Paediatric continuing medical education needs and preferences of UNRWA physicians in Jordan

Most physicians who work in the United Nations Relief and Works Agency [UNRWA] infant and child health programme in Jordan are general practitioners with no postgraduate training in paediatrics. Furthermore, in resource-poor or remote settings, the ability to deliver live continuing medical education [CME] is often limited. A questionnaire exploring the resources available for accessing CME, preferences for types of CME, current sources of CME and topics of interest in the field of paediatric care was sent to all 92 physicians practising in UNRWA clinics in Jordan. Of the 89 respondents 80% had attended live medical lectures for CME and 70% CME meetings. Despite most physicians having access to the Internet only 52.8% were interested in Internet-based courses for accessing CME. There was a statistically significant relationship between year of graduation from medical school and preference for Internet-based CME. Implications for CME participation and paediatric CME topics are discussed

Primary healthcare reform in the United Nations Relief and Works Agency for Palestine Refugees in the Near East

Palestinian refugees served by the United Nation Relief and Works Agency for Palestine Refugees in the Near East [UNRWA] are experiencing increasing rates of diagnosis of non-communicable diseases. In response, in 2011 UNRWA initiated an Agency-wide programme of primary healthcare reform, informed by the Chronic Care Model framework. Health services were reorganized following a family-centred approach, with delivery by multidisciplinary family health teams supported by updated technical advice. An inclusive clinical information system, termed e-Health, was implemented to collect a wide range of health information, with a focus on continuity of treatment. UNRWA was able to bring about these wide-ranging changes within its existing resources, reallocating finances, reforming its payment mechanisms, and modernizing its drug-procurement policies. While specific components of UNRWA's primary healthcare reform are showing promising results, additional efforts are needed to empower patients further and to strengthen involvement of the community

Promoting public-private mix for TB-DOTS: a multi-country study from the WHO Eastern Mediterranean Region

This study was carried out to document the implementation status of public-private mix [PPM] in 6 member countries of the World Health Organization Eastern Mediterranean Region, with a particular focus on advocacy, communication and social mobilization [ACSM] specific to PPM. Interviews and focus group discussions were held with staff of national tuberculosis control programmes and partners. Four PPM models were being practised. For all models, ACSM specific to PPM was at the elementary stage. Participants perceived that promoting private partners was difficult, specific policy guidelines were deficient and human resources and capacity for both initiatives were lacking across the region. Building ACSM capacity is required along with the development of guidelines and the implementation of country-specific communication plans to carry out local-level advocacy, strategic communication and effective social mobilization to maximize the benefits of PPM

Training on the Practical Approach to Lung Health: effect on drug prescribing in PHC settings in Jordan

This study assessed whether training physicians on the Practical Approach to Lung Health [PAL] reduces drug prescribing and the cost of drugs prescribed to respiratory patients in the primary health care setting. Data were compared before and after training general practitioners on standard guidelines for case management of respiratory conditions in primary care. A total of 56 general practitioners practising in 25 health centres in 3 out of 12 governorates of Jordan participated in both the baseline survey [n = 6260 respiratory patients] and the impact survey [n = 2709 patients]. Training in PAL decreased by 12.2% the number of drugs prescribed per patient, increased the prescription of inhaled medications and reduced the mean cost of a drug prescription per patient by 8.7%

Results of the feasibility test of the Practical Approach to Lung Health in the Syrian Arab Republic

We assessed implementation of the Practical Approach to Lung Health [PAL] in primary care facilities in the Syrian Arab Republic and its short-term impact on respiratory care in patients aged 5+ years. After training on PAL for 76 general practitioners in 75 health centers, referrals and sputum smear examinations for patients increased. The mean number of drugs prescribed per patient decreased by 14.8% and that of antibiotics by 33.3%, while prescriptions for inhaled medications increased. The mean cost of drug prescriptions fell by 26.2%

Tuberculosis and HIV in the Eastern Mediterranean Region

Tuberculosis [TB] is an important public health problem in the Eastern Mediterranean Region of the World Health Organization. Every year the disease kills 136,000 people and affects 630,000 more. HIV is the most significant risk factor for progression from subclinical infection with Mycobacterium tuberculosis to active TB. Although the HIV/AIDS threat in the Region appears to be relatively modest and so far there has been no evidence of an impact of HIV on TB epidemiology in the Region, there is a need to jointly address HIV infection and TB more effectively. In this paper the TB situation in the Region and the measures being taken to combat it are outlined. The impact of HIV infection on TB and the repercussions this could have on theTB situation in the Region are also discussed. Actions that are needed to tackle this double burden are suggested