[Quality of life of working women: Results of a Tunisian study using the 36 item short from health survery questionnaire [sF-3-6]]

Background: The need for a scientific evaluation of the work life quality has become today evident to all

Aim: This study aims to evaluate the short-term impact of the workload on the quality of life of employed Tunisian women.

Methods:A cross-sectional survey on a representative sample of 394 women working in the sectors of textile, shoe-manufacturing and administration was conducted between 2009 and 2010. The quality of life was assessed using the 36-item Short Form Health Survey questionnaire [SF-36]

Results: The overall quality of life score was 67.2 +/- 15.2. There was an uneven weathering of the different SF-36 scales. Vitality scale was the most affected with a score below 50. Quality of life of employed women differed significantly depending on the activity sector [p

Conclusion: The quality of life in employed women was correlated with the workload. The use of SF-36 to measure the quality of life is useful for the evaluation of work life quality

[National survey of maternal mortality of 2010: data of Tunis]

Tunisia has investigated maternal mortality in 2010 to determine maternal mortality ratio [MMR] nationally and regionally, in addition to the identifying main causes of this mortality. Describe methodology of this study and its principal findings in the region of Tunis and discuss the national maternal mortality strategy. This is a Ramos study [Reproductive Ag Mortality Studies] that consists on identifying maternal deaths from reproductive age group [RAG] women deaths. We started by the a rehearsal and targeting of [RAG] women deaths, then we investigated a next of kin person of the decedent women by verbal autopsy, thereafter we identified maternal deaths to be confidentially investigated to judge the potential avoidability of the death. The study took place in 2010, it was carried out by 5 couples of investigators supervised by a coordinator doctor. A total of 200 deaths of [RAG] women were found in Tunis, 7 deaths among them were maternal deaths, that corresponds to an MMR of 41/100000 live births. The mean age of the deceased women was 35 years. The main causes of maternal deaths were hemorrhage [3/7], thrombo-embolic diseases [2 times for7] and HELLP syndrome [1/7]. Four of a total of 4 deaths [3 deaths were not marked], were avoidable. The majority of late women had a satisfying educational level, 4 of 7 had financial autonomy. All of them had pregnancy monitoring, 5 times of 7 in university hospital. All the childbirth were medically assisted, Caesarean section was carried in 6 of 7 cases. Nationally, the MMR was estimated to 44.8/100 000 LB, that to say a decrease of 35% compared to 1993. The decrease was significant for all the regions of the country, except the great Tunis where opposite trend was recorded. This could be more likely related to quality of care rather than socio-economic conditions seeing that social determinants in Tunis are favorable. In fact, the Tunisian maternal mortality strategy had essentially focused on the monitoring system of maternal deaths rather than the quality of care improvement interventions, results were disappointing due to the lack of institutional engagement. The achievement of the OMD5 objectives is compromised, due to socio-economic constraint especially in certain regions, poor governance and lack of engagement of ministry of health in reducing maternal mortality. Tunisian maternal mortality strategy should be revised and adapted to regional context, also should include multisectoral interventions. Priority would be given to quality of care improvement, by launching the experience of care setting accreditation in one hand, and in the other improving partnership between different levels of care

Monitoring of Maternal and Infantile care Activities

In the framework of quality assessment, the basic service for health care of Tunis introduced in 1997 a service managing tool for prenatal activity monitoring.This paper aims to present the way this tool should be used its setting up within the basic health structures and its principal effects on the quality process. Prenatal activity monotiring is a process that allows evaluation, control and dysfunction level identification of a health program; it also permits a microplanification in order to compensate for its failings. The first step consists in calculating the 5 following covering determining factors: target population, material or.human resources availability, the service at one's disposal's use rate, the appropriate coverage rate according to a precise way in which the consultations are linked to each other concerning this program and the effective coverage rate including the required quality indicator for the care. A graph permits to visualize these different rates. The second step consists in identifying the bottleneck and the most relevant correcting actions to be conducted in relation with either the available human resources or the material resources or the process of health care by using an "internal audit". Setting up this tool required many training sessions and supervisions for the Tunis health care services. It proved efficient enough in order to improve the actual coverage of the population especially in the responsibility area of the staff members for certain preventive programs as prenatal services or children's growth follow up. It allowed a better documentation of the consultation activity and the objective analysis of the inherent problems to the recommended program. The solutions were taken locally and dependes on the decision maker's will

[ health care demand in the district of Tunis]

This study aims at evaluating the morbidity of Tunis city inhabitants during the last 6 months preceding the date of the study [June 1998] and at locating the medical care points. It has been led with home interviews. The sample has been selected in a random way and is supposed to give a fair view of the whole districts of Tunis city; it includes 374 families and 1747 individuals. The socioeconomic indicators of the selected families are genuine with those of the Statistics National Institute and 88.8% of the interviewed families benefit of the welfare coverage. The mean of morbidity is of 2.6 yearly by individual and the health care is 3 yearly by individual: this includes an abstention of medical care up to 1.6% and self medication for 26.0% of individuals. The structure involved in the cares appeared respectively to be of public type in 37.5% of the cases, private in 26.5% and of a par public in 10.0%. For the urgency diseases [4.4%]. patients go to the hospitals in 31% of the cases; for the less urgent diseases [23.8%] patients go to the basic welfare structures in 23% of the cases. For the needs of prevention [8.5%], patients go to the basic structures in more than half of the cases. The study indicated clear trend towards more medication of Tunis city inhabitants though it represents the 1/5 of European people. The increasing demand of Tunis city inhabitants for medical care together with the growth of the private medical structures lead to a necessary new organization of the whole medical system in Tunisia

bronchiolites du nourrisson: Etude multicentrique a Tunis

This study is made in the general framework of the basic health cares program set up by Tunis regional service to fight child serious respiratory infections. It has an objective to measure bronchiolitis winter frequency for patients aged from 1 to 36 months, serious cases frequency, changing profile, the therapeutic behavior and environmental risk factors. This is a multicentric transversal study in grappa, it has taken place in Tunis between January and march 1999 with a sample size of 1340 patients. Result of the survey has shown a medium frequency of the disease with 10% of the patients, median age group infected at 9 months, aggravating factor in 73% of cases, and a surinfection in 70% of cases. Promiscuity is the only environmental risk factor which is statistically significant. Hospitalization was necessary in 14.2% of cases. With regard to prescriptions, bronchodilators, corticoids and antibiotics were prescribed for respectively 71, 39, and 45.6% of patients. Basic health cares structure is a good alternative during the winter season, provided human expertise s are constantly updated and adequate technical staff is available