Publications

Costs and Utilization of Public Sector Family Planning Services in Pakistan

Khadija Abbas, M.Sc., Adnan Ahmad Khan, MBBS, MS, Ayesha Khan, MBBS, MPH

The public sector provides a third of family planning (FP) services in Pakistan. However, these services are viewed as being underutilized and expensive. We explored the utilization patterns and costs of FP services in the public sector.

Comparison of need and supply of syringes for therapeutic injections in Pakistan

Adnan Ahmad Khan, Momina Saleem, Huma Qureshi, Rashid Jooma, Ayesha Khan

To determine the extent of shortfall in syringes by measuring the need from nationally validated
sources and comparing it with position on the supply side. This was done in order to contribute to the ongoing national discussions that have focused on increasing syringe supply to curtail syringe reuse.

Female spouses of injection drug users in Pakistan: a bridge population of the HIV epidemic?

S. Ahmad, J. Mehmood, A.B. Awan, S.T. Zafar, K. Khoshnood and A.A. Khan

An estimated 21% of injection drug users (IDUs) in Pakistan are HIV-positive and data suggest that the spouses of IDUs may be a critical component of the HIV transmission chain. This study interviewed 101 spouses of male IDUs about their sexual practices and drug use.

Care seeking for STI symptoms in Pakistan

Adnan Ahmad Khan, Naghma-e-Rehan, Kanwal Qayyum, Ayesha Khan

To estimate the frequency of Sexually Transmitted Infections (STIs) among sex workers and drug users in Pakistan. Interviews were conducted on 3640 sex workers, injection drug users and truckers about STI symptoms within the past year and currently and the care they sought for them.

Contraception, synergies and options

Rashid Jooma, Adnan A. Khan

Many countries that prospered in the later half of the 20th century did so only once their populations stabilized.1 This is logical since limited resources can only be stretched so far and because strategizing for development and growth is difficult, particularly if the growth targets keep moving further away.

Family Planning in Pakistan: Applying What We Have Learned

Adnan Ahmad Khan, MBBS, MS, Ayesha Khan, MBBS, MPH, Wajiha Javed, MBBS, MSc, Hasan Bin Hamza, MBBS, MSc, Mejzgaan Orakzai, MSc, Aliya Ansari, MSc, Khadija Abbas, MSc

Despite six decades of government and private sector programs, CPR in Pakistan is among the lowest in the region. This article reviews published and grey literature to understand why despite sufficient time and usually sufficient funding, CPR remains low in Pakistan.

Performance and Measurement of a Community-Based Distribution Model of Family Planning Services in Pakistan

Syed Khurram Azmat, MBBS, MPH, Shirin Ahmed, BA, Waqas Hameed, MSc, Mohsina Bilgrami, MBBS, Ayesha Khan, MBBS, MPH, Adnan Ahmad Khan, MBBS, MS, Ghulam Mustafa MSc
Community-based distribution (CBD) has been successfully applied to family planning (FP) services worldwide. It forms the basis for the large lady health worker (LHW) programme in Pakistan which serves a limited number of women with contraception services.

Correlates and prevalence of HIV and sexually transmitted infections among Hijras (male transgenders) in Pakistan

A A Khan MBBS MS, N Rehan MBBS MSc, K Qayyum M Phil and A Khan MBBS MPH

This study explored the role of Hijras (male transgenders) as a core group in Pakistan’s HIV epidemic. Four hundred and nine Hijras underwent detailed behavioural and biological assessment. Our subjects were young (median age: 24 years), debuted sex early and used alcohol and drugs. Sex with men, women and other Hijras along with co-habitation/marriagewere reported.

Policy and Programme Implications of Unmet Need for Family Planning in Pakistan

Shirin Ahmed, BA, Ayesha Khan, MBBS, MPH, Adnan Ahmad Khan, MBBS, MS

With the contraceptive prevalence rate (CPR) at 30% in 2006-7, the rates of contraception use among married women of reproductive age (MWRA) in Pakistan are among the lowest in the region. This paper explores some options of unmet need as a means of addressing the low CPR.

Prioritized Targeting or Mile Wide, Inch Thin: Time to Strategize Public Sector Health Investments

Shirin Ahmed, Adnan A. Khan, Ayesha Khan

The total health care expenditure in Pakistan is Rs 185 billion (USD 3.08 billion), of which the private sector spends Rs 121 million and public sector spends Rs 59.5 million (1). This spending which comes to around 2.2% of the GDP or around USD 19 per head annually is among the lowest in the region. The government’s share of this whole is around 0.6-0.7% of the GDP (2) and has largely remained unchanged over the years due fiscal and political constraints.

Protecting Pakistan’s health during the global economic crisis

R. Jooma, A. Khan and A.A. Khan

The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan’s health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health.

Reuse of syringes for therapeutic injections in Pakistan: rethinking its definition and determinants

Adnan Ahmad Khan, Arshad Altaf, Huma Qureshi, Mejzgaan Orakzai1 and Ayesha Khan

Frequent reuse of syringes during medical injections is fuelling epidemics of human immunodeficiency virus and hepatitis C virus infections in many low- and middle-income countries including Pakistan

Somatic Symptoms in Primary Care: Etiology and Outcome

Adnan A. Khan, M.D., Ayesha Khan, M.D. Jaroslaw Harezlak, M.S., Wanzhu TU, PH.D. Kurt Kroenke, M.D.

Although somatic complaints are the predominant reason for seeking general medical care, their etiology and prognosis remain poorly understood. In a random sample of the records of all patients visiting an urban primary care clinic during four 1-month periods, 289 patients had one or more somatic symptoms, a total of 433 symptoms

The Context and Limitations of Female Sterilization Services in Pakistan

Adnan Ahmad Khan, MBBS, MS, Ayesha Khan, MBBS, MPH, Khadija Abbas, MSc, Syed Farhan Ali Tirmizi, MBBS, MSc,1 Zia ul Islam, MA

Female sterilization has long been the most popular method of family planning (FP) in Pakistan, and yet most public health experts feel it contributes little to controlling family size or to population welfare.

Sexually transmitted infection care in Pakistan: The providers perspective

Adnan Ahmad Khan, Ayesha Khan

To explore the healthcare providers perspectives in the management of sexually transmitted infections. The mixed-method qualitative study done in 2008 involved 51 general practitioners and specialists who are known among peers for managing sexually transmitted infections.

The Prevalence of Chlamydia, Gonorrhea, and Trichomonas in Sexual Partnerships: Implications for Partner Notification and Treatment

Ayesha Khan, MD, J. Dennis Fortenberry, MD, MS, Beth E. Juliar, MS, Wanzhu TU, PHD, Donald P. Orr, MD, And Byron E. Batteiger, MD

Treatment of sex partners by patient-delivered partner therapy (PDPT) may prove to be an effective strategy in reducing reinfection and preventing the sequelae of sexually transmitted infections (STIs). However, limited data exists regarding STIs within sexual partnerships (dyads).

Why don't we do enough medical research in Pakistan

Adnan Ahmad Khan, Ayesha Khan, Huma Qureshi

Madam, Phuping, et al1 identifieda lack of skills, resources and knowledge as core limitations to research productivity in Thailand. Their findings differ from what we, along with the Ministry of Health, Pakistan and the WHO found in 2009, as part of national consultation to develop a National Strategy for Health Research.