[Evaluation of the PHC system in Iraq]

Description of the availability and operation of infrastructure, workforce, equipment, and supplies at the primary health care level of the health system in Iraq, and suggesting a renovative plan for Iraqi health system reform. A cross-sectional national survey conducted during the period from February 2004 to September 2005 that evaluates 30 primary health centers from 8 governorates. Thirty primary health care centers were selected from 8 provinces by an adjusted sampling Eleven objective convenience criteria were selected for evaluating buildings structure and infrastructure; signs and label guides, state, look, and healthiness of the health care building, presence of a garden, waiting place convenience, adequate furniture, presence of AC generator, air-conditioners, examining rooms' suitability, and overall convenience of the building. Health centers' buildings are unsuitable; a prediction model of six variables is built for buildings' suitability, using logistic regression. The average catchments population is high [60977]. There is one doctor for each 10.429 citizens. Professional workforce means are: 7.6 doctors, 6.6 dentists, and 0.8 pharmacists in each primary health care center. Health centers' paramedics are deficient with poor skill-mix, especially for medical assistants, nurses, sanitarians, and dental hygienists. The infrastructure of the health centers in terms of buildings and furniture is poor, so as the manpower skill-mix especially for nurses and medical assistants. The mean catchments population is high while there is an under-doctoring and maldistribution of medical personnel. Health information records system is primitive