Quality improvement programme for diabetes care in family practice settings in Dubai

A continuous quality improvement programme for the care of registered diabetes patients was introduced in 16 government-affiliated primary health care centres in Dubai. Quality improvement teams were formed, clinical guidelines and information systems were developed, diabetes nurse practitioners were introduced and a team approach was mobilized. Audits before and after the introduction of the scheme showed significant improvements in rates of recording key clinical indicators and in their outcomes. For example, the proportion of patients with glycosylated haemoglobin levels < 7% increased from 20.6% to 31.7% and with LDL cholesterol < 100 mg/dL increased from 20.8% to 33.6%. Mean systolic blood pressure of registered patients fell from 135.3 mmHg to 133.2 mmHg

Psychosocial assessment of geriatric subjects in Abha City, Saudi Arabia

Psychosocial assessment of geriatric subjects was carried out through a home-based survey of people aged 65 years and over [n = 810] in the catchment areas of 3 primary health care centres. All the participants had a structured interview and were given a short version of the geriatric depression scale. Depression was found in 17.5% of the subjects, more commonly in women [27.7% versus 12.7%]. The combined effect of impaired perceived health status [52.4%] and functional capacity [26.6%], loneliness [4.5%], single status [24.3%], and lack of education [80.5%] explained 23.7% of the variance in depression score by multiple regression analysis. Depression is a problem among the geriatric population in the region, especially women. Periodic home psychosocial screening of geriatrics is recommended

Central obesity in elderly individuals in south-western Saudi Arabia: prevalence and associated morbidity

Central obesity in all individuals aged 65 years and over [n = 810] in the catchment areas of three primary health care centres in Abha was determined from the waist circumference [WC] and waist-to-hip ratio [WHR]. The age-adjusted prevalence of central obesity was 32.4% and 43.5% based on the WC and WHR indicators respectively. WC was significantly associated with the risk of diabetes and hypertension, while WHR was significantly associated with the risk of diabetes only. These findings suggest that reducing the prevalence of central obesity in old age would decrease the risk of diabetes and hypertension. WC is a powerful independent predictor mainly of hypertension risk, while WHC is a good predictor of the risk of diabetes

need for traditional birth attendants [dayas] in Saudi Arabia

Preferences of women living in remote areas regarding delivery place and attendant were surveyed, opinions of primary health care [PHC] doctors about traditional birth attendants' [TBA] maternal care were assessed and training needs for TBAs were identified using questionnaires and a focus group discussion. Home deliveries and TBAs were preferred by approximately 24% and 38% of the women respectively. The fact that they were women and psychological comfort were the main reasons for preferring TBAs. TBAs disclosed many harmful practices. No PHC centre help was sought by 75% of TBAs. Lack of cooperation between PHC centres and TBAs was a concern of most of the doctors. Training and links to PHC services for TBAs are needed

Cross-sectional study of a child health care programme at one family practice centre in Saudi Arabia

We randomly selected 100 mothers with children under 2 years attending an immunization clinic to measure satisfaction with and the effects of a child health care programme. Mean duration of breastfeeding was 10.7 +/- 6.9 months; 37% of children were exclusively breastfed, 16% artificially fed and 47% mixed fed. Breastfeeding knowledge scores were good or fair for most mothers. Only 26% used effective contraception and 46% had a child-spacing of < 12 months. We found 78.6% of lactating mothers had well or fairly balanced diets. Process of care was satisfactory in 73% of records reviewed, programme structure was satisfactory and 91% of mothers were satisfied with the programme

Risk factors of coronary heart disease: attitude and behaviour in family practice in Saudi Arabia

To study risk factors of attitudes and behaviour towards coronary heart disease [CHD], 280 Saudis > or = 20 years attending a family practice answered a structured health and lifestyle questionnaire and had their weight, height, blood pressure and random total cholesterol measured. Significant difference was found between males and females in the mean number of cardiovascular risk factors [t = -3.03, P < 0.01]. Few people with high dietary fat intake, obesity or physical inactivity perceived their behaviour as harmful. The number of people who perceived an associated risk to their health increased with incidence of smoking and obesity but not with high fat intake. Physically inactive people were least likely to perceive their behaviour as harmful

Compliance and control of diabetes in a family practice setting, Saudi Arabia

This study aimed to identify some determinants of compliance with diet, anti-diabetic drugs and the appointment system amongst diabetic patients [n = 294] attending a family practice setting. The results showed that good compliance with diet was significantly higher among males [P = 0.01] and those with good diabetic control [P = 0.01], while good compliance with appointment systems was significantly associated with type II diabetes [P < 0.01] and good care [P < 0.01]. Compliance with drugs showed no significant association with any of the studied determinants [P > 0.05]. When multiple regression analysis was applied, the degree of control of diabetes, its duration and the total score of care were the only predictors of the three aspects of compliance [P < 0.05]

Planning, implementation and evaluation of a nutrition education program in an Education program in an Egyptian village by community health workers

This study evaluates a community based health education program conducted by trained female community health workers [CHWs] in one of the villages in Ismailia. Selection of the CHWs was done by the mothers in the community and training took place in the same village. The first phase of the program was concerned with breast feeding, weaning and monitoring child growth and development. Also the program included training of health workers on communication and leadership skills and record keeping. Evaluation of mothers knowledge, beliefs and practice was done before and eight weeks after the program. The study revealed significant changes in mothers beliefs [p<0.02] and practice [p<0.03] toward child nutrition