Health promotion in primary health care: a model for youth friendly services

The potential role of primary health care [PHC] as a unique setting for health promotion is becoming more recognized. Despite claims to promote health, most health care organizations in Egypt do so within the narrow definition of health. Global concern is growing about the health status of young females. Health services, although available, lack comprehensiveness that addresses the needs of this still shadowed sector of the population. In an attempt to make one of the PHC facilities be more "Youth Friendly", an integrated interventional approach for health promotion, with coordinated efforts from relevant stakeholders, was conducted in a rural PHC facility of Upper Egypt and the community within its catchments area. Targeted young females were initially defined and characterized through an interview based household survey. A total study sample of 671 females aged 12-20 years was included. Health and health care problems were identified through different qualitative and quantitative techniques. This was followed by a sequence of training courses for all the PHC providers, with community and local authority mobilization, and health education sessions for the targeted young females. Results of the study revealed marked community-level improvements and collaboration. At the PHC level, modifications in the organization of the delivery system, by arranging for convenient times to accommodate females were established. In addition, the designed card system enabled documentation of health education and counseling sessions needed by each female. The performance of the healthcare team was progressively improved through training. Significant rising means of knowledge and performance post- training scores were found for various priority topics, with p-values <0.001. At the individual young females' level, there were marked improvements in the utilization of the PHC services, where 62% of the studied group visited the centre more than 12 times during the 6-months post-intervention. This study highlights the strong belief that with changes in the way healthcare is organized, delivered and financed, new practice models beyond the level of the individual could be innovated to provide a holistic approach of health promotion for populations especially the non-regular PHC users

Adult tetanus: immunity, awareness and behavior among a group of male farmers in Rural Upper Egypt

This is a cross sectional study. It was conducted in one of the small villages in Giza, Upper Egypt that was randomly selected. A convenience sample of 100 of the resident male farmers aging 20 years and older were included. All the selected farmers were practicing agriculture on regular basis since their childhood. The aim of the study was to portray their serum tetanus antitoxin antibodies levels and to recognize these farmers; perception; knowledge, attitude and beliefs about tetanus. As well, motives behind related health seeking behavior. Their tetanus serum antitoxin levels were measured by ELISA method. Interview questionnaires, focus group discussions and in depth interviews were used to collect the required data. The studied farmers were found to have good general knowledge about tetanus which was amounted principally to communal sources; 80.0%. The majority have never heard about the term “El Kazaz” which is the Arab is titling of the disease that is frequently used across the mass media; 85.0%. In fact, usually these farmers did not seek for medical care for their wounds. A very few; 9.0% were knowledgeable about adult tetanus vaccine from which only one farmers had a claim of being vaccinated in the last 10 years. Meanwhile, the progressive increase in the price of the prophylactic tetanus shot may threaten the chance of most of the farmers to have it when necessary. Substantial waning of the antitoxin antibody titer with age was found leaving many farmers specially those above 40 years unprotected. The study concluded that more emphasis should be placed on routine tetanus toxoid booster shots to farmers, especially to the elderly, given that level of tetanus antibodies decline with time. Extensive outreach communication and social mobilization activities aiming at increasing awareness and creating demand are crucial prerequisites for adult tetanus immunization activities to gear up