The Perception of Stakeholders towards Services Provided By Primary Health Care in Khartoum State, Sudan

Background: Sudan is a signatory country to Alma Ata Declaration and Primary Health Care (PHC) had been established since 1979. Although a lot of improvement is claimed to be achieved in PHC, some of the areas might be still far below the expectations. The objective of this study was to investigate the perception of the PHC stakeholders in Khartoum State about the PHC services provided and the adequacy of facilities used.Materials and Methods: This is a cross-sectional descriptive study conducted in Khartoum State, Sudan, between June and October 2015. A structured questionnaire was administered to a sample of PHC stakeholders. A 3-point Likert scale was used to indicate the quality of the different services provided and the facilities present. SPSS version 20 was used for analysis to calculate relevant descriptive statistical parameters.Results: Vaccination and care for pregnant ladies were perceived by respondents as present and adequate (100% and 95%, respectively). The other services that are perceived as adequate include: child health care, health education, chronic illness, drugs availability and the referral system. In sanitation services and feedback about patients referred to hospitals, only 20% and 4% were satisfied, respectively.Conclusion: Most of the PHC services were perceived as adequate by the respondents from Khartoum State. The services and facilities that were perceived as inadequate include sanitation services, communicable diseases, the referral system and provision of dental services.Key words: primary health care (PHC), stakeholders

A Comparison Between Students’ Performance In Multiple Choice and Modified Essay Questions in the MBBS Pediatrics Examination at the College of Medicine, King Khalid University, KSA

Objectives: To investigate the relation between the students' scores in MCQs and MEQs of the summative assessment in pediatrics at the College of medicine KKU. Introduction: Student assessment is the most difficult task in medicine since it is ultimately related to human life and safety. Assessment can take different types of formats with advantages and disadvantages and there is no single prescribed method of choice. Research Methods: This is a quantitative, observational retrospective study enrolling 50 students who completed the final MBBS examination in pediatrics in 2015.The medical students’ scores in MCQs and MEQs in the final MBBS pediatrics examination were collected and SPSS used for analysis. Results: 52% of the students scored A and B, 46% scored C and 2% scored D and nobody scored F. The mean percentage scores in MCQs, MEQs and the combined are75.03%, 79.99% and 76.68% respectively. The standard deviation (SD) for MCQs, MEQs and combined are 0.0753, 0.0763 and 0.0559 respectively.There are no significant differences in means and SD. The correlation (CR) between MCQs and MEQs is -1.73%. The CR between MCQs and MEQs for those who scored A and B is 7.38% which could indicate a weak but significant +ve CR (p value 0.017), (table3). For those who scored C inverse CR (-74.38%) was observed between MCQs and MEQs. Discussion: The main finding of this study was the weakly negative CR between students' performance on MCQs and MEQs. Good performance in MCQs is not necessary correlated with good performance in LEQs. This is not in agreement with Oyebola et al. and Moqattash et al findings, who reported positive CR in the performance of their students. The discrepancy observed in performance between MCQs and MEQs could be explained by the subjectivity and the difficulty in avoiding bias in setting and marking essay questions.   Key Words: multiple choice questions, Modified long essay questions, correlation

ASSESSMENT OF NUTRITIONAL STATUS AMONG STICKLERS

Introduction: Growth retardation in weight and height was reported among patients with sickle cell anemia (SCA).The growth retardation, delayed sexual development and poor immunologic response are possibly due to the under nutritional state associated with the disease. The active metabolic state observed in sicklers is due to an increase in the synthesis of Hb, cardiac work, cell turnover, and a decrease in appetite and intake. Objectives: Tto compare anthropometric measurement (weight, height and body mass index (BMI) ) between sicklers and normal children and to study factors related to the nutritional status of sicklers. Patients and methods: This comparative hospital based study based study done among sicklers and control group using a questionnaire. Results: Stunted weight (less than 3rd centile) was observed in 49 (56.3%) sicklers compared to 9(11.4%) controls, 38(43.7%) sicklers and 51(64.6%) controls had their weight in the range between 5th-95th centile while 30(34.5%) sicklers and 7(8.9%) controls had their height less than 5th centile. A total of 40(46%) sicklers and 53(67.1%) control had a height outside the range of than 5th-95th percentile ,however it was observed that 17(19.5%) sicklers had their height more than 95th compared to 19(24%) controls. BMI was recorded as less than 5thin 51(58.7%) of the sicklers compared to7(8.9%) in the controls. Children from low social class were recorded in79.6%, 63.3% and 78.4%of weight, height and BMI stunting respectively .Finally stunting in weight, height and BMI was more obvious in older children. Conclusion: Most of sickle cell anemia patients had weight and body mass index retardation, this problem was mostly observed towards adolescent age