Are the healthcare providers willing and able to respond to disasters: An assessment of tertiary health care system of Khyber Pakhtunkhwa.

For the tertiary health care system to provide adequate care during disasters, willing and able healthcare providers must be available to respond to the abnormal surge of the patients. Health care professionals (HCPs) constantly face a dilemma because of their profession to either respond to disasters or protect themselves. This study was conducted to assess the willingness and ability of HCPs working in the tertiary healthcare system of Khyber Pakhtunkhwa to respond to disasters. This cross-sectional survey was conducted in all the 8 tertiary care hospitals of the Khyber Pakhtunkhwa province of Pakistan. For different disaster scenarios, between 6% and 47% of HCP indicated their unwillingness, and between 3% & 41% of HCPs indicated that they were unable to respond to the given disaster scenarios. HCPs with childcare obligation indicated significantly lower willingness (p<0.05) to respond to earthquakes, MCIs, and an outbreak of Influenza, and SARS. Male HCPs showed a significantly (p<0.05) higher willingness to respond to earthquakes, MCIs, and an outbreak of Influenza as compared to their female counterparts. The overall ability indicated by HCPs for various disaster scenarios ranged between 54.1% [95% CI 0.503,0.578] for responding to victims of nuclear war and 96.4% [95% CI 0.947,0.976] for responding to conventional war. The HCPs who indicated childcare obligation showed a significantly lower ability (p<0.05) to respond to environmental disaster, influenza outbreak, and responding to victims of nuclear war. Female HCPs indicated significantly higher ability (p<0.05) as compared to their male counterparts. This survey provides an opportunity for the tertiary healthcare system to build on the findings and develop disaster mitigation plans to address the barriers to improving the HCPs' availability during disasters.

Comparison Of Knowledge Among Millennials Studying In Non-Medical Universities Regarding Premarital And Prenatal Thalassemia Screening Policies In Pakistan.

Thalassemia awareness among the youth is vital for policy- making to reduce the disease burden in our country. A descriptive cross-sectional study was conducted via simple random sampling technique for which data was collected from May 2020 to May 2021 through Google forms. Results showed that out of a total of 394 non-medical university students, the majority, i.e. 265 (67.3%), were not aware of prenatal screening. Majority, i.e. 117 (29.7%), agreed that the couple should be screened before marriage, and 190 (48.2%) strongly agreed, while 46 (11.7%) had no knowledge. Students, however, believed premarital screening was either unavailable, not possible, or expensive. Other reasons included custom and culture of arranged marriages and religious reasons. The query that if both the parents are carriers and the foetus has thalassemia major should they have an abortion, showed mixed results. The key to controlling thalassemia is awareness of future parents.

An assessment of existing surge capacity of tertiary healthcare system of Khyber Pakhtunkhwa Province of Pakistan using workload indicators for staffing need method.

BACKGROUND: Globally the occurrence of disasters has increased more than fourfold during the last three decades. The main concern for the healthcare system responding to a disaster is its ability to deal with the sudden influx of patients and maintaining a certain level of surge capacity. Health workers are considered to be the major driving force behind any health system. Their role gets even more prominent during disasters or public health emergencies. With the lack of information on the health workforce in the tertiary healthcare system of Khyber Pakhtunkhwa, where most of the disaster surge is diverted, it is difficult to plan and respond to accommodate the sudden surge of patients. METHODS: This was a mixed method cross-sectional survey conducted in all the tertiary care hospitals of Khyber Pakhtunkhwa province of Pakistan to assess the current staffing situation and surge capacity based on the current workload. Annual service statistics of 2018 were collected from all the tertiary care hospitals of the province. WISN was piloted with only one healthcare staff category, i.e., for doctors in Ayub Teaching Hospital before assessment in all the tertiary care hospitals was undertaken. RESULTS: Overall, there were 1215 surplus doctors in medical and allied specialties and 861 doctors in surgical and allied specialties in the tertiary healthcare system. The health care system has an acute shortage of 565 emergency department doctors. The tertiary healthcare system of KP has an overall shortage of 1099 nurses. Based on the WISN generated numbers for doctors, the tertiary care system of KP has a combined healthcare staff (doctors and nurses) that can manage an additional surge of 6.3% of patients with the current patient workload. CONCLUSION: The tertiary health care system of the Khyber Pakhtunkhwa Province of Pakistan does not possess the required ≥ 20% HR surge capacity indicating that the tertiary healthcare system is poorly prepared for disasters or public health emergencies. The lack of nursing staff, more than the doctors, is the major reason behind the lack of HR surge capacity of the tertiary health care system.

Hypertension and obesity in community of Nain-Sukh.

OBJECTIVE: To determine the frequency of factors related to hypertension in a peri-urban community. METHODS: It was a cross-sectional survey conducted from January to August, 2016, in Nain Sukh, Sheikhupura, near Lahore comprised household individuals of either gender aged 15-69 years. Data was collected through interviews by using a structured questionnaire focussing on socio-demography, history and factors associated with hypertension, like body mass index and lifestyle modifications. Hypertensive patients were identified by using clinical and medication history. SPSS 21 was used to analyse data. RESULTS: Of the 1080 subjects, 871(80.6%) were females and 209(19.4%) were males. The overall mean age was 33.5±14 years. Hypertension was found in 307(28.4%) subjects. Hypertension was significantly associated with lifestyle modification factors, like weight reduction, reduction in salt intake and smoking cessation (p<0.05), and with body mass index categories (p<0.05). CONCLUSIONS: Hypertension was found to be significantly high among overweight and obese participants, especially females.

Who are the women wishing to opt for contraception?

This descriptive cross-sectional research study was conducted to determine the characteristics of the women who intend to use a modern family planning method. For this 154 women were selected in a small village and faceto- face interviews were conducted. The findings indicate that 86 (56%) women intended to use a contraceptive method. The regression model showed that women who had the knowledge about different methods, those who had previously ever used family planning method and those who had never used any traditional method are more likely to adopt modern contraceptive methods.

Quality Assessment Of Focused Antenatal Care Service Delivery In Tertiary Care Health Facility.

BACKGROUND: Regardless of high maternal deaths in Pakistan, only 37% of pregnant women make four or more antenatal care visits during pregnancy. This proportion has further been diverged between urban and rural. About 62% of women visit clinics for WHO recommended sets of antenatal care (ANC) check-ups in urban as compared to 26% women in rural areas. This study was conducted with the aim to assess quality of Focused ANC service delivery in terms of examination, screening, treatment, counselling and to determine variation in service delivery with provider's clinical qualification and expertise. METHODS: Cross sectional study design was used. Data was collected from pregnant women when they were visiting hospital for their antenatal visits. Direct observation was also made regarding provision of services. RESULTS: Out of 278, 55% of study women were in 28-33 years age group and 21.2% made at least one visit. While 42.8% reported more than one visit, 98.9% received tetanus toxoid, 82% received proper screening. Counselling was done mostly regarding nutrition and self-care (42.8%), and significant association (p-value <0.05) was observed between provider's clinical qualification and provision of services such as for screening and counselling. CONCLUSIONS: The delivery of antenatal care services to pregnant women varied to some extent. Most of the routine investigation services were in accordance with recommended standards of optimal quality with little divergence from guidelines such as screening for HIV and syphilis. Better quality services were being provided to private participants in terms of counselling and danger sign screening.