Pakistan human resources for health assessment, 2009

Pakistan faces a human resources for health (HRH) crisis. A cross-sectional survey was conducted to overview frontline health workers. A total of 750 health facilities were surveyed across Pakistan. The median estimate of public sector health care workers in the district health system in Pakistan is 417 288, including 46 153 estimate of public sector health care workers in the district health system in Pakistan is 417 288, including 46 153 doctors and 41 032 nurses. Another estimated 20 000 doctors work in public sector tertiary care hospitals across the country. A total of 3549 health care workers were interviewed regarding job satisfaction and work environment. The private sector had better work environment scores compared with the public sector. Policy dimensions showed an absence of robust policies in practice. The public sector is inadequately staffed and job satisfaction and work environment need improvement. HRH crisis countries should share experiences, and developmental partners should support them in overcoming the HRH crisis

Prevalence of hepatitis B and C viral infections in Pakistan: Findings of a national survey appealing for effective prevention and control measures

A prevalence survey on hepatitis B and C infections was carried out to obtain national estimates and assess epidemiological dynamics and underlying risk factors. Overall prevalence of hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus (HCV) of 2.5% and 4.8%, respectively, reflected a combined infection rate of 7.6% in the general population, consistent with an ongoing high burden of chronic liver disease (CLD). There was significant association of these viral infections with a range of risk factors led by reuse of syringes. These findings validate currently implemented strategies by the national programme for the control of hepatitis viral infections, including universal vaccination of newborns and high-risk groups, support of auto-disable syringes, promotion of infection control and patient safety, public health education, and management of needy CLD patients as a poverty-reduction health intervention

Using models to inform policies to meet multiple objectives. Sustainable development, climate change mitigation and biodiversity conservation in Central Africa

Land-use change models can help in developing a holistic understanding of the range of potential impacts of different land-use related policy options, and so strengthen the development and implementation of policies to meet a range of objectives; including sustainable development, climate change mitigation, food security and biodiversity conservation. Member countries of the Central Africa Forest Commission (COMIFAC) have committed to sustainable management of the region’s forests, including under the COMIFAC “Convergence Plan”, and to achieving the Sustainable Development Goals (SDGs). Achieving these objectives is dependent on the development, and implementation, of new and existing national policies and approaches. Projections from land-use modelling identify potential trade-offs and synergies in the achievement of the SDGs under different macro-economic and land-use policy related scenarios. In particular they highlight the importance of effective protected areas and forest concessions for the conservation of Great Apes and other threatened species, and show that maintaining these areas has negligible impact on agricultural production in the region. As development continues in the region, further increasing the extent of protected areas could play a role in greatly reducing the number of species losing a large proportion of their habitat. However, protected area expansion needs to be well planned to avoid adverse impacts on particular species and societal challenges such as food security

Creating a National Specimen Referral System in Guinea: Lessons From Initial Development and Implementation

In the wake of the 2014–2016, West Africa Ebola virus disease (EVD) outbreak, the Government of Guinea recognized an opportunity to strengthen its national laboratory system, incorporating capacity and investments developed during the response. The Ministry of Health (MOH) identified creation of a holistic, safe, secure, and timely national specimen referral system as a priority for improved detection and confirmation of priority diseases, in line with national Integrated Disease Surveillance and Response guidelines. The project consisted of two parts, each led by different implementing partners working collaboratively together and with the Ministry of Health: the development and approval of a national specimen referral policy, and pilot implementation of a specimen referral system, modeled on the policy, in three prefectures. This paper describes the successful execution of the project, highlighting the opportunities and challenges of building sustainable health systems capacity during and after public health emergencies, and provides lessons learned for strengthening national capabilities for surveillance and disease diagnosis

Investigating socio-economic-demographic determinants of tobacco use in Rawalpindi, Pakistan

<p>Abstract</p> <p>Background</p> <p>To investigate the socio-economic and demographic determinants of tobacco use in Rawalpindi, Pakistan.</p> <p>Methods</p> <p>Cross sectional survey of households (population based) with 2018 respondent (1038 Rural; 980 Urban) was carried out in Rawalpindi (Pakistan) and included males and females 18–65 years of age. Main outcome measure was self reported daily tobacco use.</p> <p>Results</p> <p>Overall 16.5% of the study population (33% men and 4.7% women) used tobacco on a daily basis. Modes of tobacco use included cigarette smoking (68.5%), oral tobacco(13.5%), hukka (12%) and cigarette smoking plus oral tobacco (6%). Among those not using tobacco products, 56% were exposed to Environmental tobacco smoke.</p> <p>The adjusted odds ratio of tobacco use for rural residence compared to urban residence was 1.49 (95% CI 1.1 2.0, p value 0.01) and being male as compared to female 12.6 (8.8 18.0, p value 0.001). Illiteracy was significantly associated with tobacco use. Population attributable percentage of tobacco use increases steadily as the gap between no formal Education and level of education widens.</p> <p>Conclusion</p> <p>There was a positive association between tobacco use and rural area of residence, male gender and low education levels. Low education could be a proxy for low awareness and consumer information on tobacco products. As Public health practitioners we should inform the general public especially the illiterate about the adverse health consequences of tobacco use. Counter advertisement for tobacco use, through mass media particularly radio and television, emphasizing the harmful effects of tobacco on human health is very much needed.</p

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

BACKGROUND: Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. METHODS: We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. RESULTS: Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. CONCLUSION: This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field

Large-scale physical disabilities and their management in the aftermath of the 2005 earthquake in Pakistan ‫عام‬ ‫باكستان‬ ‫زلزال‬ ‫عواقب‬ ‫يف‬ ‫وتدبريها‬ ‫النطاق‬ ‫الواسعة‬ ‫العجز‬ ‫حاالت‬

ABSTRACT The October 2005 earthquake in Pakistan created a new generation of &quot;persons with disabilities&quot; (PWDs) in the affected districts. A total of 741 people suffered spinal injuries while 713 underwent amputations. A comprehensive response was launched jointly by the Ministry of Health, Earthquake Reconstruction and Rehabilitation Authority and the World Health Organization involving rescue and recovery, hospitalization, surgical interventions, building of infrastructure, development of technical guidelines to improve quality of care, human resource deployment and training. The first national megaproject for institutional and community-based rehabilitation (CBR) services was launched in the earthquake-affected areas. The institutional management of PWDs is now carried out alongside the CBR programme. This intervention also led to the concept of a national CBR programme. The study aims to identify the post-earthquake situation regarding the magnitude and type of physical disabilities and to highlight the rehabilitative interventions undertaken

S: Implementing the district health system in the framework of primary health care in Pakistan: can the evolving reforms enhance the pace towards the Millennium Development Goals? East Mediterr Health J 2010, 16Suppl:S132–S144. Submit your next manuscript

ABSTRACT There is growing renewed trust in primary health care as the best approach for ensuring equity in the delivery of essential health services. However, Pakistan with one of the most widely spread district health system networks in the region, has not delivered at the expected capacity. A series of health system reform agendas are now stipulated which include the promulgation of an essential health service package, public private partnerships and a people-centred focus. Nevertheless, success of these reforms will hinge on the ability of the three tiers of the government and other stakeholders to work together to improve the overall performance of the district health system. This paper provides an overview of the district health system infrastructure and organization of primary health care services in Pakistan, the evolving governance pattern and the operational significance and merit of health system pillars for effective service implementation

Statistical Characteristics Study of Human Blockage Effect in Future Indoor Millimeter and Sub-millimeter Wave Wireless Communications

The millimeter and sub-millimeter wave communication is a promising solution to future indoor multi-gigabit wireless communications because of its huge available bandwidth. One of the key difficulties is the human blockage effect since the human body can no longer be considered as being "transparent" as at lower frequencies. In this paper a study of statistical characteristics of this problem is presented. At first, broadband measurements of human blockage are provided. Afterwards, a realis- tic mobility model for indoor movements of humans is adopted and elliptic cylinders are applied to approximate human bodies in ray-launching simulations. Consequently, the distributions of Line-Of-Sight (LOS) path and blockage durations as well as blockage numbers are obtained by simulations. Finally, the system performance in presence of the distributed antennas is evaluated

Primary hepatitis A virus infection in developing countries: decline of maternal antibodies and time of infection.

In developing countries, HAV seems to be responsible for a widespread, inapparent and protective infection during early childhood. This report emphasizes early infection and its relationship to protection by passive immunity from maternal antibody in a highly endemic area such as Somalia. Our result show that HAV infection in Somalia primarily occurs during the first 4 years of life (4 months to 4 years). Cases are infrequent in the first 3 months due to passive immunity secondary to maternal antibody (cord-blood and colostrum anti-HAV). As the level of protection declines, the rate of acute infection rises as determined by the presence of IgM-specific anti-HAV