Knowledge, attitude, and practices of front line health workers after receiving a COVID-19 vaccine: a cross-sectional study in Pakistan.

Background: Globally, there is an increased risk of COVID-19 infection among front-line health workers (FHW). This study aimed to evaluate the knowledge, attitude, and practices of FHW of Pakistan after receiving the COVID-19 vaccine. Methods: A population web-based survey on COVID-19 vaccine was conducted on 635 FHW in Pakistan between April 15, 2021, and July 15, 2021. The survey focused on four main sections consisting of socio-demographic data, knowledge, attitude, and practices after receiving the COVID-19 vaccine. The data was analyzed on SPSS. p < 0.05 was considered significant. Results: Overall, 60% of FHW were nervous before getting vaccinated, with the leading reason to get vaccinated being their concern to protect themselves and their community (53.4%). A majority of FHW had fear about the unseen side effects of the COVID-19 vaccine (59.7%) used in Pakistan, with the most common side effect reported as soreness at the injection site (39%). It has been noted that almost all of the FHW observed preventive practices after getting vaccinated. The results showed that married respondents had favorable practices towards COVID-19 vaccines (B = 0.53, p < 0.01) (B, unstandardized regression coefficient). It was also found that more informational sources (B = 0.19, p < 0.01), higher knowledge of vaccination (B = 0.15, p < 0.001), and favorable attitude toward vaccine (B = 0.12, p < 0.001) significantly predicted favorable practices toward COVID-19 vaccination. Conclusion: The findings reflect that FHW, though they were worried about its side effects, have good knowledge and a positive attitude after getting the COVID-19 vaccine. This study is significant as the FHWs are a symbol for guidance, a reliable source of information, and an encouraging means of receiving COVID-19 vaccine for the general public. This study also reported that post-vaccination side effects were mild which will aid in reducing the vaccine hesitancy among the general Pakistani population.

Health Problems & Barriers to Healthcare Services for the Transgender Community in Lahore, Pakistan.

OBJECTIVES: To find out the major health problems and barriers in getting health care by transgender community in Lahore, Pakistan. METHODS: An analytical cross-sectional study was conducted in transgender community of Lahore from January to October 2020. The study included 214 participants from different areas of Lahore by targeting their "gurus". Non-probability, snow-ball sampling technique was used to collect required sample size. Data was collected by using a structured questionnaire. Data were analyzed using SPSS version 23. Results were generated in form of tables and graphs. Chi square test and Fischer's exact test were used to find out associations between health seeking behavior with their transgender status and p value was fixed as ≤ 0.05 as significant. RESULTS: Among total 214, 78.5% were transgender females and 21.5% were transgender male. Among the common health problems were depression (56%), anxiety (59%) and genital tract ulcers (45%). About 70% transgender seek health care from government hospitals. Among total 214 participants, 70% reported that they receive poor quality of health care. The main reasons of not getting proper care is non acceptance (20.7%), feeling ashamed (28.7%), non-availability of CNIC (44.5%) and un-affordability (6.1%). Significant association of transgender female with consultation with doctors (p=0.013), seeking care at government hospitals (p =0.038) poor experience at health care facility (0.050), neglect during medical treatment (p=0.015) and feeling of discrimination during treatment (p= 0.042). CONCLUSION: Transgender community face physical, mental, social and reproductive health issues. About 70% trans-genders receive poor quality of health care services. Non acceptance, feeling ashamed, non-availability of CNIC and non-affordability have been reported as major barriers in getting desired health care.

Corona pandemic: awareness of health care providers in Pakistan.

INTRODUCTION: Corona pandemic has resulted in a high mortality rate among health care professionals. The purpose of this study was to assess the knowledge and practices of health care providers during this pandemic in Punjab, Pakistan. METHODS: A web based cross sectional survey was conducted during 2nd of April to 20th April 2020 targeting health care professionals working in Punjab, Pakistan. A sample of 540 participants was collected using non probability, convenient sampling technique. Data was generated by using on line google forms after taking IRB approval from institution. RESULTS: Adequate knowledge was found among health care providers regarding diagnostic tests, modes of transmission, incubation period and preventive strategies. Significant association was seen in knowledge of post graduate and MBBS doctors (Bachelor of Medicine and Bachelor of Surgery) regarding viral etiology (p = 0.006), sign and symptoms (p = 0.000), risk factors (p = 0.000) and mortality rates (p = 0.001). Hand washing was considered as best preventive measure by 95% of the health care providers. CONCLUSION: Post graduate doctors have better knowledge regarding corona virus disease transmission, risk factors, incubation period and preventive strategies as compared to undergraduate doctors.

Stunting and associated factors in children of less than five years: A hospital-based study.

OBJECTIVES: To estimate frequency of stunting and associated factors in children aged less than five years in a tertiary care hospital of Lahore. METHODS: An Analytical cross-sectional study was conducted in Pediatrics Outpatient Department at Akhtar Saeed Trust Teaching Hospital, Lahore from December 2017 to July 2018. Two hundred children of ages under five years coming to outdoor for treatment of minor ailments were included after informed consent from their parents. Non-probability, convenient sampling technique was used to collect sample. Data collected and analyzed on SPSS version 19. To find out association of stunting with multiple qualitative variables, chi-square test was applied and p-value was fixed at ≤ 0.05 to be significant. RESULTS: Out of 200 children screened in OPD, 42 (21.0%) were found to be stunted. The total percentage of stunting in male children was 28 (66.6%) and in female children were 14 (33.3%). Stunting was significantly associate with male gender (p=0.047), joint family system (p=0.049), low literacy level in mothers (p=0.031), unvaccinated status (p=0.003) and history of bottle feeding (p=0.037). CONCLUSION: The frequency of stunting in children less than five years of age is 42 (21.0%). The significant risk factors associated with stunting were found as male gender (p= 0.047), joint family system (p=0.049), low maternal education (p=0.031), unvaccinated status(p=0.03).

Knowledge about the importance of antenatal care among females of child bearing age living in a suburban community of Lahore.

BACKGROUND AND OBJECTIVES: During the past few decades, females had been making conscious decision to have antenatal checkup from skilled health care provider due to improved education which had played a vital role to enhance their awareness regarding the importance of this comprehensive health service. The objective was to find out the perception of females of child bearing age about the importance of antenatal care during their last pregnancy, living in a suburban community of Kot-Lakhodare Lahore. METHODS: Females of reproductive age (15-49 years) living in Kot-Lakhodare were enrolled. Through a structured questionnaire, using convenient sampling technique, 1224 females of childbearing were interviewed through a cross sectional survey. The study was completed between January till August 2016. Question pertaining to their sociodemographic characteristics, perception about the importance of antenatal care services and comorbid conditions during the last pregnancy were asked. Data was analyzed by using SPSS version 21. The ethical approval both institutional and individual were duly taken. RESULTS: Mean age was 32 ±7.8SD years with education up to primary. Three quarter of females were un- employed with monthly income less than rupees 25,000 / month. All females 869(73%) who had perception about importance of antenatal checkup during their last pregnancy had no history of anemia, hypertension, diabetes and abortion (p<0.05). These females coming for the antenatal checkup delivered uneventfully by normal vaginal route and preferred government and private hospital for delivery and were vaccinated against Tetanus Toxoid (p<0.05). CONCLUSION: The females of child bearing age during the last pregnancy had adequate knowledge about the importance of antenatal care which played an important role in prevention of comorbid conditions like anemia, hypertension, diabetes and risk of abortion. Moreover, they had the perception of importance of institutionalized deliveries, tetanus Toxoid vaccination coverage during pregnancy.

Impact Of An Educational Intervention On Knowledge Of Health Care Professionals Regarding Hiv-Aids In Lahore, Pakistan.

BACKGROUND: The Acquired Immunodeficiency Syndrome (AIDS) is a disease associated with stigmatization and discrimination worldwide. Even the health care professionals show negative attitude towards these patients. Worldwide need of health education is felt to address the gap in knowledge and attitude of health care professionals while dealing with patients suffering from this disease. METHODS: It was an educational interventional study, conducted in Fatima Memorial College of Medicine and Dentistry in 2015. The sample was collected through Non-Probability purposive technique, targeting both male and female health care professionals interested in attending health education sessions on HIV-AIDS. A self-administered questionnaire was used to assess the knowledge of thirty participants for pre- and post- intervention. RESULTS: The study participants included public health professionals (50%), dentists (16.7%) and clinical professionals (33.3%). A significant difference was observed in knowledge of health care professionals after intervention considering the important reasons as deteriorating moral value (p=0.045) for HIV epidemic in Pakistan, prevalence status of HIV/AIDS (p=0.046), awareness about the free voluntary counselling and testing (VCT) centres /services (p=0.019), interaction with an HIV positive person (p=0.01), discriminatory attitudes due to family member (p=0.032) and availability of services for people living with HIV in Pakistan (p=0.02). CONCLUSIONS: Health educational intervention is a powerful tool for increasing awareness of health care professionals.

Sociodemographic determinants associated with parental knowledge of screening services for thalassemia major in Lahore.

OBJECTIVE: To assess the sociodemographic factors affecting parental knowledge regarding availability of screening services for thalassemia major. METHODS: A cross sectional study was conducted among biological parents of thalassemic children at three registered centers of blood transfusion in Lahore. A sample of 186 parents was selected through systematic random sampling. A pretested questionnaire was used to collect data. IRB clearance was obtained and informed consent was taken before data collection. Data was analyzed at SPSS version 23 and chi square test was applied and p value was fixed at ≤ 0.05 as significant. RESULTS: Parents of registered thalassemic children have adequate knowledge about Disease transmission and screening services. 91% of the participants knew that thalassemia major gets transmitted through parents. Cousin marriage was mentioned as a source of transmission by 77% of the participants. 91% of the parents knew about prenatal screening and 89% about premarital screening. Knowledge of parents was significantly associated with male gender, higher education and income. CONCLUSION: Male gender, higher education and income are associated with better knowledge of parents.

Needs Assessment For Establishing Faculty Development Program In A Private Medical College At Lahore.

BACKGROUND: Needs assessment helps in situation analysis and setting priorities for establishing a faculty development program to ensure quality improvement in education. The objective of this study was to identify areas for faculty development in order to incorporate them in continuing medical education program. METHODS: It was a cross sectional survey conducted from 2014 to 2015 in Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A non-probability consecutive sampling technique was used to include 195 faculty members from Medical & Dental College of all cadres. Data was collected through a self-administered questionnaire & analysed using SPSS 20. Chi square was applied and p-value of ≤0.05 was considered to be significant.. RESULTS: Out of 194 participants, 133 belonged to clinical departments and 61 to basic Sciences, with a higher proportion of female faculty members. (p=0.025). Importance of DME was recognized by 97% clinical and 95.1% basic science faculty. Faculty development program was considered essential by 69.1% of the clinical faculty & 30.9% of the basic faculty. (p=0.185). The priority areas identified were educational psychology (p=0.030), teaching skills (p=0.341), assessment techniques (p=0.296), educational research (p=0.849), management skills (p=0.797), work-based ethics & conduction of meeting. (p=0.01 & p=0.003). About 71.25% of the clinical teachers and 28.8% of the basic subject teachers have never attended any medical education program (p=0.001). The area of highest motivation was teaching (p=0.002), research (p=0.052), patient care (p=0.001) and administration (p=0.870). CONCLUSIONS: This survey reinforces the need of an effective faculty development program targeting training in teaching methodologies and assessment tools.

Pattern of addiction and its relapse among habitual drug abusers in Lahore, Pakistan.

This study assessed the pattern of drug abuse and the reasons for relapse of addiction among male drug addicts seeking rehabilitative services in different centres in Lahore, Pakistan. A cross-sectional survey was conducted on male drug abusers from April to December 2016. Nonprobability purposive sampling was done to collect a sample of 119 participants. A structured questionnaire and in-depth interviews were used for data collection. Out of 119 participants, 71.4% were in the age group 15-35 years. Educational levels were low in the majority, with 68.1% below secondary education. Unmarried (51.3%) and unemployed (44.5%) participants were at the greatest risk of using drugs. The age of addiction in 45% of patients was < 18 years and 40% had been abusing substances for > 5 years. Reasons for starting drug abuse were recreation (37%), curiosity (34.5%), and lifechanging events (14.3%). Reasons for relapse included association with former addicts, negative reactions from family, inability to manage the craving and work/social stress.

Risk factors associated with diabetes in periurban community, Lahore Pakistan.

OBJECTIVES: To identify factors (sociodemographic characteristic, behavioural factors, health care advice and physical measurements like weight, height, waist and hip circumferences) associated with diabetes. METHODS: This study was conducted in the Nain Sukh which is a peri-urban area near Lahore between January till August 2016. A sum of 1080 households of both gender with age between 15-69 years were interviewed through a structured questionnaire and necessary measurements were taken. The data analysis was done by using SPSS version 17. All the recommended ethical clearance both institutional as well as individual levels were duly taken. RESULT: The mean age of the participants was 34 years ± 14SD with female predominance. Total prevalence of diabetes was found to be 9.8% out of which 83% were females between age of 45-69 years (p<0.00). Diabetes was significantly associated with obesity with 33% participants were overweight while 42% were obese (p<0.00). Diabetes was also significantly associated with central obesity, positive family history (p<0.000). Almost 45% of the households were advised to reduce weight and take special diet (p<0.000). CONCLUSION: The diabetes is significantly associated with positive family history and deranged BMI both overweight and obesity along with central obesity. This can only be prevented by health education and life style modifications.

Medical students' perspective about role-plays as a teaching strategy in community medicine.

OBJECTIVE: To assess the students' perspective about role-plays conducted as a teaching methodology in community medicine. STUDY DESIGN: A quasi-experimental study. PLACE AND DURATION OF STUDY: Department of Community Medicine at Fatima Memorial College of Medicine and Dentistry from July to November 2010. METHODOLOGY: A probability technique of simple random sampling was used to collect 63 students from the third and fourth year MBBS who were randomly distributed in five sub-groups. They were variously ascribed the roles of obsceners, participants and helpers. A questionnaire was distributed to collect student's responses. The data was analyzed on SPSS version 17 to compare the responses. Chi-square test was applied and p-value was fixed at < 0.05 as significant. RESULTS: Sixty-three students were selected as participants of this study in which 46 belonged to the fourth year MBBS class (73%) and 17 were third year MBBS students (27%). There were 13 male (20.6%) and 50 female (79.4%) students. Role-plays were identified as most effective method of teaching (n = 25, 37.9%) followed by lectures (n = 17, 25.8%, p = 0.054). Fifty-two students (78.5%) admitted that role-plays improved their knowledge of the subject, 55 (84.6%) said that it will help them in their clinical performance. Fifty-nine participants (89.4%) found role-plays interesting and 49 (74.2%) wanted to incorporate role-plays as a part of curriculum. Fifty-six of the participants (88.9%) agreed that role-plays improved their communication skills. Twenty-one participants (31.8%) believed that it helped them in making acquaintance with the local situation. Forty-six students (76.7%) identified role-plays as a feasible way of andragogy (p = 0.005) and 48 (76.2%) said that it provoked critical thinking about the subject (p = 0.038). Fifty-four students (85.7%) admitted that their attention span was better in role-plays as compared to lectures (p = 0.047). CONCLUSION: Role-plays were well accepted by the students as an effective teaching methodology and can be incorporated as a part of teaching strategies in Community Medicine.

Lectures in medical education: students' views.

BACKGROUND: Lectures are considered most effective mode of information transfer amongst teachers and students in medical education, but in recent years there has been a noticeable decline in the attendance of lectures. Our objective was to assess the reasons of medical students' disinterest in lectures. METHODS: A cross-sectional survey was conducted in Department of Community Medicine, Fatima Memorial College of Medicine and Dentistry from December 2010 to June 2011. A non-probability technique of consecutive sampling was used to collect 307 participants from all five years of MBBS. Reasons of disinterest of medical students were asked in the questionnaire. The data was analysed on SPSS-17. Chi square test was applied and p-value was fixed at < or = 0.05 as significant. RESULTS: Factors affecting the lecture attendance of these medical students include distance of residence from the college 215 (70%), strictness of teacher in marking attendance 227 (73.9%), interest in subject 216 (70.4%), subject is part of examination 257 (83.7%), and university requirement 249 (81.1%). The personality traits of teacher affecting attendance of medical students in lectures include good communication 216 (70.4%), command on subject 194 (63.2%), students' interaction in class 180 (58.6%), friendly attitude 202 (65.8%), good control on class 163 (53.1%), punctuality 100 (32.6%), sense of humour 160 (52.1%), and humane behaviour 135 (44%). CONCLUSION: The interest of medical students can be enhanced and better attendance achieved with slight modifications in identified reasons.

Medical education: views and recommendations by final year MBBS students of a private medical college in Lahore.

OBJECTIVE: To obtain the views and recommendations of final year MBBS medical students of Lahore Medical and Dental College, Lahore about various aspects of the current medical education. STUDY DESIGN: Cross-sectional survey. PLACE AND DURATION OF STUDY: Lahore Medical and Dental College, Lahore in October and November 2007. METHODOLOGY: Preformed close ended structured questionnaire regarding medical teaching and evaluation methods and recommendations was used to collect the data from students of final year MBBS (n=120) at Lahore Medical and Dental College. SPSS 15 program was used for analysis. Data was presented as frequency percentages. RESULTS: A majority of the students (79%) thought that multimedia was the most effective teaching tool, (54%) students viewed 45 minutes as ideal lecture duration. Measures suggested to improve the examination results were regular tests (54%), improved lecture content (32%) and regular tutorials (10%). MCQ's were the mode of examination questions preferred by 62% of students. Recommendations given by students for improving the current medical education were better teaching (26%) followed by increased motivation in students 54 (16%) and more hands-on training/practical field work (12%). CONCLUSION: Medical students in this study preferred multimedia, lecture duration less than 45 minutes and MCQ's as their preferred mode of evaluation. Students recommended increased emphasis on better lectures, increasing learning motivation in students and more hands on training/practical field work to improve current medical teaching.

Medico-legal aspects of alleged rape victims in Lahore.

OBJECTIVE: To describe the socio-demographic along with the medico-legal characteristics of rape victims reporting to a female police station of Lahore. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Female Police Station in Shadman, Lahore, from, June 1995 to January 2009. METHODOLOGY: A total of 74 cases of alleged rape victims were identified while reviewing all available police files concerning reported rapes and attempted rapes from 1995 to 2008. The data was gathered on preformed questionnaires after conducting the pilot study. All information about victims and alleged offenders were extracted from the police files including socio-demographic profile of the accused and victim both. Use of weapon, evidence of physical and genital trauma, assailant identification and his relationship with the victim, number of accused persons and location of rape was noted in each case. Examination by doctor and obtaining the specimens were also identified and was related to the outcome of the court case. Chi-square test was applied to determine the association of rape with age and educational status of the victim and the accused. RESULTS: A total of 74 cases of alleged rape were reported in the study period at Shadman Female Police Station. Maximum number of victims was reported in the age group 10-19 years (n=46, 62.2%). Majority of the accused belonged to 20-39 years' age group constituting 64.8% of the total. Regarding educational status 45 (60.8%) of the victims and 51 (68.9%) of the accused were illiterate. Significant association was found between the educational status of rape victims and accused (p = 0.016) but not between their ages (p = 0.862). The maximum incidence of rape was reported in unmarried (n = 55, 74.3%) and unemployed (n =61, 82.4%) women. In 14 cases (19%) use of weapon was reported. Physical trauma was reported in 29 (39%) and genital trauma in 14 (19%) cases. The accused were identified as family friends (25%) and neighbours (23%) respectively. Only 21% of the victims were examined by doctor and specimens were obtained in only 14.9% of the cases. Acquittal of the accused was observed in 43% of the cases while 34% cases were still pending; conviction of the accused was observed in only 5% of the cases. CONCLUSION: Rape victims usually belong to young age group between 10-19 years majority of being unmarried and unemployed. Only a smaller fraction of the victims were examined by doctor and specimens were obtained in only few of the cases.

Bullying of medical students.

OBJECTIVE: To assess the frequency and forms of bullying experienced by medical students, and the associated factors. STUDY DESIGN: Cross-sectional questionnaire-based survey. PLACE AND DURATION OF STUDY: The study was conducted at a private Medical College of Lahore, from January to February 2010. METHODOLOGY: All the students of first and fourth year classes were included in the study with voluntary and anonymous participation. Self administered-questionnaires were given to the students which were completed by them in the presence of the surveyor. A modified version of the British Medical Associations (BMA) medical student's welfare and education survey form was used for data collection. The data was recorded and analyzed using the statistical package for social sciences version 16.0. Data was described in the form of frequencies and percentages. Chi-square test and Fisher exact test were used to test statistical significance between categorical variables at p < 0.05. RESULTS: More than half the students 70 (66%) had experienced some form of bullying in the past 6 months at the Medical College. It was found that 70% (49) of the students who were bullied were females. Sixty-seven percent of students reported experiencing a bullying episode at least once in a month, 26% less than once in a month and 7% at least once in a week. The most common forms were verbal abuse (n=44, 63%) and behavioural gestures i.e. making faces (n=36, 51%), followed by having been ignored or excluded (n=20, 29%). The common perpetrators of all types of bullying were fellow students followed by Professors. Feeling lonely or sad (p=0.024), not having a close friend (p=0.049) and knowledge amongst respondents regarding the availability of support services in their college (p=0.019) were significantly associated with being bullied. CONCLUSION: Most medical students reported of having been bullied in the last 6 months at the College, with verbal abuse being the commonest form of maltreatment and fellow students followed by Professors being the frequent perpetrators. A history of feeling lonely or sad, not having a close friend and knowledge amongst respondents regarding the availability of support services in their college were significantly associated with these experiences.

Needle stick injuries in nurses at a tertiary health care facility.

BACKGROUND: Needle-stick injury (NSI) is a major occupational health and safety issue faced by healthcare professionals globally. This study was aimed to assess the frequency and factors associated with NSIs in nurses of a tertiary health care facility in Lahore, Pakistan. It also focuses on safety measures adopted by these nurses after a needle stick injury. METHODS: This cross-sectional descriptive study was conducted in Ghurki Trust Teaching Hospital, Lahore from October 2009 to January 2010. All nurses have participated in the study with a response rate of 99%. These responses were obtained via a pretested self-administered questionnaire. The data was analysed using SPSS-16. Percentages of the categorical variables were computed and represented in various statistical data presentation forms, for analysis and comparison. Chi-square test was applied as a test of significance with fixing the p-value of 0.05 as significant. RESULTS: Out of 77 nurses who participated in our study, only 33 (42%) nurses were aware of the occupational hazards of their profession when they joined nursing. Needle stick injury was reported by 40 (71.9%) of the nurses in last one year. About 17 (31.5%) were injured at the time of recapping the syringe. The availability of needle cutters in the hospital was reported by 75 (97.4%) nurses while only 46 (60%) of them had undertaken a sharp management training course. Approximately 50 (64.9%) nurses failed to use gloves while administering injections. After getting stuck by a contaminated needle 71 (92%) of the nurses cleaned the wound with a spirit swab, 67 (87%) washed the area with soap and water and 58 (75%) applied a readily available bandage. Only 38 (49%) went on to inform the higher officials about a needle stick injury. Fifty-seven (74%) of the nurses were vaccinated against HBV, and 56 (72.2%) of needle stick injured nurses proceeded for HBV screening, while 53 (68.6%) for HCV and 37(48.5%) for HIV. CONCLUSION: Needle stick injury is the most important occupational health hazard in nurses with alarmingly high rates. Reporting to the concerned authorities, screening of nurses after needle stick injury and promotion of safety measures against it should be greatly encouraged.

Determinants and pattern of health care services utilisation in post graduate students.

BACKGROUND: The health care utilisation of a population is dependent on their health seeking behaviour which is determined by their physical, political, socio-economic and socio-cultural aspects. OBJECTIVES: This particular study is conducted to identify the determinants and the patterns of health services utilisation by the postgraduate students of Allama Iqbal Open University in Pakistan. It was a cross-sectional study and conducted from December 2008 to April 2009 in Allama Iqbal Open University Islamabad. METHODS: A non-probability convenience sampling was done in post graduate students who were enrolled for Masters Degree at Allama Iqbal Open University Islamabad. Data was collected on a self administered, pre-tested questionnaire to identify the pattern of utilisation of health care services by this educated class. Data was labelled and entered in SPSS version 16. Chi-square test is applied as a test of significance with fixing the p value at 0.05 as significant. RESULTS: Only 129 students 32 males, 97 females) out of 250 responded to the questionnaire with the response rate of only 51.6%. The sociodemographic profile of the participants shows that 71 (55%) belong to age group 20-29 years, followed by 43 (33.3%) in age group 30-39 years. The marital status of the participants had a significant association with selection of health care services (p = 0.04). Twenty-four (75%) of the males and 67 (65%) of the females were using private sector facilities. Age, marital status and income of the study subjects had significant association with selection of the provider with p values of 0.000, 0.047 and 0.051 respectively. CONCLUSION: The health care system in Pakistan comprises the public as well as private health facilities. In Pakistan vast majority of doctors resides in urban area and attracts the educated class towards private sector. Utilisation of public health care facility is not the main priority of the educated class of the country. Government officials should pay attention to make it more convenient for general public.