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Background Gender-based violence is a pervasive issue in Pakistan, necessitating effective interventions to enhance the responsiveness of healthcare workers’ capacity to respond effectively to Gender-based violence. This study aims to strengthen the health system’s response to Gender-based violence by implementing a need-based Life Skills-Based Training program for healthcare providers in Pakistan. Method A quasi-experimental pre-post study design was employed. The intervention, i.e., Life Skills-Based Training program was implemented across four diverse districts Matiari and Shadadkot (Sindh), Chitral (Khyber Pakhtunkhwa), and Gilgit (Gilgit-Baltistan) to ensure geographic and sociocultural variation. A total of 84 healthcare providers and 78 stakeholders were purposively selected based on their roles in patient care or Gender-based violence-related policymaking. Life Skills-Based Training was delivered over six days at each site, including tailored modules for healthcare providers and stakeholders, focusing on Gender-based violence concepts, screening, counseling, referral pathways, and system-level advocacy. A pre- and post-test assessment was administered to measure changes in knowledge, competencies, and attitudes using structured questionnaires adapted from UNHCR and UNICEF tools. Quantitative analysis of score improvements and qualitative feedback were used to evaluate training effectiveness. Results A comparative analysis of pre- and post-test assessments demonstrated significant improvements in participants’ Gender-based violence knowledge, awareness, and case management skills, with high satisfaction reported in Life Skills-Based Training evaluations. Feedback highlighted themes such as the effectiveness of training, the need for competent professionals, involving community leaders, replicating sessions, government health system responses, and integrating Gender-based violence education into curricula. Follow-up results demonstrated the sustainability of interventions, with participants actively applying their knowledge and leading community education. Conclusion The study highlights the need for continuous capacity-building and integrating Gender-based violence education into healthcare and educational systems to improve support for survivors. Strengthening the health workforce with targeted training and protocols is essential for addressing Gender-based violence effectively, offering a framework for similar efforts in other regions to foster equitable and responsive healthcare.
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Background: Timely decision-making in complex arthroplasty cases such as prosthetic joint infections (PJIs) and periprosthetic fractures is critical to optimizing patient outcomes. Traditional weekly multidisciplinary team (MDT) meetings often delay these decisions. This study evaluates the use of Siilo (Doctolib Siilo, Amsterdam, NLD), a secure medical messaging app, to facilitate expedited MDT discussions in acute arthroplasty admissions.
Methods: A retrospective audit was conducted on acute arthroplasty cases discussed via the Siilo platform over 12 months in 2024. Patient demographics, American Society of Anesthesiologists (ASA) grades, and types of diagnoses were recorded. Time from referral to decision via Siilo was compared to the institutional average wait time for conventional MDT meetings. The primary outcome was time saved in days.
Results: A total of 97 acute arthroplasty admissions were included in the study, with a median age of 72 years. The average time to decision via Siilo was 0.87 days, resulting in a mean time saving of 3.03 days per case. Most patients had ASA grades of 2 or 3, and the most common diagnoses included knee PJI, periprosthetic femoral fractures, and hip PJI.
Conclusion: The Siilo messaging platform reduced time to MDT decision-making in acute arthroplasty cases, demonstrating a practical advantage in managing complex admissions. Secure messaging should be considered as a valuable adjunct to traditional MDT frameworks to enhance clinical efficiency and patient care quality.
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Enhancing health workforce capacity through life skills-based interventions: evidence from Pakistan on reducing gender-based violence | BMC Health Services Research | Full Text
Healthcare work force
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