Prevalence and characteristics of stress among bereaved parents after the death of their under-five children in the urban slums of Karachi, Pakistan

Introduction to understand the prevalence of stress and identifying the prevalence of different differentials of stress among bereaved parents of died under-five children is of utmost importance. This paper is based on the data from Karachi VASA under-five mortality study. The cases of this study are bereaved parents of deceased under-five children belonging to randomly selected 12 slums of Karachi city

Methodology a total of 321 parents excluded out form enrolment in VASA study were undergone stress assessment using Sadaf Stress Scale [SSS]. It was found that 100% of them were truly stressed in one form or the other and the distribution is equally affecting all the slums [with slight variations]. Females were found highly stressed [72%] than males [28%]. The most prevalent types of stress identified were emotional [67%], traumatic [17.2%] and mental stress [7%]. Out of all the stressed parents, a high proportion belongs to highest severity. The highest prevalence of the severity of traumatic stress shows that the large proportion of stressed parents has gone to Post-Traumatic Stress Disorder [PTSD], especially among mothers

Conclusion the results are quiet disturbing. The data shows that there is a high prevalence of traumatic, physical and emotional stress among bereaved parents [especially mothers] of deceased children. The prevalence of traumatic stress and its severity shows that a high proportion of stressed parents have gone to PTSD, which again have a huge impact on the overall mental health of the affected and the close family members

verbal/social autopsy [VASA] child mortality inquiry to investigate under-five mortality determinants in slums of Karachi, Pakistan: a mix methods interventional study

Background Pakistan stands along top ten countries responsible for two-third of global child mortality burden. To improve Child Mortality [CM] estimates in Pakistan, there is an exigent need to understand the in-depth reasoning behind mortalities. In Pakistan, the data on cause-of-death [CoD] for a large number of child mortalities in Pakistan is either not available or not suitable for use. Pakistan uses an alternative technique called Verbal autopsy [VA]. Since VA only determines the biological cause of death [BCoD], and does not capture multitude of other modifiable social, cultural and health system determinants, it has a limited importance. Such non-biological determinants are captured by another technique i.e. Social Autopsy [SA]

Objective by integrating VA with SA, extended set of mortality related determinants will be explored, in addition to strengthening death notification coverage and assigning CoD in such missed out mortalities

Method under the working group of Health Advocacy Council for Women and Children [HACWC] in collaboration with Child Registry of Pakistan [CROP], mixed method [QUAN-QUAL] interventional study will be carried out in urban-slums of Karachi city using VASA-integrated under-five mortality investigative technique. Parents of dead children will be interviewed. Second stage of study will be followed by qualitative interviews with different cadres of stakeholders

Expected Outcomes by focusing the specific determinants related to case-management and care-seeking process [identified by The Pathway to Survival Framework-TPtoSF] an in-depth understanding of related determinants can be achieved, which will help in crafting potential interventions required to limit the barriers that increase the chances of CM in developing nations