Evaluation of the health service performance in outpatient clinics in Zagazig University

Many illnessess now can be treated on an ambulatory base [outpatient care] due to the shortage of hospital beds and escalation in operating expenses for inpatient care. The objective of this study is to evaluate the health service performance in Outpatient Clinics in Zagazig, University Hospitals for the sake of promotion of health services in these clinics. This work was done at the Pediatric and Gynecologic Outpatient Clinics, Zagazig University Hospitals. The health care - providers [physician number 37] and a random sample of 800 consumers of both studied clinics, were included in the present study The performance of the health service was evaluated by assessment of structure, care process, and outcome of care of the studied clinics.The work conditions of the studied outpatient clinics were satisfactory in general, but that for site, area and artificial ventilation of the Gynecologic clinic were inadequate. Lavatones and booklets were not adequate in both clinics while posters were not available in Gynecologic clinic The required medical equipments were available in Pediatric [35%] and Gynecologic clinics [73.9%], while non medical ones represented 62.5% and 68.7% of the required items respectively. Drugs availability was not satisfactory [at both studied clinics] according to both providors and consumers oponion. One record was present at each clinic in which recorded data were inaccurate and incomplete. Functional analysis of physicians showed that their performance was generally satisfactory except for completing ticket data and supervising subordinates. About case management, there was deficiency in communication skills [e.g. welcoming of the patient] versus manual skills [e, g.local examination] Consumer study revealed that rural residence and lower levels of education were significantly associated with higher degree of satisfaction. But consumers of both studied clinics were generally satisfied with service offered except for waiting time at Pediatric clinic. Institution of a quality assurance program to monitor the health service performance at the outpatient clinics on a regular basis is highly recommended

leading causes of under utilization of M.C.H services in Alexandria

The aim of the study is identifying reasons for underutilization of MCH services and necessary equipments and supplies needed to permit doctors to deal with obstetrical management. The main instrument of data collection was interviewing household mothers and health personnel in the area of work. The results revealed that the majority of household mothers [55%] used the available MCH services. The main causes of underutilization of health services were inconvenient accessibility, lack of specialists and lack of free drugs. Most of deliveries [67%] were carried out by private physician due to lack of necessary supplies and equipments needed for obstetrical managements

Identification of some socio-demographic factors contributing to child work in Zagazig Area

This study was carried out to detemrine some of the socio-demographic factors contributing to the phenomenon of child labour in Zagazig area. One hundred and twenty nine working boys aged from 6 to 15 years were included in this study. One hundred and thirteen non-working boys of the same age range from the neighbourhood were simultaneously studied as controls. Personal interviews were carried out using a structured questionnaire. Weight in kilograms and height in centimeters were assessed and blood haemoglobin concentration in gm/dl was esrimated for all children. The findings of this study showed that child labour is associated with large families, inadequate educational opportunities, fathers' illiteracy and irregular income. Poverty was the foremost cause of taking up employment. It was also found that most of the children had started work before the legal age. The overall effect of child work found were nutritional defeciency and work-related injuries. It was concluded that illegal child labour continued to be prevalent due to failure to enforce existing laws and standards. So, we recommend that strict efforts should be done to enforce the existing legislations to prohibit child work below the legal age

Occupational mortality: an epidemiological study

This work was intented to study the occupational mortality as a measure of community health and to throw some light on health conditions of Egyptian population in different occupations. The standardized mortality ratio [SMR] was higher among male in clerical and agricultural work [181.59, 112.87]. A negative age gradient trends in SMR were observed in clerical, services and agricultural workers of male population and among administrators, sale and services female workers. Women in agricultural work showed an alarming high SMR both in whole Egypt or in Sharqia Governorate [309.11 and 223.02]. Regarding the previously noted results a suitable recommendations were proposed for achievement a high standard of occupations health

epidemiological study of meningococcal carriers in an Egyptian village

This work was a cross-sectional study conducted in 1991 to assess the carrier rate of meningococci among students in El-Aslougy village [in Sharkia governorate]. The study included 200 students aged from 6 to 14 years old chosen from three schools in the village. Fifty students were chosen randomly from grade one, third, fifth and seventh grade. The prevalence rate of meningitis carriers was 5 percent [2.5 percent serotype A, 2 percent serotype C and 0.5 percent, serotype B]. All strains were sensitive to rifampicin, chloramphenicol and penicillin G. All were resistant to sulphonamides. Carriers were more prevalent among children from 6 to less than 8 year with no sex difference. There was a significant association between carrier rate and family size. The bigger is the family the higher is the carrier rate. A higher carrier rate was detected also in houses with crowdness index >3 [more than 3 individuals per room] and in the primary school where 4 pupils sit on the same desk with narrow distances between desks. The window area in the classroom was smaller than the standards and the number of water taps per students was 25 percent of the standards. Meningitis carriers were affected more by tonsillitis and bronchitis than non-carriers but there was insignificant difference as regards previous history of meningitis vaccination

Brucellosis in Egypt: a pilot explanatory study

Brucellosis represents a public health problem in Egypt. This disease is endemic in some governorates in which outbreaks were reported every year among animals and some sporadic human cases or even outbreaks were also reported. For these reasons this study was conducted to clarify the current status of brucellosis problem in Egypt and to provide the adequate data needed for occupational, veterinary and community health actions for management of this problem. The relevant data as regards to brucellosis in animals and human population [from 1983 through 1987] in Egypt were extracted mainly from the computerized data base, microfilms, documents and reports at the General Organization for Veterinary Service, Ministry of Agriculture and the Governorate's Veterinary laboratories. Other reliable sources e.g. the annual veterinary congress proceedings and the periodicals of veterinary association were also reviewed. The whole country was divided geographically into 4-main sectors, each one contains more than one governorate as follows: 1] Cairo and El-Sharkia, 2] Delta governorates, 3] Upper Egypt governorates and 4] Alexandria and Matroh governorates. The analysis of data pointed to the following main findings. The total number of positive human cases in the previously mentioned sectors were as follow: 25, 41, 64 and 15 respectively. In 1987 the infection rate in the tested animals were as follows: Upper Egypt 1.97 percent, Cairo and El-Sharkia 1.12 percent, Delta sector 0.66 percent and Alexandria and Matroh 0.44 percent and there is a positive correlation between the infection rate among animals and the positive human cases [r=0.954, P <0.05]. A pilot sero-epidemiological study was carried out by the authors during 1991 upon a randomly selected veterinarian group revealed that 70.8 percent of examined group was positive to brucella by tube agglutination test [titre > 1/80]. In conclusion, brucellosis represented a significant community health problem in our country. The above mentioned figures, underestimates the magnitude of the problem. The actual situation as well as control and preventive measures needs more organized efforts from different bodies

Serum uric acid in certain Egyptian groups an epidemiological study

A cross sectional study was carried out in Sharkia Governorate which involved estimation of serum uric acid in 196 individuals [125 from El-Abassa Village and 71 from the city of Zagazig]. Males above age of 15 years were found to have higher, serum uric acid levels than females both in urban and rural areas. Urban population as a whole showed higher serum uric acid level than villagers. Also those eating higher animal protein, obese subjects as well as hypertensive patients showed significant higher serum uric acid level than the others. On the other hand, no significant difference with social class, level of education, smoking habit and using of contraceptive pills

Knowledge, attitude and practice of private and governmental physicians in Zagazig in relation to diarrheal cases management

This study was performed to clarify the knowledge, attitude and practice of physicians about the different aspects of diarrheal cases management and to make benefit from oral rehydration therapy. The study included 204 physicians, 80% of them are working in urban areas in Zagzaig and 75% of those urban physicians received previous training courses on oral rehydration therapy[ORT]. The study reveated that 57% of physicians had high level of knowledge about ORT, 40% know the right indications of use of nasogastric tube and intravenous therapy. 37% of physicians had positive attitude towards treatment of dehydration by ORT. Urban physicians had higher attitude than rural physicians. As for feeding with rehydration, 70% of urban physicians recommended that scheme, while 40% only of rural physicians had the same attitude. In practice, 43% physicians did not use ORS in treatment of diarrhea. 4.9% use it alone and the rest use ORS with other medications. The causes of ORD limitations of use might be due to lack of knowledge, and training or confidence among doctors and mothers to use it alone

Some epidemiological features of addiction among industrial workers in Zagazig area, Sharkia Governorate

5378 industrial workers in Zagazig area were interviewed and examined by a questionnaire and urine screening for detection of drug dependence. These revealed 663 drug dependend workers [12.3%]. The latter group was further subjected to medical examination, liver function testing and personality scaling. The dependent workers were all males, relating mainly in the middle age group and with neurotic personality. The dependent workers were abused tobacco [45%], hashish [15.6%], caffiene [11.9%], simple analegesics [11.9%] and tobacco and caffiene [11.3%]. Alcohol and benzodiazepines were misused by 3.3% and 0.9% of addicts, respectively. The drug dependence had adverse effects on social life, general health and liver function of abusers when compared with control group. The drug dependent workers showed a higher mean value of days-off-work than non dependent. Moreover, the productivity and the quality of their work were adversely affected by their habit of drug abusing

Diabetes mellitus among a group of farmers in Sharkia Governorate: an epidemiological study

To study the magnitude, trends and determinant factors of diabetes mellitus [D.M] in a rural area, this study was carried out upon 500 farmers, selected randomly from a village in Sharkia Governorate during the year 1990. For detection of diabetic cases, an examination protocol was used which include: personal interview, medical examinations and determination of glucose in urine and capillary blood by using simple methods suitable for field screening. The main findings of this study were as follows: the prevalence of D.M. was 3.4% [4.14% males and 2.71% femals]. D.M. was more prevalent among age group > 30 years [765%] and among obese than non obese subjects [8.33% vs 1.23%]. 28.6% of diabetic persons reported a history of bilharzial infestation, while 14.3% had previous viral infection. In view of these results, mass screening for detection of missed diabetic cases in various sectors of population should be done in an out reach health programmes. Further studies should be devoted to investigate the role of bilharzial infestation and other infection in development of diabetes in susceptible subjects, and to study the impact of agricultural total environment upon D.M. as a multifactorial disease