Right To Play's intervention to reduce peer violence among children in public schools in Pakistan: a cluster-randomized controlled trial

BACKGROUND

Peer violence is common globally, but a little researched topic in low-and middle-income countries. This study presents the evaluation of a two-year randomized controlled trial of a structured play-based life-skills intervention implemented in schools in Hyderabad, Pakistan.

OBJECTIVE

To determine the impact of the intervention on school-based peer violence (victimization and perpetration) and depression among school children.

METHODS

40 single-sex public schools were randomized into two study arms (20 per arm 10 of each sex). A total of 1752 grade 6 students (929 from intervention and 823 from control schools) were enrolled in the trial. The two-year intervention was a biweekly structured game led by a coach followed by critical reflection and discussion for 30 minutes. Primary outcomes (exposure to peer violence exhibited through victimization and perpetration and depression) were evaluated using generalized linear-mixed models.

RESULTS

Of the enrolled children (N = 1752) 91% provided data for analysis. There were significant decreases in self-reported peer violence victimization, perpetration and depression. For peer violence victimization, the reductions in the intervention and control arms were: 33.3% versus 27.8% for boys and 58.5% versus 21.3% for girls. For peer violence perpetration, the reductions were: 25.3% versus 11.1% for boys and 55.6% versus 27.6% for girls in the intervention and control arms, respectively. There were significant drops in mean depression scores (boys 7.2% versus 4.8% intervention and control and girls 9.5% versus 5.6% intervention and control).

CONCLUSION

A well-designed and implemented play-based life-skills intervention delivered in public schools in Pakistan is able to effect a significant reduction in peer violence.

Community health nursing clinical teaching models practiced in undergraduate nursing programme at a private university in Pakistan

OBJECTIVE

To explore the perceptions and experiences of students and faculty about the modified community clinical model.

METHODS

The descriptive qualitative study was conducted at a nationally-accredited Baccalaureate School of Nursing and Midwifery in Pakistan in November 2016, and comprised final year students enrolled in Advanced Concepts in Community Health Nursing course, and experienced community health nursing faculty members. Individual interviews were conducted with students while faculty members were requested to write out their reflections. On the basis of this data, codes and categories were identified which led to two broader themes; window of opportunities, and challenges in practice.

RESULTS

Of the 17 subjects, 12 (70.6%) were students and 5(29.4%) were faculty members. All subjects were females. The window of opportunities theme had three categories: perceived comfort and safety; stakeholder's involvement and support; and open door for personal recognition and self-image. The challenges in practice theme had two categories: time consuming, and home visits. Faculty reflections highlighted the need for sustaining student-related activities within the communities.

CONCLUSIONS

The findings are suggestive of a wide range of application of the modified clinical model at undergraduate nursing education level.

Development of an economic skill building intervention to promote women's safety and child development in Karachi, Pakistan

Violence against women is a global epidemic phenomenon that can result in major mental health problems. Not only are women affected but also the health and well-being of their children are in jeopardy. To prevent violence and promote women's safety, several strategies have been tested in various cultural contexts. This article describes the process of developing and validating an economic skill building intervention for women of an urban slum area of Karachi, Pakistan. The purpose of the intervention is to increase women's economic independence, promote women's safety, and improve the behavioral functioning of their children.