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: Provision of essential surgery is important in achieving Universal Health Coverage. However, data on the capacity of first-level hospitals to provide surgical care are currently unavailable in Sindh Province, Pakistan.

Aim: To assess surgical care services and needs in public sector hospitals in Sindh Province, Pakistan.

Methods: Between May and August 2021, we examined surgical care in 15 public sector district and subdistrict headquarters hospitals in Sindh Province, using the consolidated hospital assessment tool adapted from the WHO tool for assessing emergency and essential surgical care. We analysed the data using STATA version 15 and calculated the frequency of essential surgical procedures per 100 000 population for each health facility.

Results: Overall surgical beds density was 0.22 per 100 000 population, with 0.7 certified specialists and 1.4 combined certified and non-specialist physicians offering surgical and anaesthesia care per 100 000 population. Clinical support services were deficient, and only 76% of drugs for anaesthetic and surgical care were available. Outpatient procedures were performed in all facilities, while obstetrics/gynaecology, surgical and trauma-related procedures were performed in 87%, 60% and 53% of facilities, respectively. Three of the 15 hospitals performed the 3 Bellwether procedures.

Conclusion: This study identified multiple deficiencies in infrastructure, workforce, governance, management, and support services for essential surgical services in Sindh Province of Pakistan. To achieve Universal Health Coverage in Pakistan, there is a need for more research on surgical services in Sindh Province to identify other gaps and implement strategies to bridge the gaps.

Background: Mortality statistics are essential for public health planning, policy and decision-making. However, underreporting of mortality has been a significant concern in Islamic Republic of Iran.

Aim: To analyse trends in mortality and crude death rates, and the completeness of death registration in Islamic Republic of Iran.

Methods: We obtained and analysed mortality indicators for Islamic Republic of Iran from 2006 to 2021.

Results: Completeness of death registration increased consistently from approximately 80% in 2006 to 94% in 2021 for both sexes. However, there were variations in completeness from province to province. Mortality rates were higher for males than for females.

Conclusion: Consistency in the completeness of death registration varied significantly among the provinces, therefore, policies and interventions are needed to address these disparities and improve the overall quality and completeness of mortality data in Islamic Republic of Iran.

Background: Knowledge about menstruation and menstrual hygiene significantly impacts women's health and it is often influenced by economic, cultural and religious factors.

Aim: To assess knowledge about menstruation and menstrual hygiene among the Kho and Kalash ethnic groups in Chitral, Pakistan.

Methods: From May to September 2023, this cross-sectional study collected data on knowledge about menstruation and menstrual hygiene practices from 415 Kho and 105 Kalash women in Pakistan. The data were analysed using SPSS version 22 and associations between the variable factors were analysed using chi-square test (P < 0.05).

Results: Respondents aged 14-20 years had better knowledge about menstruation than older adults and educated women were nearly 4 times more knowledgeable than illiterate women (49% vs 13%). Respondents with educated mothers had better knowledge about menstruation than those with illiterate mothers (52% vs 43%, P = 0.003). There was a significant difference in menstrual hygiene practices between Kalash and Kho women (P < 0.0001); Kalash women reported better practices than the Kho (90% vs 46%). The main sources of information about menstruation before menarche were friends (44%), mass media (21%) and elder sisters (13%).

Conclusion: Knowledge about menstruation and menstrual hygiene is poor among the study population, indicating the need for targeted interventions and policies to improve knowledge and hygiene practices, thereby improving menstrual health among the women.

Substance use is a major public health challenge that has implications for security, safety and development, and requires coordinated, multidimensional and multidisciplinary response. Substance use and its consequences, particularly crime, health problems and lost productivity, cost as much as 2% of the Gross Domestic Product (GDP) of some countries. The United Nations 2024 World Drug Report estimates that globally, 292 million (5.6%) individuals aged 15-64 years used drugs in 2022 and cannabis was the most used substance. Injecting drug use continues to be an important driver of HIV and viral hepatitis epidemics in some populations, and 64 million people suffer from substance use disorders (SUDs) globally.

Background: Tobacco products taxes are a source of revenue for governments, but more importantly a strategy to reduce consumption of tobacco products and their associated health risks.

Aim: To investigate how tobacco products taxes have altered tobacco use in Türkiye.

Methods: This retrospective study collected data published between 2010 and 2023 on tobacco and tobacco products in Türkiye, including tobacco products taxes imposed by the government. Data analysis was performed using SPSS version 22.0 and correlation analysis was conducted to determine the relationship between domestic cigarette and fine-cut tobacco sales.

Results: Between 2010 and 2023, excise taxes on tobacco products varied between 19.2% and 34.2%. Consumer spending on fine-cut tobacco products per capita increased 42 694.6 folds due to an increase in the consumer price index. The annual number of cigarettes consumed per capita increased from 1266 in 2010 to 1609 in 2023 and fine-cut tobacco consumption per capita increased from 0.0037 g/year in 2010 to 106.8139 g/year in 2023. These increases in cigarette and fine-cut tobacco sales were attributed partly to population growth and a shift from cigarette consumption to fine-cut tobacco products consumption.

Conclusion: Although the main tobacco product consumed in Türkiye is industrial cigarettes, increasing the prices increased interest in fine-cut tobacco. Therefore, the production of cigarettes from fine-cut tobacco above the legal estimates reduced the effect of the tax on cigarette consumption. The taxation system needs to be reformed to prevent the effect of such alternatives.

Background: Infodemic is an emerging concept in public health and effective strategies are required to combat it.

Aim: To identify documented strategies for combating infodemics in the health sector, particularly during the COVID-19 pandemic.

Methods: In November 2022, we reviewed 87 articles on the management of infodemics in public health on PubMed and Web of Science using the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews.

Results: The number of articles on infodemic more than doubled from 18 in 2020 to 37 in 2021 and decreased to 32 in 2022, indicating efforts at different levels to combat infodemics especially during the COVID-19 pandemic. Strategies to combat infodemics included health literacy and education, use of more effective information resources, content control, social networking and communication, restrictive laws, use of electronic platforms, awareness campaigns, and health care provider involvement.

Conclusion: Findings from this review indicate that infodemic, especially during a pandemic, is a serious challenge in public health and a multifaceted approach involving education, technology, policy and community engagement is essential to combat it.

Availability, accessibility and affordability of safe, effective and quality essential medicines and medical products are central to the provision of reliable and sustainable health care services. Equitable access to medicines and vaccines can save up to 10 million lives annually, which is critical for achieving Universal Health Coverage and the health-related Sustainable Development Goals.

Background: The burden of hypertension among women of childbearing age in Jordan is increasing, indicating the need to explore its prevalence and associated risk factors.

Aim: To assess the prevalence and determinants of hypertension among women aged 18-49 years in Jordan.

Methods: This study used secondary cross-sectional data on hypertension, diabetes and hypercholesterolemia from 2675 Jordanian and Syrian women aged 18-49 years from the 2019 WHO STEPS survey in Jordan. Data analysis was performed using SPSS version 28, and univariate analysis was conducted to determine the associations between the variables.

Results: Prevalence of hypertension among the study participants was 17% and women who had hypertension were also obese. Having hypertension was significantly associated with being married, having lower educational attainment and consuming high amounts of salt. Those who had hypertension were more likely to have a history of diabetes, hypercholesterolemia and cardiovascular disease (P < 0.05).

Conclusions: The 17% prevalence of hypertension among the study participants, alongside obesity, indicates the need for weight management and lifestyle modification interventions to reduce the burden of hypertension among women of childbearing age in Jordan.