Sajida Abdul Hussein, Sajida Abdul Hussein.
Social and educational determinants of child mental health: effects of neighborhood, family and school characteristics in a sample of Pakistani primary school children.
J Pak Psych Soc Jan ;6(2):90-8.

Objective: To identify socioeconomic risk factors for poor child mental health in the sample of primary school children in Karachi, Pakistan. Design: Cross sectional survey. Place and Duration of Study: The study was conducted in private, government and community schools in Karachi having 5-11 year old children during January to June 2006. Subjects and Methods: 2188 consent forms were sent to 700 parents of private and government school and 788 parents of community school children. A total of 968 parents agreed to participate in the study. Assessment of children’s mental health was conducted using Strength and difficulties questionnaire (SDQ). Results: Logistic regression was used to establish the association between socio-economic variables and child psychopathology. Poor physical health (OR=2.83, 1.89-4.23, p<0.0001); male gender (OR=1.47, 1.12-1.96, p<0.0054), urban neighbourhood (OR=46.34, 21.7-99.1, p<0.0001) , head of family other than father figure (overall p value<0.0001), school type (government and community) (OR=4.17, 2.94-6.25, p<0.0001), lower teacher’s qualification (overall p value<0.0001), less teaching experience (overall p-value<0.0001); poor child school attendance (OR=1.62, 95%CI=1.01-2.61, p<0.0463); and academic performance (p-value for all categories versus very good p<0.0001) were significantly associated with the likelihood of child mental health problems. Poor general health and residential neighborhood were related to emotional and conduct problems as well as hyperactivity. Emotional disorders and conduct disorders were most closely associated with family variables, while ADHD was only related to child characteristics. Conclusions: The multiple factors associated with child mental health in Pakistan are broadly consistent with previous findings from other countries. Public health programs require multiple targets to disseminate basic assessment and treatment skills more widely to other professionals and to establish strong links between frontline and specialist services.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com