Research nominated for Times award

Nicola Lowe, Abaseen Foundation Trustee, and her colleague from the University of Central Lancashire (UCLan), Fiona Dykes, will be attending the award ceremony on November 25th 2010 at the Grosvenor in London where the following piece of research has been nominated for the Times Higher International Research Collaboration of the year award.

Background and aims

The project is a collaboration between researchers at the University of Central Lancashire (UCLan), UK, and the Khyber Teaching Hospital, Khyber Medical College, Peshawar, Pakistan, to improve the nutrition and health status of communities in Pakistan and the UK, and to gain an insight into the cultural issues relating to health inequalities amongst our South Asian immigrant populations in the UK.

This project is based in the Emergency Satellite Hospital (ESH) in Nahaqi, close to Peshawar, that serves a population of 200, 000, including 60,000 Afghan refugees.  Ninety Five percent of the population is poor and, according to a 2007 survey, 13% of under five children had moderate, and 7% had severe, acute malnutrition.

The research team worked together with the local community through participatory research methodology to develop a, first of its kind in NWFP, community based Nutrition Rehabilitation Unit at ESH. It quickly became apparent that poverty, lack of access to quality food, inadequate health education, illiteracy and gender inequality were the main contributing factors to the high incidence of malnutrition. Possible actions and interventions were agreed in consultation with the community. These included screening for malnourished children below 5 years old and pregnant or lactating women. The malnourished children and PLW were registered for long term care and food supplements were provided to them. The community was educated in nutrition and breast feeding practices, and a demonstration kitchen was established to teach mothers how to make a balanced meal out of locally available foods.

This project, although started with very modest and limited resources, has quite successfully changed the beliefs and behaviours of the locals regarding maternal and infant nutrition. This has resulted in decreased child malnutrition, with acute malnutrition falling to 4% moderate and 1% severe.

Challenges

One of the key challenges for this research collaboration is the inability of UK based researchers to travel to PK to meet with our collaborators because of security issues. This has been successfully overcome through regular communication by email and “Skype”, by visits to the UK from the PK based research lead, and a video diary of our PK researchers (see additional information).

Dissemination

This innovative research has been disseminated through cluster meetings of NGO’s operating in Pakistan, which has lead to changing the way in which UNICEF operate their Nutrition support and humanitarian relief activities in this region (by adoption of this community participatory methodology), through research publication, and through a meeting with the British High Commissioner to Pakistan in April 2010. In the UK, the research is disseminated through our partner charity activities and meetings with community groups.

Ongoing collaboration

The research team is currently planning the next phase of research that will be embedded into the humanitarian relief work so that successful practices can be recorded and used as a model for implementation in other relief situations.

Enhancement of international profile.

This has raised the profile of the University in Pakistan and internationally via its contribution to UNICEF policy.

Additional information.

The video diary of our PK researchers showed a day in the nutrition support clinic. This was invaluable in helping the UK team to understand the day –to- day challenges the PK team face, which include security of female personnel travelling around the area, gaining the trust of the rural communities in which they work, and the practical issues such as loss of electrical power at the hospital.

This unique and strong  partnership operates through our close partnership with a Lancashire based charity, the Abaseen Foundation UK (AFUK), which pursues its charitable objectives by way of partnership with the Abaseen Foundation Pakistan (AFPK). Staff members from both institutions sit on the board of trustees both in the AFUK and AFPK. Together these organizations comprise the Abaseen Foundation (AF)

After the initial success of this pilot project, UNICEF has asked the Abaseen Foundation to extend its activities to other districts, including the Swat Valley, affected by the large scale displacement of communities resulting from the political instability.

Funding support from UNICEF  as a direct result of this Nutrition support project

2010: £56,000. UNICEF Provision of Quality Nutritional Services to Internally Displaced Persons and Host Communities in selected UCs of District Kohat . Pakistan Humanitarian Response Plan (PHRP 2010)

[PKA-10/H/30567/1124)]  (funds to Abaseen Foundation)

2010: £130,000. Swat mother and Child (funds to Abaseen Foundation) Maternal and Child Health Care (MCHC) Program NWFP (AWP Reference No:[Health (UNICEF-PAK-08/H10)])

Mother and Child Days in selected Union Council of District Swat.

2009: £300,842 UNICEF (funds to Abaseen Foundation) Provision of comprehensive health services, including Medical Care, MNCH, Nutrition, EPI and Community mobilisation, to the IDPs and host communities in Daudzai area, District Peshawar.

Research publications to date from this project:

Seven abstracts and three full papers:

• Nicola M Lowe ,Soma R Mitra, Peter C Foster, Issak Bhojani, John F McCann.  Biochemical markers of bone turnover in Postmenopausal South Asian and Caucasian Women.  British Journal of  Nutrition   (IF 2.76) In Press
• Victoria Moran, Nicola Lowe, Fiona Dykes. Zinc requirements in pregnancy and Lactation Maternal and Child nutrition. (IF 1.28) Accepted April 2010
• Monique Lhussier, Fiona Dykes, Sonia Ali Bagash,  Mukhtiar Zaman, Nicola Lowe.   Implementation and evaluation of a health promotion initiative in north Pakistan: a realist framework.  Health Promotion International. (IF 1.35). Accepted May 2010