Feasibility of a birth-cohort in Pakistan: evidence for better lives study.
Creators: name: Anwer, Yasmeen
name: Abbasi, Fahad
name: Dar, Ariba
name: Hafeez, Abdullah
name: Valdebenito, Sara
name: Eisner, Manuel
name: Sikander, Siham
name: Hafeez, Assad
Publisher: name: Apollo - University of Cambridge Repository
Year: 2022
Subjects: Research
Feasibility
Birth Cohort Study
Pakistan
Maternal and child wellbeing
Maternal Mental Health Evidence for Better Lives Study (EBLS)
Foundational research
EBLS-FR

description: Funder: fondation botnar; doi: http://dx.doi.org/10.13039/501100011318
description: Funder: jacobs foundation; doi: http://dx.doi.org/10.13039/501100003986
description: Funder: ubs optimus foundation; doi: http://dx.doi.org/10.13039/501100008391
description: Funder: consuelo zobel alger foundation
description: Funder: british academy
description: Funder: centre for research in the arts, social sciences and humanities, university of cambridge; doi: http://dx.doi.org/10.13039/501100000587
description: Funder: economic and social research council; doi: http://dx.doi.org/10.13039/501100000269
description: Funder: queensland university of technology; doi: http://dx.doi.org/10.13039/501100001793
description: Funder: university of edinburgh; doi: http://dx.doi.org/10.13039/501100000848
description: Funder: scottish funding councilsfc oda global challenges internal fund
description: Funder: university of cambridge gcrf fund
description: Funder: wolfson professor of criminology discretionary fund
description: BACKGROUND: Evidence for Better Lives Study Foundational Research (EBLS-FR) is a preliminary endeavor to establish the feasibility of a global birth cohort, and within this feasibility study, piloting the research instrument, with participants from eight lower middle-income countries across the globe. It aims to investigate mediators and moderators of child development and wellbeing; it envisages informing policy and practice change to promote child health and wellbeing globally. Pakistan is one of the resource poor lower middle-income country (LMIC) taking part in this global birth cohort; we report the feasibility of establishing such a birth cohort in Pakistan. METHOD: From March 2019 to July 2019, 153 third trimester pregnant women were identified, using community health worker registers, and approached for baseline demographics and a number of maternal wellbeing, mental health, support-related information, and stress-related biomarkers from bio-samples in a peri-urban area of Islamabad Capital Territory. One hundred fifty of these women gave consent and participated in the study. From October 2019 to December 2019, we re-contacted and were able to follow 121 of these women in the 8-24 weeks postnatal period. All interviews were done after obtaining informed consent and data were collected electronically. RESULTS: One hundred fifty (98.0%) third trimester pregnant women consented and were successfully interviewed, 111 (74.0%) provided bio-samples and 121 (80.6%) were followed up postnatally. Their mean age and years of schooling was 27.29 (SD = 5.18) and 7.77 (SD = 4.79) respectively. A majority (82.3%) of the participants were housewives. Nearly a tenth were first time mothers. Ninety-two (61.3%) of the women reported current pregnancy to have been unplanned. Overall wellbeing and mental health were reported to be poor (WHO-5 mean scores 49.41 (SD = 32.20) and PHQ-9 mean scores 8.23 (SD = 7.0)). Thirty-eight (21.8%) of the women reported four or more adverse childhood experiences; 46 (31.3%) reported intimate partner violence during their current pregnancy. During the postnatal follow up visits, 72 (58.0%) of the women reported breastfeeding their infants. CONCLUSION: The foundational research demonstrated that Pakistan site could identify, approach, interview, and follow up women and children postnatally, with a high response rates for both the follow up visits and bio-samples. Therefore, a future larger-scale pregnancy birth cohort study in Pakistan is feasible.