Satisfaction Level of Tuberculosis Patients Regarding Their Access to TB Care and Prevention Services, Delivered Through a Public-Private Mix Model in Pakistan.

OBJECTIVE: The private healthcare providers (PHCP) are believed to improve access to healthcare services in public-private mix (PPM) projects, as they are considered first point of contact for healthcare. The purpose of this study was to determine the satisfaction level of tuberculosis (TB) patients. DESIGN: A questionnaire-based, cross-sectional study was carried out during November and December 2017 for 572 under-treatment patients registered with PHCPs in the PPM project. Lot quality assurance sampling technique was used to randomly select 19 districts from a sample frame of 75 districts. In each selected district, the data collector retrieved a TB register of 8 months (January-August 2017) and systematically selected patients by fixed periodic interval. SPSS version 24.0 (IBM Corp, Amonk, NY, USA) was used to analyze the data. RESULTS: This study included 53% (n = 301) males and 47% (n = 271) females, with mean age of 38 years (SD, ±18). Almost half of the participants were illiterate (51%, n = 289), and 64% (n = 365) were non-earning members of the family. In practice, most of the participants visit private providers (71%, n = 407), including private hospitals/clinics (44%) and traditional practitioners (27%; n = 153); 55% of participants visited their current doctor because of the clinic's proximity to their residence. Of the participants, 82% (n = 469) were satisfied with TB care services and 85% (n = 488) said that they would recommend this clinic to others. Conclusion: PHCPs are preferred providers for individuals, which is consistent with findings of other studies. Though they are satisfied with TB care and services, interventions should be introduced to reduce the financial burden on the patient. Partnering PHCP is a way forward to ensure universal health coverage and better health outcomes of the population.

Basic neonatal resuscitation, knowledge assessment at primary health care centers of district Sheikhupura in Pakistan -- a cross-sectional study.

OBJECTIVE: To assess the knowledge of lady health visitors and midwives working at primary healthcare facilities about neonatal resuscitation. METHODS: The cross-sectional survey was conducted in District Sheikhupura of Pakistan's Punjab province from September to November 2013, and comprised lady health visitors and midwives at primary level healthcare facilities. Datas was gathered using a close-ended questionnaire. SPSS 16 was used for statistical analysis. RESULTS: Of the 103 health workers interviewed, 54(52.4%) were lady health visitors and 49(47.5%) were midwives. Overall, 71(69.90%) health workers had received training on neonatal resuscitation, while 32(30.10%) had no formal training. Basic neonatal resuscitative arrangements were available at all the 54(100%) basic health units and 7(100%) rural health centres. Basic neonatal care knowledge was found adequate but the knowledge of midwives on the subject was poor as only 24(49%) answered correctly. CONCLUSIONS: There is a need for regular in-service trainings of lady health visitors and midwives regarding Basic Neonatal Resuscitation.

Knowledge and awareness of harmful effect of substance abuse among users and non-users: a cross-sectional study from Bari Imam.

OBJECTIVES: To determine the prevalence of substance abuse among adult population of Nurpur Shahan and assess the participants' knowledge and awareness regarding substance abuse. METHODS: This was a cross-sectional study conducted in the households of Nurpur Shahaan, adjacent to Bari Imam on the outskirts of Islamabad, Pakistan, during January 2010. A structured questionnaire was used and 200 adults of ages 18 and above were assessed about their awareness of substance abuse, its social effects and health hazards. All collected data was entered into SPSS ver. 10. The independent variables in the study were age, gender, marital status, social class, education level and knowledge of substance abuse. The dependent variables were substance abuse, type of substance abuse, attitude towards using and attitude towards quitting. RESULTS: Out of the 200 adults consenting to participate in the survey, 65 (33%) were reported to suffer from substance abuse, while 135 (67%) claimed not to be in the habit. Awareness about the dangers of substance abuse was higher among non-users (59.4%) as compared to the users, but 40.6% users continued to use drugs despite knowing that adverse effects would follow. Non-user respondents were more aware of the risks involved (75.8%) than the users (23.4%). It remained unclear whether anxiety and depression were an outcome of addiction or a defence mechanism to perpetuate maladaptive behaviour of substance abuse. CONCLUSIONS: Substance abuse is prevalent among the lower and lower middle classes of Pakistan, with a propensity among male victims, to blame external circumstances, which they feel are beyond their control.