Community health needs assessment: findings from a community-university partnership strengthening program on maternal and child health in Pakistan.

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.