BackgroundThe prevalence of double burden of malnutrition (DBM) is high in low- and middle-income countries (LMICs). Data on malnutrition trends is present for children <5 years of age, however the data for school-going children and adolescents aged 5–15 years is scarce.ObjectiveThis systematic review presents the pooled prevalence of nutritional status and dietary intake among school-going children and adolescents (5–15 years of age) in an LMIC of Pakistan and the perspective for broader global nutrition in this age group.MethodsAn electronic search of databases was run on Pubmed and Medline (via Ovid) along with gray literature and archives of local scientific journals till 2nd January 2021. Studies meeting the eligibility criteria were included and relevant data were extracted, and a pooled proportional analysis was performed.ResultsA total of 51 studies including 62,148 children of 5–15 years met the inclusion criteria, of which 30 studies reported on anthropometric indices alone, eight on dietary intake patterns while 13 reported both. All of the included studies had a cross-sectional study design. There were 20 studies from the province of Punjab, 15 from Sindh, eight from Khyber Pakhtoonkhwa, two from Balochistan, and three from multiple cities across Pakistan. The pooled proportional analysis showed that the proportion of underweight children and adolescents was 25.1% (95% CI 17.3–33.7%); stunting 23% (95% CI 11.8–36.7%); wasting 24% (95% CI 15.2–34%); thinness 12.5% (95% CI 9.4–16.1%); overweight 11.4% (95% CI 7.2–16.3%); and obesity 6.9% (95% CI 3–12%). A relatively high intake of carbohydrates, soft drinks, and sweets/chocolates; and a low intake of protein-rich foods, fruits, and vegetables, compared to the recommended daily allowance (RDA), was reported.ConclusionThe limited data suggests the presence of DBM amongst children aged 5–15 years and also identified that dietary intake patterns are not meeting the recommended allowance. This review highlights the gaps and the need for larger, well-designed studies for this age group with the representation of different contexts and the need for similar studies in various LMICs, so that appropriate actions be deliberated and appropriate programs should be designed focusing on this vital population.

BackgroundHuman resources are an important building block of the health system. During the last decade, enormous investment has gone into the information systems to manage human resources, but due to the lack of a clear vision, policy, and strategy, the results of these efforts have not been very visible. No reliable information portal captures the actual state of human resources in Pakistan’s health sector. The World Health Organization (WHO) has provided technical support for the assessment of the existing system and development of a comprehensive Human Resource Information System (HRIS) in Pakistan.MethodsThe questions in the WHO-HRIS Assessment tool were distributed into five thematic groups. Purposively selected (n=65) representatives from the government, private sector, and development partners participated in this cross sectional study, based on their programmatic affiliations.ResultsFifty-five percent of organizations and departments have an independent Human Resources (HR) section managed by an establishment branch and are fully equipped with functional computers. Forty-five organizations (70%) had HR rules, regulations and coordination mechanisms, yet these are not implemented. Data reporting is mainly in paper form, on prescribed forms (51%), registers (3%) or even plain papers (20%). Data analysis does not give inputs to the decision making process and dissemination of information is quite erratic. Most of the organizations had no feedback mechanism for cross checking the HR data, rendering it unreliable.ConclusionPakistan is lacking appropriate HRIS management. The current HRIS indeed has a multitude of problems. In the wake of 2011 reforms within the health sector, provinces are even in a greater need for planning their respective health department services and must work on the deficiencies and inefficiencies of their HRIS so that the gaps and HR needs are better aligned for reaching the 2015 UN Millennium Development Goals (MDGs) targets.

ObjectiveThe objective of this abstract is to share the lessons learned from the dengue epidemic in Lahore, Pakistan in 2011 and development of a comprehensive electronic surveillance system for dengue prevention and management.

Objectives Healthy eating habits in childhood promote optimal growth and development. With rapid globalization and urbanization, dietary patterns have been negatively impacted in many countries. For households and ultimately children, there is increased access to unhealthy, nutrient-poor, ultra-processed foods. In Pakistan, there is a persistent high burden of undernutrition and micronutrient deficiencies coupled with rising overweight and obesity. The recent Pakistan Demographic and Health Survey 2017–18 and National Nutrition Survey 2018 has offered insights into the nutritional status of children under-5 years, adolescents and women of reproductive age. However, there is a marked absence of school-aged children (5–9.9 years) within these surveys, and other school-based surveys miss children out-of-school. As such, the objectives of this research are to determine dietary intake, investigate the household and retail food environments and its association with nutritional status. Methods A multi-stage complex household survey was developed for the provinces of Sindh and Punjab, Pakistan. Both in-school and out-of-school-aged children are eligible to participate. Three core modules will be administered to the total sample of children (n = 3832) (and their caregivers): Module 1: Household, Module 2: Child and Module 3: Child Anthropometric Assessment. Three expanded modules will be administered to a subsample of children (n = 1691): Module 4: 24-hour Dietary Recall, Module 5: Child Biochemical Collection and Module 6: Food Environment. Results Preliminary results will be available in May 2020. Conclusions Given our limited knowledge of dietary intake and food environments of school-aged children in Pakistan, this research aims to provide an understanding of both upstream predictors and downstream health outcomes in order to inform policy and develop an evidence-based school health and nutrition intervention planned for 2021. Funding Sources The survey was undertaken under the auspices of the Ministries of Health, Punjab and Sindh, Pakistan with technical support from the Mother & Child Care & Research Inc. and Aga Khan University, Pakistan. Financial support was provided by the Trust for Vaccines & Immunizations Pakistan, MCCR, Governments, with additional unrestricted funding from the Societe des Produits Nestle Ltd, Switzerland.

Background: Rabies is a neglected and underestimated national public health issue in Pakistan. Freeroaming dogs are the principal reservoir and also potentially cause thousands of dog bite injuries in different age groups of people. Objectives: The present study was designed to evaluate the burden and frequency distribution of total dog bite injuries in Punjab. The comparison of total dog bite injuries between 2019 and 2020 were made to understand whether there is significant difference in total number of dog bite injuries in 2019 and 2020. Methods: Total dog bite data from public sector hospitals of Punjab province were collected for the time period between January 2019 to December 2020 with the help of District Health Information System (DHIS) which is a comprehensively designed digital program. Descriptive measures and the graphical representation were used to describe and interpret the said data. A non-parametric test (Mann-Whitney test) was used to compare the median number of dog bite injuries in 2019 to 2020. Results: Results show that more than 0.2 million number of dog bite injuries have been recorded in 2019 and 2020. The medium number of the dog bite injuries in 2019 and 2020 were statistically significant, having pvalue