Relationship of Family Members’ Support with Practice of Community Midwives in Rural Sindh, Pakistan

Background: Pakistan has one of the highest maternal mortality rates in the world. Community Midwives (CMWs) were introduced in 2006 as a new cadre of birth attendants who would bring midwifery services to rural areas by being based in designated communities. The CMWs face many obstacles and retaining them in practice is a challenge. This study aimed to examine whether there was a relationship between family support and CMWs retention in midwifery practice. We hoped to learn about influences on retention that might improve the Maternal Newborn and Child Health (MNCH) programme. Methods: This was a cross-sectional survey conducted in five districts of rural Sindh, a province in Pakistan. A list of all CMWs who graduated between 2007 and 2012 was obtained from the MNCH programme Sindh. The CMWs were tracked by MCHIP (Maternal Child Health Integrated Program) clinical supervisors posted in the respective districts to gather information about families’ support of CMWs. Findings: Of the 148 CMWs in the MNCH list, 112 (76%) were tracked. Of 112, 44 (39%) CMWs were in active practice while 69 (61%) had completed their training but had not started a practice. Of the 44 practising CMWs, 82% had family members who worked in a health-related field or previously were traditional birth attendants (TBAs). Only 18% of those who established a practice had a family without this profile. Conclusion: These preliminary findings indicate a strong relationship between family engagement in health care work and the capacity of CMWs to establish a midwifery practice. A further comparative analysis of practising and non-practising CMWs is warranted

Low-Cost National Media-Based Surveillance System for Public Health Events, Bangladesh.

We assessed a media-based public health surveillance system in Bangladesh during 2010-2011. The system is a highly effective, low-cost, locally appropriate, and sustainable outbreak detection tool that could be used in other low-income, resource-poor settings to meet the capacity for surveillance outlined in the International Health Regulations 2005

Recursive temporal meta-cluster of daily time series

xi, 134 leaves : ill. (some col.) ; 29 cm.Includes abstract.Includes bibliographical references (leaves 125-134).Identifying pattern groups from large temporal data sets, preserving clustering schemes obtained from different heuristic algorithms and presenting temporal pattern profiles for a specific day and previous days are significant concerns in many fields. As clustering schemes created by different heuristic algorithms may not completely agree with each other, researchers have proposed different clustering ensemble techniques to combine such schemes. In the first phase, this research proposes a rough set based ensemble method that preserves the inherent order in clustering. In the second phase, the Recursive Meta-cluster algorithm is used to create meta-profiles having current volatility with historical perspective for the financial daily temporal pattern clusters, which a trader may use while making decisions. Traditionally, any information of the historical or future clustering is not considered for temporal clustering. The proposed algorithm clusters the temporal patterns iteratively using previous clustering results from connected historical patterns

Implementation of graphic health warnings in Bangladesh - current status and challenges

Background Graphic Health Warning (GHW) in 50% of all tobacco packets/packages has been implemented from 19 March 2016 following the tobacco control (TC) law that amendment in 2013 and rules notified in 2015. But, there are many small and large tobacco industries bypass and ignore the TC law in different ways. The study was conducted to identify and show the current GHW implementation and challenges in Bangladesh and the sample collection period of the study was January 2017 to April 2017. Methods Out of 64, survey was conducted in 25 Districts and both qualitative and quantitative techniques, semi structured questionnaire and observational methods used to conduct the study. GHWs in all types of tobacco products were observed. 3 retail shops and 3 wholesale shops selected from each district. A research team was developed and organized a workshop regarding tobacco control law and GHW implementation for effectiveness and quality of the study and Excel software was used to analyze the data. Results Total 5234 tobacco products was investigated, 1757 smoking tobacco (1497 Cigarette packets and 260 Bidi packets) and 3477 smokeless tobacco (3263 different packs of Jarda and 214 Gul). Study found that, 34% Bidi, 25% Jarda and 15% Gul in market without GHW. 64% bidi, 75% Jarda, 85% Gul provide GHWs, but among these, 50% bidi, 45% jarda and 30% gul doesn't follow law. It shows that, excluding cigarettes packets, bidi and smokeless tobacco vastly ignore about GHWs section of law. Absence of manufacturing date and different size/forms of smokeless tobacco and bidi packets, it is very difficult to measure GHWs implementation on all tobacco products. Conclusions Its necessary to ensure uniform packets for smokeless tobacco and bidi with date of manufacture and monitoring for effective implementation of GHW provisions in Bangladesh

Assess compliance to existing Tobacco Control Law among task force (TF) committee members across 10 districts in Bangladesh

Background Bangladesh is the first signatory countries of WHO FCTC. Bangladesh signed on 16 June 2003 and ratified on 14 June 2004. The government of Bangladesh has taken several initiatives to reduce tobacco use. Bangladesh government has enacted tobacco control law in 2005 and amended in 2013 along with notification of the revised rules in 2015. Methods Cross sectional study design, quantitative and qualitative approaches, purposive sampling method and semi-structured questionnaire and oral interview used to conduct the survey. The objectives of the study was to assess the knowledge and attitudes of Task Force (TF) regarding Tobacco Control (TC) Law. SPSS 21, Microsoft Excel used to analysis the data. Results 85 % staff know about TC law among the visited office and still now people smoke into the office area in 25 % offices. But 83 % office display No Smoking Signage. In terms of Task Force (TF) committee meeting, 67% TF members said that district TF meeting hold regularly. In terms of enforcement of tobacco control law, 85% respondents argue that mobile court conduct regularly but 57% said that they have lack of logistic support for conducting mobile court. Very interesting is that 59% TF members do not know about FCTC article 5.3, which is known as safeguard for tobacco control. Conclusions It can be said that a noticeable change have been seen on tobacco control issues. But tobacco companies are still trying to increase their sales among the young as potential customer by different illegal promotional campaign. So that awareness building programs should be conducted, logistic support should be delivered and social pressure should be created as people can be aware of their strategy and can able to protect it. So, government should take initiative immediately to implement the graphic health warning on all tobacco products to protect people as well as society

Implementation of Distributed Generation with Solar Plants in a 132 kV Grid Station at Layyah Using ETAP

Decentralized power generation efficaciously merges technological advances in a rapidly changing face of power networks introducing new power system components, advanced control, renewable sources, elegant communication, and web technology paving the way for the so called smart grids. Distributed generation technology lies at the intersection point of power systems, power electronics, control engineering, renewable energy, and communication systems which are not mutually exclusive subjects. Key features of renewable integration in a distribution network include loss minimization, voltage stability, power quality improvement, and low-cost consumption resulting from abundant natural resources such as solar or wind energy. In this research work, a case study has been carried out at a 132 kV grid station of Layyah, Pakistan, which has active losses, reactive losses, low power factor, low voltage on the demand side, and overloaded transformers and distribution lines. As a result, power outage issue is frequent on the consumer side. To overcome this issue, a simulation of load flow of this system is performed using the Newton-Raphson method due to its less computational time, fewer iterations, fast convergence, and independence from slack bus selection. It finds the harsh condition in which there were 23 overloaded transformers, 38 overloaded distribution lines, poor voltage profile, and low power factor at the demand side. There is a deficit of 24 MW in the whole system along with 4.58 MW active and 12.30 MVAR reactive power losses. To remove power deficiency, distributed generation using solar plants is introduced to an 11 kV distribution system with a total of 24 units with each unit having a capacity of 1 MW. Consequently, active and reactive power losses are reduced to 0.548 MW and 0.834 MVAR, respectively. Furthermore, the voltage profile improves, the power factor enhances, and the line losses reduce to a great extent. Finally, overloaded transformers and distribution lines also return to normal working conditions