Search

Background: Several factors in the family profile contribute significantly to determining the effective policy when heading the family. This study aims to evaluate the sociodemographic and economic burdens on parents-headed families in Ramadi City, west of Iraq. Methods: A prospective cross-sectional household-based survey was conducted from 1st to 28th February 2019 among Iraqi people residents in Ramadi city, Anbar province. A multistage sampling technique was recruited to identify the eligible sample. A semi-structured questionnaire was used to interview (face-to-face) the respondents. Data from 267 households have undergone univariate and bivariate analyses. Multiple logistic regression, odds ratio (OR), and confidence intervals (CIs) were estimated to explore the predicting variables. The statistically significant is considered at less than 0.05. Results: The mean age of respondents was 43.88 (± 12.1) years (range: 25 to 69 years). Out of the total surveyed people, 52.8% were young (less than 44 years), male-headed families (59.6%), low educated level (65.5%), unemployed (52.4%), married (67.4%) and headed big families of seven members and above (43.1%). History of chronic diseases and smoking habits was positive among 46.4% and 45.7% of respondents, respectively. Findings of the binary logistic regressions showed that history of smoking (OR = 7.201, 95% CI: 3.254 to15.936), families of 7 members and above (OR = 6.239, 95% CI: 2.938 to 13.250), unhappy (OR = 5.237, 95% CI: 2.140 to 12.818), aged 44 years and above (OR = 3.518, 95% CI: 1.581 to 7.829), being single (unmarried, divorced, widow) (OR = 2.697, 95% CI: 1.230 to 5.914), and had a monthly income of less than USD400 (OR = 2.333, 95% CI: 1.112 to 4.859) are significantly associated with female-headed family. Conclusion: Priority must be given to some elements such as genetic, physical differences, biopsychosocial factors, and the economic situation when discussing parents' behavior in heading the family.

Background: International efforts to confront the COVID-19 pandemic are joining forces by accelerating the pace of vaccination. This study aims to explore the attitude and the intent to get vaccinated against COVID-19 among healthcare providers (HCPs) in Iraq. Methods: A cross-sectional survey was conducted in January 2021 using web-based facilities to access the respondents. The data were collected through a semi-structured and self-administered questionnaire, including sociodemographic and close-ended questions related to attitude and intention toward COVID-19 vaccination. Bivariate and multivariate logistic regression were recruited to predict variables. The statistical significance is considered at less than 0.05. Results: Data of 209 HCPs with a mean age of 45.12 (± 6.37) years have undergone final analysis. Most of the HCPs were males (112, 53.6%) and nurses (110, 52.6%), who had close contact (64.6%) with COVID-19 patients, and forty percent have been infected with COVID-19. Overall, 115 HCPs (58.0%) reported intention to get vaccinated compared to 94 (42.0%) who declined vaccination. Variables associated with intention to get vaccinated among HCPs were high attitude toward COVID-19 vaccination (odds ratio (OR) = 1.740, 95% confidence interval (CI): 0.799, 3.786), aged less than 45 years (OR = 3.713; 95% CI: 1.647, 8.367), married (OR = 2.155; 95% CI: 0.984, 4.720), highly educated (OR = 2.657; 95% CI: 1.202, 5.871), doctors (OR = 3.153; 95% CI: 1.428, 6.963), contracted with COVID-19 (OR = 4.119; 95% CI: 1.623, 10.455), directly engaged in management of COVID-19 patients (OR = 3.962; 95% CI: 1.569, 10.005), and had lost a close relative due to COVID-19 (OR = 5.698; 95% CI: 1.506, 12.564). Conclusion: The urgent need to improve the COVID-19 vaccine uptake rates among Iraqis requires a positive attitude and a high vaccination rate among HCPs.

Improved knowledge among women about maternal risk factors significantly reduced the likelihood of adverse events in pregnancy and childbirth. This study aimed to explore Iraqi women's knowledge and attitudes about maternal risk factors in pregnancy. A multicenter cross-sectional survey was conducted from 01 January to 31 March 2019 among women of the reproductive age (15-49 years). A convenient sampling technique using a semi-structured questionnaire was recruited to interview the sample. SPSS version 16.0 was used to analyze the data. Descriptive and inferential statistics (Chi-square test) were used to present data with the significance level considered at

Background: Since the 2003 United States–British Coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion. Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study. Results: A total of 365 heads of households (response rate: 71.7%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Young age group (p = 0.003), men (p = < 0.001), unmarried (p = 0.001), high educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001), and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system. Conclusions: Most Iraqis surveyed expressed disappointment from the health system after the 2003 US-led invasion. The current health system is faltering at all levels and does not meet the citizens' basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system.

Background: Successful plans in disaster and epidemics management depend on the feedback response and the assessment of knowledge, attitudes, and practices among the target population. This study aims to assess the knowledge, attitude, and practice towards COVID-19 among Libyan people. Methods: A cross-sectional web-based survey designed to assess the knowledge, attitude, and practice towards COVID-19 among the Libyan people from 13-20 October 2020. A self-administered questionnaire was recruited to collect the data of 287 participants. SPSS version 16.0 was used to analyze the data using univariate and multivariable regression data analyses. Results: More than half of respondents were males (53.7%), married (61.3%), aged less than 45 years old, highly educated (46.3%), employed (44.6%), urban resident(79.8%), experience good or very good health (71.1%) and earned more than USD 200 monthly (84.3.%). The participants showed a high rate of good knowledge (81.0%), attitude (71.1%), and practice (83.7%) towards COVID-19, respectively. Regression analysis showed that married (P=0.056), female (P=0.037), living in the urban regions (P

Background: Measuring knowledge, attitude, and practice towards COVID-19 helps policymakers observe knowledge gaps and provide key messages to people to act better against the pandemic. This study aims to assess the knowledge, attitude, and practice towards COVID-19 among Syrian people resident in Turkey. Methods: A cross-sectional study designed to assess the knowledge, attitude, and practice towards COVID-19 among the Syrian people resident in Turkey. The data were collected via a web-based and self-administered questionnaire of 313 participants from 17-31 July 2020. SPSS version 16.0 was recruited to analyze the data using univariate and multivariable regression data analyses. Results: Our finding as the first study among Syrian people resident in Turkey found a high rate of good knowledge, attitude, and practice towards COVID-19 accordingly with 83.0%, 72.0%, 84.0%. Regression analysis showed that age-group of 45 years and more years, marital status of being married, female gender, living in urban area were significantly associated with upper knowledge score. Age-group of 45 years and more significantly associated with positive attitude score but inversely being married and unemployed statues significantly associated with a negative attitude. Regarding practice score, married and female people had better practice, but poor-rated health status was significantly associated with the weak practice. Conclusion: Although our finding showed a good rate for knowledge, attitude, and practice towards COVID-19, but it needs to improve cause of many barriers on Syrian people resident in Turkey, such as living in a crowded place, distant from health care services, losing whole or part of their income due to COVID-19 as an economic crisis, different language barriers. Some groups like men, people living in a rural area, and those unemployed or lost their job should be exposed by timely and accurate knowledge.

Background: Iraq was among the first countries invaded by the novel human coronavirus (SARS-COV-2) after China. This study aimed to assess the Iraqi people's knowledge, attitudes, and practices toward COVID-19 during the pandemic. Methods: A cross-sectional study recruiting an online self-reported survey conducted from 17-31 July 2020. Data of 877 participants have undergone descriptive, univariate, and multivariable regression analyses, respectively, to assess the differences in mean scores and identify factors associated with knowledge, attitudes, and practices (KAP) toward COVID-19. Results: Most of the respondents (78.8%) from the urban region, highly educated (69.7%), aged less than 45 years (61.2%), females (58.3%), married (51.9%), and 74.0% self-ranked health as good. Less than half (45.4%) were employed; however, the average monthly income was USD 400 or more in about 66.8% of them. The mean knowledge, attitude and practice score was 15.57 ± 2.46 (range: 0-20), 38.88 (SD = 3.57, (range: 11-55), and 5.13 (SD = 1.14, range: 0–6), respectively. Findings of regression analysis showed that higher educated (p< 0.001), urban residents (P

Background: Healthcare providers are increasingly interested in patient satisfaction as an indicator to assess the quality of health services. This study investigates the level of satisfaction among Iraqi patients attending the outpatient (OP) clinic. Methods: This was a cross-sectional study conducted from October to December 2019 among outpatient attendees in two busiest centers in Iraq. A convenience sample of 235 (response rate of 88.0%) completed the self-administered short-form patient satisfaction questionnaire (PSQ-18). The independent variables included socio-demographic, economic, and self-perceived health status. Data were analyzed in SPSS, where descriptive analysis (mean ± standard deviation) and univariate (independent sample t-test, ANOVA test) and multivariate linear regression “Enter technique” was done at 0.05 level of significance and 95% confidence interval. Results: The mean age of respondents was 39.3 (±14.8). The sample was mostly women (55.3%), and 37.4% in the age group of 30-49 years. More than half of participants residing in the urban regions (54.5%) from families of monthly household income less than 500,000 Iraq Dinars (USD 400). However, the majority (70.6%) have the first visit to the OP clinic, and 53.6% self-perceived health as good or very good. Results of multiple linear regression showed that patients residents in rural regions (B= 5.4 , P

Background: Displacement in Iraq has been widespread and for frequent periods. Education was one of the most prominent victims of displacement at all levels, including higher education. This study aims to assess the impact of displacement on the psychosocial and health status of undergraduate students living in student accommodation of Anbar University, Iraq. Methods: A retrospective cross-sectional study was conducted from 3rd to 17th April 2017. Data was collected using a universal sampling technique. A total of 355 students (Response Rate: 82.1%.) completed a self-administered questionnaire consisting of 26 close-ended questions related to the socio-demographic and economic characteristics of students. Data were analyzed using SPSS version 16. Descriptive data presented as the mean and standard deviation (±SD). Results: The mean age (±SD) was 22.1 (±1.7) years (range 18-29). About two-third (240, 67.6%) of students experienced some mental disorders. Moreover, 25.1% of students confirmed that the mental disorders were negatively related to their level of performance in college, and the treatment was not available for 31.0% of them. Because of ID, about 45.4% of surveyed students had lost at least one academic year, and 17.5% began to smoke tobacco during the ID period. However, the social and psychological support was absent for about 57.4% of respondents. Conclusion: Our results suggest an urgent and strategic plane to improve the quality of logistics, health, and infrastructure of student accommodation.

Background: The understanding of what mothers think about breastfeeding helps in developing successful breastfeeding promotion programs. This study aims to assess the maternal knowledge, attitude, and practice about the complementary feeding for infants aged 6-12 months. Methods: A cross-sectional study designed to interview 219 mothers with children between 6-12 months. Data was collected between 1st March and 30th April 2019 from ten maternal and child health clinics (MCHCs) in Anbar Province, Iraq. SPSS version 16.0 was recruited to analyze the data. Descriptive and inferential statistics such as Chi-square used to present data with the significance level set at less than 0.05. Results: The mean age of respondents was 27.76 ± 6.3 years, and 31% were at the primary school level. Two third (66.82%) of the surveyed mothers exclusively used breastfeeding to feed their infants. Most women (84.09%) have the correct knowledge about the best time to start complementary food. The vast majority of women (93.64%) refused to give vitamins to children even with signs of malnutrition. Conclusion: Although exclusive breastfeeding is common among mothers of the western region in Iraq, there is still a considerable percentage depend on the mixture of breastfeeding and bottle feeding. The positive impact of the family and society on mothers was evident. However, more attention should be given to improve knowledge, attitude, and practice through qualified healthcare providers.

Background: The increasing number of women graduating from medical schools doubles the level of responsibility and increases competition with males. Therefore, the assessment of the emotional exhaustion impact on women has become necessary to avoid over-stress at work. This study aims to assess and discuss the gender differences in nine-item emotional exhaustion (EE) subscale of the validated Maslach Burnout Inventory (MBI) among a sample of Iraqi physicians. Methods: A descriptive cross-sectional study conducted over the first half of 2014. Data was collected from 576 doctors using a self-administered questionnaire with a multistage sampling technique. An independent sample t-test used to compare the means. Results: More than half of respondents (310, 53.8%) were females with a mean age (±SD) of 40.43 years (±8.59). Female doctors are less affected than males in term of emotional draining from work (p=0.008) and strained by people (p=0.009) respectively. Male doctors are less affected than females in being used up at the end of the week (p

Background: Internally displaced people in Iraq are still suffering because the solutions were not radical. This study aims to assess the impact of displacement on the socio-economic, wellbeing and mental health status of internally displaced families in Anbar province, Iraq. Methods: A descriptive cross-sectional study was conducted from 3rd to 17th April 2017. Data was collected using a universal sampling technique. A total of 355 households interviewed with a modified questionnaire consisting of 26 close-ended questions related to the socio-economic, demographic, wellbeing and the mental health characteristics. Results: At the time of the study, about 55.5% of the surveyed displaced families have not returned home yet. Big families of more than seven members (59.4%) and residency in renting houses (82.8%) are two variables that may contribute to an economic burden. Mental health disorders such as depression and anxiety spread among 62.3% of surveyed families. Significant rise in chronic diseases from 64 (18.0%) cases before displacement to 102 cases (28.7%) after displacement. Few of them (21.6%) were able to access public health services. People who experienced violence are verbally abused at 52.1%. Lack of the services (50.3%), the inability to repair the destroyed houses (26.4%) and the loss of house due to complete destruction (23.3%) were the significant factors inhibited families to return home back. Conclusion: Our findings indicate the need for urgent and strategic plans to improve the quality of logistics, health and infrastructure services to motivate the displaced families to return back to their homes.

Background: Doctors and paramedics in countries suffering from long acting conflicts including Iraq are working in serious and exceptional conditions, putting them under severe physical and psychological pressure, therefore examining burnout is important when dealing with quality of care and working conditions. The aim of this study was to assess the point prevalence and to explore factors associated with emotional exhaustion (EE) among medical doctors in Iraq. Methods: Descriptive and cross sectional study was conducted (January to June 2014) among a randomly selected sample of medical doctors (n=576, 87.3% response rate) working in twenty large general hospitals and medical centers. In additions to EE, the self-administered questionnaire used consisting of questions on sociodemographic, work-related characteristics, conflict-related variables and job satisfaction. EE was measured using the emotional exhaustion subscale of the Maslach Burnout Inventory (MBI). Results: The prevalence of EE was reported by 60.0% of the respondents. In multiple linear regression analysis the emotional burnout was higher among doctors who were married, female, bearing children, being threatened, displaced internally, non-specialist doctors, working more than 40 hours per week, experienced unsafe medical practice, disagreed with the way manger handle the staff and those who reported that the doctor-patient relationship as not excellent. Conclusion: Our findings suggest that job dissatisfaction, conflict and violence related factors were significantly associated with high level of emotional exhaustion among Iraqi physician.

Background: This study aims to assess the mandatory practical skills of caregivers towards implementation of the Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy in primary health care (PHC) centers of Salah al-Din governorate in Iraq. Methods: A cross-sectional comparative study was conducted from January to May 2014. An equal sample of 42 trained and 42 non-trained caregivers who are working in 20 PHC centers in Tikrit city and other districts of Salah al-Din governorate of Iraq were included. The study tool was semi-structured questionnaire with 20 questions covering different required practical skills that caregivers should have. The total score was 100 and in a range of 4-6 points for each question. An independent sample t-test was used to compare means of numerical variables. Results: The mean age of total respondents was (33.18 SD 5.82Years) and the vast majority 63 (75%) were females. More than two third 58(69.0%) were paramedical compared to 26 (31.0%) who were doctors. Trained caregivers had statistically significant better practice (73.48 SD 13.46) compared to non- trained caregivers (63.95 SD 17.44). Trained doctors had statistically significant better practice (88.15 ± 2.70) compared to trained paramedical staff (66.90 ± 10.84). Trained caregivers from Tikrit city had statistically significantly better practice (80.26 SD 7.38) compared to trained caregivers from districts (67.89SD 14.85). The highest proportion (97.5%) of trained caregivers felt the child for fever or body hotness properly and the lowest proportion (59.5%) of them recorded age, height and weight correctly. Conclusions: This study showed that training has a positive influence on the implementation of IMNCI interventions. IMNCI-trained caregivers were more likely to correctly classify illnesses than non-trained caregivers.

Background: During the last decade the events of violence against healthcare providers have been escalated, especially in the areas of conflicts. This study aimed to test the impact of conflict-related and workplace -related violence on job satisfaction among Iraqi physicians. Methods: A cross sectional study with a self-administered survey was conducted among medical doctors in Iraq from January to June 2014. Participants (n=535, 81.1% response rate) were selected at random from 20 large general and district hospitals using multistage sampling technique. Results: The mean (+SD) value on the total job satisfaction score was 42.26 (SD = 14.63). Majority of respondents (67.3%) experienced unsafe medical practice, however, the conflict- related violence showed no significant difference on job satisfaction scores. In backward regression analysis, two socio-demographic variables (age, gender), and three work-related variables (being a specialist, working less than 40 hours per week, working in both government and private sector) were positively related to job satisfaction, while the workplace violence variables were negatively related. It was found that increases in physical attack, verbal abuse, bullying and racial harassment brought about decreases in job satisfaction scores of 6,087, 3.014, 9,107 and 4,242 respectively. Conclusion: Our results suggest that work related variables and workplace violence really do have an effect on job satisfaction. Specifically, when physicians have been physically attacked, verbally abused, bullied and racially harassed, their job satisfaction decreases significantly.

Background: Medical students constitute the backbone of the future human resource for health, and therefore, as much as attention should be given to secure high level of education it should also be given to understand their wishes to leave or to stay at home country. This study aimed at finding out the prominent factors associated with Iraqi medical students’ planning to leave their country after graduation. Methods: A descriptive cross-sectional study was conducted among clinical medical students (4th, 5th, and 6th classes) of two medical colleges (University of Anbar and University of Fallujah) in Anbar Governorate from 1st to 14th March 2018. A total of 183 students (Response Rate: 72.6%.) completed a self-administered questionnaire consisting of 15 close ended questions related to the socio-demographic factors, economic characteristics and some other factors inspired from Iraq’s situation. Moreover, one open ended question was designed to explore the main reasons for migration from student’s point of view. Results: Although, 109 students (59.6%) felt that serving their citizens and country is a priority, however the vast majority 133 (72.7%) of the surveyed students had a plan to leave Iraq. About two thirds (69.4 %) of students intended to migrate as soon as they manage to: obtain their graduation certificate (50.0%); have enough money (32.0%), and the remaining 18.0% when they get parents’ permission. Conclusion: Our results suggest that living environments and work related variables are significantly associated with medical students’ intention of migration, however social reasons and inspiring of academic achievement were the main factors triggering students to leave Iraq.