Real-Time Deep Learning for Multi-Label Retinal Disease Diagnosis with Embedded System

Deleted Journal, Год журнала: 2025, Номер unknown, С. 100035 - 100035

Опубликована: Март 1, 2025

Язык: Английский

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Strengthening primary health care through community health workers in South Asia

The Lancet Regional Health - Southeast Asia, Год журнала: 2024, Номер 28, С. 100463 - 100463

Опубликована: Авг. 23, 2024

The growing health challenges in South Asia require further adaptations of community worker (CHW) programs as a key element primary care (PHC). This paper provides comparative analysis CHW five countries (Bangladesh, India, Nepal, Pakistan, and Sri Lanka), examines successes challenges, suggests reforms to better ensure highly performing programs. To examine the region, we conducted narrative review peer-reviewed grey literatures, well eliciting opinions from experts. Common roles CHWs include education, mobilization, community-based services, particularly related reproductive, maternal, neonatal, child health. Some utilize for non-communicable diseases other emerging issues. maximize potential contribution achieving Universal Health Coverage, recommend future research policy focus on strengthening existing systems support expansion integrating into national PHC systems. is Paper 4 Series Primary Care Asia, addressing areas that have revitalize Asian countries.

Язык: Английский

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The unspoken grief of multiple stillbirths in rural Pakistan: an interpretative phenomenological study

BMC Women s Health, Год журнала: 2022, Номер 22(1)

Опубликована: Фев. 22, 2022

Pakistan has the highest rate of stillbirth (30.6 stillbirths per 1000 total births) as compared to other South Asian countries. The psychological impact on bereaved women is well documented; however, there a dearth literature lived experiences with multiple in Pakistan.The purpose this research understand who had Thatta, Pakistan.An interpretative phenomenological study was conducted district Thatta eight experienced more than one stillbirth. A semi-structured in-depth interview guide used for data collection. were analyzed by using thematic analysis approach.The results show that experiencing devastating women's mental and social wellbeing. are stigmatized "child-killer" or cursed being punished God. They avoided gatherings within families community, because these pressures seek spiritual religious treatment, struggle conceive again deliver live baby. It observed psycho-social medical needs remain unaddressed not only healthcare system but also society at large.The physical, well-being experience stake. These considered outcast. Health care providers including physicians, lady health workers, traditional birth attendants should be trained provision psychosocial support along routine they provide communities facilities. inform about biomedical causes would helpful mitigate stigma associated stillbirths. Moreover, counsel family members especially in-laws sorrowful

Язык: Английский

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Modern Contraception in Pakistan: A Cross-Sectional Study

Population and Economics, Год журнала: 2024, Номер 8(1), С. 77 - 96

Опубликована: Март 29, 2024

Despite numerous family planning awareness campaigns, modern contraceptive prevalence remains low in Pakistan. This reality stimulates risky sexual behaviours and compromises reproductive rights. Our study has explored factors associated with use among sexually active married women used data from the 2017-2018 Pakistan Demographic Health Survey (PDHS). A total of 10,282 who were during last 3 months prior to survey included this study. The equals 27.7%. Furthermore, results indicate that age, region, education level, wealth index, fieldworker visit, number children significantly group is not homogeneous. In order increase contraception population, different groups should be targeted interventions specific their needs.

Язык: Английский

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Risks to Child Development and School Readiness Among Children Under Six in Pakistan: Findings from a Nationally Representative Phone Survey

International Journal of Early Childhood, Год журнала: 2023, Номер 56(1), С. 129 - 167

Опубликована: Март 8, 2023

This paper analyzes the risks to child development and school readiness among children under age 6 in Pakistan. Drawing on a nationally representative telephone survey conducted midst of global pandemic, between December 2021 February 2022, we present first estimates for 3 years 3-6 age, using internationally validated instruments. The examines how risk factors that were exacerbated due COVID-19 such as parental distress, lack psychosocial stimulation, food insecurity, low maternal education, no enrollment early childhood living rural area, are associated with children's outcomes. data indicate more than half (57 percent) parents distressed 61 percent households reported cutting down size or skipping meals since start pandemic. reveal over fail engage adequate stimulation their education is very (39 percent). finds outcomes decline rapidly number increase. Specifically, years, at home higher levels distress most significantly lower levels. For aged amount received had strongest association scores.

Язык: Английский

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Expanded roles of community health workers beyond malaria in the Asia-Pacific: A systematic review

PLOS Global Public Health, Год журнала: 2024, Номер 4(10), С. e0003113 - e0003113

Опубликована: Окт. 16, 2024

In the Greater Mekong Subregion (GMS), community health workers (CHWs) are a key component of malaria elimination strategies. As declines, support for, and uptake of, services may also subsequently decrease. Expanding their roles beyond has been proposed to sustain services. A systematic review was conducted identify characterize programmes with CHWs providing in addition those for Asia Pacific. This describes expanded roles, identifies evidence impact or success programmes, explores strategies ensure sustainability factors effective implementation inform design CHW programmes. Searches were 6 databases, grey literature, bibliographies retrieved articles. Data extracted from 38 published articles, 12 programme reports, 4 briefs analysed using thematic coding descriptive analysis. Twenty-nine identified performing both non-malaria There on incidence these, none mortality, other diseases. Monitoring evaluation mechanisms, multi-sectoral stakeholder collaborations, adequate training consistent supervision implementation. Integration into broader services, ongoing political funding support, engagement local communities found contribute sustaining provision by CHWs. depends management strengthening linkages systems. To countries need policies financing, sufficiently strong systems deliver basic that adapted needs which means transitioning away vertical disease programs. Further research should explore have not captured this address gaps measuring outcomes.

Язык: Английский

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Home-based digital counselling by frontline community workers for anxiety and depression in rural Pakistan: piloting mPareshan - a task-shifting primary mental health care intervention

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Дек. 17, 2024

Background There is limited evidence that interventions for improving mental well-being can be integrated sustainably into primary health care in Pakistan. We aimed to pilot ‘mPareshan digital intervention’ locally, adapted from WHO mhGAP and delivered by trained supervised women lay workers learn if it was feasible possibly effective reducing anxiety depression prior proposing implementation on a larger scale. Method Using Generalized Anxiety Disorder-7 (GAD-7) Patient Health Questionnaire-9 (PHQ-9), baseline household survey conducted independent data collectors measure depression. 72 government Lady Workers (LHWs) Supervisors (LHSs) District Badin, Sindh 3 days screen counsel adult men (> 18 years) with mild moderate symptoms of Supervised LHSs, these positive participants (SPs) received 6 counselling sessions LHWs through the mPareshan app during their routine visits. The had interactive audio/video psychoeducation features. Severe cases were referred nearest available service. Results Out 366 individuals surveyed at baseline, 98 (53 45 women, mean age 43.2 screened eligible intervention. SPs lost follow up various reasons. Of 92 who completed all sessions, PHQ-9 score declined 7.5 (sd 3.1) before intervention 2.6 2.2) after Mean GAD-7 fell 6.6 3.0) 2.1 sessions. No significant association between sociodemographic variables (age, gender, education, income levels) scores noted. Conclusion Preliminary meaningful improvement found using this locally rural setting Sindh, need test effectiveness task-shifting model an appropriately powered randomised controlled trial. Trial Registration ACTRN12622000989741 Australian New Zealand Clinical Registry (https//www.anzctr.org.au/Default.aspx).

Язык: Английский

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Impact of COVID-19 on mental health of primary healthcare workers in Pakistan: lessons from a qualitative inquiry

BMJ Open, Год журнала: 2022, Номер 12(12), С. e065941 - e065941

Опубликована: Дек. 1, 2022

The existing literature regarding the mental health consequences of COVID-19 among healthcare workers revolves predominantly around specialised hospital settings, while neglecting primary (PHCW) who are first point contact for patients. In view negligible evidence, this study explored impact and system response, sought suggestions recommendations from PHCWs to address their needs during pandemic crisis. We employed a qualitative exploratory design. A total 42 facilities across 15 districts in Sindh Punjab provinces Pakistan. telephonically conducted 47 in-depth interviews with service providers managers. combination inductive deductive approach was used data analyses using NVivo V.11.0. There immense fear, stress anxiety being infected infecting families at beginning outbreak its peak which tapered off over time. It triggered by lack information about virus management, false rumours, media hype, personal protective measures (personal equipment, PPE) non-cooperation patients community people. Trainings on awareness raising PPEs provided system, emotional support coworkers supervisors, were instrumental addressing needs. Additionally, they recommended appreciation recognition, provision psychosocial professionals. Primary should be prepared provide timely informational (eg, continuous updates training guidelines), PPE, recognition), organisational safe conducive working environment) frequent or needs-based session professionals) order mitigate

Язык: Английский

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Diabetic retinopathy service delivery and integration into the health system in Pakistan—Findings from a multicentre qualitative study

PLoS ONE, Год журнала: 2021, Номер 16(12), С. e0260936 - e0260936

Опубликована: Дек. 15, 2021

This paper is based on qualitative research carried out in a diabetic retinopathy (DR) programme three districts of Pakistan. It analyses the organisation and delivery DR services extent to which interventions resulted fully functioning integrated approach care treatment. Between January April 2019, we conducted 14 focus group discussions 37 in-depth interviews with 144 purposively selected participants: patients, lady health workers (LHWs) professionals. Findings suggest that integration was helpful prevention management DR. Through efforts LHWs general practitioners, patients community became aware eye issues related uncontrolled diabetes. However, number systemic pressure points continuum seem have limited impact integration. Some components intervention, such as patient tracking system reinforced interdepartmental links, show great promise need be sustained. The results this study point for action ensure inclusion list local departments’ priority conditions, greater provision closer-to-community services, mobile clinics. Future will consider complexity adding an already heavy workload LHWs.

Язык: Английский

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Integrating eye care in low-income and middle-income settings: a scoping review

BMJ Open, Год журнала: 2023, Номер 13(5), С. e068348 - e068348

Опубликована: Май 1, 2023

Objectives Integrated people-centred eye care has been recommended as a strategic framework for reducing global vision impairment and blindness. The extent to which integrated with other services not widely reported. We aimed investigate approaches integrating service delivery systems in low resource settings, identify factors associated integration. Design Rapid scoping review based on Cochrane Review Preferred Reporting Items Systematic Reviews Meta-Analyses guidelines. Data sources MEDLINE, Embase, Web of Science, Scopus Library databases were searched September 2021. Eligibility criteria Papers interventions involving or preventative into health systems, peer-reviewed English, conducted low-income middle-income countries, published between January 2011 2021 included. extraction synthesis Two independent reviewers screened, quality appraised coded included papers. A deductive–inductive iterative analysis approach was used focus delivery. Results search identified 3889 potential papers, 24 Twenty papers incorporated more than one intervention type (promotion, prevention and/or treatment), but none rehabilitation. Most articles involved human resources development yet rarely appeared be people-centred. level integration building relationships enhancing coordination. Integrating challenged by the need ongoing support worker retention. In primary workers often already at full capacity, had competing priorities, varying capabilities limited motivation. Additional barriers inadequate referral information poor supply chain management procurement practices finite financing. Conclusion is challenging task, compounded limitations, priorities needs. This highlighted future interventions, further investigation rehabilitation services.

Язык: Английский

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