Retrospective study on the impact of COVID-19 lockdown on patients with type 2 diabetes in Northern Jordan.

OBJECTIVE: During COVID-19 pandemic, complete lockdown of cities was one of the measures implemented by governments worldwide. Lockdown had a significant impact on people's lifestyles and access and utilisation of health services. This study aimed to assess the impact of the lockdown on glycaemic control among patients with type 2 diabetes mellitus (T2DM). DESIGN AND SETTING: This was a retrospective study, electronic medical records at a leading University Hospital in Northern Jordan were used to extract study data. PARTICIPANTS: All outpatients with T2DM. PRIMARY AND SECONDARY OUTCOME MEASURES: Glycated haemoglobin (HbA1c), blood glucose and lipid profile for patients with T2DM, 6 months before and 6 months after the full COVID-19 lockdown. RESULTS: A total of 639 patients (289 (45.2%) males and 350 (54.8%) females) were included in this study. Their age ranged from 18 to 91 years, with a mean (SD) of 59.9 (13.8) years. The overall means of HbA1c (8.41 vs 8.20, <0.001), high-density lipoprotein (1.16 vs 1.12, <0.001), low-density lipoprotein (2.81 vs 2.49, <0.001) and total cholesterol (4.45 vs 4.25, p<0.001) levels were significantly higher in the period before lockdown compared with the period after the lockdown. However, triglyceride and fasting blood glucose levels were not affected significantly after the lockdown. CONCLUSIONS: The glycaemic control and lipid profile had significantly improved after COVID-19 pandemic lockdown. The availability of medication and medical advice delivery systems (monthly medicine deliveries) during the lockdown in Jordan might have positive impact on patients with diabetes.

Duty to Work During the COVID-19 Pandemic: A Cross-Sectional Study of Perceptions of Health Care Providers in Jordan.

INTRODUCTION: This study aimed to assess perceptions of duty to work among health care providers during the coronavirus disease 2019 response and to identify factors that may influence their perceptions. METHODS: This was a cross-sectional study conducted from April 1, 2020, to April 20, 2020, using an online survey distributed to health care providers in Jordan. Descriptive statistics were used, as well as chi-square test for independence to assess relationships between variables. RESULTS: A total of 302 questionnaires were included. Commitment to serve the community was the primary reason for coming to work (36%), followed by commitment to faith (29.6%). The major perceived barriers for coming to work were lack of appropriate personal protective equipment and appropriate training (62.6% and 53.5%, respectively). Males perceived higher work obligations than females in all potential barriers (P < .05), except for the lack of appropriate training. Nurses perceived higher work obligations than other health care providers despite the lack of appropriate training (χ2 = 11.83, P = .005), lack of effective vaccine or treatment (χ2 = 21.76, P < .001), or reported infection among coworkers (χ2 = 10.18, P = .03). DISCUSSION: While the majority of health care providers perceive an obligation to work during the coronavirus disease 2019 pandemic, specific conditions, mainly lack of protective gear and training, may significantly alter their perception of work obligation. Providing training and proper personal protective equipment are among the vital measures that could improve the work environment and work obligation during pandemic conditions.

Walk the Talk: The Transforming Journey of Facility-Based Death Review Committee from Stillbirths to Neonates.

BACKGROUND: Facility-based death review committee (DRC) of neonatal deaths and stillbirths can encourage stakeholders to enhance the quality of care during the antenatal period and labour to improve birth outcomes. To understand the benefits and impact of the DRCs, this study was aimed at exploring the DRC members' perception about the role and benefits of the newly developed facility-based DRCs in five pilot hospitals in Jordan, to assess women empowerment, decision-making process, power dynamics, culture and genderism as contributing factors for deaths, and impact of COVID-19 lockdown on births. METHODS: A descriptive study of a qualitative design-using focus group discussions-was conducted after one year of establishing DRCs in 5 pilot large hospitals. The number of participants in each focus group ranged from 8 to10, and the total number of participants was 45 HCPs (nurses and doctors). Questions were consecutively asked in each focus group. The moderator asked the main questions from the guide and then used probing as needed. A second researcher observed the conversation and took field notes. RESULTS: Overall, there was an agreement among the majority of DRC members across all hospitals that the DRC was successful in identifying the exact cause of neonatal deaths and stillbirths as well as associated modifiable factors. There was also a consensus that the DRC contributed to an improvement in health services provided for pregnant women and newborns as well as protecting human rights and enabling women to be more interdependent in taking decisions related to family planning. Moreover, the DRC agreed that a proportion of the neonatal deaths and stillbirths occurring in the hospitals could have been prevented if adequate antenatal care was provided and some traditional harmful practices were avoided. CONCLUSIONS: Facility-based neonatal death review audit is practical and can be used to identify exact causes of maternal and neonatal deaths and is a valuable tool for hospital quality indicators. It can also change the perception and practice of health care providers, which may be reflected in improving the quality of provided healthcare services.

The usability of Jordan stillbirths and neonatal deaths surveillance (JSANDS) system: results of focus group discussions.

BACKGROUND: Jordan Stillbirths and Neonatal Deaths Surveillance system (JSANDS) is a newly developed system and is currently implemented in five large hospitals in Jordan. This study aimed at exploring the healthcare professionals' perception about the usability of JSANDS. METHODS: A descriptive qualitative approach, using focus group discussions, was adopted. A total of 5 focus groups including 23 focal points were conducted in five participating hospitals in Jordan. RESULTS: Data analysis identified nine main issues related to the JSANDS system: the system usefulness, the system performance, data quality, the system limitations, human rights, female empowerment, nurses' competencies strengthened, the sustainability of the JSANDS, and COVID-19 impact on the system. Users reported that JSANDS data were useful, the system was simple and easy to use, and the data were accurate and complete. However, some users reported that some technical issues need to be enhanced. CONCLUSIONS: JSANDS was perceived positively by the current users. According to them, it provides a formative and comprehensive data on stillbirths and neonatal deaths and their causes, and therefore, was recommended to be adopted by its users and scaled up.