Outbreaks of faecal-orally transmitted diseases in displacement camps: A scoping review of pathogens, risk factors, exposure routes, and drivers of transmission.

Many forcibly displaced people reside in camps characterised by precarious living conditions, exposing them to numerous health risks. This scoping review elucidated the risk factors and exposure routes implicated in outbreaks of faecal-oral pathogens in camps, as well as the context-specific drivers of transmission that shape these outbreaks. Journal articles were identified from PubMed, Embase, Scopus, and Web of Science. Portals for grey literature were also searched. A total of 48 records, published between 1937 and 2022, were included in the analysis. Cholera outbreaks were the most frequently reported. Risk factors included drinking water from shallow wells and rivers, consuming ice and leftover food, and inconsistent handwashing. These indicate exposure through vehicles of transmission in both public and domestic domains, emphasising the importance of a multipronged approach to outbreak prevention and control. Outbreaks were often exacerbated by extreme weather events and acute population influxes that damage or overwhelm water and sanitation facilities. Such shocks warrant explicit recommendations in preparedness and response guidelines. Development projects and outbreak response measures in surrounding areas may reduce the risk of importing pathogens into camps. Future research could further investigate faecal-oral pathogens other than Vibrio cholerae and analyse the co-occurrence of the identified transmission drivers.

The primary healthcare network in Lebanon: a national facility assessment.

BACKGROUND: The assessment of material and human resources, as well as services at healthcare facilities can further our understanding of their capacity to adapt to a people-centred framework. AIMS: To assess health infrastructure, drugs, equipment and human resources in primary healthcare centres (PHCCs) within the Lebanese National Primacy Healthcare Network. METHODS: The study surveyed all 212 primary healthcare centres in the network to assess services, as well as material and human resource availability. The survey was developed by the Ministry of Public Health and administered at each PHCC through face-to-face interviews with the facilities' directors. Data collection took place between December 2017 and January 2018. Descriptive statistics and χ² tests were used to analyse the collected data. RESULTS: The majority of PHCCs in the network delivered all services required by the national standards (78%), and had all basic equipment necessary for the delivery of care (89%), in addition to viable means of communication (85%). However, there was a significant shortage of family medicine physicians and nurses. Bivariate analysis highlighted regional disparities between urban and rural areas. CONCLUSIONS: This study can further our understanding of the capacity and ability of healthcare facilities to adapt to a people-centred framework. It provides baseline data that will inform Lebanon in its efforts to strengthen primary health care, and assist donors and local and international nongovernmental organizations in planning interventions and programmes, and better allocation of financial support.

Patient satisfaction with primary healthcare services in Lebanon.

BACKGROUND: Reorienting the model of care towards preventive services is integral to successfully move towards a people-centered healthcare system. Patient satisfaction is an essential component of people-centered care and an important quality of care indicator. In its efforts to strengthen primary healthcare, the Ministry of Public Health in Lebanon assessed patient satisfaction with services offered at primary healthcare centers (PHCCs) and explored the relationship between patient satisfaction and patient characteristics and accreditation. METHODOLOGY: The study followed a cross-sectional design. A survey was administered through phone calls with 1313 patients receiving services as part of a benefits package provided by 59 PHCCs. The survey collected data on patients' sociodemographic characteristics, perceptions, and satisfaction. RESULTS: Overall, 96.66% of surveyed patients reported being either satisfied (60.23%) or very satisfied (36.43%) with the services provided at the PHCCs. Patients' perceptions of patient-provider communication, healthcare provider competency, and health education quality constituted strong predictors for satisfaction. However, facilities' accreditation status was not associated with satisfaction with PHC services. CONCLUSION: Patient satisfaction with primary healthcare services in Lebanon was remarkably high. Findings highlighted the need for quality improvement particularly in health education and the alignment of accreditation standards with patient needs and expectations.