Dental caries and Oral hygiene status among primary school children in Quetta, Pakistan: A quantitative approach.

This study was conducted to ascertain the extent of dental caries among primary school children in Quetta. A total of 362 children were examined for their dental and oral hygiene status. WHO recommended indexes, including Oral Hygiene Index-Simplified (OHI-S) and Decayed, Missing, and Filled Teeth (DMFT), were used for dental examinations. The study results reveal a high prevalence of dental caries (74%), and the mean "DMFT" score was 1.07±1.63, and "deft" score 2.29± 2.31. There were no significant differences among mean deft, gender, and type of school (P=.27 and .07) in deciduous dentition. Public school children were approximately two times more likely to have dental caries (OR 1.92; P=.021). Dental caries were significantly higher among children with poor oral hygiene (OR 2.40; P=.005). Overall, the treatment needs of the children were noted to be over 90%.

Managers' Perspectives on the Devolved Health System Response to the Public Health Needs of Internally Displaced Persons in Pakistan: A Qualitative Study.

Population displacement has been embedded in Pakistan's history since its inception in 1947. The displacement of more than 3 million people from the tribal areas of the Khyber Pakhtunkhwa Province of Pakistan and their settlement in recipient areas have posed challenges to governance, service delivery, financial management, and integration of internally displaced persons (IDPs) into existing devolved district health systems. Evidence is lacking on the management of devolved health systems to respond to the public health needs of IDPs. The authors adapted qualitative methods to explore challenges faced by managers of health departments in Khyber Pakhtunkhwa Province in responding to the public health needs of IDPs and to explore policy recommendations for a devolved health system. Study findings revealed that the lack of a skilled workforce, lack of political will, financial limitations, and poor intersectoral collaboration had an impact on the humanitarian crisis response in the province. These findings suggest a dire need for overarching binding international laws and local national policies for complete protection of IDPs, particularly in regard to their health, shelter, and social security.

STATUS OF ETHICAL REVIEW BOARDS IN MEDICAL COLLEGES OF KHYBER PAKHTUNKHWA.

BACKGROUND: Ethics means custom, character, habit or disposition and as a discipline is frequently called Moral Philosophy. Ethics cannot be regulated until it is incorporated in Law. With the advent of research in life sciences, the need of ethical review boards was felt to protect individual and public interests. The objective of this study was to know the status of ethical review boards at all medical colleges of Khyber Pakhtunkhwa in terms of its existence, membership and activities. METHODS: This province wise cross-sectional survey was conducted over a period of three months. All the sixteen medical colleges of the province registered with Pakistan Medical and Dental Council Islamabad were included. A structured questionnaire was used as data collection tool. Single respondent from each medical college was identified by the respective chief executive officer or principal. Data was analysed through SPSS V-20 and MS Excel 2007. Descriptive statistics were calculated for quantitative data. RESULTS: Out of sixteen medical colleges, one had no ethical review board and another neither refused nor returned filled questionnaire. Eleven medical colleges reported combined boards with their teaching hospitals, while 3 had separate boards. Highest number of members noted was 14 and lowest being 4. Mode was 8. None of the boards had a medical doctor with degree or diploma in bioethics, as its member. Six medical colleges had medical doctors who had attended workshops on bioethics. Majority of medical colleges had no track of record about its review boards. CONCLUSION: Overall situation of ethical review boards at the medical colleges of Khyber Pakhtunkhwa is not satisfactory and needs proper regulatory measures.

Health care seeking patterns and out of pocket payments for children under five years of age living in Katchi Abadis (slums), in Islamabad, Pakistan.

BACKGROUND: Since 1990, Pakistan has faced an unprecedented rate of urbanization, thereby resulting in the uncontrolled proliferation of slums (Katchi Abadis) in all large cities. These areas lack the basic municipal services such as safe water supply, sanitation and waste collection. There is limited access to quality health care services, both curative and preventive. Therefore, communities living in katchi abadis are faced with health seeking challenges and catastrophic expenditure to pay for health care services (formal or informal). METHODS: This cross-sectional quantitative study was conducted in Islamabad, using a semi-structured questionnaire with mothers of children 5 years of age. There are 34 katchi abadis, 11 are recognized by the Capital Development Authority, out of which seven were included in the study. The calculated sample size was 207. MAIN FINDINGS: Average household income was found to be Pak Rupee 10,000 (approx.US$100) per month. Diarrhea, fever, common cold and cough were common illnesses among under 5 children. Approximately 43% of the mothers were illiterate and they preferred consulting a private doctor or a private dispenser in the katchi abadi. Mother's level of education was significantly associated with the type of health provider consulted. Majority had to spend out of pocket, while many either borrowed money from relatives or friends or sold a household item. Delay in seeking health care added to the out of pocket expense. The mean cost on child's treatment was approximately PkRs400 (approximately US$ 4) for a single consultation. CONCLUSION: There are several factors associated with health seeking behavior of mothers of children under the age of 5 years, living in the katchi abadis of Islamabad. The latter population group is one of the most vulnerable given their poor standard of living conditions. A multi-sectoral approach is needed to address the provision of basic amenities, the availability of safety nets to pay for health care is crucial to avoid catastrophic expenditure and the provision of community-based health promotion programs are essential to improve health seeking behaviors whilst simultaneously promoting and protecting health.