Research / Grant
Research / Grant
Pakistan, one of the world’s most climate-vulnerable nations, faces recurring natural disasters
such as floods and heatwaves, threatening health systems and social determinants of health.
Climate change has led to a rise in both communicable and non-communicable diseases (NCDs),
as well as psychological impacts like anxiety and trauma. Primary care physicians are critical in
addressing these challenges through patient education and climate-informed care. A
conference organized by SINA Health, Education and Welfare Trust brought together 110
primary care physicians to address the health implications of environmental change. The event
focused on the links between climate and rising cases of cardiovascular disease, stroke, and
vector-borne illnesses such as dengue and malaria. Discussions also addressed the mental
health burden of environmental disasters. Practical sessions introduced climate-smart solutions
and sustainable clinic practices. To mitigate the effects of climate change SINA launched the
“Green Initiative Program”, which included solar energy adoption, waste reduction, and
environmental audits, and positioning family physicians as frontline responders to Pakistan’s
climate-health crisis.
1. Primary Care Physicians and Planetary Health published in the WONCA regional newsletter for Southasia:
Primary healthcare physicians (PHCPs) in low-resource settings often face challenges in
maintaining consistent quality care, particularly in underserved urban communities. Clinical
audit and feedback (A&F) cycles offer a structured approach to identifying and addressing
performance gaps. In a study published in BMJ Open Quality, researchers from SINA Health,
Education and Welfare Trust evaluated the impact of A&F on 61 PHCPs across Karachi from
2019 to 2023. The study showed significant improvements in consultation skills, clinical
assessments, and adherence to protocols following targeted feedback. Improvements were
particularly evident in managing dermatological and gastrointestinal conditions, and in
antibiotic prescribing practices. This model integrated local guidelines with international
standards to address the unique healthcare needs of marginalized populations. By
incorporating EMR-based audits and the Calgary-Cambridge consultation framework, the
intervention demonstrated that regular feedback can enhance provider performance and
patient care. Future efforts will focus on sustaining these gains through continued training and
context-sensitive quality improvement strategies.
2. "Exploring the Role of Audit and Feedback Cycle in Primary Healthcare Quality Improvement" published in BMJ Open Quality:
