When workaholism is negatively associated with burnout: A moderated mediation.

Aim: Previous theory and research postulate that workaholism is one of the important factors that contribute to burnout. The present study aimed to analyze the role of psychological capital as a mediator between the two. Moreover, the study examined the moderating role in the stated mediated relationship. Methods: The researchers approached a sample of university teachers (N = 1,008) including both male (n = 531) and female (n = 477) university teachers by using a multi-stage random sampling technique. For this purpose, DUWAS-10 Oldenburg Burnout Inventory, Challenging Job Demands Scale, and Anila PsyCap Scale were applied to measure workaholism, burnout, challenging job demands, and PsyCap, respectively. The data obtained from the sample was subjected to analysis by using Model 14 of Process Macro by Hayes. Results: The results confirmed the mediating role of PsyCap and moderating role of time pressure and cognitive demands in the relationship of the two variables. The results concluded that workaholism is not directly related to burnout rather the negative relationship existed through psychological capital, and the mediated relationship was stronger for the university employees who were to face a higher level of challenging job demands including cognitive demands and time pressure. Conclusion: Burnout is an occupational health problem that causes devastating effects on both the employees as well as to the organizational economy. Improving personal resources might help the negative relationship between workaholism and burnout in higher education institutions in the country.

Impact of Drinking Water Source and Sanitation Facility on Malnutrition Prevalence in Children under Three: A Gender-Disaggregated Analysis Using PDHS 2017-18.

OBJECTIVES: The proposed research studied the determinants of male and female child malnutrition in Pakistan. More specifically, it observed the role of the sanitation facility and drinking water source as important determinants of malnutrition in a gender analysis. METHODS: Novel data of 1010 children under three years of age from PDHS 2017-18 were used. A CIAF (Cumulative Index for Anthropometric Failure) was established to assess malnourishment in the children. Discrete-choice logistic methodology was applied in this empirical research to study the likelihood of malnourishment in children. RESULTS: The logistic regression results depicted that factors such as a child belonging to a deprived area, the status of home wealth, and the education of the mother were common determinants of malnutrition in children. Factors such as a child having diarrhea (OR = 1.55, CI = 0.96-2.50) and the drinking water source (OR = 0.62, CI = 0.37-1.03) were separate prominent predictors of malnutrition in male children whereas the sanitation facility was the main determinant of malnutrition in female children (OR = 0.64, CI = 0.43-0.95). CONCLUSION: This study concludes that important links exist between the drinking water source and male child malnutrition and between sanitation facilities and female child malnutrition.

Comparison of Different Nutritional Screening Approaches and the Determinants of Malnutrition in Under-Five Children in a Marginalized District of Punjab Province, Pakistan.

OBJECTIVES: This research measures the occurrence of malnutrition amongst under-five children in the Rahimyar Khan district of Southern Punjab in Pakistan. Employing different anthropometric measurement approaches such as (1) conventional indices (HAZ, WAZ, and WHZ), (2) CIAF, (3) BMI-for-age, and (4) MUAC, we compare their estimated results and examine the relationship between socioeconomic determinants and different anthropometric indicators. METHODS: The study employs a proportional purposive random sampling method to collect data from 384 rural households in the community-based study using a self-administered survey and following the Lady Health Workers (LHWs) registered records. The nutritional status of 517 under-five children is measured with references to WHO (2009) child growth standards. Furthermore, the investigation used the model of binary logistic regression to measure the impact of socioeconomic factors on child malnutrition. RESULTS: Compared with other approaches, the CIAF identifies more malnourished children (63%). The results of binary logistic regression illustrate that all the explanatory variables indicate a more significant empirical association with CIAF than conventional indices, BMI-for-age, and MUAC. CONCLUSION: CIAF is a more reliable tool for assessing child nutrition because it not only demonstrates more accurate estimates of malnutrition but also recognizes children with multiple anthropometric failures.

Key Challenges to Optimal Therapeutic Coverage and Maternal Utilization of CMAM Program in Rural Southern Pakistan: A Qualitative Exploratory Study.

Severe Acute Malnutrition (SAM) is a serious public health problem in many low- and middle-income countries (LMICs). Therapeutic programs are often considered the most effective solution to this problem. However, multiple social and structural factors challenge the social inclusion, sustainability, and effectiveness of such programs. In this article, we aim to explore how poor and remote households face structural inequities and social exclusion in accessing nutrition-specific programs in Pakistan. The study specifically highlights significant reasons for the low coverage of the Community Management of Acute Malnutrition (CMAM) program in one of the most marginalized districts of south Punjab. Qualitative data are collected using in-depth interviews and FGDs with mothers and health and nutrition officials. The study reveals that mothers' access to the program is restricted by multiple structural, logistical, social, and behavioral causes. At the district level, certain populations are served, while illiterate, and poor mothers with lower cultural capital from rural and remote areas are neglected. The lack of funding for nutrition causes the deprioritization of nutrition by the health bureaucracy. The subsequent work burden on Lady Health Workers (LHWs) and the lack of proper training of field staff impact the screening of SAM cases. Moreover, medical corruption in the distribution of therapeutic food, long distances, traveling or staying difficulties, the lack of social capital, and the stigmatization of mothers are other prominent difficulties. The study concludes that nutrition governance in Pakistan must address these critical challenges so that optimal therapeutic coverage can be achieved.

Distance to Healthcare Facility and Lady Health Workers' Visits Reduce Malnutrition in under Five Children: A Case Study of a Disadvantaged Rural District in Pakistan.

This study accesses the impact of lady health worker (LHWs) visits in the community and distance to a healthcare facility on the nutritional status of under-five children. Additionally, it explores the perceptions and attitudes of the community about the performance of LHWs. A self-administered instrument was applied to gather data on different parameters, such as children's height, age, weight, and socioeconomic status from 384 rural households in a marginalized district of Punjab province with the help of a purposive random sampling technique. The binary logistic regression model was employed for the computation of the probability of malnutrition. The prevalences of stunting, underweight children, and wasting in the district were 34.8%, 46.1%, and 15.5%, respectively. The logistic results illustrate that those households in which LHW visits occur regularly within 15 days (OR = 0.28 with 95% CI: 0.09-0.82) have a lower probability of malnutrition prevalence among their children. The distance to the health facility shows that the odds of malnutrition were higher from 3-4 Kilometers (Km) (OR = 2.61, 95% CI: 0.85-8.14), and odds were also higher for the ≥5 km category (OR = 2.88, 95% CI: 0.94-8.82). Children from richer families had lower chances of being malnourished (OR = 0.28, 95% CI: 0.07-1.14). Furthermore, the respondents show a positive attitude towards LHWs. They have given the first rank to their performance being beneficial to mothers and childcare, especially on checkups and safe deliveries, while they have shown negative responses and given lower ranks to their performance due to irregular visits (6th rank) and poor community awareness (7th rank). We conclude that LHWs' regular visits to targeted households and less distance to healthcare facilities reduce the malnutrition risk in under-five children.

Socio-Economic and Environmental Determinants of Malnutrition in under Three Children: Evidence from PDHS-2018.

OBJECTIVES: This research investigates the association of malnutrition with social and economic factors in general and environmental factors in specific such as sanitation facilities and drinking water sources for Pakistan. METHODS: Authors used the latest data of 1010 Under-Three children from Pakistan Demographic and Health Survey (PDHS) 2017-2018. Cumulative Index of Anthropometric Failure (CIAF) was developed to measure the malnutrition status among children based on z-scores of WHZ, WAZ, and HAZ, respectively. The study has applied the discrete-choice logistic methodology to find the relationship of malnutrition with socio-economic characteristics. The interaction terms of drinking water source and sanitation facility have been measured to see the impact of environmental factors on child malnutrition. RESULTS: The study results depict that the likelihood of malnutrition increases when the child had diarrhea recently and the child belongs to the deprived region such as KPK, Sind, and Baluchistan. However, the chances of child malnutrition drop with (1) an escalation of mothers' education, (2) a rise in wealth status of the household, and (3) the improved water source and sanitation facility in the household. The only water-improved sanitation category of the interaction term is significant in the model which depicts that households having both improved water and improved sanitation facilities had very fewer chances of malnutrition among their children. CONCLUSION: Authors conclude that malnutrition in younger children is associated with improved water as well as sanitation facilities, maternal education, and household wealth in Pakistan.

Prevalence of child malnutrition and household socioeconomic deprivation: A case study of marginalized district in Punjab, Pakistan.

Better socioeconomic status and well-being in households decrease malnutrition and health risks in children. The objective of the present study is to assess the current nutritional status of pre-school children and to correlate the prevalence of malnutrition with Household Deprivation Status (HDS) in one of the deprived districts of the Punjab province in Pakistan. Using primary data collected from 384 households through a proportional purposive random sampling technique, this study calculates the z-scores of weight-for-age (WAZ), weight-for-height (WHZ), and height-for-age (HAZ). The study has used a cut-off point which is -2 standard deviations below the median of the WHO/NCHS reference population for each anthropometric indicator. The results indicate that the underweight, stunting, and wasting prevalence rates are 46.1%, 34.83%, and 15.49% respectively in district Rahimyar Khan. Also, the expected tendency of malnutrition is worst for HDS-1 and HDS-2 which are the most deprived segments of the population. As the household shifts from HDS-1 to HDS-2 and further to HDS-3, the rates of stunting (HAZ) and underweight (WAZ) decreases but wasting (WHZ) does not. The study concludes that the high prevalence of malnutrition in the district is correlated with overall socio-economic deprivation.

Does Mothers' Awareness of Health and Nutrition Matter? A Case Study of Child Malnutrition in Marginalized Rural Community of Punjab, Pakistan.

Maternal nutritional awareness might reduce the risk of malnutrition in children. This study assesses the impact of mothers' nutritional and health awareness (MNHA) on the nutritional status of pre-school children in rural South Punjab. Using a proportionate purposive simple random sampling technique we collect data with the help of a self-administered questionnaire on height, age, the weight of children, and socio-economic profile from 384 rural households in one of the marginalized districts of Punjab. The study applied the binary logistic regression model to compute the probability of malnutrition. The results indicate that malnutrition was high in the district (the prevalence rate for underweight is 46.1%, for stunting 34.83%, and for wasting is 15.49%). Around 91.84% of malnourished children belonged to the low MNHA category compared to medium (5.61%) and high (2.55%) MNHA categories. The results further show that the prevalence of moderate and severe stunting, wasting, and underweight in low MNHA categories was much higher with large differences compared to both medium and high MNHA categories. The binary logistic regression results depict that, across the household deprivation index (HDS), the odds of a child becoming malnourished were lower in households HDS-2 category (OR = 0.02, 95% CI: 0.01-0.89), and odds were also lower in households HDS-3 category (OR = 0.001, 95% CI: 0.001-0.16). Similarly, across the scores of MNHA index, the odds of malnutrition were lower among the children of those mothers who had medium MNHA (OR = 0.04, 95% CI: 0.002-1.24), and also the probability of child malnutrition was lower among the children of mothers who had high MNHA (OR = 0.008, 95% CI: 0.002-0.29). The study urges that well-resourced, targeted, and coordinated health and nutritional education and awareness programs are required to tackle malnutrition.

A Qualitative Exploration in Causes of Water Insecurity Experiences, and Gender and Nutritional Consequences in South-Punjab, Pakistan.

Although water insecurity has been discussed in general, its impacts on mothers' physical and mental health, and infants' and young children's feeding (IYCF), has largely been ignored. This study explores household water insecurity experiences and their association with optimal health and nutrition of women and children in the Rajanpur district of Punjab Province. Using focus group discussions (FGDs) and key informants (KIIs) interviews from an area with high maternal-child malnutrition prevalence, a qualitative study was conducted to describe local experiences of water acquirement and arrangement, and of the consequences of water insecurity. The findings highlight that rural Western marginalized populations of the Rajanpur district rely on brackish, canal, or flood surface water as the water supply is absent, which intensifies mothers' work burden and stress, and often makes them victims of violence, stigma, and sickness. Water fetching impacts women in unforeseen ways, impacting the psychosocial and physical health of mothers engaged in maternal breastfeeding. Water insecurity, originally rooted in regional disparities, compounds with gender inequities, which leads to maternal stress and child sickness. Justice in water resources is imperative and urgent in the deprived South of Punjab province for improving public health nutrition.