Perceptions and utilization of primary health care services in Iraq: findings from a national household survey

<p>Abstract</p> <p>Background</p> <p>After many years of sanctions and conflict, Iraq is rebuilding its health system, with a strong emphasis on the traditional hospital-based services. A network exists of public sector hospitals and clinics, as well as private clinics and a few private hospitals. Little data are available about the approximately 1400 Primary Health Care clinics (PHCCs) staffed with doctors. How do Iraqis utilize primary health care services? What are their preferences and perceptions of public primary health care clinics and private primary care services in general? How does household wealth affect choice of services?</p> <p>Methods</p> <p>A 1256 household national survey was conducted in the catchment areas of randomly selected PHCCs in Iraq. A cluster of 10 households, beginning with a randomly selected start household, were interviewed in the service areas of seven public sector PHCC facilities in each of 17 of Iraq's 18 governorates. A questionnaire was developed using key informants. Teams of interviewers, including both males and females, were recruited and provided a week of training which included field practice. Teams then gathered data from households in the service areas of randomly selected clinics.</p> <p>Results</p> <p>Iraqi participants are generally satisfied with the quality of primary care services available both in the public and private sector. Private clinics are generally the most popular source of primary care, however the PHCCs are utilized more by poorer households. In spite of free services available at PHCCs many households expressed difficulty in affording health care, especially in the purchase of medications. There is no evidence of informal payments to secure health services in the public sector.</p> <p>Conclusions</p> <p>There is widespread satisfaction reported with primary health care services, and levels did not differ appreciably between public and private sectors. The public sector PHCCs are preferentially used by poorer populations where they are important providers. PHCC services are indeed free, with little evidence of informal payments to providers.</p

The global workforce shortages and the migration of medical professions: the Australian policy response

Medical migration sees the providers of medical services (in particular medical practitioners) moving from one region or country to another. This creates problems for the provision of public health and medical services and poses challenges for laws in the nation state and for laws in the global community

Urban warfare ecology: A study of water supply in Basrah

This article assesses the impact of armed conflict on the drinking water service of Basrah from 1978 to 2013 through an ‘urban warfare ecology’ lens in order to draw out the implications for relief programming and relevance to urban studies. It interprets an extensive range of unpublished literature through a frame that incorporates the accumulation of direct and indirect impacts upon the hardware, consumables and people upon which urban services rely. The analysis attributes a step-wise decline in service quality to the lack of water treatment chemicals, lack of spare parts, and, primarily, an extended ‘brain-drain’ of qualified water service staff. The service is found to have been vulnerable to dependence upon foreign parts and people, ‘vicious cycles’ of impact, and the politics of aid and of reconstruction. It follows that practitioners and donors eschew ideas of relief–rehabilitation–development (RRD) for an appreciation of the needs particular to complex urban warfare biospheres, where armed conflict and sanctions permeate all aspects of service provision through altered biological and social processes. The urban warfare ecology lens is found to be a useful complement to ‘infrastructural warfare’ research, suggesting the study of protracted armed conflict upon all aspects of urban life be both deepened technically and broadened to other cases

Globalised violence, community psychology and the bombing and occupation of Afghanistan and Iraq

In this article, I first set out a conceptualisation of globalised violence. I then reflect upon how psychology networks in general and community psychology networks in particular appear to have positioned themselves publicly in relation to the violence of the recent bombing and occupation of Afghanistan and Iraq. I ask whether networks of Community Psychologists are able/willing to publicly position themselves in regards to these specific events and the levels of globalised violence in general