Saima Hirani

Applying community-based participatory research methods to improve maternal and child health in Karachi, Pakistan

To achieve health for all, the development of partnerships between community residents and researchers is essential. Community-based participatory research (CBPR) engages community members, uses local knowledge in the understanding of health problems and the design of interventions, and invests community members in the processes and products of research. CBPR pivots on an iterative process of open communication, mutual respect, and power sharing to build community capacity to sustain effective health interventions. This article describes how the tenets of CBPR were applied by a multidisciplinary, international research team of maternal-child health specialists toward better health for women and children in multilingual, multiethnic, low socioeconomic communities in Karachi, Pakistan.

Development of an Economic Skill Building Intervention to Promote Women's Safety and Child Development in Karachi, Pakistan

Violence against women is a global epidemic phenomenon that can result in major mental health problems. Not only are women affected but also the health and well-being of their children are in jeopardy. To prevent violence and promote womens safety, several strategies have been tested in various cultural contexts. This article describes the process of developing and validating an economic skill building intervention for women of an urban slum area of Karachi, Pakistan. The purpose of the intervention is to increase womens economic independence, promote womens safety, and improve the behavioral functioning of their children.

Preventing Abuse and Trauma to Internally Displaced Children Living in Camps Due to Disasters in Pakistan

Recently, Pakistan has experienced several natural disasters—such as the earthquake of 2005 in Swat, measuring 7.5 on the Richter scale, and unprecedented flooding that caused havoc from the Himalayas to the shores of the Arabian Sea in 2010. In addition, people are affected by armed conflicts both within Pakistans borders and in Afghanistan, such as the decade-long conflict in the Northern provinces along the border. Consequently, a large number of refugees and internally displaced people, mostly women and children, are in shelters in internally displaced population camps. These camps lack sufficient supply and storage of daily ration, sanitation, health and educational facilities. Inhuman living conditions add an enormous burden to the level of post-traumatic stress disorder and depression of these internally displaced people. While women are extremely vulnerable to these mental health problems, their children are equally exposed and suffer with mental stresses, as mothers do not have the capacity to supervise and protect their children from the potential physical, psychological and sexual abuse prevalent in marginalised living conditions and an environment of easy exposure to social hazards and the toxic mentality of men. This conceptually based paper addresses some of the challenges and risks identified and faced by children of the camps for displaced persons in Pakistan. The authors propose a psycho-social framework based on public health interventions to decrease the risk of abuse and trauma, to protect these vulnerable children, and to maximise the strength and resilience of the family unit.

Meeting the 2015 Millennium Development Goals with new interventions for abused women.

In a developing country such as Pakistan, where illiteracy, poverty, gender differences, and health issues are prevalent, violence against women is a commonly observed phenomenon. The rising incidences of abuse among women indicate a need to introduce evidence-based community-derived interventions for meeting Millennium Developmental Goals by 2015. This article discusses the application of counseling, economic skills building, and microcredit programs as practical and effective interventions to improve the health outcomes of abused women and, therefore, improving maternal and child health in the Pakistani society.

Comparison of Urdu Versions of the Resilience Scale and the Resilience Scale for Adults

Background and Purpose: Several methodological challenges are associated with measuring resilience in women. This study compares the 14-item Resilience Scale (RS-14) and the Resilience Scale for Adults (RSA) in a community sample of women. Methods: Data were collected from 120 women residing in low socioeconomic areas of Karachi, Pakistan. Construct validity, internal consistency, and responsiveness were calculated. Results: Both scales demonstrated satisfactory psychometric characteristics. The total RS-14 score was significantly associated with all subscales of the RSA. However, two items of the RS-14 did not show any association with any of the subscales of the RSA. Medium effect size was noted on the “structured style”subscale of the RSA. Conclusion: Differences between the scales concluded that the Urdu version the of RSA yielded improved results in this sample.

Social support intervention to promote resilience and quality of life in women living in Karachi, Pakistan: a randomized controlled trial

ObjectivesThis study tested the efficacy of a 6-week social support intervention for enhancing resilience and quality of life among women living in low socioeconomic areas of Karachi, Pakistan.MethodsOne hundred and twenty women were randomly allocated to the intervention (n = 60) or control group (n = 60). Women in the intervention group attended a 6-week social support program, while those in the control group attended a single mental health awareness session. Outcome variables were measured via the resilience scale-14 item (RS-14), the resilience scale for adults (RSA), and World Health Organization quality of life brief scale (WHOQOL-BREF).ResultsCompared to participants in the control group, women in the intervention group reported improvements in resilience measured by RS-14 (p = 0.022) and the structured style subscale of the RSA (p = 0.043). A medium effect size was also measured on the structured style subscale (d = 0.6, 95% CI = 0.62874, 2.57126). No significant findings were noted on QOL scores.ConclusionsCommunity-based social support interventions are a gender-sensitive-, culturally appropriate-, and resource-sparing approach to promote women’s resilience and improve their mental health.