Job satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee’s work environment, job responsibilities and powers and time pressure; the determinants which affect employee’s organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector.

Low Birth Weight (LBW) is considered as a major public health issue and leading cause of neonatal death. Almost one in four newborns are reported as underweight in Pakistan. Children born with low birth weight are highly vulnerable to develop diseases and death and/or remain undernourished (i.e., stunted and wasted). This study determines the LBW newborns are more prone to develop stunting and wasting in province of Sindh, Pakistan. Moreover, regression-based estimation of the impact of LBW on the child health outcomes of under five years of age, may be prone to selection bias because of the nature of non-experimental data set, thus, propensity score matching methods are used in this study. Data for this study was used from Multiple Indicators Cluster Survey (MICS-2014). MICS is a two-stage, stratified cluster sampling household level data covering urban and rural areas and consists of 19,500 households from five administrative divisions and 28 districts of Sindh province of Pakistan. The total sample size of children less than five years of age after cleaning the data are 7781, of which 2095 are LBW having birth weight categorized as “smaller than average and very small” and 5686 are normal birth weight (NBW) having birth weight very large, larger than average, and average. This study employed propensity score matching (PSM) regression methods to understand whether the children born as low birth weight are more prone to stunting and wasting and/or both. In province of Sindh, moderate wasting children under five years were 21%, severe wasting 6% and both wasting and stunting 10%. The propensity score results are shown significant in all groups. Specifically, all four types of PSM methods confirm a significant difference in the potential outcome variables—meaning that a child born with LBW has a significant adverse effect on the potential child health outcome variables (stunting, wasting and both). Thus, the propensity score matching findings confirm a significant and adverse effect of LBW on potential health outcomes of under five children. Similarly, low birth weight children are significantly more likely to be moderately wasted (OR = 1.5, CI = 1.3–1.6) and severely wasted (OR = 1.6, CI = 1.3–2.0) and both (stunted and wasted, OR = 2.0, CI = 1.7–2.3) as compared to children with normal birth weight. Male children, if born with low birth weight, are significantly more likely to be moderately wasted (OR = 1.3, CI = 1.1–1.5) and both (wasted and stunted, OR = 1.3, CI = 1.1–1.5) than girls. This large data analysis finding proved that the LBW newborns are on higher risk to develop wasting and stunting in Pakistan.

Background: Pakistan is facing a serious problem of child under-nutrition as about 38% of children in Pakistan are stunted. Punjab, the largest province by population and contributes high gross domestic product (GDP) share in economy has reported 27% moderately and 10% severely stunted children of less than 5 years. Thus, this study aims at examining the determinants of stunting (moderate and severe) at different level of hierarchy empirically in Punjab province of Pakistan.Methodology: Data for this study is coming from Punjab Multiple Indicators Cluster Survey (MICS-2014), used two-stage, stratified cluster sampling approach. Sub-national level data covering urban and rural areas were used for this study consists of 25,067 children less than 5 year’s ages, from nine administrative divisions and 36 districts of Punjab province of Pakistan. Descriptive statistics and multilevel hierarchical models were estimated. Multilevel data analyses have an advantage because it provides robust standard error estimates and helps in finding variation in the data at various levels.Results: Punjab has a stunting prevalence of about 27% moderately and 10% severely stunted children of less than 5 years. The results depict that increasing the age of the child, increasing birth order, illiterate mothers and fathers, lack of sanitation facilities and being poor are associated significantly with the likelihood of moderate and severe stunting. Surprisingly, there is a gender bias in stunting in Punjab, Pakistan and being a girl child is more likely associated with moderate and severe stunting, which shows the patriarchal nature of the society and a substantial prevalence of gender bias in household resource allocations.Conclusion: This outcome of our analysis points towards targeting not only households (focus on girls) but also their families and communities.

Infectious waste management has always remained a neglected public health problem in the developing countries, resulting in high burden of environmental pollution affecting general masses. Health workers are the key personnel who are responsible for the management of infectious waste at any hospital, however, their proper training and education is must for an optimal performance. This interventional study was conducted to assess the effectiveness of Intensive healthcare waste management (IHWM) training model at two tertiary care hospitals of Rawalpindi city, Pakistan. This study was quasi-experimental pre and post design with control and intervention groups. Out of 275 health care workers enrolled for the study, 138 workers were assigned for intervention group for 3 months trainings, hands-on practicum and reminders on infectious waste management; whereas 137 workers were assigned to the control hospital where routine activities on infectious health care waste management were performed. Pre and post intervention assessment was done for knowledge, attitude and practices (KAP); and was statistically analyzed. Bivariate and multivariate analysis, independent, paired and unpaired t-test, chi-square with p values, and mean of the responses were calculated. Overall the response rate was 92% at the end of intervention. During the baseline survey, 275 healthcare workers (HCW) included doctors, nurses, paramedics and sanitary workers, and after 3 months of intervention, 255 were reached out to complete the questionnaire. With regard to KAP at baseline, there were no significant differences between two groups at baseline, except for gender and department. However, in the post intervention survey, statistically significance difference (0.05) after 3 months. Study results suggest that IHWM training could be an effective intervention for improving knowledge, attitudes and practices among health workers regarding infectious waste management. Such training should become a regular feature of all hospitals for reducing the hazards attached with infectious wastes.

Objectives This study aims to determine the prevalence of and factors associated with underweight children under the age of 5 in Punjab, Pakistan. Design We analysed cross-sectional household-level subnationally representative Multiple Indicator Cluster Survey. Settings Punjab province, Pakistan. Participants 24 042 children under 5 years of age. Data analysis Multilevel multivariate logistic regression analysis. Results Prevalence of moderately and severely underweight children was found to be (33.3% and 11.3%, respectively). Multivariate multilevel logistic regression results show that as the child grows older the likelihood of the child being underweight increases significantly (eg, children between 12 and 23 months are one and half times more likely to be underweight, whereas children between the ages of 36 and 47 months are two and a half times more likely to be underweight). Gender was found to be another significant factor contributing to underweight prevalence among children under the age of 5. The likelihood of a girl child being underweight is more than that of a boy child being underweight (OR 0.92, 95% CI 0.8 to 1.0). Similarly, a child whose birth order is three or more is two times more likely to be underweight (OR 1.96, 95% CI 1.5 to 2.5) relative to a child of a lower birth order. Moreover, diarrhoea also significantly increases the likelihood of the child being underweight (OR 1.31, 95% CI 1.1 to 1.5). Child size is another determinant for underweight prevalence among children under 5, for example, a child with a size smaller than average at the time of birth is 2.7 times more likely to be moderately underweight than a child with an average or larger than average size at the time of birth. Conclusion Rigorous community-based interventions should be developed and executed throughout the province to improve this grave situation of underweight prevalence in Punjab. Mother’s education should be uplifted by providing them formal education and providing awareness about the importance of proper nutrition for children.

Background: Child undernutrition is a severe health problem in the developing world, which affects children’s development in the long term. This study analyses the extent and patterns of under-five child undernutrition using Demographic and Health Surveys (DHS) for 73 low- and middle-income countries (LMICs). Methods: First, we mapped the prevalence of undernutrition in the developing world. Second, using the LISA (a local indicator of spatial association) technique, we analyzed the geographical patterns in undernutrition to highlight the localized hotspots (regions with high undernutrition prevalence surrounded by similar other regions), cold spots (regions with low undernutrition prevalence surrounded by similar other regions), and outliers (regions with high undernutrition surrounded by low undernutrition and vice versa). Third, we used Moran’s I to find global patterns in child undernutrition. Results: We find that South Asia has the highest under-five child undernutrition rates. The intra-country nutritional inequalities are highest in Burundi (stunting), Kenya (wasting), and Madagascar (underweight). The local indicator of spatial association (LISA) analysis suggests that South Asia, Middle East and North Africa (MENA) region, and Sub-Saharan Africa are undernutrition hotspots and Europe and Central Asia and Latin America, and the Caribbean are undernutrition cold spots (regions with low undernutrition surrounded by similar other regions). Getis Ord-Gi* estimates generally support LISA analysis. Moran’s I and Geary’s C gave similar results about the global patterns of undernutrition. Geographically weighted regressions suggest that several socioeconomic indicators significantly explain child undernutrition. Conclusions: We found a significant within and across country variation in stunting, wasting and underweight rates among the under-five children’s population. The geospatial analysis also suggested that stunting, wasting, and underweight patterns exhibit clear regional patterns, underscoring the need for coordinated interventions at the regional level.