Transition towards health promoting hospitals: adapting a global framework to Pakistan.

The World Health Organization encourages hospitals to become Health Promoting Hospitals (HPH) but adapting this concept to Pakistan has not been investigated. We explore perceptions of healthcare stakeholders about strategies and a priority action-plan to encourage HPHs in Pakistan. We conducted a qualitative study in 2007 where key-informant interviews and focus group discussions were held with healthcare stakeholders in Karachi. Thematic analysis was done and emerging themes were categorized. The HPH core components were perceived as the "standard framework"; however more emphasis was placed on priority actions as to satisfy "basic needs" of patients, staff and the community. This included basic facilities of comfort, health, hygiene, safety, security and emotional support. A change in the traditional mindset from cure to care and identification of key personnel, awareness-raising and cooperation would strengthen advocacy efforts for HPH in Pakistan.

Transition towards health promoting hospitals: adapting a global framework to Pakistan

The World Health Organization encourages hospitals to become Health Promoting Hospitals [HPH] but adapting this concept to Pakistan has not been investigated. We explore perceptions of healthcare stakeholders about strategies and a priority action-plan to encourage HPHs in Pakistan. We conducted a qualitative study in 2007 where key-informant interviews and focus group discussions were held with healthcare stakeholders in Karachi. Thematic analysis was done and emerging themes were categorized. The HPH core components were perceived as the [standard framework]; however more emphasis was placed on priority actions as to satisfy [basic needs] of patients, staff and the community. This included basic facilities of comfort, health, hygiene, safety, security and emotional support. A change in the traditional mindset from cure to care and identification of key personnel, awareness-raising and cooperation would strengthen advocacy efforts for HPH in Pakistan

Community context of health system development: implications for health sector reform in Pakistan.

To describe local sociopolitical and organizational factors that influence health system development in Karachi, Pakistan, we conducted participant observation while working with health providers and communities in one urban district to reorient services towards a primary health care district health system. We found that the community characteristics, particularly the diverse socialpolitical and cultural make-up and organizational complexity that involved multiple levels of government, influenced efforts towards collaboration and shaped the development of the health system. We conclude that for effective implementation of health sector reform there is a need to comprehend fully the community context and complexity of existing health service provision.

Community context of health system development: implications for health sector reform in Pakistan

To describe local sociopolitical and organizational factors that influence health system development in Karachi, Pakistan, we conducted participant observation while working with health providers and communities in one urban district to reorient services towards a primary health care district health system. We found that the community characteristics, particularly the diverse socialpolitical and cultural make-up and organizational complexity that involved multiple levels of government, influenced efforts towards collaboration and shaped the development of the health system. We conclude that for effective implementation of health sector reform there is a need to comprehend fully the community context and complexity of existing health service provision

Community-based nursing education in Pakistan.

The nursing profession is not looked on favorably by Muslim families. In one rural area there were only three nurses for 1 million people. Community health and public health care have been lacking in the nursing curriculum. Therefore, preparing recruits for the community health nursing (CHN) posts in the Community Health Sciences Department (CHSD) and for faculty of the School of Nursing has involved a sequence of continuing education: inservice and on-the-job training in the CHSD and courses in the new BScN program. Those who joined with a diploma in nursing and a year of midwifery, and who followed this sequence, could be selected as Aga Khan University (AKU) scholars, and be sponsored for support in the two-year BScN program with its community health orientation. After two more years of advanced experience, the CHN is given the opportunity to apply for master's studies abroad. All who were accepted have returned to work at the Aga Khan University and have increased their career opportunities.