Profile: Maternal and Child Health Surveillance System in peri-urban areas of Karachi, Pakistan

Abstract

A Maternal and Child Health Surveillance System (MCHSS) was set up by the department of pediatrics and child health, Aga Khan University, Pakistan in peri-urban areas of Karachi to provide a platform for various research projects. It was established in five low-socioeconomic communities in a stepwise manner between 2003 and 2014. The total area currently under surveillance is 18.6 km2 covering a population of 302,944. We maintain a record of all births, deaths, pregnancies, and migration events by two monthly household visits. Verbal autopsies for stillbirths, deaths of children under the age of five years and adult female deaths are also conducted. For over a decade, the MCHSS has been a platform for a variety of studies describing the burden of various infectious diseases like typhoid, pneumonia and diarrhea, evaluation of effectiveness of various treatment regimens for neonatal sepsis, assessment of the acceptance of hospitalized care, determination of the etiology of moderate to severe diarrhea, assessment of burden and etiology of neonatal sepsis and a multi-center cohort study measuring the burden of stillbirths, neonatal and maternal deaths. More recently we have also established a bio-repository of the well-characterized maternal and newborn cohort. Through a well-established MCHSS, we aim to provide concrete evidence base to guide policy makers to make informed decisions at local, national, and international levels.

Predictors of Respiratory Syncytial Virus, Influenza Virus, and Human Metapneumovirus Carriage in Children Under 5 Years With WHO‐Defined Fast‐Breathing Pneumonia in Pakistan

“…The exact burden of respiratory viruses such as RSV, hMPV, and influenza virus in Pakistan remains unknown; most literature is hospital‐based, which underestimates their true prevalence in the community. Ibrahim‐Hyderi is a peri‐urban low‐income community with a high Infant mortality rate (IMR) of 60.1, and an under‐five mortality rate (U5MR) of 69.5 per 1000 live births, a majority of which is attributable to vaccine preventable respiratory infections [ 38 ]. Seventy‐six percent of the population refuses to seek hospital‐based care due to financial constraints, language barriers, religious, and cultural beliefs, so community‐acquired RSV, hMPV and influenza virus infections may never be tested or treated in hospitals.…”

Pandemic disruptions in vaccine uptake in a low-income setting: a qualitative inquiry

“…The Ali Akbar Shah site served as the Primary Healthcare Center (PHC) in the Health Demographic Surveillance System (HDSS) of The Aga Khan University, located in a peri-urban area of Karachi. The most common occupation in this area is fishing, and this area has a high poverty rate and literacy gaps [ 17 ]. The second urban site established tertiary care with the main center of the Cosmopolitan city, Karachi.…”