Shafiqullah Hemat - Academia.edu (original) (raw)

Papers by Shafiqullah Hemat

Environmental Health and Preventive Medicine, 2022

Background: To protect the health and safety of healthcare workers (HCWs), it is essential to ens... more Background: To protect the health and safety of healthcare workers (HCWs), it is essential to ensure the provision of sustainable water, sanitation, and hygiene (WASH) services and standard precautions in healthcare facilities (HCF). The objectives of this short communication were 1) to assess the availability of WASH services and standard precautions in HCFs in seven provinces in Afghanistan before the COVID-19 pandemic, and 2) to elucidate the relevance of these patterns with the number of reported HCW infections from COVID-19 in the mentioned provinces. Methods: We analyzed secondary data from the 2018-19 Afghanistan Service Provision Assessment survey, which included 142 public and private HCFs in seven major provinces in Afghanistan. Data on COVID-19 cases were obtained from the Afghanistan Ministry of Public Health Data Warehouse. Weighted prevalence of WASH services and standard precautions were calculated using frequencies and percentages. ArcGIS maps were used to visualize the distribution of COVID-19 cases, and scatter plots were created to visualize the relevance of WASH services and standard precautions to COVID-19 cases in provinces. Results: Of the 142 facilities surveyed, about 97% had improved water sources, and over 94% had improved toilet for clients. Overall, HCFs had limited availability of hygiene services and standard precautions, which was lower in private than public facilities. More than half of the facilities had safe final disposal and appropriate storage of sharps and medical waste. Of the seven provinces, Herat province had the highest cumulative COVID-19 case rate among HCWs per 100,000 population and reported lower availability of WASH services and standard precautions in HCFs compared to other provinces. Conclusion: Our findings show disparities in the availability of WASH services and standard precautions in public and private facilities. Private facilities had a lower availability of hygiene services and standard precautions than public facilities. Provinces with higher availability of WASH services and standard precautions in HCFs had a lower cumulative COVID-19 case rate among HCWs per 100,000 population. Pre-pandemic preparation of adequate WASH services and standard precautions in HCFs could be potentially important in combating infectious disease emergence.

Public Health in Practice

Poor hygiene and sanitation practices lead to increased burden of diarrhoeal diseases which is a ... more Poor hygiene and sanitation practices lead to increased burden of diarrhoeal diseases which is a leading cause of death among children under five years of age. According to the Afghanistan Demographic and Health Survey the under-five mortality rate is 55 deaths per 1,000 live births in Afghanistan and diarrhoea prevalence rate is 29% among children under age of five. Considering the importance of sustained hygiene and sanitation in reduction of diarrhoea, community dialogue approach was designed and implemented in six districts of three provinces in Afghanistan. This study revealed that installation of hand washing facilities, availability of soap and safe storage of water are improved 71.6, 75.3 and 41.9 percentage points respectively and entire target communities are declared open defecation free through implementation of community dialogue approach during a year.

Vaccine, May 1, 2009

A total of 1327 households were surveyed in Kabul province, Afghanistan to evaluate child immuniz... more A total of 1327 households were surveyed in Kabul province, Afghanistan to evaluate child immunization coverage and its association with distance to health facilities, attendance at antenatal care, the place of delivery and contact by outreach activity. The proportion of fully immunized children, those who had received at least 1 dose of BCG, 3 doses of DPT, and 1 dose of measles vaccine, was 84.5% in the city centre and 60.7% in the rural area. Fully immunized status was positively associated with close proximity to a health facility (odds ratio [OR] = 1.92, [95%CI, 1.08, 3.39]), and attendance at antenatal care (OR = 1.39, [95%CI, 1.00, 1.93]) in the city centre, and outreach contact (OR = 11.6, [95%CI, 6.92, 19.4]) in the rural area after adjustment for demography, socioeconomic factors, participation in health education and experiences of hardship. Attendance at antenatal care in the rural area (OR = 1.91, [95%CI, 1.35, 2.72]), and institutional delivery in the city centre and rural area (OR = 2.83, [95%CI, 1.20, 6.71]; OR = 2.17, [95%CI, 1.01, 4.64], respectively) were positively associated with antigen specific coverage. Improving multiple community conditions including health-care provision and socioeconomic factors through close partnership among various sectors promotes the immunization program.

PLOS global public health, Mar 7, 2023

Overweight/obesity constitutes a major risk factor for non-communicable diseases (NCDs), whose gl... more Overweight/obesity constitutes a major risk factor for non-communicable diseases (NCDs), whose global prevalence is growing rapidly, including in Afghanistan. However, the effects of risk factors on NCDs have rarely been studied in the educator workforce. Therefore, the objective of this study is to determine the prevalence, determinants, and association of overweight/obesity with NCD-related biomedical indicators among schoolteachers in Afghanistan. The sample comprised 600 schoolteachers aged 18 years and above. We conducted questionnaire interviews, anthropometric measurements, and blood biochemistry tests. The main explanatory variable was overweight/obesity (body mass index � 25.0 kg/m 2). NCDrelated biomedical indicators were the outcome variables. Poisson regression models were applied to investigate the association between overweight/obesity and outcome variables. The prevalence of overweight/obesity was 58.2%, which was significantly higher in women, those aged 41-50 years, married participants, and those with 10-20 years of working experience than in their counterparts. After adjusting for sociodemographic variables and lifestyle behaviors, overweight/obesity was significantly associated with hypertension (adjusted prevalence ratio [aPR] = 1.83, 95% confidence interval [CI]: 1.33-2.51); elevated levels of glycosylated hemoglobin (HbA1c) (

Nagoya Journal of Medical Science, Nov 1, 2020

The World Health Organization (WHO) defines the postnatal period as the first six weeks (42 days)... more The World Health Organization (WHO) defines the postnatal period as the first six weeks (42 days) after delivery and recommends four postnatal care (PNC) visits for women giving birth to a child to enable early detection and treatment of complications. However, a low utilization of PNC visits by Afghan women has contributed to a relatively high maternal mortality in Afghanistan. This study aimed to identify factors influencing the utilization of PNC visits among Afghan women by sampling nationally representative data from Afghanistan Demographic and Health Survey (AfDHS), 2015. The logistic model was used to measure the adjusted odds of utilizing PNC services among women, with a 95% confidence interval (95% CI) and a p-value of <0.05 for statistical significance. The study found that the utilization of PNC visits in Afghanistan is low; among 8,581 women (44%) who utilized PNC visits and 10,924 women (56%) who didn't, the women's age, place of residence, parity, education, occupation, number of antenatal care (ANC) visits, place of delivery, exposure to public media, the woman's role in decision making and needing a permission to seek healthcare were found to be associated with the level of utilization of PNC visits. Based on the study results, health promotion interventions are recommended to increase the utilization of PNC visits.

Gates open research, Jun 4, 2019

Afghanistan ranks among the most disadvantaged globally Background: for many key reproductive, ma... more Afghanistan ranks among the most disadvantaged globally Background: for many key reproductive, maternal, newborn and child health (RMNCH) indicators, despite important gains in the past decade. Youth (15 to 24 years) are a key audience for RMNCH information as they enter adulthood, marry and begin families; however, reaching Afghan youth with health information is challenging. Internally displaced persons (IDPs), including youth, experience additional challenges to obtaining health-related information and services. This study measured current and preferred RMNCH information channels to explore the feasibility of using mobile phone technology to provide RMNCH information to IDP youth in Afghanistan. We conducted a subgroup analysis of survey data from a Methods: mixed-methods, cross-sectional, formative assessment to understand current access to RMNCH information. The target population for this analysis includes 15-25-year-old male and female IDP youth from three Afghan Provinces. Survey data were collected using a structured questionnaire administered through face-to-face interviews. Data were analyzed descriptively. A total of 450 IDP youth were surveyed in the three provinces (225 Results: male and 225 female). Access to RMNCH information outside of health facilities was limited. Mobile phone ownership was nearly universal among male participants, yet considerably lower among females; nearly all participants without personal phones reported access to phones when needed. Although few participants spontaneously mentioned mobile phones as a preferred source of RMNCH information, most male and female respondents reported they would be very or somewhat likely to use a free, mobile-phone-based system to access such information if offered. Given widespread access and considerable interest voiced Conclusions: by participants, mobile phones may be a viable way to reach IDP youth with

CRC Press eBooks, Oct 26, 2018

Digital health, 2022

ObjectiveDigital health technologies have contributed to the adoption of beneficial reproductive,... more ObjectiveDigital health technologies have contributed to the adoption of beneficial reproductive, maternal, newborn, and child health (RMNCH) behaviors through social and behavior change programming, including in hard-to-reach settings. On-demand digital health interventions rely on promotions to build awareness and increase use among target audiences. There is little research on preferred content and use of promotional approaches for RMNCH digital health activities.MethodsWe conducted a retrospective descriptive analysis of Mobile for Reproductive Health (m4RH) data in Afghanistan to assess the use and changes in call volume via the 2-3-4 platform by promotional approaches over 23 months between October 2017 and August 2019.ResultsThere were 103,859 completed messages (CM) heard. Most callers reporting demographics were under 18 years, with roughly even distribution by gender. The number of CMs listened to across all menus increased with time. The basic m4RH family planning menu was most popular, with callers most frequently selecting information on intrauterine contraceptive devices. Nine types of promotional approaches were implemented. Compared against call volume, SMS blast promotion was the most productive promotional approach, radio broadcasts had modest increases, and social media and interpersonal communication demonstrated no clear change.Conclusionsm4RH use increased over time, particularly among younger people. The number of promotional approaches used does not appear as important as the type of approach used to generate program awareness. Mass media communications, including SMS blast promotions and radio broadcasts, may be the most effective strategies. Deeper program data analysis can guide tailoring of message content and promotional approaches to reach target audiences with the RMNCH content they most value.

Conflict and Health, Aug 5, 2020

Background: Rural Afghan populations have low skilled birth attendance rates and high maternal an... more Background: Rural Afghan populations have low skilled birth attendance rates and high maternal and infant mortality. Insecurity and armed conflict, geographic barriers, and cultural norms often hinder women's access to facility-based reproductive, maternal, newborn, and child health (RMNCH) services. Community health workers (CHWs) are critical agents for behavioral change in this and similarly fragile settings, where RMNCH information exposure is limited by low literacy and mass media access. We assessed the feasibility and acceptability of a computer tablet-based health video library (HVL) to enhance CHW counseling on RMNCH topics in three rural Afghan districts. Methods: The HVL was introduced by trained CHWs in 10 pilot communities within one rural district in each of Balkh, Herat, and Kandahar provinces. We used a mixed-methods study design to assess exposure to and perception of the HVL 6 months post-introduction. We surveyed married women (n = 473) and men (n = 468) with at least one child under 5 years and conducted in-depth interviews with CHWs and community leaders (shuras and Family Health Action groups) within pilot communities (n = 80). Program improvement needs were summarized using quantitative and qualitative data. Results: Higher proportions of women in Balkh (60.3%) and Herat (67.3%) reported viewing at least one HVL video compared to women in Kandahar (15%), while male HVL exposure was low (8-17%) across all districts. Most HVLexposed clients (85-93% of women and 74-92% of men) reported post-video counseling by CHWs. Nearly all (94-96% of women and 85-92% of men) were very interested in watching videos on other health topics in the future. Participants recommended increasing the number of videos and range of topics, using tablets with larger screens, and translating videos into additional local languages to improve the HVL program.

Health Promotion International, 2016

Introduction: In Afghanistan, despite the high awareness levels of contraceptive methods, the con... more Introduction: In Afghanistan, despite the high awareness levels of contraceptive methods, the contraceptive prevalence is low and short birth spacing is common. The aim of this study was to understand the perception about family planning and contraceptive utilization among reproductiveaged married women, their husbands, their mothers-in-law, religious leaders and healthcare providers. Methods: Focus group discussions and semi-structured interviews were conducted among married women of reproductive age (n ¼ 482), their husbands (n ¼ 133), their mothers-in-law (n ¼ 194), their religious leaders (n ¼ 16), and healthcare providers (n ¼ 36) in rural and urban areas in five provinces. Results: Bigger family size was generally considered as desirable for emotional, economic and social well-being. The majority endorsed contraception. However, some religious scholars and their followers argued that contraception is a sinful act in Islam by interpreting contraception as equivalent to infanticide and suppression of the increase of the Muslim population. Healthcare providers attempted to disseminate health benefits of modern contraception on a family basis. However, fear of various side effects and doubts about their effectiveness due to irregular supply were prevalent in communities. Discussion: It is important to increase awareness on the health benefits of appropriate birth spacing at community level. Public health campaigns supported by Islamic religious scholars and a system that ensures appropriate counselling and a steady supply of contraceptives are likely to increase contraceptive utilization.

DIGITAL HEALTH

Objective Digital health technologies have contributed to the adoption of beneficial reproductive... more Objective Digital health technologies have contributed to the adoption of beneficial reproductive, maternal, newborn, and child health (RMNCH) behaviors through social and behavior change programming, including in hard-to-reach settings. On-demand digital health interventions rely on promotions to build awareness and increase use among target audiences. There is little research on preferred content and use of promotional approaches for RMNCH digital health activities. Methods We conducted a retrospective descriptive analysis of Mobile for Reproductive Health (m4RH) data in Afghanistan to assess the use and changes in call volume via the 2-3-4 platform by promotional approaches over 23 months between October 2017 and August 2019. Results There were 103,859 completed messages (CM) heard. Most callers reporting demographics were under 18 years, with roughly even distribution by gender. The number of CMs listened to across all menus increased with time. The basic m4RH family planning me...

Background: Afghanistan ranks among the most disadvantaged globally for many key reproductive, ma... more Background: Afghanistan ranks among the most disadvantaged globally for many key reproductive, maternal, newborn and child health (RMNCH) indicators, despite important gains in the past decade. Youth (15 to 24 years) are a key audience for RMNCH information as they enter adulthood, marry and begin families; however, reaching Afghan youth with health information is challenging. Internally displaced persons (IDPs), including youth, experience additional challenges to obtaining health-related information and services. This study measured current and preferred RMNCH information channels to explore the feasibility of using mobile phone technology to provide RMNCH information to IDP youth in Afghanistan. Methods: We conducted a sub-group analysis of survey data from a mixed-methods, cross-sectional, formative assessment to understand current access to RMNCH information. The target population for this analysis includes 15-25-year-old male and female IDP youth from three Afghan Provinces. S...

Family Practice In The Eastern Mediterranean Region, 2018

Characteristics of the women who lost their MCH handbook in Mirbachakot and Kama districts of Afg... more Characteristics of the women who lost their MCH handbook in Mirbachakot and Kama districts of Afghanistan from August 2017 to April 2018. (PDF 360 kb)

Questionnaire used for data collection in the study. (PDF 975 kb)

Prevalence of and factors influencing posttraumatic stress disorder among mothers of children und... more Prevalence of and factors influencing posttraumatic stress disorder among mothers of children under five in Kabul, Afghanistan, after decades of armed conflicts

Objectives of this study were: (1) to examine gender differences in biomedical indicators, lifest... more Objectives of this study were: (1) to examine gender differences in biomedical indicators, lifestyle behaviors, self-health check practices, receipt of professional non-communicable disease (NCD)-related lifestyle advice, and the use of health services among teachers in Afghanistan; and (2) to seek the patterns of these indicators among users and non-users of health services among both male and female teachers. This cross-sectional study was carried out among 600 schoolteachers in Kabul city in February 2017. Gender differences in percentage distributions of abnormal biomedical indicators, lifestyle behaviors, self-health check practices, and receipt of professional lifestyle advice were examined. These patterns were further analyzed according to the use of health services in the previous 12 months by both genders. The results showed that male teachers had a higher prevalence of hypertension, increased serum triglycerides, physically active lifestyle, and tobacco use than female tea...