new concept may provide significant benefits such as losses compensation, achieving high degree of efficiency and reliability to the transmission and distribution networks. This novel idea provides more advantages about Microgrids like general structure and different topologies. Also an original methodology for facilitating its design is proposed. Finally Simulink model of Microgrid is designed and then analyzed.Â

Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? evidence from Pakistan.

BACKGROUND: The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. METHODS: An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. RESULTS: Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. CONCLUSION: Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in quality of services. However, contracting out of health facilities is insufficient to increase service access across the catchment in remote rural contexts and requires accompanying measures for demand enhancement, transportation access, and targeting of the more disadvantaged clientele