(1) Background: Antimicrobial resistance causes significant disease burden in low- and middle-income countries. The objective of this paper is to describe antibiotic dispensing/prescribing practices and underlying factors associated with these practices among community-based healthcare workers. (2) Methods: Cross-sectional survey data were collected from private and public health facilities in 14 union councils, Lahore Pakistan. Respondents included physicians, nurses, lady health workers/volunteers, midwives, pharmacy and medicine shop employees, and medical technicians. Descriptive and bivariate analysis are used to present the data; (3) Results: 177 respondents completed the survey. In terms of weekly dispensing of antibiotics, the most common were Amoxicillin/Augmentin (2.3 [SD 1.5]), Cefixine (2.4 [SD 1.6]), and Azithromycin (2.5 [SD 2.1]). For children, antibiotics were more likely to be prescribed/dispensed for sore throat (54.3%/95) and diarrhea (48.9%/86). For adults, antibiotics were more likely to be prescribed/dispensed for sore throat (67.0%/118), diarrhea (59.7%/105) and burning sensation when urinating (55.7%/176). In total, 55.4% of respondents stated that they have sold partial antibiotic courses to patients/customers. A total of 44.6% of respondents incorrectly answered that antibiotics could be used for viral infections; (4) Conclusions: Data from this study and similar research emphasize the urgent need to implement community-based stewardship programs for all healthcare workers.

Iron and folic acid deficiency is a significant public health concern, especially in low and middle‐income countries, particularly among women of reproductive age, leading to adverse maternal and child health outcomes. In Pakistan, approximately 41.7% of women of reproductive age have iron deficiency. For this research, we conducted 33 key informant interviews and 32 focus group discussions with stakeholders from all four provinces and the two federally administered regions of Pakistan for in‐depth and representative bottleneck assessment. The modified Tanahashi model was used to inform the determinant codes and for coding reliability thematic analysis using NVivo 14. On the supply side, barriers relate to effective forecasting, procurement, and distribution of Iron Folic Acid supplements to the recipients. The demand–supply gap widened due to the supply bottlenecks, impacting the community's trust in the frontline health worker. These factors were gravely impacted by the governance challenges of ensuring sustainable funds, minimizing bureaucratic and procedural delays, and eliminating political pressure. Affordability of Iron Folic Acid and conservative social norms influenced the demand and awareness of Iron Folic Acid and nutritional knowledge among the target population. The stakeholder recommendations emphasize the need for intersectoral collaboration, mass media campaigns, frequent capacity building and incentivizing of healthcare workers, engagement of key community stakeholders, digitizing the health system, improvement in supply chain mechanism, and investment in small‐scale innovative solutions.

To examine the associations between parent perceived environmental factors, nighttime sleep duration and 24-h sleep duration among an international sample of preschool-aged children. Secondary analyses of cross-sectional data from preschoolers across 23 countries (19 LMICs), collected during the third pilot phase (January 2021-August 2024) of the SUNRISE Study. Parents completed a questionnaire which asked about their child's sleep patterns and environmental factors that impacted their child's sleep in the previous 3 days. Data from 2,219 children were analyzed. A significant difference was observed between nighttime sleep (F = 14.27, p = <0.0001) and nap duration (F = 9.10, p = 0.0004) across country income level. Environmental factors such as heat (-12.87, 95% CI: -11.54, -0.61) and cold (-17.70, 95% CI: -34.53, -0.85) were negatively associated with nighttime sleep duration. Public health researchers and professionals should prioritize context-specific strategies to minimize the impact of weather conditions on sleep to promote healthy levels of sleep among preschoolers from diverse settings.

Background: Routine immunization programs in Pakistan rely heavily on estimated population denominators, limiting accurate identification and follow-up of zero-dose and under-immunized children, particularly in high-risk urban settings such as Quetta, Balochistan. Methods: A quasi-experimental, pre–post implementation study was conducted from June 2024 to June 2025 across three low-performing union councils. A CHW-based household tracking tool was integrated within existing PEI–EPI systems. Data were derived from CHW Books, Rapid Convenience Assessments (RCA), and routine MIS reports. Descriptive statistical analysis was employed to assess trends in immunization coverage and program performance; no inferential statistical tests were applied due to the use of complete programmatic (census-based) data rather than sampled observations. Results: Antigen-specific coverage improved substantially, with Penta-3 coverage increasing from 22% to 95%, zero-dose conversion from 45% to 65%, and defaulter follow-up from 14% to 79%. All three union councils transitioned to Category 1 operational status. Administrative coverage exceeding 100%, reflecting population-level coverage and denominator correction rather than true population-level coverage. Conclusions: Integrating CHW-based tracking with dynamic denominator verification enhances routine immunization, microplanning, equity, and operational performance in high-risk LMIC urban settings.

Globally, suicide is remarkably growing at unprecedented rates among young people. District Ghizer, Gilgit-Baltistan in Pakistan, witnesses a surge in mental health issues and suicide among its youth. Limited research in remote areas coupled with profound stigma, underreporting of suicide cases, and the absence of validated data recording mechanisms significantly impact our grasp of the burden and the factors associated with it. Additionally, the inadequate mental health workforce in the region and the lack of evidence-based preventive measures implemented leave a vulnerable demographic at a heightened risk of suicide attempts. Insufficient platforms for youth mental health screening and provision of individualized care, especially for students attending educational institutions, hinder our understanding of the extent of the problem, and how best we may address the suicidal tendencies and youth mental health needs. The paper describes the implementation of the Zero Suicide Model in educational institutions in rural Pakistanwith minimal access to mental healthcare for testing its feasibility and acceptability. The model incorporates key elements of suicide risk factor stratification and modification, including suicide risk identification, comprehensive suicide risk assessment, safety planning intervention, counselling on reducing access to lethal means, parental/familial involvement and school leadership engagement, suicide-specific clinical interventions, follow-up care, and monitoring. The foundational premise of the model focuses on associating an at-risk individual with a trained care provider to prevent suicide incidence. Leveraging parental trust in schools, the school-based zero suicide model seeks to engage parents/caregivers in suicide prevention initiatives, optimizing the influential role of school teachersand leadership in normalizing and enforcing suicide prevention policies and guidelines. It further involves the evaluation of processes and individual outcomes to devise institutional policies and integration of a holistic suicide care system within schools. The multifaceted approach will derive evidence to signify the potential of sustaining clinical and preventive measures within the model and provide insights into the components that need to be further strengthened to best fit the needs of beneficiaries.

To estimate the proportion of children who meet the restrained sitting guidelines (i.e. <1 h in continuous restrained sedentary). The secondary aim was to determine which factors contribute to the probability a child will meet the restrained sitting guidelines. Secondary data analysis of 32 countries participating in the SUNRISE International Study. Parent surveys were used to collect child demographic information and total restrained sitting. Physical activity was assessed with an accelerometer (ActiGraph wGT3X-BT). A generalized linear mixed model was used to determine the probability of a child meeting the restrained sitting guidelines based on sex, age, geographic region, time spent in a vehicle, and hours of total physical activity. Separate models were run by country income level. Final analysis included 2647 children (4.3 ± 0.5 years, 50.6% girls, 49.0% rural). Overall, 81.9% of participants met the restrained sitting guidelines. Odds of meeting the guidelines were 35% lower for children in urban areas and 71% lower for spending 60 min or more in a vehicle. Every additional hour of physical activity increased the odds of meeting the guidelines by a factor of 1.25. These relationships differed when stratified by country income level. While most children meet the guidelines, a focus on children living in urban areas, spending more time in vehicles, and those who engage in less physical activity is warranted.