Implementation of the ANISA Study in Karachi, Pakistan

Shafiq, Yasir; Nisar, Imran; Kazi, Abdul Momin; Ali, Murtaza; Jamal, Saima; Ilyas, Muhammad; Jehan, Fyezah; Sultana, Shazia; Qureshi, Shahida; Hotwani, Aneeta; Zaidi, Anita K. Sm

doi:10.1097/inf.0000000000001109

Cited by 14 publications

(14 citation statements)

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“…The department of Pediatrics and Child Health at Aga Khan University (AKU) conducted a baseline census in the study area in 2010 (Shafiq et al, 2016). During that year, 200,000 people lived in the study area.…”

Section: Study Methodsmentioning

confidence: 99%

“…During that year, 200,000 people lived in the study area. Among them, 25% were women of reproductive age (age range, 15–49 years) and 12% were children aged less than five years (Shafiq et al, 2016; Zaidi et al, 2013). The gross fertility rate was 131 out of 1000 women of reproductive age, the under-five mortality rate was 68.8 per 1000 live births and the neonatal mortality rate was 42.7 per 1000 live births (Shafiq et al, 2016; Zaidi et al, 2013).…”

Section: Study Methodsmentioning

confidence: 99%

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Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan

Shafiq

Khowaja

Yousafzai

et al. 2017

Journal of Infection Prevention

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Section: Study Methodsmentioning

confidence: 99%

Section: Study Methodsmentioning

confidence: 99%

Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan

Shafiq

Khowaja

Yousafzai

et al. 2017

Journal of Infection Prevention

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“…In Karachi, data were collected by community health workers who visited households every three months in 2011. 8 In Sindh, the trial investigated the effect of interventions involving traditional birth attendants and Lady Health Workers on birth asphyxia, sepsis and the number of low-birth-weight infants and, consequently, on neonatal mortality. For the United Republic of Tanzania, data from all participants in an individually randomized trial examining the effect of applying chlorhexidine to the umbilical cord stump on neonatal mortality were used because the intervention had no significant effect.…”

Section: Methodsmentioning

confidence: 99%

Neonatal mortality within 24 hours of birth in six low- and lower-middle-income countries

Baqui

Mitra

Begum

et al. 2016

Bull. World Health Organ.

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ObjectiveTo estimate neonatal mortality, particularly within 24 hours of birth, in six low- and lower-middle-income countries.MethodsWe analysed epidemiological data on a total of 149 570 live births collected between 2007 and 2013 in six prospective randomized trials and a cohort study from predominantly rural areas of Bangladesh, Ghana, India, Pakistan, the United Republic of Tanzania and Zambia. The neonatal mortality rate and mortality within 24 hours of birth were estimated for all countries and mortality within 6 hours was estimated for four countries with available data. The findings were compared with published model-based estimates of neonatal mortality.FindingsOverall, the neonatal mortality rate observed at study sites in the six countries was 30.5 per 1000 live births (range: 13.6 in Zambia to 47.4 in Pakistan). Mortality within 24 hours was 14.1 per 1000 live births overall (range: 5.1 in Zambia to 20.1 in India) and 46.3% of all neonatal deaths occurred within 24 hours (range: 36.2% in Pakistan to 65.5% in the United Republic of Tanzania). Mortality in the first 6 hours was 8.3 per 1000 live births, i.e. 31.9% of neonatal mortality.ConclusionNeonatal mortality within 24 hours of birth in predominantly rural areas of six low- and lower-middle-income countries was higher than model-based estimates for these countries. A little under half of all neonatal deaths occurred within 24 hours of birth and around one third occurred within 6 hours. Implementation of high-quality, effective obstetric and early newborn care should be a priority in these settings.

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“…Regarding administrative challenges to undertaking vital events registration, many articles mentioned geographic factors as barriers. These geographic factors included low population density, large geographic catchment areas, increasing distance from a HEW station, and long distances between houses [16,24,30,31,33,38,39]. Migration of the community was also noted as a challenge in areas in which there is a nomadic population or in cases in which the effect of migration within the community is not clear [24,34].…”

Section: Factors Impacting Performancementioning

confidence: 99%

“…Additionally, two articles noted that there may be underreporting due to conflict of interest when CHWs or TBAs who are tasked with reducing adverse events such as maternal or neonatal deaths are asked to report on those events [11,24]. Finally, regarding project/study methods, mobile phones and SMS messaging were used to assist in timely reporting of births and deaths in several articles [11][12][13][14][15][16][17]25,38]. One article noted that mobile phone use increased the reporting of previously hardto-capture events such as miscarriages, abortions, and stillbirths [15].…”

Section: Factors Impacting Performancementioning

confidence: 99%

A systematic review of vital events tracking by community health agents

Nichols

Ragunanthan

et al. 2019

Global Health Action

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Background: Efforts to improve national civil registration and vital statistics (CRVS) systems are focusing on transforming traditionally passive systems into active systems that have the ability to reach the household level. While community health agents remain at the core of many birth and death reporting efforts, previous literature has not explored elements for their successful integration into CRVS efforts. Objective: To inform future efforts to improve CRVS systems, we conducted a systematic review of literature to understand and describe the design features, resulting data quality, and factors impacting the performance of community health agents involved in tracking vital events. Methods: We reviewed 393 articles; reviewers extracted key information from 58 articles meeting the eligibility criteria: collection of birth and/or death information outside of a clinic environment by a community agent. Reviewers recorded information in an Excel database on various program aspects, and results were summarized into key themes and topic areas. Results: The majority of articles described work in rural areas of Africa or South-East Asia. Nearly all articles (86%) cited some form of household visitation by community health agents. Only one article described a process in which vital events tracking activities were linked to official vital events registers. Other factors commonly described included program costs, relationship of community agents to community, and use of mobile devices. About 1/3 of articles reported quantitative information on performance and quality of vital events data tracked; various methods were described for measuring completeness of reporting, which varied greatly across articles. Conclusions: The multitude of articles on this topic attests to the availability of community health agents to track vital events. Creating a programmatic norm of integrating with CRVS systems the vital events information collected from existing community health programs has the potential to provide governments with information essential for public health decision-making. ARTICLE HISTORY

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Implementation of the ANISA Study in Karachi, Pakistan

Abstract: ANISA offers lessons for successful implementation of complex study protocols in areas of high child mortality and challenging social environments.

Cited by 14 publications

References 4 publications

Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan

Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan

Neonatal mortality within 24 hours of birth in six low- and lower-middle-income countries

A systematic review of vital events tracking by community health agents

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