Proactive measures in family practice: the approach and limitations in a chronic disease model

ABSTRACT

Chronic diseases form an important health problem facing the health system in Egypt. The family health model provides an integral approach to health problems including chronic diseases to provide the basic services which include both health and population interventions. The aim of this work was to improve the health of the Egyptian population and to decrease the burden of chronic illness. Specific objectives were to assess the present and potential role of family practice in prevention and control of priority chronic diseases and to develop a prototype for family practice services dealing with these diseases. The study was conducted in one of family health units, Kafr Ayoub rural health unit Belbeis district, Sharkeya governorate. The methodology followed a Systems Analysis [SA] approach. In addition an exit interview questionnaire was done with clients for assessment of satisfaction and orientation about family practice. Hypertension was the selected model of chronic diseases in this study. Results of basic clinical examination done by the Ministry of Health and Population health team was compared to the results of clinical examination done by the research team to assess the quality of initial examination. Cases of Diabetes Mellitus were similar whereas diagnosed cases of hypertension showed variation. A protocol for diagnosis and follow up was suggested and implemented in this unit during the study period. Health education messages were prepared by the study team. Health care providers were trained to implement health education sessions for clients and hypertensive patient as a starting model for health education within the family practice program. The main recommendation is to increase awareness about family practice and the importance of the family physician in detecting and follow up of chronic disease being the first gait to the health system in the country. The importance of cooperation between MOHP and the university was emphasized