Impact of Health Education on Mothers' Knowledge of Preventive Health Practices

A prospective community-based intervention study was conducted in a slum area of Karachi, Pakistan, with the objective of evaluating the impact of health education on the knowledge of mothers. One hundred and fifty households were studied in the intervention and the same in the non-intervention group. The post intervention knowledge scores of the mothers showed a significant difference of P &lt; 0.05. Nearly 50.7% mothers in the intervention group knew of at least four diseases against which vaccination is given as compared to the non-intervention group ( P &lt; 0.05). Similarly, mothers in the intervention group were more aware about the advantages of breast feeding, signs of dehydration, measures for prevention of measles and tuberculosis as compared to the non-intervention group ( P &lt; 0.05). Finally, a comparison was made between the pre- and post-intervention scores between the two groups. The score in the non-intervention group changed from 11.5 to 16.1 ( P &gt; 0.05) as compared to the intervention group in which it changed from 10.2 to 32.2 ( P &lt; 0.05). </jats:p

Practice of Modern Methods of Family Planning in Two Urban Slums of Karachi and Effect of Counselling

Abstract BACKGROUNDThe means and services used for prevention of pregnancies is referred as Family Planning (FP) (1). The successful implementation of Family Planning has remained a difficult task in Pakistan because of socio-cultural beliefs, lack of information or misinformation and lack of access to contraceptive services. Cultural taboos and social bonds related to women are major factors in the low uptake of FP services (2). METHODOLOGThis study is the analysis of retrospective secondary data from an NGO, HELP’s Family Planning clinics, to determine the trends and patterns of contraceptive methods used in two squatter settlements(Neelam Colony and KKB) in Karachi from 2010-2018. The data originated from Mother and Child centers of HELP. Records of the monthly data collected by CHWs from their catchments areas were obtained and it was cumulated annually. Variables studied included number of women of childbearing age (CBA), number of married women of childbearing age, information about number of family planning users, number of babies born. The data also included different types of FP methods used by married couples. For analysis, the data was entered in Microsoft Excel and then exported to SPSS version 19. Mean and percentages, graphs and other graphics for all the variables were calculated and created through SPSS 19 and Excel.RESULTSThe Mean number of FP users were 43% in Neelum Colony and 48% at KKB. Similar data was reported in PDHS 2017-18 that 34% of married women in Pakistan were opting for methods of family planning (3). Use of Condoms was the most commonly used method of family planning in Neelum Colony and in KKB, recorded as being 36%, and 41% users respectively. The FP2020 reports that there are 34% condom users in Pakistan (4). Our study also found that that that the increase in use of FP was influenced by increased reminders and nudging techniques during counselling by CHWs. CONCLUSIONSTo progressively increase the practice of couples using modern FP methods, it is crucial that repeated messages giving correct scientific information regarding FP methods be given frequently. Acceptance of using FP has to be developed primarily in the male counterpart and therefore, male social mobilisers should form part of a team.</jats:p

Determinants of inappropriate timing of introducing solid, semi-solid or soft food to infants in Pakistan : secondary data analysis of Demographic and Health Survey 2006-2007

Inappropriate timing of introducing complementary food deprives the infant of optimum nutrition, leading to undernutrition, and increased mortality and morbidity. The aim of this analysis was to identify determinants of inappropriate timing of introduction of solid, semi-solid and soft foods in Pakistan. Data on 941 infants 3.00 to 8.99 months were obtained from the Pakistan Demographic and Health Survey 2006-2007. The prevalence of introduction of foods among infants aged 3.00-5.99 months and 6.00-8.99 months was examined against a set of individual, household and community level variables using univariate analysis. Adjusted odds ratio (AOR) for early introduction in age 3.00-5.99 months and non-introduction in 6.00-8.99 months of age were calculated using backward stepwise logistic regression models. The prevalence of early introduction of complementary foods among 3.00- to 5.99-month-old and timely introduction among 6.00- to 8.99-month-old infants were 10.6% and 39.2%, respectively. Multivariate analyses revealed that mothers who had four or more antenatal clinic visits (AOR=2.68) and who lived in the provinces of Sindh (AOR=2.89) and Baluchistan (AOR=6.75) were more likely to introduce complementary foods early. Mothers from middle-level households (AOR=7.82), poorer households (AOR=4.84) and poorest households (AOR=5.72) were significantly more likely to delay introduction of complementary foods. In conclusion more than half (60.8%) of Pakistani infants do not receive complementary foods at recommended time. Public health interventions to improve the timing of introduction of complementary food are needed at national level with special focus on high risk groups

Determinants of suboptimal breast-feeding practices in Pakistan

Objective: Exclusive breast-feeding is estimated to reduce infant mortality in low-income countries by up to 13 %. The aim of the present study was to determine the risk factors associated with suboptimal breast-feeding practices in Pakistan. Design: A cross-sectional study using data extracted from the multistage cluster sample survey of the Pakistan Demographic and Health Survey 2006-2007. Setting: A nationally representative sample of households. Subjects: Last-born alive children aged 0-23 months (total weighted sample size 3103). Results: The prevalences of timely initiation of breast-feeding, bottle-feeding in children aged 0-23 months, exclusive breast-feeding and predominant breast-feeding in infants aged 0-5 months were 27•3 %, 32•1 %, 37•1 % and 18•7 %, respectively. Multivariate analysis indicated that working mothers (OR = 1•48, 95 % CI 1•16, 1•87; P = 0•001) and mothers who delivered by Caesarean section (OR = 1•95, 95 % CI 1•30, 2•90; P = 0•001) had significantly higher odds for no timely initiation of breast-feeding. Mothers from North West Frontier Province were significantly less likely (OR = 0•37, 95 % CI 0•23, 0•59; P < 0•001) not to breast-feed their babies exclusively. Mothers delivered by traditional birth attendants had significantly higher odds to predominantly breast-feed their babies (OR = 1•96, 95 % CI 1•18, 3•24; P = 0•009). The odds of being bottle-fed was significantly higher in infants whose mothers had four or more antenatal clinic visits (OR = 1•93, 95 % CI 1•46, 2•55; P < 0•001) and belonged to the richest wealth quintile (OR = 2•41, 95 % CI 1•62, 3•58; P < 0•001). Conclusions: The majority of Pakistani mothers have suboptimal breast-feeding practices. To gain the full benefits of breast-feeding for child health and nutrition, there is an urgent need to develop interventions to improve the rates of exclusive breast-feeding

Comparisons of complementary feeding indicators and associated factors in children aged 6-23 months across five South Asian countries

Improving infant and young child feeding practices will help South Asian countries achieve the Millennium Development Goal of reducing child mortality. This paper aims to compare key indicators of complementary feeding and their determinants in children aged 6-23 months across five South Asian countries - Bangladesh, India, Nepal, Pakistan and Sri Lanka. The latest Demographic and Health Survey and National Family Health Survey India data were used. The analyses were confined to last-born children aged 6-23 months - 1728 in Bangladesh, 15028 in India, 1428 in Nepal, 2106 in Sri Lanka and 443 infants aged 6-8 months in Pakistan. Introduction of solid, semi-solid or soft foods, minimum dietary diversity, minimum meal frequency and minimum acceptable diet, and their significant determinants were compared across the countries. Minimum dietary diversity among children aged 6-23 months ranged from 15% in India to 71% in Sri Lanka, with Nepal (34%) and Bangladesh (42%) in between. Minimum acceptable diet among breastfed children was 9% in India, 32% in Nepal, 40% in Bangladesh and 68% in Sri Lanka. The most consistent determinants of inappropriate complementary feeding practices across all countries were the lack of maternal education and lower household wealth. Limited exposure to media, inadequate antenatal care and lack of post-natal contacts by health workers were among predictors of inappropriate feeding. Overall, complementary feeding practices among children aged 6-23 months need improvement in all South Asian countries. More intensive interventions are necessary targeting the groups with sup-optimal practices, while programmes that cover entire populations are being continued

Introduction : the South Asia Infant Feeding Research Network (SAIFRN)

The South Asia Infant Feeding Research Network (SAIFRN) was established in 2007 to foster and coordinate a research partnership among South Asian and international research groups interested in infant and young child feeding. SAIFRN has brought together a mix of researchers and program managers from Bangladesh, India, Nepal, Pakistan, and Sri Lanka together with international partners from Australia. As the first activity, SAIFRN conducted a series of analyses using Demographic and Health Surveys of Bangladesh, Nepal, and Sri Lanka and the National Family Health Survey of India. The results highlight that most indicators of infant and young child feeding in these four countries have not reached the targeted levels. The rates vary considerably by country, and the factors associated with poor feeding practices were not always consistent across countries. Driven by the ultimate goal of improved child survival in the region, SAIFRN wishes to expand its partnerships with governmental and nongovernmental organizations that share common interests both within and outside the South Asia region. In the future, SAIFRN hopes to provide more opportunities to researchers in the region to improve their skills by participating in capacity-building programs in collaboration with international partner institutions, and looks forward to liaising with potential donors to support such activities