Quality of antenatal care services at family health units in Alexandria

Quality care encourages health seeking behaviors of clients, motivates health providers, safe guard's client's health and ensures sustainability of the programs, however no adequate data is available on quality of antenatal care in Alexandria. To assess quality of antenatal care through client satisfaction, provider's performance and availability of basic and necessary equipment in seven selected family health units in Alexandria. A cross sectional study was carried out in seven family health units. One health unit was selected randomly from each of the seven administrative zones in Alexandria. Data were collected from clients of the antenatal care service, health providers and the seven health units. For the exit interview, a total of 427 women were selected by proportion to size of clients in each health unit and a structured pre-tested questionnaire was used. All the seven physicians working in the antenatal clinics were observed using observation check list while examining sampled pregnant women. An Observational checklist was used to assess the availability of instruments and medical equipments necessary for antenatal care. Findings indicated poor structure in all the family health units. By observation, 91.3% of pregnant women received poor care while 8.7% received fair care. With concern to interpersonal and technical aspects of antenatal care received, 93.9% and 59.7% respectively had good level of satisfaction. Regarding constellation of services and continuity of care mechanisms, 90.4% and 50.1% of women respectively had fair level of satisfaction, while 54.8% had poor level of satisfaction with information and counseling. Overall satisfaction of antenatal care is high, although health providers did not follow proper management of the antenatal care service. Family health units should be equipped with essential medical equipments. Regular in-service training of health professionals on use of guidelines for examination and management of women attending antenatal care services is essential

Compliance of general surgeons with safe surgery in a general navy hospital, Alexandria, Egypt

Surgical care is an integral part of health care throughout the world, and gaining attention from the public health community worldwide. This study was conducted to assess compliance and attitudes of the surgeons in the General Navy Hospital toward safe surgery. Fifty-five general surgical operations, performed in the 3 main operation rooms of the Anesthesia and Operations Department of study hospital were observed to assess the compliance of the operating 11 general surgeons to the WHO safe surgery checklist starting from 15 March 2010 and for three weeks. Five observations were done for each surgeon. WHO checklist divides the operation into three phases namely sign in, time out and sign out, each corresponding to a specific time period in the normal flow of a procedure. All safety practices and steps were weighted equally such that a team was given 1 point for compliance with a practice or process and 0 point for noncompliance and scores could range from 0% to 100%. In order to assess how the safe surgery checklist was perceived, the same 11 general surgeons were interviewed with a structured questionnaire. The least aggregate surgeons' compliance was in completing the safety practices comprising 'time out' phase; 56.4% [31 times out of the 55 surgeries]. The highest aggregate surgeons' compliance was in completing the safety practices comprising 'sign in' phase was 65.5% [36 times out of the 55 surgeries]. While, the aggregate compliance score of the 'sign out' phase was 67.3% [37 times out of the 55 surgeries], and that the overall aggregate compliance score for completing the 19 safety practices comprising the safe surgery checklist was 52.7% [29 surgeries out of the 55 surgeries].Regarding surgeons' attitude to safety practices items, none of the items was rated to be definitely 'of no importance. Hospitals should consider implementing operating room briefings as a strategy to improve operating room efficiency and clinical and economic outcomes in surgical patients. Surgeons must be committed to the common goals of patient safety to ensure safe surgery

effect of a training program in communication skills on primary health care physicians' knowledge, attitudes and self-efficacy

Communication has been identified as one of the core clinical skills for all health care providers, but it is especially important for primary health care disciplines. Findings suggest the need for more attention to communication skills in continued physician education. This work aims at evaluating the effect of a communication skills training program on physicians1 knowledge, attitude and self efficacy related to communication. In this pretest- posttest intervention study, a three-day, 18-hour training program was developed and implemented. The teaching method was learner-centered and includes theoretical information, practical applications and attitude change. A self administered questionnaire was used to evaluate the program. The results showed significant improvement in physicians' knowledge about communication where those having good knowledge increased from 13.1% before the intervention to 82% after the intervention. Physicians reported significantly higher confidence levels in their ability to build rapport with patients, counsel patients for smoking cessation and medication adherence after the intervention. Overall, in this study we found that training in communication skills improves clinicians' knowledge, changes some negative attitudes and enhances assessment of physicians' own ability to perform specific communication tasks

Drug compliance among hypertensive patients attending outpatient clinic of Abou-Qir Hospital in Alexandria

The present study aimed at estimating compliance with drugs among hypertensive patients [n=300] and at determining the association of compliance with blood pressure control among patients attending outpatient clinic of Abou-Qir Hospital in Alexandria. The patients were interviewed using a structured questionnaire to collect data of patients, disease, and treatment characteristics. The average compliance rate for the 2 visits was calculated using the pill count method. The compliance rate was 62.3%. Among compliant patients, over ninety percent [96.3%] were controlled as compared to only 41.6% among non-compliant patients [P<0.001]. Complications were significantly more prevalent among non-compliant than among compliant patients [44.2% versus 18.2%, P<0.001]. The combined effect of the six significant variables, i, e., sex, source of treatment, number of drugs, frequency of drug intake, control of hypertension, and complications of hypertension was examined by means of multiple regression analysis. The source of treatment and control of hypertension were the only significant predictors of drug compliance among hypertensive patients. Patient participation is essential to the whole process and antihypertensive drugs should be available in the clinic to make it free of charge to all patients especially poor ones