Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit最新文献

Background: Oman's digital health information system now supports over 85% of its healthcare institutions. However, there are challenges in digital health governance, infrastructure, workforce development, and interoperability.

Aim: To assess the progress and challenges in Oman's digital health system in the past 4 decades and explore opportunities for a sustainable system.

Methods: We interviewed 80 digital health service providers and policymakers in Oman. We reviewed and analysed secondary data from the Oman Digital Health Maturity Assessment survey and from relevant documents, including national health policies, strategic plans, regulatory frameworks, and guidelines.

Results: Over 40% of health care institutions did not have formal digital health governance structures, more than half did not fully implement cybersecurity protocols and approximately half lacked patient data encryption. There were differences in digital health readiness between the public and private health institutions. Key challenges include weak digital health governance, inadequate information technology infrastructure to support digitalisation and lack of a unified data exchange system across health institutions.

Conclusion: Strengthening interoperability, expanding public-private partnerships and establishing clear oversight frameworks will help Oman achieve a sustainable, patient-centred digital health system.

"Most households in our country have at least one person living with a noncommunicable disease." This is what many ministers of health and officials from the Eastern Mediterranean Region (EMR) tell me when we discuss priority actions. Their words reflect a stark reality: 66% of deaths in the region, reaching as high as 86% in some countries, are attributed to noncommunicable diseases (NCDs).

Background: Consanguinity, the tradition of marrying within ancestral kinship, remains common in many Arab and Middle Eastern countries, despite its well-known health risks.

Aim: To explore the prevalence of consanguineous marriage in Settat, Morocco, and the contributing factors.

Methods: This cross-sectional analytical study collected data on consanguineous marriage from 453 married Moroccan women aged ≥18 years, using an interviewer-administered structured questionnaire, and analysed the data using SPSS version 26.

Results: We found a consanguineous marriage rate of 26.7% (average consanguinity coefficient 0.0145871) among the respondents, with mostly (69.4%) first cousin marriages. Consanguinity was mostly influenced by parental consanguinity, traditional marriage arrangement, age at time of marriage, education level, rural vs urban residence, and socioeconomic status.

Conclusion: Our findings show that consanguinity is still prevalent in Morocco due to a combination of reasons. Targeted interventions should be implemented to increase awareness and knowledge about the health risks of consanguinity and reduce its prevalence among the population.

Background: Tobacco use is a major contributor to noncommunicable diseases in the Eastern Mediterranean Region, resulting in substantial health care costs and economic losses.

Aim: To review investment cases for tobacco control in selected countries of the WHO Eastern Mediterranean Region and estimate the economic benefits of implementing the WHO Framework Convention on Tobacco Control (WHO FCTC) measures.

Methods: Using scenario modelling, we compared the WHO-UNDP investment cases for Egypt, Islamic Republic of Iran, Jordan, Lebanon, Pakistan, and Tunisia with implementation of the WHO FCTC measures. We estimated the tobacco-related deaths and economic costs and projected the returns on investing in tobacco control over a 15-year period.

Results: Tobacco-related economic losses in the region ranged from US$ 139 million in Lebanon to over US$ 5 billion in Egypt, driven mainly by health care costs and productivity losses. Projected returns on investment in control measures were highest with tax increases (up to 1547:1 in Jordan), followed by smoke-free laws, mass media campaigns and graphic warnings. In countries with available data, lower-income populations had the highest projected health and financial gains.

Conclusion: Implementing the WHO FCTC in the WHO Eastern Mediterranean Region offers substantial health and economic benefits. Comprehensive, multisectoral actions should be prioritised to reduce tobacco use, particularly among vulnerable populations, in the region.

Background: Hepatitis B virus infection is a major health concern globally, with regional and national variations that require context-specific analyses.

Aim: To assess trends, including age- and gender-specific variations, of hepatitis B virus incidence in Iraq from 2012 to 2022.

Methods: We analysed national surveillance data from 2012 to 2022 on confirmed hepatitis B virus cases among all age groups in Iraq. Joinpoint regression was used to estimate the annual percentage change and average annual percentage change in incidence.

Results: Annual incidence decreased from 9.7 per 100 000 population in 2012 to 3.5 in 2022. Incidence was consistently higher among males, however, joinpoint regression showed a significant decrease in incidence among males (-13.8%) and females (-14.9%). The lowest decrease (-41.1%) occurred after 2017 among those aged 0-4 years. Incidence among the 5-14 years age group peaked in 2014 and decreased thereafter (-10.8%). Among individuals aged 15-44 years, incidence increased until 2016 and then decreased significantly (-18.9%). Among those aged >45, incidence increased until 2015 and then stabilised.

Conclusion: Age- and gender-specific interventions are needed to strengthen hepatitis B prevention and control in Iraq.

Background: Stray dogs pose a serious threat to health and safety in Morocco.

Aim: To explore policy options for humane management of stray dogs in Morocco.

Methods: We conducted a review of relevant literature regarding the management of stray dogs in Morocco and elsewhere and interviewed an animal management expert. Based on our findings, we developed this policy brief for the management of stray dogs in Morocco.

Results: We highlight 4 key policy options for humane management of canine populations in Morocco: the treat, neuter, vaccinate and tag method; awareness-raising and education involving community members; canine population management; and partnering with the private sector.

Conclusion: There is an urgent need for a new policy approach to managing stray dogs in Morocco, including a robust monitoring and evaluation framework with key indicators that will enhance vaccination coverage, reduction in density and reduction in incidence of rabies and hydatidosis.

Background: Although immunisation services are free in Islamic Republic of Iran, coverage among refugee Afghan children remains suboptimal.

Aim: To assess immunisation coverage among refugee Afghan children aged ˂2 years in suburban Mashhad, Islamic Republic of Iran.

Methods: Using a locally adapted version of the WHO standard immunisation coverage questionnaire, we collected immunisation data from 313 refugee Afghan children aged ˂2 years in suburban Mashhad, Islamic Republic of Iran. Immunisation status was confirmed using immunisation cards or maternal recall if cards were unavailable. We analysed the data using SPSS version 21 and conducted chi-square tests to examine associations between categorical variables, analysis of variance for continuous variables, and unadjusted linear regression to identify predictors of immunisation status. P ≤ 0.05 was considered statistically significant.

Results: Of the children, 79.9% were fully vaccinated. Immunisation status was associated with maternal age, number of children, child's sex, religion, and duration of residence in the country. Main barriers to immunisation were fear of sideeffects, low confidence in vaccines, illness, and scheduling challenges.

Conclusion: The approximately 20% immunisation gap found in this study highlights the need for tailored interventions to address the structural and behavioural barriers to immunisation among this population group, including education campaigns to counter common misconceptions about vaccines.