Ikram Shah
Biographic Data
| ID | 72804 |
|---|---|
| NAME | Ikram Shah |
| GIVEN NAMES | Ikram |
| FAMILY NAME | Shah |
| SIGNATURE | SHAH I |
| AFFILIATIONS | World Health Organization |
| ORCID | 0000-0001-8850-4374 |
| VERIFIED | Yes |
| TOTAL WORKS | 53 |
| TOTAL CITATIONS | 77 |
| AUTHOR COUNT | 53 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1982 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 5 |
Integration of family planning and nutrition programmes in 64 WHO member states of Africa, Eastern Mediterranean and South-East Asia regions
BACKGROUND: Family planning (FP) and nutrition services are essential for the health and well-being of girls and women in low- and middle-income countries (LMICs), yet evidence on their existing and potential integration is limited. Also, little is known about relevant national programmes and the views of health officials. METHODS: An on-line survey of national health ministry officials in member states of WHO Regions for Africa (AFRO), Eastern M…
Opportunities and challenges for integrating family planning and nutrition policies and programmes in Burkina Faso
BACKGROUND: Despite known linkages between family planning (FP) and nutrition, there is little evidence on whether and how these services are integrated for women of reproductive age (WRA; aged 15-49 years) in Burkina Faso. This study aimed to obtain an overview of FP and nutrition policies and programmes in Burkina Faso to understand the value, current efforts, gaps and opportunities for integration. METHODS: In this mixed-methods study, we anal…
Opportunities and challenges in integrating family planning and nutrition services in Tanzania
BACKGROUND: Integration of family planning (FP) and nutrition is critical for improving maternal and child health, yet evidence on effective integration remains limited in Tanzania. This study explored challenges and opportunities for integrated service delivery in Tanzania. METHODS: A mixed-methods approach was used, combining analysis of the 2022 Tanzania Demographic and Health Survey (n=15, 254 women), a desk review of 25 national documents, a…
Leveraging connections between family planning and nutrition to improve the health of women
The global burden of malnutrition and unmet need for family planning (FP) among women of reproductive age remains high. Leveraging the epidemiological and programmatic links between FP and nutrition could help improve outcomes in both domains for women, with wider benefits to health and well-being. Here, we draw on findings from our recently concluded Family Planning and Nutrition Project, which synthesised epidemiological and programmatic linkag…
Family planning and nutrition
INTRODUCTION: Contraceptive use may affect women's nutritional status through birth spacing, parity, age at first birth, menstruation changes, and increased income. To inform the integration of family planning with nutrition interventions, we synthesised evidence linking the use of family planning to nutritional outcomes in women of reproductive age (15-49 years) and adolescents (10-19 years) in low- and middle-income countries (LMICs). METHODS: …
Abortion and unintended pregnancy in Pakistan
BACKGROUND: Despite induced abortion being highly legally restricted in Pakistan, studies in 2002 and 2012 showed that many women rely on abortion when faced with an unintended pregnancy. Following the 2012 study, concerted efforts were made to improve contraceptive services and to strengthen postabortion care. The availability and use of misoprostol also expanded in the past decade. Our primary objective was to provide new evidence on the rates …
Perspectives on integrating family planning and nutrition
BACKGROUND: Limited information is available on the value of integrating family planning and nutrition services to improve related outcomes among women of reproductive age and effective approaches to achieve this. This study aimed to ascertain the perspectives and experiences of global and regional stakeholders about integrating family planning and nutrition services, examine facilitators and barriers and identify opportunities and considerations…
Integrating family planning with nutrition and other sexual and reproductive health services in low-income and middle-income countries
INTRODUCTION: Integrating family planning with nutrition could address unmet family planning needs and malnutrition in low-income and middle-income countries (LMICs). Integrating family planning with sexual reproductive health (SRH) services may provide valuable insights as well. This scoping review synthesised evidence from published and grey literature on interventions integrating family planning with nutrition or SRH services in LMICs. METHODS…
Nutrition and reproductive potential of women in low- and middle-income countries
INTRODUCTION: Nutrition plays a critical role in key physiological processes related to reproduction. However, there is limited understanding of the impact of nutritional factors and interventions on the reproductive outcomes of women in low- and middle-income countries (LMICs). METHODS: This systematic review and meta-analysis aimed to synthesise evidence regarding the impact of nutritional factors and interventions on the reproductive outcomes …
Quality education in post-devolution scenario in Pakistan
The 18th Constitutional Amendment in Pakistan vested provinces, including KP, with exclusive responsibility to undertake school education. However, after passing one and a half decades of provincial autonomy, none of the provinces displayed satisfactory outcomes in achieving the targets of Sustainable Development Goal 4: Quality Education. This research evaluates the Quality Education performance of KP province in Pakistan following the devolutio…
Who decides what? Women's decision-making after men's out-migration in the mountainous communities of Pakistan
Men’s out-migration and its consequent economic effects have received much attention in mainstream migration and development literature. However, its impact on the lives of the wives [of the migrants] and their decision-making power and ability is largely neglected, especially those living in restrictive joint family systems. Typically, in these situations, the women live in shared spaces within laws and enjoy little freedom to make decisions. Us…
Cultural Heritage Under Attack
This article aims to trace the Taliban's motives behind the deliberate destruction of cultural heritage in Swat while also looking into the local's reaction and their relationship with cultural heritage after the conflict. The Taliban insurgents deliberately defaced and dynamited the second largest seated statue of Lord Buddha after Bamiyan in Afghanistan and bomb-damaged Swat Museum. The findings are the outcomes of in-depth interviews and FGDs …
Integrating postpartum IUD counselling and insertion into routine maternity care in Nepal
To meet the postpartum family planning (PPFP) needs of women in Nepal, an intervention was launched to integrate PPFP counselling and postpartum IUD (PPIUD) insertion into maternity care. Women delivering in study hospitals over a period of 18 months were interviewed at the time of delivery and at 15 months following the end of the study enrollment period to assess if the impact of the intervention observed at the end of the study was maintained.…
Social inclusion of minorities in Pakistan
This paper aimed at analyzing the social inclusion of the Sikh community living in Pakistan with emphasis on social, economic dimensions. The mixed-method research approach was employed and data was collected from 94 respondents through questionnaires, focus group discussions, and in-depth interviews, and analyzed using descriptive statistics and thematic analysis. The results revealed that both communities extend moral and financial support at t…
The Effect of Family Planning Counseling on Incident Pregnancy in Nepal
An intervention aimed at institutionalizing postpartum intrauterine device (PPIUD) services was introduced in Nepal between 2015 and 2019. The intervention was evaluated using a cluster‐randomized stepped‐wedge trial, with data on women being collected immediately after delivery and at one‐ and two‐year postpartum follow‐ups. The sample consists of 19,155 women. We used intention‐to‐treat (ITT) analysis and structural equation model (SEM) to inve…
Understanding Women Empowerment in Rural Communities
Purpose of the study: The purpose of the study was to analyze the socio-cultural constraints that affect different dimensions of women empowerment in rural areas of Punjab province. Political participation and self-esteem were taken as dominant characteristics of women empowerment among lots of variables that collectively define women empowerment. Methodology: A mixed-method approach was used to study different dimensions of women empowerment. A …
Capitalizing on religious narratives
This article examines how militants in Northern Pakistan capitalized on religious narratives to reconstruct militants’ reality in anticipation to help entrench their presence and control in the conflict torn district of Swat. The study entailed collection of data from both primary as well as secondary sources. Primary data were collected through conducting semi-structured interviews, whereas secondary data were collected through a rigorous review…
Proximate and distal factors associated with the stall in the decline of adolescent pregnancy in Uganda
The stall in the decline of adolescent pregnancies in Uganda was linked to a stall in the reduction of adolescent marriage, which in turn was associated with limited progress in female educational attainment between 2006 and 2016. We emphasize the need for a renewed focus on girl's education and poverty reduction to reduce adolescent pregnancy in Uganda and subsequently improve health outcomes for adolescent girls
The impact of a personalized, community-based counselling and referral programme on modern contraceptive use in urban Ghana
Community-based demand-generation family planning programmes have been associated with increased contraceptive use in rural areas of Ghana. However, rigorous evaluations of such programmes in urban contexts are lacking. We used a retrospective, cross-sectional with comparison group design to estimate the immediate and sustained impact of the Willows intervention on modern contraceptive use in Kumasi, Ghana. The Willows intervention is a home-base…
Dynamics of Emergency Contraceptive Use in Accra, Ghana
Recent data suggest increasing rates of emergency contraception (EC) use in Ghana, particularly in urban areas. In 2018, we collected survey data from 3,703 sexually experienced women aged 16–44 years living in low‐income settlements of Accra. We estimated the prevalence of lifetime and current EC use. Multivariate logistic regression was used to assess factors associated with current use of EC. Retrospective monthly calendar data on contraceptiv…
Institutional arrangement for disaster risk management
The distance-quality trade-off in women’s choice of family planning provider in North Eastern Tanzania
Introduction: Studies on the determinants of contraceptive use often consider distance to the nearest health facility offering contraception as a key explanatory variable. Women, however, may not seek contraception from the nearest facility, rather opting for a more distant facility with better quality services or to ensure greater privacy and anonymity. Methods: The dataset used include the name of facility where each women obtained contraceptio…
An Application of the List Experiment to Estimate Abortion Prevalence in Karachi, Pakistan
CONTEXT: Abortion is particularly difficult to measure, especially in legally restrictive settings such as Pakistan. The List Experiment-a technique for measuring sensitive health behaviors indirectly-may minimize respondents' underreporting of abortion due to stigma or legal restrictions, but has not been previously applied to estimate abortion prevalence in Pakistan. METHODS: A sample of 4,159 married women of reproductive age were recruited fr…
Women's Perspectives on Postpartum Intrauterine Devices in Tanzania
Despite the numerous benefits of the postpartum copper intrauterine device (PPIUD), which is inserted within 48 hours after giving birth, it is underutilized in many resource‐constrained settings, including Tanzania. We conducted in‐depth interviews with 20 pregnant women who received contraceptive counseling during routine antenatal care in 2016–2017 and 27 postpartum women who had a PPIUD inserted in 2018 to understand reasons for use versus no…
Ethnolinguistic Concordance and the Receipt of Postpartum IUD Counseling Services in Sri Lanka
CONTEXT: Ethnic and linguistic concordance are important dimensions of the patient-physician relationship, and are linked to health care disparities. However, evidence on the associations between health behavior and outcomes and patient-provider concordance is limited, especially in low- and middle-income settings. METHODS: To examine how concordance between women and their primary health midwife is associated with women's receipt of postpartum I…
Unmet Need for Contraception
Unmet need for contraception has been a central indicator for monitoring the progress of family planning programs for 25 years. The purpose of this article is to provide a broad context for the more focused contributions that follow in this special issue. The validity and measurement of the concept of unmet need are discussed. We then present regional trends among married women since 1970. Major reductions in unmet need have been achieved, with t…
Multi-state analysis of marital status life tables
A multi-state life table, also known as a multi-dimensional or an increment-decrement life-table, is a generalization of the conventional life table. Members of a birth cohort are followed as they age, and move between various states of life. In this paper, the mathematical theory of multi-state life table construction is reviewed. It is shown that the mathematics becomes simple if the matrix approach, initiated by Rogers for the design of multi-…
Unsafe abortion differentials in 2008 by age and developing country region
Each year, nearly 22 million women worldwide have an unsafe abortion, almost all of which occur in developing countries. This paper estimates the incidence and rates of unsafe abortion by five-year age groups among women aged 15-44 years in developing country regions in 2008. Forty-one per cent of unsafe abortions in developing regions are among young women aged 15-24 years, 15% among those aged 15-19 years and 26% among those aged 20-24 years. A…
Age Patterns of Unsafe Abortion in Developing Country Regions
Globally, 19 million women are estimated to undergo unsafe abortions each year. Age patterns of unsafe abortion are critical for tailoring effective interventions to prevent unsafe abortion and for providing post-abortion care. This paper estimates the incidence and the rate of unsafe abortion among women aged 15—44 in the Africa, Asia (excluding Eastern Asia), and Latin America/Caribbean regions, where a woman is likely to have close to one unsa…
Proportional hazards models for current status data
Unsafe abortion in 2008
Despite the availability of safe and highly effective methods of abortion, unsafe abortions continue to be widespread, nearly all in developing countries. The latest estimates from the World Health Organization put the figure at 21.6 million unsafe abortions worldwide in 2008, up from 19.7 million in 2003, a rise due almost entirely to the increasing number of women of reproductive age globally. No substantial decline was found in the unsafe abor…
Unsafe Abortion
Unsafe abortion is preventable and yet remains a significant cause of maternal morbidity and mortality in much of the developing world. Over the last decade, the World Health Organization has developed a systematic approach to estimate the regional and global incidence of unsafe abortion. Estimates based on figures around the year 2000 indicate that 19 million unsafe abortions take place each year, that is, approximately one in ten pregnancies en…
Interventions to Improve Postpartum Family Planning in Low‐ and Middle‐Income Countries
This article provides programmatic guidance and identifies future research priorities through a review of interventions to improve postpartum contraception. Thirty‐five interventions in low‐ and middle‐income countries were identified and classified according to timing and nature of administration: antenatal, postnatal, both ante‐ and postnatal, and integration with other services. With the exception of single, short antenatal interventions, the …
Maternal Mortality and Maternity Care from 1990 to 2005
Maternal mortality continues to be the major cause of death among women of reproductive age in many countries. Data from published studies and Demographic and Health Surveys show that gains in reducing maternal mortality between 1990 and 2005 have been modest overall. In 2005, there were about 536,000 maternal deaths, and the maternal mortality ratio was estimated at 400 per 100,000 live births, compared to 430 in 1990. Noteworthy declines took p…
Dynamics of Emergency Contraceptive Use in Accra, Ghana
Recent data suggest increasing rates of emergency contraception (EC) use in Ghana, particularly in urban areas. In 2018, we collected survey data from 3,703 sexually experienced women aged 16–44 years living in low‐income settlements of Accra. We estimated the prevalence of lifetime and current EC use. Multivariate logistic regression was used to assess factors associated with current use of EC. Retrospective monthly calendar data on contraceptiv…
Knowledge and perceptions about aids among married women in Bangkok
Adapting Fertility Exposure Analysis to the Study of Fertility Change
Fertility exposure analysis was developed recently by Hobcraft and Little in order to evaluate the relative importance of the various proximate determinants upon levels of current fertility. In the present paper we extend the analysis to the study of changes in fertility between two cross-sectional surveys. We show how to express fertility change as a product of terms which represent changes in the proximate determinants. The model of change is a…
Women's Perspectives on Postpartum Intrauterine Devices in Tanzania
Despite the numerous benefits of the postpartum copper intrauterine device (PPIUD), which is inserted within 48 hours after giving birth, it is underutilized in many resource‐constrained settings, including Tanzania. We conducted in‐depth interviews with 20 pregnant women who received contraceptive counseling during routine antenatal care in 2016–2017 and 27 postpartum women who had a PPIUD inserted in 2018 to understand reasons for use versus no…
Multi-state analysis of marital status life tables
A multi-state life table, also known as a multi-dimensional or an increment-decrement life-table, is a generalization of the conventional life table. Members of a birth cohort are followed as they age, and move between various states of life. In this paper, the mathematical theory of multi-state life table construction is reviewed. It is shown that the mathematics becomes simple if the matrix approach, initiated by Rogers for the design of multi-…
Fertility in Pakistan during the 1970s
A survey conducted in 1975, as part of the World Fertility Survey programme, provided evidence that fertility began to decline in Pakistan during the early 1970s. Because of the low level of contraceptive use recorded in that survey, the fertility decline was attributed to delayed marriage. However, a second and similar survey conducted approximately 5 years later showed almost exactly the same pattern of very recent decline, and indeed a reducti…
Proportional hazards models for current status data
Adapting Fertility Exposure Analysis to the Study of Fertility Change
Fertility exposure analysis was developed recently by Hobcraft and Little in order to evaluate the relative importance of the various proximate determinants upon levels of current fertility. In the present paper we extend the analysis to the study of changes in fertility between two cross-sectional surveys. We show how to express fertility change as a product of terms which represent changes in the proximate determinants. The model of change is a…
Knowledge and perceptions about aids among married women in Bangkok
Contraceptive transition in Asia
Infertility treatment
These three papers, with Nahid Toubia and Iqbal Shah responding to Marcel Vekemans, contain three different points of view on the priority that infertility treatment should be given when there are limited resources for public health services. The authors address the question of whether infertility treatment is a luxury in a world of population expansion, its costs and effectiveness, the role of sexually transmitted diseases, prevention vs cure, t…
Unsafe Abortion
Unsafe abortion is preventable and yet remains a significant cause of maternal morbidity and mortality in much of the developing world. Over the last decade, the World Health Organization has developed a systematic approach to estimate the regional and global incidence of unsafe abortion. Estimates based on figures around the year 2000 indicate that 19 million unsafe abortions take place each year, that is, approximately one in ten pregnancies en…
Trends in Reproductive Behavior among Young Single Women in Colombia and Peru
Using “calendar” data for single women aged 15-24 from successive Demographic and Health Surveys (DHS) conducted in Colombia and Peru during the 1990s, we document trends, year by year, in sexual activity, the use of contraceptives, and subsequent reproductive outcomes. We provide evidence of the important and hitherto largely untapped potential of DHS calendar data to draw complete sexual and reproductive profiles when data from various surveys …
Age Patterns of Unsafe Abortion in Developing Country Regions
Globally, 19 million women are estimated to undergo unsafe abortions each year. Age patterns of unsafe abortion are critical for tailoring effective interventions to prevent unsafe abortion and for providing post-abortion care. This paper estimates the incidence and the rate of unsafe abortion among women aged 15—44 in the Africa, Asia (excluding Eastern Asia), and Latin America/Caribbean regions, where a woman is likely to have close to one unsa…
Unsafe abortion
Trends in Protective Behaviour among Single vs. Married Young Women in Sub-Saharan Africa
The trends in contraceptive uptake and condom use among single and married young women show distinct patterns in sub-Saharan Africa. A large median increase of 1.4 percentage points per year in condom use by single young women for pregnancy prevention was witnessed in 18 countries based on Demographic and Health Survey data from 1993 to 2001. In contrast, a modest increase in condom use was noted for married or cohabiting young women. Condom prom…
Induced abortion
Sexual attitudes, pattern of communication, and sexual behavior among unmarried out-of-school youth in China
A substantial proportion of out-of-school youth engage in risky sexual behaviors. Prevention programs that empower communication and sexual negotiation skills, and promote condom use should be implemented for this vulnerable group
Maternal Mortality and Maternity Care from 1990 to 2005
Maternal mortality continues to be the major cause of death among women of reproductive age in many countries. Data from published studies and Demographic and Health Surveys show that gains in reducing maternal mortality between 1990 and 2005 have been modest overall. In 2005, there were about 536,000 maternal deaths, and the maternal mortality ratio was estimated at 400 per 100,000 live births, compared to 430 in 1990. Noteworthy declines took p…
Fertility Intentions and Reproductive Health Care Needs of People Living with HIV in Cape Town, South Africa
Unsafe abortion in 2008
Despite the availability of safe and highly effective methods of abortion, unsafe abortions continue to be widespread, nearly all in developing countries. The latest estimates from the World Health Organization put the figure at 21.6 million unsafe abortions worldwide in 2008, up from 19.7 million in 2003, a rise due almost entirely to the increasing number of women of reproductive age globally. No substantial decline was found in the unsafe abor…
Suffering in silence
Sexual violence within marriage is common in Nepal. Findings provide circumstantial evidence of links between sexual violence and negative general and reproductive health outcomes for women. Various actions are required to prevent SVWM and provide immediate support to the victims
Induced abortion
Condom use within marriage
The aim of the study is to measure trends in condom use in marital and cohabiting relationships in South Africa and Uganda. The data for the study come from two cross sectional surveys conducted in 1998 and 2008 among adult men and women and their partners in KwaZulu-Natal, South Africa and the Jinja district, Uganda. The findings suggest that consistent condom use has risen substantially in both countries. The percentage reporting consistent con…
Unsafe abortion differentials in 2008 by age and developing country region
Each year, nearly 22 million women worldwide have an unsafe abortion, almost all of which occur in developing countries. This paper estimates the incidence and rates of unsafe abortion by five-year age groups among women aged 15-44 years in developing country regions in 2008. Forty-one per cent of unsafe abortions in developing regions are among young women aged 15-24 years, 15% among those aged 15-19 years and 26% among those aged 20-24 years. A…
Unmet Need for Contraception
Unmet need for contraception has been a central indicator for monitoring the progress of family planning programs for 25 years. The purpose of this article is to provide a broad context for the more focused contributions that follow in this special issue. The validity and measurement of the concept of unmet need are discussed. We then present regional trends among married women since 1970. Major reductions in unmet need have been achieved, with t…
A Fresh Look at the Level of Unmet Need for Family Planning in the Postpartum Period, Its Causes and Program Implications
One central rationale for the promotion of family planning is the potential benefit to the health of mothers and children. The achievement of adequate spacing between pregnancies is a major pathway through which contraceptive practice can render benefits. Pregnancies conceived less than 20 months following a prior birth are at considerably higher risk of prematurity low birth weight fetal death and early neonatal death.1 The importance of this li…
The mediating role of individual resilience resources in stigma–health relationship among people living with HIV in Guangxi, China
Despite the vigorous global efforts to reduce stigma, HIV-related stigma continues to undermine the health status of people living with HIV (PLHIV). Internalized HIV stigma may cause stress adversely affecting the health of PLHIV. Resilience is the process of an effective coping and positive adaption in the face of adversities. To date, limited data are available on the mediating role of resilience in the relationship of internalized HIV stigma a…
Pregnancy wastage among HIV infected women in a high HIV prevalence district of India
HIV prevention and care programs need to consider the reproductive health needs of HIV infected married women as a priority area since large proportion of these women reported negative pregnancy outcomes. There is also a need to explore ways to raise the age at marriage in order to stop women getting married before the legal age at marriage
Medicine (37 works) · Population (32 works) · Demography (30 works) · Global Maternal and Child Health (30 works) · Environmental health (27 works) · Family planning (24 works) · Reproductive Health and Contraception (22 works) · Pregnancy (21 works) · Sociology (21 works) · Economic growth (17 works)