BackgroundThe proportion of incompletely immunized children in Pakistan varies from 37-58%, and this has recently resulted in outbreaks of measles and polio. The aim of this paper is to determine the factors associated with incomplete immunization among children aged 12-23 months in Pakistan.MethodsSecondary analysis was conducted on nationally representative cross-sectional survey data from the Pakistan Demographic and Health Survey, 2006-07. The analysis was limited to ever-married mothers who had delivered their last child during the 23 months immediately preceding the survey (n = 2,435). ‘Complete immunization’ was defined as the child having received twelve doses of five vaccines, and ‘incomplete immunization’ was defined if he/she had missed at least one of these twelve doses. The association between child immunization status and determinants of non-utilization of vaccines was assessed by calculating unadjusted and adjusted odds ratios (AOR) with 95% confidence intervals using a multivariable binary logistic regression.ResultsThe findings of this research showed that nearly 66% of children were incompletely immunized against seven preventable childhood diseases. The likelihood of incomplete immunization was significantly associated with the father’s occupation as a manual worker (AOR = 1.47; 95% CI: 1.10-1.97), lack of access to information (AOR = 1.35; 95% CI: 1.09-1.66), non-use of antenatal care (AOR = 1.33; 95% CI: 1.07-1.66), children born in Baluchistan region (AOR = 1.74; 95% CI: 1.12-2.70) and delivery at home (AOR = 1.39; 95% CI: 1.14-1.69).ConclusionsDespite governmental efforts to increase rates of immunization against childhood diseases, the proportion of incompletely immunized children in Pakistan is still high. Targeted interventions are needed to increase the immunization rates in Pakistan. These interventions need to concentrate on people with low socioeconomic and educational status in order to improve their knowledge of this topic.

Background: A large amount of new HIV infections worldwide is observed amongst key populations which include e.g. commercial sex workers or transgender people and their respective sexual partners. Therefore, this study examined the multi-level context of inconsistent condom use (ICU) in sexual interactions of transgender street-based workers (KSWs) with commercial and non-commercial sexual partners in Lahore. Methods: We conducted 20 in-depth interviews with street-based KSWs to investigate challenges to consistent condom utilization with sexual partners. The qualitative data was analyzed using thematic analysis to produce an initial set of codes during the first-level round. An essence-capturing strategy was utilized to identify broader themes through a heuristic exploration of the text. Results: Within a socio-ecological analysis we identified factors influencing ICU among KSWs at three levels. At the individual level, we identified knowledge and awareness, perceived characteristics of sexual partners, age and physical attributes, pleasure and pain, and mental health issues impacting on ICU. Gentrification of historical red-light district, discrimination, harassment and regular evictions, dynamics of cruising spots and places of sexual interactions, competition in sex trade, violence and lack of safety nets in street-based sex work, condom use with lovers, networks with non-governmental organizations were factors associated with ICU. Risk factors at community level were poverty, the influence of gurus, and Dera culture.Conclusions: Until now, HIV prevention efforts in Pakistan have primarily focused on HIV risk factors at the level of individual behaviors within specific networks of target populations. However, our study points towards both the effectiveness and the urgency of interventions that address macro-level risk factors specific to key populations in Pakistan, in addition to behavioral interventions.

Background A large amount of new HIV infections worldwide is observed amongst key populations which include e.g., commercial sex workers or transgender people and their respective sexual partners. Therefore, this study examined the multi-level context of inconsistent condom use (ICU) in sexual interactions of transgender street-based workers (KSWs) with commercial and non-commercial sexual partners in Lahore. Methods We conducted 20 in-depth interviews with street-based KSWs to investigate challenges to consistent condom utilization with sexual partners. The qualitative data was analyzed using reflexive thematic analysis to produce an initial set of codes and identify broader themes through a recursive exploration of the text. Results Within a socio-ecological analysis we identified factors influencing ICU among KSWs at three levels. At the individual level, we identified knowledge and awareness, age, pleasure and pain, and mental health issues impacting on ICU. perceived characteristics of sexual partners, dynamics of cruising spots and places of sexual interactions, competition in sex trade, violence and lack of safety nets in street-based sex work, and condom use with lovers were factors associated with ICU. Risk factors at community level were changing urban geography of sex work, discrimination, harassment and regular evictions, networks with non-governmental organizations and the influence of gurus and Dera culture. Conclusions Until now, HIV prevention efforts in Pakistan have primarily focused on HIV risk factors at the level of individual behaviors within specific networks of target populations. However, our study points towards both the effectiveness and the urgency of interventions that address macro-level risk factors specific to key populations in Pakistan, in addition to behavioral interventions.

The aim of the study is to look into the nurse’s views of the conflict in family and work demands working in various hospitals of Sargodha District. The study follows a quantitative methodology hence survey research design is considered as the most appropriate research design for this research. Structured questionnaires was developed containing 21 items. Data was collected through personal visits. The population for this study was nurses working in government and private hospitals of district Sargodha. For the respondent selection, a multi-stage sampling method was used.  In first stage six government and private hospitals were selected through simple random sampling. Target was three government and three private hospital located in district Sargodha. Purposive sampling was employed in the second stage of sampling to choose a sample of 150 nurses from randomly selected hospitals. Results from the study showed that work family conflict was more evident among nurses aged 25-35 and married having 1-3 children. The result of the study showed that as compared to family demands, work demands are more strongly associated with work family conflict. The study recommends that work family conflict should continue to be researched further. In particular, a national study of nurses and the profession should be conducted. The nursing profession’s collective voice ought to be heard in Pakistan.

Pakistan is going through large scale infrastructure development with most of the state-led mega projects being funded by international financing agencies. Many of these agencies have mandatory social safeguards to mitigate the negative impacts of the projects for project-affected-communities especially women. This provides the government an opportunity to advance the conditions of women in project areas. However, the gender mainstreaming efforts usually face resistance from communities on various grounds including religion. This study explores the nature of resistance on religious basis and the strategies used by the development practitioners to manage such resistance. A qualitative research approach was employed and through a purposive sampling technique participants were recruited for this study. In-depth interviews were used to collect data which was analyzed by thematic analysis. The data was collected from development practitioners working for government and international financing agencies on infrastructure projects. Resistance towards development of women initiatives are on interventions, presence of female staff in communities, and on giving access to project teams, including women, to females in communities. Major reasons for this resistance were suspicion of projects, especially if the financing agencies were Western, and the fear that development of women may result in women losing their religious and cultural values which may lead to the breakdown of the institution of family and Islamic society. The strategies to deal with these resistances include involving religious leaders as stakeholders, peer education through religious scholars, exposure visits for local religious leaders, developing gender and cultural sensitivities of the staff, meaningful consultation with community, and effective grievance redress mechanism.