Community Health Needs Assessment: Findings from a Community-university Partnership Strengthening Program on Maternal and Child Health in Pakistan

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2025 Feb 18

PMID 39962471

Authors

Rubeena Zakar

Nazoora Manal Zakar

Ruhma Shahzad

Ara Tekian

Florian Fischer

Affiliations

Soon will be listed here.

Abstract

Background: Pakistan has been progressing at a slow pace in enhancing maternal and child health (MCH) indicators, experiencing some of the poorest pregnancy outcomes globally. In response to the challenges faced at the community level in MCH, a community health needs assessment (CHNA) was undertaken through a community-university partnership project. The aim of this CHNA was to understand the MCH needs and associated social determinants within the specific local context of the community.

Methods: The assessment of community MCH needs was performed in two phases in Lahore, Pakistan. Initially, the semi-urban area of Shah Di Khoi, within the university's catchment area, was chosen based on an extensive review of both primary and secondary data. In the second phase, a CHNA was conducted among females of reproductive age (15-49 years) having at least one child under 5 years. Data encompassing socio-demographic characteristics, anthropometric measures, and the health needs of mothers and children were collected using a structured questionnaire. The data were analyzed employing SPSS version 21, utilizing descriptive statistics and Pearson chi-square, and binary logistic regression at a 95% confidence interval.

Results: In this study, 253 reproductive-age females and 371 children under 5 were examined. Critical community issues included unmet family planning needs (29.6%), maternal anemia (18.6%), and child malnutrition (28.6%). Concerns encompassed suboptimal drinking water practices (62.0%), child non-vaccination (19.1%), widespread ghutti use (84.9%), suboptimal birth spacing (25.7%), non-exclusive breastfeeding for the first six months (88.7%), and prelacteal feeding (66.8%). Analysis identified maternal anemia (AOR = 0.38; p = 0.010), nuclear family adoption (AOR = 2.049; p = 0.033), unhealthy water practices (AOR = 0.48; p = 0.023), and ghutti provision at birth (AOR = 0.37; p = 0.030) as pivotal predictors of child nutritional status.

Conclusion: In order to improve the overall health status of community, it is imperative to implement collective strategies tailored to the specific factors and challenges prevalent in the community. The results underscore the importance of maintaining the community-university partnership through establishing a dedicated Maternal and Child Health Center. These findings contribute to the growing body of knowledge in MCH research and inform evidence-based policies for enhanced health outcomes in similar contexts.

References

Islam M, Billah A, Islam M, Rahman M, Khan N . Negative effects of short birth interval on child mortality in low- and middle-income countries: A systematic review and meta-analysis. J Glob Health. 2022; 12:04070. PMC: 9441110. DOI: 10.7189/jogh.12.04070. View

Omer S, Zakar R, Zakar M, Fischer F . The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan. Reprod Health. 2021; 18(1):97. PMC: 8130310. DOI: 10.1186/s12978-021-01151-6. View

Ravaghi H, Guisset A, Elfeky S, Nasir N, Khani S, Ahmadnezhad E . A scoping review of community health needs and assets assessment: concepts, rationale, tools and uses. BMC Health Serv Res. 2023; 23(1):44. PMC: 9847055. DOI: 10.1186/s12913-022-08983-3. View

Miller J, Workman C, Panchang S, Sneegas G, Adams E, Young S . Water Security and Nutrition: Current Knowledge and Research Opportunities. Adv Nutr. 2021; 12(6):2525-2539. PMC: 8634318. DOI: 10.1093/advances/nmab075. View

Minkler M, Breckwich Vasquez V, Tajik M, Petersen D . Promoting environmental justice through community-based participatory research: the role of community and partnership capacity. Health Educ Behav. 2006; 35(1):119-37. DOI: 10.1177/1090198106287692. View

Dietscher C . How can the functioning and effectiveness of networks in the settings approach of health promotion be understood, achieved and researched?. Health Promot Int. 2017; 32(1):139-148. DOI: 10.1093/heapro/dat067. View

Livergant R, Ludlow N, McBrien K . Needs assessment for the creation of a community of practice in a community health navigator cohort. BMC Health Serv Res. 2021; 21(1):657. PMC: 8256652. DOI: 10.1186/s12913-021-06507-z. View

Rayan-Gharra N, Ofir-Gutler M, Spitzer S . Shaping health: conducting a community health needs assessment in culturally diverse peripheral population groups. Int J Equity Health. 2022; 21(1):131. PMC: 9469555. DOI: 10.1186/s12939-022-01735-z. View

Asif M, Pervaiz Z . Socio-demographic determinants of unmet need for family planning among married women in Pakistan. BMC Public Health. 2019; 19(1):1226. PMC: 6727575. DOI: 10.1186/s12889-019-7487-5. View

10.

Aziz A, Saleem S, Nolen T, Pradhan N, McClure E, Jessani S . Why are the Pakistani maternal, fetal and newborn outcomes so poor compared to other low and middle-income countries?. Reprod Health. 2020; 17(Suppl 3):190. PMC: 7745345. DOI: 10.1186/s12978-020-01023-5. View

11.

Ali A . Current Status of Malnutrition and Stunting in Pakistani Children: What Needs to Be Done?. J Am Coll Nutr. 2020; 40(2):180-192. DOI: 10.1080/07315724.2020.1750504. View

12.

Asim M, Nawaz Y . Child Malnutrition in Pakistan: Evidence from Literature. Children (Basel). 2018; 5(5). PMC: 5977042. DOI: 10.3390/children5050060. View

13.

Williamson H, Chief C, Jimenez D, Begay A, Milner T, Sullivan S . Voices of Community Partners: Perspectives Gained from Conversations of Community-Based Participatory Research Experiences. Int J Environ Res Public Health. 2020; 17(14). PMC: 7400085. DOI: 10.3390/ijerph17145245. View

14.

Neves P, Armenta-Paulino N, Arroyave L, Ricardo L, Vaz J, Boccolini C . Prelacteal feeding and its relationship with exclusive breastfeeding and formula consumption among infants in low- and middle-income countries. J Glob Health. 2022; 12:04104. DOI: 10.7189/jogh.12.04104. View

15.

Finifter D, Jensen C, Wilson C, Koenig B . A comprehensive, multitiered, targeted community needs assessment model: methodology, dissemination, and implementation. Fam Community Health. 2005; 28(4):293-306. DOI: 10.1097/00003727-200510000-00003. View

16.

Li Y, Cao J, Lin H, Li D, Wang Y, He J . Community health needs assessment with precede-proceed model: a mixed methods study. BMC Health Serv Res. 2009; 9:181. PMC: 2770049. DOI: 10.1186/1472-6963-9-181. View

17.

Barry M, Doherty A, Hope A, Sixsmith J, Kelleher C . A community needs assessment for rural mental health promotion. Health Educ Res. 2000; 15(3):293-304. DOI: 10.1093/her/15.3.293. View

18.

Ijaiya M, Anjorin S, Uthman O . Quantifying the increased risk of illness in malnourished children: a global meta-analysis and propensity score matching approach. Glob Health Res Policy. 2024; 9(1):29. PMC: 11290152. DOI: 10.1186/s41256-024-00371-0. View

19.

Hohenberg M, Metri N, Firdaus R, Simmons D, Steiner G . What we need as we get older: needs assessment for the development of a community geriatrics service in an Australian context. BMC Geriatr. 2021; 21(1):597. PMC: 8543109. DOI: 10.1186/s12877-021-02553-8. View

20.

Wallerstein N, Duran B . Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity. Am J Public Health. 2010; 100 Suppl 1:S40-6. PMC: 2837458. DOI: 10.2105/AJPH.2009.184036. View