Papers by Ehsanullah Tarin
lqbal for encouraging me to embark on this course. However, the ladder I decided to climb to reac... more lqbal for encouraging me to embark on this course. However, the ladder I decided to climb to reach this scholastic height had many and difficult rungs, but Dr. Andrew Green, the Rev. Jane Shaw and Dr. Mayeh Omar helped me along the way. Everything good in this thesis is due to them. I am thankful to the staff at the Nuffield Institute for Health, especially Vivienne Sercombe for facilitating my work Maurine Hastie for her editorial suggestions, and Susan Mottram for helping in referencing. I owe a great deal to individuals and organisations, both governmental and nongovernmental. Without their cooperation , I could have done nothing. Amongst many, I must mention Nasim, Rana, Usmani and Haroon. I have tried my best to safeguard the interests of the participants of this research, but for any deviance, I apologise. I am grateful to the Alliance for Health Policy and Systems Research for partially funding this research. However, they bear no responsibility for the contents. There were some upheavals; for example, my laptop was stolen. During such difficult times, I am indebted to Mian Naeem, Khawja Mehboob, the Rev. Jane
Annals of King Edward Medical University, Mar 11, 2017
Annals of King Edward Medical University, Jul 4, 2023
Crat e, have implemented initiatives with varying degree of dividends. In Southeast Asia, for exa... more Crat e, have implemented initiatives with varying degree of dividends. In Southeast Asia, for example, Bangladesh implemented MPDR (maternal and perinatal death review). This initiative facilitated data management for maternal mortality rate (MMR) and neonatal mortality rate (NMR), although difficulties were observed in capturing all deaths, and making distinction between stillbirths and newborn deaths. Indonesia introduced Maternal and Perinatal Death Surveillance and Response system (MPDSR), which contributed to the country's progress on key indicators. Likewise, in Myanmar, the community based maternal death review (CBMDR) and facility based maternal death review (FBMDR) was a major factor in reducing MMR from 453 per 100,000 live births in 1990 to 178 per 100,000 live births in 2015. It is in this vein that in 2015-16, Nepal Ministry of Health and Population (MOHP), building on Maternal Death Review (MDR) that was ongoing in hospitals since 1 1990, established MPDSR system. The initiative is meant to ensure that all births are wanted, and while every newborn starts a healthy life, there is an end to the preventable maternal and new-born's deaths. It comprises the identification and notification of maternal and perinatal deaths, determining the cause(s), and
Annals of King Edward Medical University, Jun 6, 2017
Ethics and collegiality in medical profession requires a doctor to treat fellow professional as b... more Ethics and collegiality in medical profession requires a doctor to treat fellow professional as brother and sister. Ethnography was employed to study the status of collegiality in public sector hospital, where an ailing doctor sought clinical care from a physician. The former, on account of the latter's cold reception and behaviour, reacted with his blood pressure shooting-up. The communication gap led the ailing doctor, who complied by coming to the laboratory, was perturbed, making him firstly unfit and later decided not to undergo the prescribed test. While Pakistan Medical and Dental Council have the responsibility to oversee, the undergraduate medical education and training should also lay greater emphasis on ethics in medical practice and healthy collegiality in the medical profession.
Eastern Mediterranean Health Journal, May 1, 2009
An action research project was carried out by a team from the National Public Health Management C... more An action research project was carried out by a team from the National Public Health Management Centre in Tabriz, Iran to test the following hypothesis: Health Volunteers are more able to support health improvements by focusing on community participation and empowerment through facilitating communities to define and solve their own problems than by only providing information on health problems. Training on participatory approaches was given to Women Health Volunteers (WHV) in a pilot area. The results gave evidence that local people could identify and act upon their own health needs and request more information from professionals to improve their own health. Further research is needed however to assess how the pilot can be scaled up and how initial enthusiasm can be sustained.
lqbal for encouraging me to embark on this course. However, the ladder I decided to climb to reac... more lqbal for encouraging me to embark on this course. However, the ladder I decided to climb to reach this scholastic height had many and difficult rungs, but Dr. Andrew Green, the Rev. Jane Shaw and Dr. Mayeh Omar helped me along the way. Everything good in this thesis is due to them. I am thankful to the staff at the Nuffield Institute for Health, especially Vivienne Sercombe for facilitating my work Maurine Hastie for her editorial suggestions, and Susan Mottram for helping in referencing. I owe a great deal to individuals and organisations, both governmental and nongovernmental. Without their cooperation , I could have done nothing. Amongst many, I must mention Nasim, Rana, Usmani and Haroon. I have tried my best to safeguard the interests of the participants of this research, but for any deviance, I apologise. I am grateful to the Alliance for Health Policy and Systems Research for partially funding this research. However, they bear no responsibility for the contents. There were some upheavals; for example, my laptop was stolen. During such difficult times, I am indebted to Mian Naeem, Khawja Mehboob, the Rev. Jane
Annals of King Edward Medical University
Objective: To determine the trends in the prevalence of non-communicable diseases associated risk... more Objective: To determine the trends in the prevalence of non-communicable diseases associated risk factors and implications for policies and strategies. Background: Non-Communicable Diseases (NCDs) contribute increasingly to disease burden in Nepal. The main drivers to this situation are the NCD related risk factors; and to determine their prevalence the Nepal Ministry of Health and Population conducted WHO Stepwise Approach to NCD Risk Factor Surveillance (STEPS) surveys in 2007, 2012 and 2019. This paper, by using results of STEPS surveys, explores the trends of NCD related risk factors and their implications for policies and strategies. Methods: This paper relies on the desk review of literature and secondary data, collected from the unpublished grey literature, mainly reports of the STEPS surveys. In addition, to corroborate findings, the evidence and experience from other countries available as published literature was brought. The data were analysed manually. Findings: Overall,...
Annals of King Edward Medical University
The objective of this paper is to share Nepali experience of maternal death surveillance and resp... more The objective of this paper is to share Nepali experience of maternal death surveillance and response in reducing preventable maternal deaths. Secondary data, mainly an assessment report of Maternal and Perinatal Death Surveillance and Response system, is used in developing this paper. To bridge the information gap, informal discussions were held with key informants. Reducing maternal mortality is an unfinished agenda of millennium development goals, which is carried over to sustainable development goals era. Nepal, building on an ongoing initiative of Maternal Death Review, established a Maternal and Perinatal Death Surveillance and Response system. It comprises: (a) maternal death review and response in community; and (b) maternal death review and response in hospitals. Until 2019, 11 districts implemented the former component, while 77 hospitals practiced the latter. The main reason underlying maternal death was delay in getting adequate care. Social factors contributed to delay ...
The Province of the Punjab underwent a number of attempts to decentralize the health sector in th... more The Province of the Punjab underwent a number of attempts to decentralize the health sector in the 1990s. Among the most important were the decentralization of financial management within the district, the Sheikhupura PHC Pilot Project, the establishment of the District Health Authorities and District Health Management Teams, the creation of semi-autonomous hospitals and the programme of District Health Government (DHG). These usually received donor sup-port and promotion, and emerged from within the provincial Department of Health, and more specifically the Secretariat and the internationally supported Second Family Health Project (FH2). Of particular significance was the DHG change, which involved a decentralization to the district, the appointment of powerful Chief Executives, the formation of District Management Committees and purchaser–provider separation. The paper reviews these propo-sals, focusing on the need to build on experiences and learning lessons from pilot projects, ...
© 2009 Omar et al; licensee BioMed Central Ltd. This is an Open Access article distributed under ... more © 2009 Omar et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License
Objective: to share the experience regarding an innovative approach, “Seven-Flag Approach to Tota... more Objective: to share the experience regarding an innovative approach, “Seven-Flag Approach to Total Sanitation (7FATS) in Schools” introduced in Nepal. Background: Safe drinking-water, use of improved sanitation and hand hygiene remained an unfinished millennial agenda and is carried over as part of SDG 6 and allied goals in Nepal. Particularly, to improve sanitation services in schools, Government of Nepal implemented several initiatives. While there was an apparent improvement, equally the continuing challenges have been the sustainability, the needed behaviorural change, and lack of motivation both amongst teachers and students. 7FATS or total sanitation in schools is an approach, which addresses these issues. Concept: The underlying concept is that, as minimum requirement, children in school should use clean toilets, wash hands with soap, and drink water from a safe supply. In this manner, children, who spend a substantial part of their time in schools, can improve their own hygi...
Journal of Health Informatics in Developing Countries, 2020
Background:Smoking cessation clinics were established in Saudi Arabia in 2014 to control smoking ... more Background:Smoking cessation clinics were established in Saudi Arabia in 2014 to control smoking among the Saudi population and contribute to realizing the Saudi vision 2030 of having a healthy nation. This study aimed to determine the frequency of smoking cessation and associated factors among consumers of Ministry of Health (MOH) clinics and to measure their satisfaction with the services provided. Methods:A cross-sectional study of 800 participants was conducted from June to December 2019 at MOH smoking cessation clinics in Saudi Arabia. A predesigned questionnaire was used to collect databy phone interview through the health consultation center (937) at (MOH). Results:The frequency of quitting smoking among the consumers of (MOH) smoking cessation clinics was 26.0% and the frequency of smoking relapse after quitting attempts was 52.3%. The main indicators of quitting smoking were related to contentment, self-efficacy and social, family support as well as counseling services an...
In this paper we define and classify the health technologies in order to map its range of use in ... more In this paper we define and classify the health technologies in order to map its range of use in health care. Given the technology impacts on the performance of health systems, it is explored further, highlighting the importance of assessing it before selection, acquisition and use. Examples are presented from the developed countries where they have taken steps for the institutionalisation of health technology assessment (HTA). We also assess the new developments in this regard. The Iranian health system is also assessed, emphasising the importance of HTA particularly in the context of health sector reforms.
Punjab produces nurses holding diploma in general nursing, while globally this qualification is i... more Punjab produces nurses holding diploma in general nursing, while globally this qualification is increasingly been replaced with baccalaureate and master in nursing. As a consequence, whereas the quality of healthcare is on the lower ebb, nurses holding diploma qualification can hardly compete in the international job market and only a few of them can join post graduate education. Objectives: (i) To define a conceptual framework for nurses' education and training; (ii) To review the nurses' education and training in Punjab, Pakistan; and (iii) to propose measures for improving the situation with the purpose to improve quality in health care delivery. Methods: this is a cross sectional study that used mix methods. All 42 public sector schools of nursing in Punjab were included. A structured questionnaire was used to collect primary data about the status of the nursing education and training. In addition to infrastructure, issues related to pre-education, education and training...
This study explores factors that influenced the policy process for the health sector reforms unde... more This study explores factors that influenced the policy process for the health sector reforms undertaken by the government. This is a qualitative research, which employs a case study approach. Four cases were selected and, based on a framework for analyzing the policy process, data was collected using interviews, FGDs and document reviews. With the help of a computer-assisted data processing system, the qualitative data was analyzed and findings are presented as four single-case studies. The cross-case analysis generated discussion and a multiple-case study was developed that helped in identifying factors influencing the policy process for the Punjab health sector reforms. The study revealed six factors: (1) absence of clearly defined principles and purposes; (2) insufficient involvement of stakeholders; (3) lack of a holistic view of context; (4) shortcomings of the policy machine; (5) need for a proper implementation structure; and (6) administrative fatigue of donors.
Journal of Nepal Medical Association
The constitution of Nepal provides appointing a council of ministers both at federal and provinci... more The constitution of Nepal provides appointing a council of ministers both at federal and provincial levels without defining portfolios. There is a political agreement that MOH will be retained at the federal level. This article draws evidences around the world to meet health needs of Nepalese, the role of provincial ministry of health and coordinating structure at district/local level.The constitution emphasises on health and pronounced in 46 articles which provides guidance for the creation of federalized governance levels at federal, provincial and local levels. Retaining ministry of health at federal level without creating devolved structure at province and local levels in health sector will create difficulty in translating the spirit of the constitution and may not be effective in addressing health issues nationally and meeting global achievements like SDGs.It is suggested to establish an elaborate health system accordingly in Nepal to ensure constitutional mandate of health as ...
Annals of King Edward Medical University
Annals of King Edward Medical University
Ethics and collegiality in medical profession requires a doctor to treat fellow professional as b... more Ethics and collegiality in medical profession requires a doctor to treat fellow professional as brother and sister. Ethnography was employed to study the status of collegiality in public sector hospital, where an ailing doc-tor sought clinical care from a physician. The former, on account of the latter’s cold reception and behaviour, reacted with his blood pressure shooting-up. The communication gap led the ailing doctor, who com-plied by coming to the laboratory, was perturbed, making him firstly unfit and later decided not to undergo the prescribed test. While Pakistan Medical and Dental Council have the responsibility to oversee, the under-graduate medical education and training should also lay greater emphasis on ethics in medical practice and healthy collegiality in the medical profession.
Annals of King Edward Medical University, 2016
Background: Ever since inception, allopathic medicine has increasingly been practiced all over th... more Background: Ever since inception, allopathic medicine has increasingly been practiced all over the world including Pakistan. However, a significant proportion of practitioners are unqualified quacks. In order to curb quackery and assure the provision of quality healthcare by clinics and other healthcare establishments the Punjab Government established Punjab Healthcare Commission. How far this body has achieved its objectives? Methods: A qualitative study was conducted for responding to the research question. Participants were drawn purposefully representing stakeholders, including general practitioners of allopathic medicine, association of general practitioners, academy of family physicians, and Punjab Healthcare Commission. Interviews held were audio-recorded and transcribed verbatim, followed by coding and generation of themes. Results: The study yielded themes: protection of the
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Papers by Ehsanullah Tarin