2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Background: Social determinants such as poverty, limited access to preventive health services, poor sanitation, undernutrition, and educational disadvantage strongly influence child health outcomes in low-resource urban communities. In Karachi, Pakistan, many children attending public schools live in underserved settlements where routine screening, early referral, and health promotion are limited. Schools can therefore serve as practical and equitable platforms for reaching children who are often missed by conventional health services.

Objective: To evaluate whether tailored, low-cost, school-based health interventions could reduce common health complaints among children attending public schools in Azam Basti, a semi urban community in Karachi.

Methods: A quasi-experimental pre-post study was conducted in five government schools. A total of 357 students completed both baseline and follow-up assessments. Screening included anthropometry, hygiene status, vision assessment, oral health assessment, ENT symptoms, abdominal and urinary complaints, musculoskeletal concerns, and skin conditions. Interventions were designed according to identified needs and included health education on hygiene, nutrition, eye care, ENT health, and oral hygiene; mass deworming; hygiene kit distribution; provision of spectacles for children with poor vision; cleanliness drives; and referrals to local primary care services.

Results: The intervention showed broad improvements across multiple health domains. Mean complaints per child declined from 4.0 to 1.4. Normal visual acuity increased from 77.0% to 94.7%, while decreased visual acuity fell from 23.0% to 5.3%. Dental decay decreased from 38.4% to 19.9%, ear wax build up from 23.5% to 4.8%, abdominal pain from 22.4% to 3.1%, urinary burning from 10.9% to 1.1%, and malnutrition from 34.3% to 25.8%. The number of children without visual, ENT, abdominal-urinary, musculoskeletal, and skin complaints increased significantly after intervention.

Conclusion: Tailored school-based interventions can address health inequities by bringing preventive, promotive, and referral services directly to children in underserved public schools. The findings support integrating a minimum school health package into education and primary care systems, with frontline health workers, teachers, local providers, and public-sector stakeholders working together. Such a model offers a scalable and equity-oriented strategy for improving child health, educational participation, and long-term wellbeing in low-resource urban settings.