Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-22T15:42:00.711Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of health service provision on mothers and infants in a rural village in North West Frontier Province, Pakistan

Published online by Cambridge University Press:  01 March 1998

Christine A Northrop-Clewes ,
Nisar Ahmad ,
Parvez I Paracha  and
David I Thurnham
Christine A Northrop-Clewes*
Affiliation:
Northern Ireland Centre for Diet and Health, University of Ulster, Coleraine, Northern Ireland BT52 ISA, UK
Nisar Ahmad
Affiliation:
Pakistan Medical Research Council, Health Services Research Centre, Lady Reading Hospital, Peshawar, NWFP, Pakistan
Parvez I Paracha
Affiliation:
Department of Human Nutrition, Agricultural University, Peshawar, NWFP, Pakistan
David I Thurnham
Affiliation:
Northern Ireland Centre for Diet and Health, University of Ulster, Coleraine, Northern Ireland BT52 ISA, UK
*
*Corresponding author: E-mail: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

The objective of this paper is to examine the impact of the Health Service Research Project of the Pakistan Medical Research Council (PMRC) on mothers and infants in Budhni village, North West Frontier Province (NWFP), Pakistan.

Methods:

Information from the PMRC records on the socioeconomic and demographic situation over the last 10 years and anthropometric measurements made on all infants from 1986–96 were collected and analysed.

Results:

The demographic data showed a number of changes, namely a reduction in birth rate and improvements in perinatal, neonatal, infant and child mortality rates. Literacy in the village was poor (27 and 39% literate in 1986 and 1996, respectively) and female literacy showed no improvement (14%). Improvements in sanitation and in the water supply introduced by the PMRC had limited success, as clean water was subsequently contaminated by unclean hands and utensils, and 50% of the population continued to use open fields for sanitation. In 1986 only 27% of children 0–5 years were vaccinated, but by 1996, 96% of children had completed polio, diphtheria/pertussis/tetanus (DPT) and bacille Calmette-Guérin (BCG) vaccination programmes and 95% of women of child-bearing age were vaccinated against tetanus. Protection against tetanus reduced neonatal deaths and from 1333 onwards there have been no further cases.

Anthropometric data for the period 1986–96 for infants (0–24 months) showed that at birth the majority of infants were close to the 50th National Centre for Health Statistics (NCHS) centile for weight and length, and only 5% of birth-weights were less than 2.5 kg. Growth charts showed faltering in length and weight and by 24-months length in both boys and girls was below the 3rd NCHS centile and weights were just above.

Conclusions:

Reductions in child mortality have occurred over the period 1986–96. However, the slow progress in adopting hygienic practices, despite health education, and the low literacy rates, particularly in women, may hamper continued improvement.

Keywords

Rural Pakistan health servicesInfant growthNutrition and health education
Type
Research Article
Information
Public Health Nutrition , Volume 1 , Issue 1 , March 1998 , pp. 51 - 59
Copyright
Copyright © The Nutrition Society 1998

References

1Grant, J.P. The State of the World's Children. United Nations Children's Fund. New York: Oxford university 1995, 5: 66.Google Scholar
2UNICEF. Situation Analysis of Children and Women in Pakistan. Pakistan: UNICEF, 1992.Google Scholar
3Majumdar, B, Amarsi, Y, Carpio, B. Pakistan's community health workers. Canadian Nurse 1997; 93: 32–4.Google ScholarPubMed
4National Center for Health Statistics. Growth charts. Rockville, MD: US Department of Health, Education and Welfare, Public Health Service, Health Resources Administration (HRA76–1120, 25 3), 1976.Google Scholar
5World Development Report. International Bank for Reconstruction and Development/the World Bank, Washington, DC 1993.Google Scholar
6Chavasse, D., Ahmad, N, Akhtar, T. Scope for fly control as a diarrhoea intervention in Pakistan: a community perspective. Soc. Sci. Med. 1996; 8: 1289–94.CrossRefGoogle Scholar
7Lunn, P.G., Northrop-Clewes, C.A., Downes, R.M. Intestinal permeability, mucosal injury and growth faltering in Gambian infants. Lancet 1991; 338: 907–10.CrossRefGoogle ScholarPubMed
8Northrop-Clewes, C.A, Paracha, P.I., McLoon, U, Thurnham, D.I. Effect of improved vitamin A status on response to iron supplementation in Pakistani infants. Am. J. Clin. Nutr. 1996; 64: 694–9.CrossRefGoogle ScholarPubMed
9Northrop-Clewes, C.A, McCullough, F, Das, B.S, Lunn, P.G, Downes, R.M, Thurnham, D.I. Improvements in Vitamin A Intake Influence Gut Integrity in Infants. XVll TVACG Meeting Cairo, Egypt, 1997.Google Scholar
10Kurian, G.T., ed. Pakistan. In: Encyclopaedia of the third World, third edition, Vol. ii, 1987.Google Scholar