Availability and affordability of essential medicines: Exploring the health seeking behaviours and health service utilisation for children under-5 years living in squatter settlement of Karachi, Pakistan

Background: Child health outcomes in the poor communities are largely affected by the non-availability of essential medicines at government health facilities and non-affordability of prescribed medicines at private retail pharmacies. This phenomenon largely defines health seeking behaviours and health service utilisation patterns of the families of the children.Methods: Using observational visits, we examined the shelf-availability of medicines for children less than 5 years of age at a rural health centre and conducted focus group discussions with the mothers to explore the effects of non-availability and non-affordability of medicines. We also validated all information by interviewing the health care providers of the area.Results: We found that erratic and insufficient supply of essential medicines at the government health facility and a limited purchasing power to buy medicines from a retail pharmacy, led to considerable \u27financial burden\u27 on the poor people, non-compliance with the treatment, health care seeking from informal health providers and healer shopping. This trend has a serious repercussion on the health seeking behaviours and of course the health outcomes, especially among children.Conclusion: On the users\u27 side, health education and health promotion campaign must be instituted to explain the adverse effects on child health ensure appropriate health care seeking behaviours. For the supply side, the health care authorities must ensure the availability of essential medicines for the children at the government facilities. Local community representatives must be involved in the matters related to medicines stock management at the facility

Unveiling and addressing implementation barriers to routine immunization in the peri-urban slums of Karachi, Pakistan: A mixed-methods study

Background: Great disparities in immunization coverage exist in Pakistan between urban and rural areas. However, coverage estimates for large peri-urban slums in Sindh are largely unknown and implementation challenges remain unexplored. This study explores key supply- and demand-side immunization barriers in peri-urban slums, as well as strategies to address them. It also assesses immunization coverage in the target slums.Methods: Conducted in four peri-urban slums in Karachi, this mixed-methods study consists of a baseline cross-sectional coverage survey of a representative sample of 840 caregivers of children aged 12-23 months, and 155 in-depth interviews (IDIs) through purposive sampling of respondents (caregivers, community influencers and immunization staff). After identifying the barriers, a further six IDIs were then conducted with immunization policy-makers and policy influencers to determine strategies to address these barriers, resulting in the development of an original validated implementation framework for immunization in peri-urban slums. A thematic analysis approach was applied to qualitative data.Results: The survey revealed 49% of children were fully vaccinated, 43% were partially vaccinated and 8% were unvaccinated. Demand-side immunization barriers included household barriers, lack of knowledge and awareness, misconceptions and fears regarding vaccines and social and religious barriers. Supply-side barriers included underperformance of staff, inefficient utilization of funds, unreliable immunization and household data and interference of polio campaigns with immunization. The implementation framework\u27s policy recommendations to address these barriers include: (1) improved human resource management; (2) staff training on counselling; (3) re-allocation of funds towards incentives, outreach, salaries and infrastructure; (4) a digital platform integrating birth registry and vaccination tracking systems for monitoring and reporting by frontline staff; (5) use of digital platform for immunization targets and generating dose reminders; and (6) mutual sharing of resources and data between the immunization, Lady Health Worker and polio programmes for improved coverage.Conclusions: The implementation framework is underpinned by the study of uncharted immunization barriers in complex peri-urban slums, and can be used by implementers in Pakistan and other developing countries to improve immunization programmes in limited-resource settings, with possible application at a larger scale. In particular, a digital platform integrating vaccination tracking and birth registry data can be expanded for nationwide use

Empirical Study of Consumer Ethics: A Comparative Study of Two Firms of Faisalabad, Pakistan

Ethics are very important factor in today business. We have conducted this study to identify consumer ethics and their buying behavior in Particular two Organizations of Faisalabad, to study the consumer ethics we used four different dimensions. The purpose of this paper to find the situation in which consumer behaves unethically in Pakistan. And the result compares with previous consumer ethics researches. It is an exploratory research for the purpose of seeing the consumer ethics. The study shows that different consumers behave differently in term of ethical point of view. Our study shows that customers similar in terms of Machiavellian ism they display. Limitation in this paper is that the study was conducted only in Faisalabad. Another problem is that time; willingness and mood of the customers also affect the responses. This is an exploratory research and the results are not claimed to be generalized. So the further research should be made on social and political problems which affect the ethical behaviours and try to generalize the results

Empirical Study of Consumer Ethics: A Comparative Study of Two Firms of Faisalabad, Pakistan

Ethics are very important factor in today business. We have conducted this study to identify consumer ethics and their buying behavior in Particular two Organizations of Faisalabad, to study the consumer ethics we used four different dimensions. The purpose of this paper to find the situation in which consumer behaves unethically in Pakistan. And the result compares with previous consumer ethics researches. It is an exploratory research for the purpose of seeing the consumer ethics. The study shows that different consumers behave differently in term of ethical point of view. Our study shows that customers similar in terms of Machiavellian ism they display. Limitation in this paper is that the study was conducted only in Faisalabad. Another problem is that time; willingness and mood of the customers also affect the responses. This is an exploratory research and the results are not claimed to be generalized. So the further research should be made on social and political problems which affect the ethical behaviours and try to generalize the results

Design and Fabrication of Small Vertical-Take-Off-Landing Unmanned Aerial Vehicle

Modern UAVs available in the market have well-developed to cater to the countless field of application. UAVs have their own limitations in terms of flight range and manoeuvrability. The traditional fixed-wing UAVs can fly for long distance but require runways or wide-open spaces for take-off and landing. On the other hand, the more trending multirotor UAVs are extremely manoeuvrable but cannot be used for long-distance flights because of their slower speeds and relatively higher consumption of energy. This study proposed the implementation of hybrid VTOL UAV which has the manoeuvring advantage of a multirotor UAV while having the ability to travel fast to reach a further distance. The design methodology and fabrication method are discussed extensively which would be followed by a number of flight tests to prove the concept. The proposed UAV would be equipped with quadcopter motors and a horizontal thrust motor for vertical and horizontal flight modes respectively

Predictors and outcome of tetanus in newborns in slum areas of Karachi city: A case control study

Background: Tetanus in newborns, is an under-reported public health problem and a major cause of mortality in developing countries. This study aimed to determine the predictors and outcome of tetanus in newborn infants in the slums of Bin-Qasim town, Karachi, Pakistan.Methods: We conducted a case-control study at primary health care centers of slums of Bin-Qasim town, area located adjacent to Bin Qasim seaport in Karachi, from January 2003 to December 2013. Cases were infants aged ≤30 days with tetanus, as defined by the World Health Organization. Controls were newborn infants aged ≤30 days without Tetanus, who were referred for a checkup or minor illnesses. The case to control ratio was 1:2.Results: We analyzed 26 cases and 52 controls. The case fatality was 70.8%. We identified four independent predictors of Tetanus in newborns: maternal education (only religious education with no formal education OR 51.95; 95% CI 3.69-731), maternal non-vaccination (OR 24.55; 95% CI 1.01-131.77), lack of a skilled birth attendant (OR 44.00; 95% CI 2.30-840.99), and delivery at home (OR 11.54; 95% CI 1.01-131.77).Conclusions: We identified several potentially modifiable socio-demographic risk factors for Tetanus in newborns, including maternal education and immunization status, birth site, and lack of a skilled birth attendant. Prioritization of these risk factors could be useful for planning preventive and cost-effective measures

Impact of Service quality on customer satisfaction: a study of hotel industry of Faisalabad, Pakistan

The main purpose of this paper is to evaluate the hotels’ service quality through customer satisfaction. Theory tells us that if the customers are satisfied then the hotels are providing higher service quality. And also check that which dimensions of SERVPREF is need to be focused more in Pakistan. For this purpose SERVPERF tool was adopted and administrative to customers who stayed in the hotels of Faisalabad, Pakistan. The results indicates that in Pakistan among the five dimensions of SERFPERF the dimension tangible and empathy needed to be focused more

Impact of Service quality on customer satisfaction: a study of hotel industry of Faisalabad, Pakistan

The main purpose of this paper is to evaluate the hotels’ service quality through customer satisfaction. Theory tells us that if the customers are satisfied then the hotels are providing higher service quality. And also check that which dimensions of SERVPREF is need to be focused more in Pakistan. For this purpose SERVPERF tool was adopted and administrative to customers who stayed in the hotels of Faisalabad, Pakistan. The results indicates that in Pakistan among the five dimensions of SERFPERF the dimension tangible and empathy needed to be focused more