Dr Anwar Rafay

MB;BS, MSc

[(Epidemiology and Biostatistics)

The Aga Khan University, Karachi, Pakistan]

+92 3333475231

Dr Anwar Rafay is a medical doctor, having a specialization in Epidemiology and Biostatistics (a Double Masters) from the Aga Khan University, Karachi. In a career spanning over 14 years, Dr Rafay has worked as an Academician, Epidemiologist, Biostatistician, M&E and QualityManagement specialist in the public and private sectors and international development agencies’ (World Bank, USAID, CIDA and recently DFID/UKAID) funded projects.

Dr Rafay has also been involved at university-level teaching. He has conducted courses in epidemiology and biostatistics at the Aga Khan University, the Baqai Medical University [MPH], Dow Medical University, the University of Karachi [Clinical Psychology], Institues of Behavioral Sciences and Anthropology and, lately, at Institute of Public Health, Lahore [MPH & MPhil]. He has also been teaching research methodology coursework and qualitative and quantitative techniques at the Institute of Business Administration (IBA, city campus), Karachi. He has also conducted six-sigma black belt courses at the PIQC (Pakistan Institiute of Quality Control). Dr Rafay has supervised a number of research projects, theses and publications and attended a host of international conferences.

As an experienced epidemiologist, Dr Rafay has a track record in planning, design and execution of public health projects and analysis of data for large scale peer-reviewed studies. He possesses a skill set in quantitative (mainly linear, logistic andCox’s regressions; Survival Analysis and non-parametric analysis) and qualitative research methods, which are rather crosscutting, bearing focus on operational, behavioral and biological research in particular. Dr Rafay has managed projects related to Health Systems, Infectious Disease, NCD and nutritional surveillance, public-health communication, MNCH & reproductive health.

Dr Rafay has a considerably long experience in designing and running health advocacy BCCcampaigns at the highest executive and legislative levels in the federal and provincial governments and legislatures. Putting up the pictorial warning on the cigarette pack in tobacco control andpromotion of breastfeeding among the neonates in flood hit areas were some of the notable successes.

Dr Rafay is married with two children and currently based in Lahore, Pakistan, but glad to be relocated.

Present Pursuit

  • Currently serving as aSenior Consultant to Contech International and working on RAF commissioned research, titled,“Development of Deployment Guidelines for Community Midwives (CMWs) in Balochistan”,awarded to Contech International Health Consultants.

Previously,

Assistant Professor of

Epidemiology & Biostatistics at IPH, Lahore

August 2011 – October 2012

Following functions were specifically performed.

  • Teaching Post-graduate classes in Institute of Public Health, Lahore, in the specialties of Epidemiology and Biostatistics [MPhil and MPH]
  • Analysis of Dengue data (disease and vector surveillance) and daily presentation in the 7’o clock meetings to the honorable CM Punjab during the dengue epidemic in 2011
  • Developing recommendations for timely action (daily basis)
  • Supporting and coordinating between the Office of the Director General Health Services, Punjab and Department of Health, Civil Secretariat, Lahore on dengue –related activities.
  • Remained instrumentally involved in developing the vertical program on dengue and other vector-borne diseases in Punjab.
  • Worked as a Pakistani counterpart with the epidemiologists of the Sri Lankan Dengue Control that visited Lahore in 2011 and 2012
  • Serving on a host of committees, namely re-structuring of IPH, Vector Control Committee, Infectious Disease Control Committee etc.

Simultaneously,

  • DFID/AusAID funded Public Health Consultant for Nutrition mapping and scaling –up Assignment: (Jan 2012 – Oct 2012)

Previously completed a mapping exercise on nutrition initiatives on the national level and proposed a scale-up for selected initiatives expected to become cornerstone of Provincial Nutrition Policies in the post 18th amendment scenario.

  • He has also served as Advisor to Punjab Information Technology Board (PITB), for developing Disease Surveillance System Project (DSS) for the province of Punjab. This core will be finally developed as service provision of health facilities making a knowledge hub for the Ministry of Health and other relevant departments.

Public Health Consultant, DFID-funded tama (through Crown Agents), on the inception of the Punjab Healthcare Commission (PHC)

Jan 2011 – july 2011

  • The prime responsibility was building the process for registration and licensing of the healthcare establishments: Developed & pre-tested the database-building strategy for the Private Sector Hospitals in 02 districts of Punjab;
  • Developed a systematic review of literature and understanding the gaps and impediments in the way to set-up a quality and safety assurance regulatory body. The breakdown of the deliverables and activities run as follows:
  • Clinical Governance: Reviewed and adapted of the Minimum Service Delivery Standards (MSDS) for the tertiary-care hospitals, developed sample M&E tools/protocols for haemovigilance and TTIs for QA

National Advocacy & Research consultant,

International Union against TB and Lung Diseases for managing Bloomberg grant Initiative partnering with Tobacco Control cell Moh islamabad,(Since June 2010 –sep 2011)

  • Looking after the program activities of tobacco control (The Union, Tobacco Free Kids & Bloomberg Grant Initiative), with the Tobacco Control Cell (TCC), MoH, Islamabad
  • Advocacy with the parliamentarians regarding Pictorial Health Warnings (PHWs) on the cigarette packs
  • interaction with the media from the national to the district level
  • interaction with the CBOs
  • conducting awareness sessions on the radio, with media and CBOs in seminars

The following epidemiological studies are conducted:

  • Effects of the Pictorial Health Warnings on cigarette packs upon the buying behavior of consumers in Rawalpindi and Islamabad, Pakistan(primary data)
  • The prevalence of smoking among the households of eighty four districts of Pakistan (PSLM, 2007, secondary data)

Consultant Epidemiologist,

National AIDS Control Program (NACP, Sindh Chapter)on the World Bank TA,

September 2007- June 2010

  • It was a national level position which providespolicy support to the Provincial Programs to help curb the HIV/AIDS menace in the country.
  • The surveillance comprised of active and passive components. Being the Epidemiologist, Dr Rafay was responsible for setting up of HIV/AIDS surveillance throughout the province and commissioning appropriate studies serving active component.This included the Most at Risk People (MARP) and the bridging populations visiting 46 STI clinics and 23 VCT Centers run by the Sindh Govt. Hospitals throughout the Sindh province.
  • Dr Rafay was also the part of team developing a UnifiedNational M&E frameworkfor the various implementing partners working in HIV/AIDS sector. The main challenge was to bring about a consensus among the partner NGOs for generating information on indicators of national and provincial, programmatic and academic interest.
  • The responsibilities included, inter alia, a close interaction with the Health Department, Govt. of Sindh, all relevant UN agencies, GFATM, City District Governments & CCPO offices Karachi, Hyderabad, Sukkur, Larkana and all other relevant government departments.
  • Also spearheaded the advocacy campaign among the Industrial Workers and Business Leaders regarding HIV/AIDS awareness by bringing closer ties with the Karachi Chamber of Commerce & Industry (KCCI) and the Sindh AIDS Control Program (SACP)

M&E Specialist (Consultant),

Empower Pakistan Project (EPP),USAID

short-term assignment

AUGUST 2009 – NOVEMBER 2009

  • District Level Scorecards on healthcare delivery in the selected 23 districts of Pakistan were developed. The input, process and output indicators were developed and a subsequent pilot was conducted.
  • Worked under direct supervision of the Economic Growth Office, US Embassy in Pakistan, Islamabad

Assistant Professor of Epidemiology & Biostatistics, Baqai Medical University, Karachi

OCTOBER 2006 - August 2007

  • Simultaneously held three portfolios, namely, Assistant Professor of Epidemiology and Head of Research in Public Health & Epidemiology at the Baqai Medical University, Karachi
  • Taughtepidemiology and biostatistics to post graduate [Masters in Public Health (MPH)] and undergraduate classes.
  • Contributed to the development of MPH coursework and also served on the undergraduate curriculum committee.

Director of Research center & STATS CLINIC

AND

Advisor to the Baqai Vision (Integrated Community Programs), Baqai Medical University, Karachi

October 2006 – August 2007

  • Looked after the RESEARCH CENTER& STATS CLINIC (brainchild of the author) which was catering for the current public health and epidemiology research needs (inclusive of support in grant writing, the study design, analysis, report writing and publication) of the University. The Research Center was also an implementing partner in CIDA (Canadian International Development Agency) funded initiative called HASP (HIV/AIDS Surveillance Program) in Integrated Behavioral & Biological Survey (IBBS) Round 2.
  • Evaluated the community programs addressing Women Development, Poverty Alleviation, Health and Education running under Baqai Vision.
  • Responsible for the CME carried out at the Baqai Medical University

Various teaching and training assignments

may 2005- Ongoing

  • Teaching assignment to undergraduates (MBBS) at the Aga Khan University during academic session 2005-6 and later as Research Coordinator 2006-7
  • Visiting Faculty at IBA, Karachi teaching research methodology, statistics and conducting research projects 2008-2009
  • Visiting Faculty at SDPI (Sustainable Development Policy Institute), Islamabad (on-going)
  • Visiting Faculty at Eye Department Dow University of Health Sciences/ Civil Hospital, Karachi2008-2010

Business DevelopmentQuality ManagementConsultant,

Novartis Pakistan, Consumer Health DivisionSeptember 2006 – August 2007

  • Conducting epidemiological studies:(Statistical modeling was done on three studies),
  • To understand the health seeking behaviors of the patients visiting the GPs
  • To understand the practicing and prescribing patterns of General Practitioners
  • To understand the factors influencing the sales of the company
  • Based on the findings of the above studies, evidence-based strategic interventions were developed to increase the sales volume
  • Market Intelligence:By triangulating the data from IMS (International Medical Statistics) sales and surveillance data on file to facilitate decision-making process regarding resource allocation in marketing strategies.

Medical Advisor, Novartis Consumer Health, Pakistan 2000-2004

Product Manager, Roche1995-2000

  • Worked as a Product Manager for a couple of years for BoeringerMannhiem at their head offices in Lahore. Joined Roche whenBoeringer was taken over by the former.

Education

  • 2004-06: MSc (Epidemiology & Biostatistics), The Aga Khan University
  • Jan-Jul 2008 Project Management Professional (PMP)

a six month courseworkattendance from Pakistan Institute of Management, Karachi campus

  • 1993-1994: House Office

Worked as House Officer in Medicine & Surgery at the Services Hospital, Lahore

  • 1986–1993: MBBS

AllamaIqbal Medical College, Lahore

Master’s Thesis

Knowledge about and management of Sexually Transmitted Infections by general practitioners of Karachi

The success in STI control is most likely to occur when the messages are launched from a fully trained health provider in managing the STIs. But as the STI management is not taught as a part of the coursework in the medical colleges of the country at the undergraduate level, it is highly unlikely that the GPs would manage STI patients visiting them. In order to cater for this approaching public health problem, it is imperative to assess the abilities of GPs for managing STIs.

The objectives of the study were to estimate the proportion of GPs who managed STI patients, to determine the factors associated with whether or not the GP manages STI patients; to estimate the proportion of GPs who appropriately managed three most prevalent STI syndromes namely Urethral Discharge Syndrome (UDS), Genital Ulcer Syndrome (GUS) and Vaginal Discharge Syndrome (VDS), and to determine the factors associated with whether or not the GP appropriately manages these STI syndromes in their private practices in Karachi.

A cross sectional survey was conducted utilizing structured questionnaires to interview 518 general practitioners of Karachi.

Publications

  1. Diet Chart

This project was undertaken at Baqai Institute of Endocrinology and Diabetes, Baqai Medical University. Its predictive values were recorded at AKU and tested in field.

(Rafay A, Masood Q, Basit A, sponsored by Roche Diagnostics, Jan 2006)

  1. White Paper on National Drug Policy of Pakistan

(Rafay A, Klara T, Miraz Z, Sponsored by WHO, commissioned by Ministry of Health, Government of Pakistan, April 2007)

  1. Series of Lay Press Publications on Medical Negligence with a special focus on pregnancy related deaths
  1. Seeking justice from the grave: a case of medical negligence

(Anwar Rafay, March 5, 2006, daily dawn.

  1. The causes of Medical Negligence in Pakistan: a formative study(Rafay A, The Network for Consumer Protection, Dec 2006)
  1. Effects of the Pictorial Health Warnings (PHWs) on cigarette packs upon the buying behavior of smokers in the twin cities of Rawalpindi & Islamabad

(a study jointly commissioned by the International Union Against TB & lung diseases AND Bloomberg Grant Initiative through Tobacco Control Cell, Ministry of Health, Government of Pakistan, Islamabad, Nov. 2010)

PHWs on the cigarette packs are used as an evidence-based intervention to modify the buying behaviors of smokers the world over. Various modifications in behaviors have been reported in contemporary literature. Such modifications also need to be reported from our communities so that a further course of action regarding the smoking control should be decided.

  1. The prevalence of Tobacco use among the households of eighty four districts of Pakistan

(Tobacco Control Cell, Ministry of Health, Government of Pakistan, Islamabad, Dec. 2010)

The Pakistan Social and Living standard Measurement 2007-8 data was utilized. The prevalence of tobacco use among the households was calculated in 108 districts of Pakistan. The associated factors were also determined that explained the tobacco use among these households. A set a modifiable factors was reported that can reduce the prevalence of tobacco use among families if appropriately reduced.

  1. Assessing Implementation status of the Protection and Promotion of Breastfeeding Ordinance, 2002 in four hospitals of Islamabad & Rawalpindi – a cross-sectional study

(The Network for Consumer Protection, funded by UNICEF, Pakistan, August 2009)

  1. prevalence of HIV among Hijras (transexuals) and Factors associated with the spread of HIV infection among them in Larkana, Pakistan

(Rafay A, Zaheer HA, CIDA-sponsored HASP Round 2, National AIDS Control Program, Ministry of Health, Government of Pakistan, Dec 2008)

The evidence does not support the direct transmission of HIV from IDUs (the driver of HIV infection in Pakistan) to Hijras in Larkana as none of the known factors for transmission tip in favor of this hypothesis. However, indirect transmission to hijras through theirclients, who may either be the clients of the positive IDUs or the clients infected from a different source altogether (either local or foreign) needs to be ascertained thus warranting a fresh study on the clients of Hijras and IDUs of Larkana. The existence of such a population is an indication that the bridging population might have already been involved in the transmission dynamics of HIV.

  1. Is Pakistani woman independent in making her basic decision-making? A descriptive study.

(Rafay A, The Network for Consumer Protection, funded by UNICEF, Pakistan, Sept 2010)

This study is based on the PSLM Round IV.2007-08 and depicts whether or not a Pakistani woman is independent in making decisions regarding her education, paid work, marriage, child bearing, contraception and its mode and procurement of consumption items e.g., food, clothing, footwear, medical treatment, recreation etc. The heavy dependence of women upon men in Pakistan led to a natural question of finding associated factors that could explain as to why this happens but PSLM does not offer adequate variables to answer this question

  1. HIV/AIDS in Pakistan: Where are the women?

(Rafay A, CIDA-sponsored HASP Round 2, Sindh AIDS Control Program, Ministry of Health, Government of Pakistan, April 2009)

This study shows that only twenty percent of the women are registered as compared to men. Only 12% of the men have brought their spouses for testing and registration to the treatment center whereas almost 100% women have brought their husbands instead. The men still keep their wives ignorant of their HIV status

  1. Operations research for Programmatic purposes

(Rafay A, Sindh AIDS Control Program, Ministry of Health, Government of Pakistan, June 2008)

Identification of gaps in the STI Clinics’ and VCT Centers’ performance in the provincewas conducted. Also factors associated with patients’ satisfaction at the STI Clinics in Sindh were determined.

  1. STUDY ON CHILDHOOD DIARRHEA FOR INTERNAL USE/DATA FILE

(the project was funded by IspenBeufore, France)

Study was conducted in the Civil Hospital Karachi by Dr. IqbalMemon (PI), Professor of Pediatrics, Dow University of Medical Sciences, Karachi, Pakistan and presented at Pakistan Paediatric Association (PPA) annual congress at Quetta, August 2005. I conducted the statistical analysis of the study

  1. Mapping of Nutrition Initiatives and Proposing Program Components for up-scaling

(DureSaminAkram, PervaizParacha, AhsenMaqbool, Anwar Rafay. UKAID & AusAID funded, Oct 2012)