Rural mothers' beliefs and practices about diagnosis, treatment, and management of children health problems: A qualitative study in marginalized Southern Pakistan

Impact of social determinants of health on causes of ophthalmic trauma: A narrative review

Ophthalmic trauma (OT) is a leading cause of monocular vision loss that preferentially affects certain populations. In this narrative review, we aim to discuss the impact of social determinants of health (SDOH) on the prevalence and outcomes of OT. We conducted literature search to identify studies published between 2019 and 2024 that discuss the impact of SDOH on OT. A total of 92 studies were included. Overall, males, particularly those of younger and working age groups, are most commonly affected with OT, with assault, firearm, and occupation-related injuries being most common types of injuries encountered. In comparison, falls and intimate partner violence are the most common causes in women. Children are more prone to toys, sports, and firework-related injuries, while falls represent the leading cause in the elderly frequently resulting in open globe injury. Black and Hispanic individuals suffer disproportionately from assault and firearm-related injuries. Unemployed individuals and those of rural residence and low socioeconomic status have higher rates of OT. Our review underscores the impact of demographic, social, and economic factors on the risk and outcomes of OT and its subtypes. Only by understanding the patterns, targeted interventions and policy changes can be undertaken to address these disparities.

Role of Maternal Empowerment in Addressing Child Malnutrition: Evidence from Asian Developing Countries

BACKGROUND

Malnutrition among expectant mothers in underdeveloped areas is abundant and a serious public health concern. This study examines how maternal empowerment affects nutritional outcomes among under-five children in developing Asian nations.

OBJECTIVE

With an emphasis on nutritional outcomes, including stunting, wasting, and underweight, the main objective of this study is to investigate the connection between mother empowerment and child malnutrition and explore how better child health in developing Asian nations can be achieved through empowering mothers.

METHODS

Using Demographic and Health Survey (DHS) data of ten emerging Asian countries from three regions of Asia, this study evaluates maternal empowerment using the composite maternal empowerment index (CMEI) and examines how it relates to children's nutritional health. For the assessment of the significance of the association between maternal empowerment and child health outcomes, statistical analysis was conducted.

RESULTS

Our results indicated that maternal empowerment and child health have a statistically significant relationship, especially regarding a reduction in the prevalence of stunting, wasting, and underweight conditions in children. At the same time, maternal education showed a significant role in reducing malnutrition in children in all three regions of Asia.

CONCLUSION

In conclusion, developing Asian nations require empowering women. Also, it is essential to initiate nutrition programs, extension education, and synergistic working models that are especially suited to rural women. By strengthening mothers' roles in promoting their children's health, these initiatives can help solve the widespread problem of child malnutrition.

Addressing nutritional inequities in vulnerable Colombian communities: an analysis from socioeconomic, cultural, and healthcare challenges

BACKGROUND

Malnutrition remains a significant public health challenge in low-middle-income countries, particularly in rural and ethnic communities where structural inequalities exacerbate health disparities. This study aimed to examine the socioeconomic, cultural, and healthcare factors influencing malnutrition in children under two years old in three vulnerable regions of Colombia: Guajira, Cesar, and Chocó.

METHODS

A mixed-methods approach was utilized, combining quantitative analysis with qualitative interviews exploring cultural practices and healthcare access. Data was collected from clinical records of 269 children under two years diagnosed with severe and moderate acute malnutrition, data were stratified by region, ethnicity, and maternal education levels. The socioeconomical analysis includes a geographical analysis according to the location of the households.

RESULTS

Socioeconomical disparities, with over 52% of households living on less than $125 USD per month, limited access to complementary foods, and high food insecurity characterized by families eating only once or twice a day. Prolonged exclusive breastfeeding over six months was observed in 10.7% of cases, influenced by cultural beliefs and food insecurity. Health complications, such as diarrhea and respiratory infections, were the most prevalent, where systemic barriers to healthcare access were most evident.

DISCUSSION

These findings align with global evidence from the WHO Global Nutrition-Report, which highlights the critical role of poverty, food insecurity, and inequitable healthcare access in perpetuating malnutrition. The study underscores the urgent need for culturally sensitive interventions, social protection programs, and infrastructural investments to address these disparities. By integrating local cultural contexts with evidence-based strategies, targeted-policies can improve maternal and child nutrition outcomes in Colombia's most vulnerable regions.

Strength in silence: the journey of mothers raising children with hydrocephalus

BACKGROUND

Raising a child with hydrocephalus can be very challenging, especially in low- and middle-income countries. In Pakistan, mothers being the primary caregivers for their hydrocephalic children are under tremendous stress.

METHODS

This study explores the challenges faced by Pakistani mothers raising children with hydrocephalus, employing a qualitative methodology through focus group discussions comprising ten mothers of hydrocephalic babies at Tertiary Care Hospital in Pakistan.

RESULTS

The findings highlight three main themes: emotional toll, social isolation, and financial strain. Mothers experience significant emotional stress due to societal stigma and a lack of support, particularly from their husbands and family. Social isolation is prevalent, as mothers fear sharing their burdens and face physical confinement due to their children's needs. Financial strain is another major issue, with high medical costs adding to their economic difficulties.

CONCLUSION

The study emphasizes improved access to specialized care, awareness campaigns to reduce stigma, financial assistance, and stronger community support networks to support these mothers better. Addressing these unmet needs is crucial for empowering Pakistani mothers in their caregiving roles and improving the quality of life for their children with hydrocephalus.

Political Economy of Maternal Child Malnutrition: Experiences about Water, Food, and Nutrition Policies in Pakistan

This study examined access to water, food, and nutrition programs among marginalized communities in Southern Punjab, Pakistan, and their effects on nutrition. Both qualitative and quantitative data were used in this study. We held two focus group discussions (one with 10 males and one with 10 females) and conducted in-depth interviews with 15 key stakeholders, including 20 mothers and 10 healthcare providers. A survey of 235 households was carried out to evaluate water and food insecurity, with the data analyzed using Wilcoxon's rank-sum test, t-test, and Pearson's chi-square test. The results revealed that 90% of households experienced moderate-to-severe water insecurity, and 73% faced moderate-to-severe food insecurity. Household water and food insecurity were positively correlated with each other (correlation coefficient = 0.205; p = 0.004). Greater household water (p = 0.028) and food insecurity (p < 0.001) were both associated with higher perceived stress. Furthermore, lower socioeconomic status was strongly related to higher levels of water (p < 0.001) and food insecurity (p < 0.001). Qualitative findings highlight the impact of colonial and post-colonial policies, which have resulted in water injustice, supply issues, and corruption in water administration. Women face significant challenges in fetching water, including stigma, harassment, and gender vulnerabilities, leading to conflicts and injuries. Water scarcity and poor quality adversely affect sanitation, hygiene, and breastfeeding practices among lactating mothers. Structural adjustment policies have exacerbated inflation and reduced purchasing power. Respondents reported a widespread lack of dietary diversity and food quality. Nutrition programs face obstacles such as the exclusion of people with low social and cultural capital, underfunding, weak monitoring, health sector corruption, and the influence of formula milk companies allied with the medical community and bureaucracy. This study concludes that addressing the macro-political and economic causes of undernutrition should be prioritized to improve nutrition security in Pakistan.

"An obedient wife never says "no" to her virtual god." High fertility conceptions and barriers to contraceptive use among mothers of Southern Pakistan: a qualitative study

ISSUE

Biomedical approaches want to change locals' behaviors without understanding the sociocultural rationales and contextualizing the cultural and structural backdrop of women's agency.

OBJECTIVES

This study explored the perceptions and practices of rural mothers about fertility and reproductive health and further examine the lack of preference for contraception and birth spacing in Southern Pakistan.

METHODOLOGY

Using purposive sampling we recruited 15 healthcare providers and 20 mothers from Southern Punjab. Key informants and in-depth interviews were used for data collection. We extracted themes and sub themes to analyse qualitative data.

FINDINGS

Five major themes identified preventing birth spacing and contraceptive use: (1) cultural barriers (2) economic difficulties and demographic factors; (3) gender-related hurdles; (4) spiritual and religious obstacles, and (5) medico-ethical complications. Nearly, ten sub-themes contributing to these major themes were: custom of girls' early marriages, in-laws' permission for contraception, women's concern for medical complications and preference for safer methods, misuse of contraceptive methods by the medical community, mothers' perception of contraception as sinful act and controlling birth is against faith, economic and rural-ethnic factors for high fertility, masculine disapproval of condom use, and wishing to give birth to male children.

SUGGESTIONS

We advocate for understanding the sociocultural explanations for low contraceptive use and urge practice of more natural methods of birth spacing over commercial solutions. The study suggests socio-economic development of less developed communities and empowerment of poor, illiterate, and rural women along with behavior change communication strategies.