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Dr. Assad Hafeez 

Title: Dean & Head of Research & Development mail A103(Ground Floor)
Disciplines: Health Policy, MNCH, Primary Health Care, Health Systems +92-51-9522290-4
Research Areas: Health Policy, MNCH, Primary Health Care, Monitoring & Evaluation , Health Systems +92-51-9255591
az10@hotmail.com

 

Background

Dr. Assad Hafeez is a leading public health specialist and researcher with extensive clinical and management experience in various capacities, spanning over 30 years. He has held various positions in the health sector and has performed leadership, financial, monitoring and strategic guidance roles in international organizations, the public sector and civil society organizations. He is the Executive Director/Dean of the Health Services Academy, a public health institution mandated by the Government of Pakistan to provide policy advice and research; he is also the Dean of Faculty of Medicine in Quaid-i-Azam University, Islamabad. He is currently the Director-General of Health in the Federal Ministry of Health Services, Regulations and Coordination, Islamabad − the country’s most senior public sector technical post in the field of health. He has been the National Programme Manager of the National Program for Family Planning & Primary Health Care, one of the world’s largest community health workers’ programmes. He also has been the chief of National Health Policy and System Strengthening Unit of the Ministry of Health.

Dr. Hafeez is a medical graduate with post-graduate studies in paediatrics; and he holds a Fellowship of the College of Physicians and Surgeons, Pakistan and the Royal College of Paediatrics and Child Health, London. He also has obtained a Masters in Epidemiology from the London School of Hygiene & Tropical Medicine and a PhD in Public Health from the University of Manchester in the United Kingdom. He has held a number of clinical and academic posts in national and international institutions. He is on various international technical organizational boards and editorial boards of reputed journals, in addition to having had more than 80 publications in peer reviewed journals.  He is an expert researcher and has completed a number of research grants as Principal Investigator and Co-Principal Investigator with seminal research in the field of Maternal, Newborn and Child Health, health systems and evidence-based policy-making.

Dr. Hafeez has played a leading role in areas of national importance, while at different positions in and outside ministry, like the development of National Health Vision 2016−2025, the National Health Information Dashboard, the National Strategic Framework for Containment of Antimicrobial Resistance, the national strategy for the prevention and control of Ebola virus disease, the Government’s poliomyelitis-control efforts, the Joint External Evaluation for the International Health Regulations (2005)/Global Health Security Agenda and many other key tasks of public health importance. Dr. Hafeez has also been the key architect/team member in conceiving, designing, implementing and monitoring the first-ever large-scale National Health Insurance Program, with an innovative design covering a population of 100 million beneficiaries.

Dr. Hafeez is currently representing Pakistan on the Executive Board of the World Health Organization (2015−2018). He was elected Vice-Chairman of the Board in May 2015 and Chairman in May 2017. He is also member of WHO EMRO regional committee for Research & Development in health and a member of WHO’s International Health Regulations (2005) Emergency Committee concerning ongoing events and context involving transmission and international spread of poliovirus, in addition to performing a number of other international assignments. He has participated in and led Pakistan’s delegation to Regional Committee meetings and to the World Health Assembly for a number of years.

Research and Teaching

  • Child Health, Maternal Health
  • Early Child Development
  • Epidemiology, Health Systems
  • Health Policy and Planning
  • Health Financing
  • Social Protection.

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Post Held (Most Recent First)

  • Dean/Executive Director Health Services Academy, Federal Ministry of Health. (Nov 2009-Date).
  • Director-General Health (DGH), Federal Ministry of National Health Services, Regulations and Coordination (since 2014)
  • Chief of National Health Systems and Policy Unit, Federal Ministry of Health. (May 2009).
  • Senior Technical Advisor in Public Health to Federal Ministry of Health (April 2009).
  • Honorary Senior Research Associate at University of Liverpool UK. since (Dec 2008).
  • National Coordinator National Program for Family Planning and Primary Health Care, Federal Ministry of Health. (2008).
  • Consultant WHO for Commission on Macroeconomics & Health (CMH) and Maternal & Child Health. (2005- 2006).
  • Head of Paediatric Department & Secretary, Epidemiology Unit. (1996-2007).
  • Honorary Research Associate at Faculty of Medicine, University of Manchester UK. (2005).
  • National Project Director Emergency Drug Supply Project (EDSP) for Baluchistan & NWFP. (2002).
  • Consultant Paediatrician, Military Hospiltal, Lahore. (1994).
  • Registrar, City Hospital (Neonatal Unit), Birmingham, UK. (1994).
  • Resident Paediatrics Medicine, Military Hospital, Rawalpindi. (1989-1993)
  • Field Medical Officer, Pakistan Army in various units in AK and rural Punjab. (1987).

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Education

  • PhD Public Health, School of Medicine, University of Manchester, UK, 2009.
  • MSc Public Health – Epidemiology, LSHTM London University UK, 2003.
  • Diploma-Epidemiology, LSHTM UK, 2002.
  • Fellow Royal College of Paediatrics and Child health (FRCPCH), London 2001.
  • Member Royal College of Physicians, London (MRCP), 1994.
  • Fellow of College of Physicians and Surgeons of Pakistan, (FCPS) 1993.
  • MBBS, Army Medical College, Quaid-e – Azam University, 1987.

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Publications in Peer Reviewed Journals

  • Hafeez A, Mirza Z. Pharmaceutical companies response to request for more drug information in Pakistan: A Postal survey , British Medical Journal 1999;319:547 .
  • Rehman SA, Hafeez A. Suicidal feelings run high among Afghan refugee women Acta Pshychiatra Scandinavia 2003: 108: 392-3.
  • Hafeez A, Riaz R, Samin S, Pervaiz J, Southall DP. Integrating health care for mothers and children in refugee camps and at district level. British Medical Journal 2004;328:834-836
  • Hafeez A, Kiayani AG, Saif Ud Din et al. Prescription and dispensing practices in public sector health facilities in Pakistan: Survey report Journal of Pakistan Medical Association 2004;53:156-59
  • Hafeez A, Mehmud G, Mazhar F, Oral zinc supplementation in pregnant women and its effect on birth weight: a randomized controlled trial, Arch Dis Child. Fetal and Neonatal Feb 2005;90:F170-171.
  • Hafeez A, Kiyani A. Creation of HTA network, Insights from Pakistan, Italian Journal of public health June 2005; 2(2), supplement 1-53.
  • Zafar S, Hafeez A, Qureshi F, Southal D. Evaluation of structured maternal and child life support courses in Paksitan: An audit of trainees log books Archives of Gynecology and Obstetrics May 2007: supplement vol 275; 4
  • Bile K, Hafeez A, Nisther S. Public Sector health financing in Pakistan: A retrospective study Journal of Pakistan Medical Association 2007;57: 55-59 .
  • Jonathan CK, Bilal R, Abbass KA, Latif Z, Roohi S and Hafeez A. Breast milk intake in exclusively breastfed Pakistani infants; An estimation by deuterium dilution method. Pak Paed J 2007; 31(3): 111-19.
  • Hafeez A, Zafar S, Qureshi F, Mirza I, Bile Khalif M, Southall DP. Emergency maternal and child health training courses to achieve Millennium Development Goals in a poorly resourced country; challenges and opportunities JPMA April 2009; 59 (4): 243-47
  • Zafar S, Hafeez A, Qureshi F, Arshad N, Southall DP. Effectiveness of structured training in the management of MCH emergencies in a poorly resourced health system: Utilization of log-books as assessment tool. Resuscitation April 2009; 80 (4): 229-332.
  • Haq Z, Hafeez A, Khanum A, Southhall DP. Birth preparedness and role of private sector: a community survey from Pakistan JPMA June 2009; 59 (6): 343-47
  • Bile K, Hafeez A. Crisis in the Swat Valley of Pakistan: need for international action The Lancet July 2009; 374 (9683): 23-4
  • Haq Z, Hafeez A. Knowledge and communication needs assessment of community health workers in a developing country: a qualitative study Human Resources for Health July 2009, 7:59
  • Hafeez A, Khan Z, Bile KM, Jooma R and Shiekh M. Pakistan Human Resource for Health Assessment 2009 Eastern Mediterranean Health Journal August 2010, vol 16 supplement: 145-51.
  • Sabih F, Bile KM, Bueheler W, Hafeez A, Nishter S and Siddiqi S. Implementing the district health system in the framework of primary health care in Pakistan: can the evolving reforms enhance the pace towards the Millennium Development Goals? Eastern Mediterranean Health Journal August 2010, vol 16 supplement: 132-44.
  • Hafeez A, Bile Khalif M, Shaikh MR, Shah SAI, Jooma R. Lady health workers programme in Pakistan: challenges, achievements and way forward. JPMA, March 2011; 61 (3) 210-15.
  • Nisar YB, Hafeez A, Zafar S, Souhall DP. Impact of essential surgical skills with an emphasis on emergency maternal, neonatal and child health training on the practice of doctors: A cluster randomized controlled trial in Pakistan. Resuscitation
    August 2011; 82 (2011) 1047– 1052
  • Bile KM, Hafeez A, Kazi GN, Southall DP. Protecting the rights to health of internally displaced mothers and children: the imperative of an inter cluster coordination for translating best practices into effective participatory action. Eastern Mediterranean Health Journal Dec 2011; vol 17 (12): 981-89.
  • Sheikh BT, Mazhar A, Khan SA, Hafeez A. Social protection strategies and health financing to safeguard reproductive health for the poor: Making a case for Pakistan. J Ayub Med Coll 2011;23(4): 126-30
  • Winrow B, Bile K, Hafeez A et al. A proposed new international convention supporting the rights of pregnant women and girls and their newborn infants. Arch Dis Child Jan 2012 (97) 5; 447-51. doi:10.1136/archdischild-2 of 5 2011-300684
  • Rahman A, Haq Z, Sikander S, Ahmad I, Ahmad M, Hafeez A. Using cognitive-behavioral technique to improve exclusive breastfeeding in a low- literacy disadvantaged population. Maternal and Child Nutrition 2012; vol 8(1): 57-71
  • Khan A, Kinney MV, Hazir T, Hafeez A, Wall SN, Ali N, et al. Newborn survival in Pakistan: a decade of change and future implications. Health policy and planning. 2012;27(suppl 3):iii72-iii87.
  • Khan A, Kinney MV, Hazir T, Hafeez A, Wall SN, Ali N, Lawn JE, Badar A, Khan AA, Uzma Q, Bhutta ZA; Pakistan Newborn Change and Future Analysis Group. Newborn survival in Pakistan. A decade of change and future implications. Health Policy Plan July 2012; 27 supply 3: iii 72-87. Doi: 10. 1093/heapol/czs047
  • Khan AW, Amjad CM, Hafeez A, Shareef R. Perceived individual and community barriers in the provision of family planning services by Lady Health Workers in tehsil Gujar Khan. JPMA Dec 2012; 62:1318
  • Kumar R, Sheikh BT, Hafeez R, Hafeez A. Job satisfaction among public health professionals working in public sector; A cross sectional study from Pakistan. Human Resource for Health Jan 2013; 9:11(1):2 doi 10.1186/1478-4491-11.2
  • Bigdeli M, Zafar S, Assad H, Ghaffar A. Health System Barriers to Access and use Magnessium Sulfate for women with severe pre-eclampsia and eclampsia in Pakistan: Evidence for Policy and Practice. PLoS ONE 2013; 8(3): e59158. Doi 10. 1371/journal.pone.0059158
  • Ghaffar A, Zaidi S, Qureshi H, Hafeez A. Medical education and research in Pakistan: What the numbers really tell us? The Lancet May 2013; http://dx.doi.org/10.1016/S0140-6736(13)60146-4
  • Bhutta ZA, Hafeez A, Rizvi A et al. Reproductive, Newborn and Child health in Pakistan: Challenges and opportunities. The Lancet May 2013; http://dx.doi.org/10.1016/S0140-6736(12)61999-0
  • Shiekh BT, Ejaz I, Mazhar A, Hafeez A Resource Allocation in Pakistan’s Health sector: A critical appraisal and path towards Millennium Development Goals. World Health and Population 2013; 14 (3): 22-30.
  • Zafar S, Sikander S, Haq Z, Hill Z, Lingam R, Skordis Worrall J, Hafeez A. Integrating maternal psychosocial wellbeing into a child development intervention: the five pillars approach. Annals of the New York Academy of Sciences. 2014;1308 (1):107-17.
  • Sikander S, Maselko J, Zafar S, Haq Z, Ahmad I, Ahmad M, Hafeez A, Rahman A. Cognitive-Behavioral Counseling for Exclusive Breastfeeding in Rural Pediatrics: A Cluster RCT. Pediatrics. 2015:peds. 2014-1628.
  • Zafar S, Najam Y, Arif Z, Hafeez A. A randomized controlled trial comparing Pentazocine and Chamomilla recutita for labor pain relief. Homeopathy 2015 http://dx.doi.org/10.1016/j.homp.2015.09.003
  • Rahman A, Hafeez A, Bilal R, Sikander S, Malik A, Minhas F, et al. The impact of perinatal depression on exclusive breastfeeding: a cohort study. Maternal & child nutrition. 2015 Feb 16. doi: 10.1111/mcn.12170 2015.

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    Monographs

    • Primary Health Care Performance Assessment – Pakistan: Report prepared for and submitted to WHO EMRO office in July 2008.
    • Inventory of Health and Population investment in Pakistan published jointly by Ministry of Health, Ministry of Planning and WHO.
    • Provider manual for Emergency Maternal and child Health (EMCH) course published by Advanced Life Support Group (ALSG) UK, Child Advocacy International and WHO.
    • Contributed chapter in “Methodological issues in health systems research” under publication by Concerted-Action group European Union.
    • Baseline survey report on prescription, dispensing and storage practices in NWFP, Punjab and Baluchistan, published by TheNetwork for Consumer Protection and WHO, 2002.
    • Standard Operating Procedures for prescription handling and dispensing practices, published by TheNetwork, WHO, MOH Baluchistan & NWFP.
    • Standard Operating Procedures for inventory control and storage practices, published by TheNetwork, WHO, MOH Baluchistan & NWFP.
    • Guidelines for development and maintenance of formularies, published by TheNetwork, WHO, MOH Baluchistan & NWFP.
    • Provincial formulary Baluchistan, published by TheNetwork, WHO and MOH Baluchistan.
    • Provincial formulary NWFP, published by TheNetwork, WHO and MOH NWFP.
    • Guidelines for diagnosis and management of Tuberculosis in children published by Pakistan Paediatric Association.
    • Guidelines for diagnosis and management of Bronchial Asthma in children published by Pakistan Paediatric Association.
    • Contributed a chapter in Anthology, “Voices for Peace” published by Simon Schuster 2002, Edited by Anna Kiernan.

    Papers Presented At International Conferences

    • Hafeez A. Review of private sector health care in Pakistan. Invited speaker at WHO Regional Health systems meeting in Cairo, Egypt June 2014
    • Hafeez A. Use of Evidence in Policy process in Pakistan. Invited speaker at Regional HTA   conference in Ankara, Turkey, March 2009.
    • Hafeez A. Lady health Worker Program :A catalyst for change in Pakistan. Invited Speaker at First Primary Health Care conference WHO EMRO, Doha, Qatar, Nov 2008.
    • Hafeez A, Kiyani A, Creation of HTA network: Insights from Pakistan, read as invited speaker at  2nd HTAi international conference in Rome, Italy June 2005
    • Hafeez A, Southall DP, Experience of combining maternal and child health in emergencies, read as invited speaker at Eighth Annual Spring meeting of Royal College of Pediatrics and Child Health London at York University UK, 2004
    • Hafeez A. ESSEMCH Pakistan, Results of pilot project. Key note speaker at first GIESC Meeting WHO Head Quarters Geneva, Switzerland, Dec 2005.
    • Hafeez A. Development and implementation of a structured life support course for developing countries: A pioneering experience from Pakistan. Invited speaker at Ulster Paediatric society annual meeting Belfast, Northern Ireland UK in April 2006.
    • Hafeez A, Hassan M. Abdominal Pain and H. Pylori infection in children, Research paper presented at XXIInd International Pediatric Conference at Amsterdam, Holland August 1998.
    • Hafeez A, Recurrent Abdominal pain in children, Research paper presented at First World Congress of Pediatirc Gastroenterology, Boston USA. 2000
    • Hafeez A, Efficacy and safety of Saccharomyces boulardii in treatment of acute gastroenteritis in children., Research Paper read at 23rd International Pediatric Conference at Beijing China, 9-14 sept 2001.
    • Hafeez A, Mirza Z. Methodological issues of monitoring health systems in Pakistan, Research paper read at Workshop on Monitoring Shifts in Health Sector Policies in South Asia’Kathmandu, Nepal, 23-24-25 November 2002 organised by European Union.

    Research Projects/ Grant

    Completed various research projects in the institution as well as in individual capacity. The cumulative grants amount to more than 500 million Pak Rs for these projects in which Dr Hafeez has been involved either as principal recipient or Co recipient. The following are few of the recent (last 5 years) and ongoing activities:

    • PI (Pakistan): Sustainable Interventions to Promote Nutrition & Child Development – the SPRING Programme, Wellcome Trust, UK funded project, in which India and Pakistan along with LSHTM and Liverpool university have partnered to develop an innovative, feasible, affordable and sustainable community-based approach to close the access gap, in two of the worst affected countries, using existing community-based agents. Dr Hafeez is the PI from Pakistan and the total project grant is 2.57 million GBP for 5 years (2011-2015).
    • PI: Costs of Maternal Care Services in District Attock-Pakistan, Research & Advocacy Fund DFID funded project with a grant of GBP 97,000 (started Jan 2012).
    • Co PI: Communication tool for community Midwives, Research & Advocacy Fund DFID funded project with a grant of GBP 49,000 ( 2011-2013).
    • PI: Evaluation of ESS_EMCH trainings in Pakistan. Field research funded by USAID (100,000 US$) to evaluate impact of life saving trainings on skills and knowledge of health workers. (completed 2008)
    • PI: Evaluation and improvement of drug management systems in NWFP and Baluchistan, Action research funded by “DFID” UK. GBP 92,000. (completed 2002).
    • PI : Effect of zinc supplementation of pregnant women on birth weight and serum zinc levels. Community and Multicentre trial funded by a competitive grant from “Save the children US”. US$ 12,000. (completed 2003-4).
    • Co investigator: Evaluation of serum Vitamin A & micronutrient levels in the community after supplementation campaigns. Community study funded by “UNICEF” Pakistan. US$ 10,000. (completed 2003).
    • PI: Comparison of sensitivity and specificity of various available tests for H Pylori in children. Multicentre clinical trial funded by participating institutions. (completed 2005).
    • Co PI: Effect of lacto gouges on breast milk production. Hospital based study funded by MoH Pak Rs 1 million (completed 2009).
    • Co PI: Effect of maternal depression on breast milk quantity and duration. Community based study funded by HEC. Pak Rs 1.97 millions.
    • Co PI: Comparison of homeopathic and allopathic analgesic for prevention of labor pains; a randomized control trial. A hospital based study funded by HEC Pak Rs 0.4 millions (completed 2010).

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    Memberships

    • Member Academic council and Faculty of medicine Quiad Azam University Islamabad: QAU is the most prestigious university in Pakistan and has a faculty of medicine with clinical and public health institutions on board. Dr Hafeez is a member of both the academic council and the faculty of medicine since 2010.
    • Examiner and Supervisor: Examiner at Agha Khan University. Recognised supervisor of PhD in Public Health with Higher Education Commission and Liverpool University UK. Supervised PhD, FCPS, M Phil and MCPS students in the last few years.
    • Teaching Experience. More than 7 years of recognised teaching experience from Pakistan Medical and Dental Council.  Have taught on various international/national courses.
    • Chief Editor, Pakistan Journal of Public Health, Pakistan.
    • Member Editorial Board of Journal of Pakistan Paediatric Association.
    • Member National Task force for development of national 5 years development program for health (MTDF 2010-2015).
    • Faculty member Advanced Life Support Group (ALSG) UK (since 2005): ALSG is the international certifying body for advanced life supporting trainings in UK and worldwide. Dr Hafeez is on the board of the ALSG’s Advanced Paediatric Life Support and Essential Maternal Child Health (EMCH) Course since 2005. He was one of the pioneers to start EMCH course and piloted it in Pakistan which is now being replicated through WHO in many countries around the world.
    • Member Executive Council of Pakistan Medical and Dental Council (2010-2011). Remained member of PMDC executive committee for one year and also remained member of various select committees of the professional regulatory authority of Pakistan.
    • Member grant selection committee of EMRO for health system research awards
    • Member Faculty of Medicine and Academic Council, Quaid e Azam University, Islamabad

    Honours And Awards

    • Value in Person (VIP) 2006, awarded by Welcome Trust UK for completion of PhD studies.
    • International Outreach Award by International society of Paediatric Gastroenterology 2001.
    • Awarded “Young Researcher Award” by International Paediatric Association, for outstanding research paper submitted at 23rd International Paediatric Conference, 9-14 Sept, 2001 Beijing, China.
    • Awarded “International outreach award” for the World Congress of Paediatric Gastroenterology, Nutrition and Hepatology, held at Boston USA on 5-9 August, 2000.
    • Visiting Fellowship for the year 1999, by Royal College of Paediatrics and Child health,   London UK.
    • Jamal Bhutta Gold Medal in Paediatrics for attaining distinction in FCPS part 2 examination. College of Physicians and Surgeons of Pakistan. 1993.

    Experience

    • More than seven years of recognized teaching experience (Associate Professor) from PMDC and supervised 14 FCPS students, registered as supervisor with CPSP.
    • Honorary Senior Research Associate at university of Liverpool UK.
    • Affiliated with various academic institutions in public health and child health in the country in addition to being part of a number of research projects as PI or Co investigator with a total of 16 million Rupees won as research grants.
    • Published more than 40 research papers and have contributed to a number of books and monographs in the field of pediatrics and public health in addition to various papers as invited and plenary speaker in national and international forums.

    Research, Policy & M&E Experience

    • Vice Chair and member WHO Executive Board: (2015) The WHO Executive Board is composed of 34 technically qualified members and is the apex body which sets the policy directions and guides the DG WHO regarding various issues. Dr Hafeez was nominated by GoP for the membership of the board and after contesting the election was installed for 3 years as member and was also elected as Vice Chair of the board in 2015.
    • Member IHR Emergency Committee on Polio: (2014) The IHR emergency Committee is convened by DG WHO for considering various options to contain international spread of polio. Dr Hafeez is one of the 12 independent members of the committee for giving inputs as a public health expert.
    • Member National Technical Advisory Group for Immunization: (2014) NITAG is an independent advisory panel to Ministry of Health for technical issues related to immunization in Pakistan. Dr Hafeez is a senior member of the committee since 2014.
    • Delegation Leader at WHO Regional Conference EMRO: (2013) Dr Hafeez led the Pakistani delegation at the annual RC of EMRO countries in Oman. Important issues like Polio, NCDs, UHC and other public health challenges were brought under discussion at this high level forum.
    • Team Leader, DFID Team for developing a 5 years costed Health Sector Strategy for the state of Azad Jammu and Kashmir.(2012).
    • Member, Independent Review Committee for Global Alliance for Vaccination and Immunization (IRC GAVI). (2011).
    • Lead Consultant, for report on migration policy and WHO code of ethics for recruitment of health workers in Pakistan. (Nov 2011).
    • Consultant, for Country Coordination and Facilitation Mechanism in HRH for WHO. (2010).
    • Lead Consultant, for compiling technical Joint Programming Component (JPC) documents for one United Nations. (Feb 2009).
    • Independent Evaluation, of Major Barriers to Interrupting Poliovirus Transmission in Pakistan by WHO (2009). Report was presented to DG WHO in Jan 2010.
    • Evaluation of UNICEF Health & Nutrition response to Earth Quake 2005 (Dec 2008).
    • Lead Consultant, for “United Nation Country Team” capacity assessment for One UN Project in Pakistan (Sept 2008).
    • National Consultant, for “One UN Project” for review of health systems in Pakistan. (May 2007).
    • Consultant WHO for Commission on Macroeconomics & Health (CMH) and Maternal & Child Health: (Jan 2005 to Jan 2006).
    • National Consultant WHO Country Cooperation Strategy (CCS) 2005-2010 & 2011-2015 for Pakistan (Aug 2004 & March 2011).
    • Environmental Health Impact Assessment Consultant, (2006)Environmental Impact Assessment (EIA) is being carried out in Pakistan for the last few years however Health component of the EIA is not robust enough to meet the requirements. Evaluation of Drug Management Systems in Public Sector in NWFP & Balochistan (2003).

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    Job satisfaction among public health professionals working in public sector: a cross sectional study from Pakistan.

    Kumar R, Ahmed J, Shaikh BT, Hafeez R, Hafeez A.

    Hum Resour Health. 2013 Jan 9;11(1):2. doi: 10.1186/1478-4491-11-2.

    PMID: 23298253 [PubMed] Free PMC Article

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