Suchergebnisse

OBJECTIVES: To describe the evolution of the Sehat Sahulat Programme (SSP), a large-scale health insurance scheme launched by the provincial government of Khyber Pakhtunkhwa, Pakistan and to contextualise it in the national discourse around Universal Health Coverage (UHC). METHODS: This review was based on peer-reviewed publications and publicly available grey literature over the last five years (2016-2020). We employed a combination of deductive and inductive approaches informed by the World Health Organisation's (WHO) UHC box framework. REVIEW: SSP was launched on 15 December 2015. It has been implemented in four phases, with a gradual expansion in the population, services and cost coverage. In 2015, SSP covered the poorest 21% of the population in four pilot districts. On 20 August 2020, the coverage was expanded to 100% of the population of Khyber Pakhtunkhwa. SSP conferred free access to an expanding list of inpatient, secondary and tertiary care services. The scheme covered all expenditures during hospital admission, with a defined upper ceiling. The ceiling for secondary and tertiary care has improved, with marked changes in tertiary coverage, from PKR 0 in Phase1 – PKR 400,000 in Phase 4. Despite the progress, SSP did not cover key health-related targets under Goal 3 of the Sustainable Development Goals (SDGs) and partially covered Pakistan's UHC benefits package. CONCLUSION: SSP coverage of population, disease and financial protection has expanded over five years. However, SSP coverage was not aligned with the national UHC priorities and the SDGs.

Background:Despite scientific literature and media reports of rising cases of suicide and attempted suicide in different parts of Pakistan, the extent of this problem remains unknown, particularly from outside the main urban centres of the country.Aims:To report data on Suicidal Behaviour (SB) from Malakand Division, a rural and marginalised part of Khyber Pakhtunkhwa (KPK) province, explore aetiological factors and propose preventive strategies.Methods:This study followed an explanatory, mixed-method study design. The first part quantitative [QUANT] comprised of police reports on suicidal behaviour, from 2001 till first 8 months of 2018. Detailed analysis of only data from 2013 was undertaken, as data prior to 2013 contained insufficient information. The second part that is, qualitative (QUAL) consisted of in-depth interviews with relevant stakeholders. A mixed method of inductive and deductive analytical approach was used.Results:From 2013 until the first quarter of 2018, the police recorded 1,645 attempts of both males and females of which 144 (8.75%) resulted in fatalities. Suicide attempts rose by 83.4% over the 5 years and 8 months. Approximately, 43.3% of the attempts were attributed to 'depression'. Domestic abuse was reported in 49.6% of cases. Of the total victims, 1,049 (63.7%) were females, whereas 60.1% were married. Ingestion of the organophosphates poison (pesticide) was reported in 53.2% ( n = 999) of suicide attempts. In more than 90% of the non-fatal suicide attempts, victims were booked under punitive laws. Poor socio-economic status, inter-personal stressors, violence against women and mental illnesses were the major causes of suicidal behaviour in Malakand [QUAL]. Investment in human development, strengthening of the healthcare system, de-stigmatisation of mental illnesses and women empowerment could possibly prevent suicidal behaviour in Malakand [QUAL].Conclusion:SB in Malakand Division is steadily increasing. The increase is more evident in vulnerable populations such as women and the younger population. 'Psychosocial stressors' and 'depression' were the main causes of suicidal behaviour. A broad-based, proactive, multi-sectorial approach is needed to prevent SB in the region.

This cross-sectional study aimed to evaluate the knowledge, attitudes and practices of secondary school students regarding carbonated drinks in the district of Rahim Yar Khan, Punjab, Pakistan. This study was conducted through a self-reported questionnaire, and 350 students participated in the survey from rural (n=148; 42.29%) and urban areas (n=202; 57.71%). 77.02% of rural students and 84.65% of urban students were aware of carbonated drinks. 31.08% of rural and 44.05% of urban students were mindful of carbonated drinks' components (p=0.014). 16.89% of rural students and 81.76% of urban students were known to know the caloric values of carbonated drinks (p<0.001). 89.19% of rural and 96.04% of urban students were aware of sugar-free carbonated drinks (p=0.012). 85.81% of rural students and 76.73% of urban students believed that consuming carbonated drinks is bad for health (p=0.034). 66.89 %, 11.49%, 34.46% 70.95% & 68.92% rural students and 82.18%, 40.09%, 29.21%, 84.16% & 83.17% urban students thought that carbonated drinks had association with obesity (p=0.001), bone decay (< 0.001), dental caries (p=0.296), belching (p=0.003) and hyperacidity (p=0.002) respectively. 66.89% & 75.68% of rural students and 74.25% & 79.21% of urban students believed that carbonated drinks were associated with diabetes type II and sleep disturbance, respectively. 64.19% of rural and 71.78% of urban respondents showed positive attitudes and agreed to stop consuming soft drinks. Most secondary school students from both areas preferred to drink carbonated soft drinks even with their awareness of the health issues of these drinks. Potential repercussions from the authorities in charge of the government might raise people's awareness of the problem.