Personal data governance and privacy in digital reproductive, maternal, newborn, and child health initiatives in Palestine and Jordan: a mapping exercise

IntroductionThere is a rapid increase in using digital technology for strengthening delivery of reproductive, maternal, newborn, and child health (RMNCH) services. Although digital health has potentially many benefits, utilizing it without taking into consideration the possible risks related to the security and privacy of patients' data, and consequently their rights, would yield negative consequences for potential beneficiaries. Mitigating these risks requires effective governance, especially in humanitarian and low-resourced settings. The issue of governing digital personal data in RMNCH services has to date been inadequately considered in the context of low-and-middle-income countries (LMICs). This paper aimed to understand the ecosystem of digital technology for RMNCH services in Palestine and Jordan, the levels of maturity of them, and the implementation challenges experienced, particularly concerning data governance and human rights.MethodsA mapping exercise was conducted to identify digital RMNCH initiatives in Palestine and Jordan and mapping relevant information from identified initiatives. Information was collected from several resources, including relevant available documents and personal communications with stakeholders.ResultsA total of 11 digital health initiatives in Palestine and 9 in Jordan were identified, including: 6 health information systems, 4 registries, 4 health surveillance systems, 3 websites, and 3 mobile-based applications. Most of these initiatives were fully developed and implemented. The initiatives collect patients' personal data, which are managed and controlled by the main owner of the initiative. Privacy policy was not available for many of the initiatives.DiscussionDigital health is becoming a part of the health system in Palestine and Jordan, and there is an increasing use of digital technology in the field of RMNCH services in both countries, particularly expanding in recent years. This increase, however, is not accompanied by clear regulatory policies especially when it comes to privacy and security of personal data, and how this data is governed. Digital RMNCH initiatives have the potential to promote effective and equitable access to services, but stronger regulatory mechanisms are required to ensure the effective realization of this potential in practice

Lung Function, Respiratory Symptoms, Skin Problems and Chemical Exposures - A Cross-Sectional Occupational Health Study among Female Hairdressers in Hebron City, Palestine

Background Hairdressers are exposed to chemicals and work tasks which may be harmful to their health. Studies have shown that this group of working women have a high incidence of both asthma and skin problems. The information on the prevalence of respiratory and skin symptoms caused by (reactive) chemicals used in hairdressing salons is limited. Most previous studies have been done in Europe and other developed countries. So there is a need of similar studies from developing countries to describe the occurrence and severity of respiratory and skin problems among hairdressers, and to investigate the associated factors. A study on the health situation in the hairdressing salons in Palestine will contribute to increased awareness about occupational health risks in the country. Objectives The main objective of the present study was to assess respiratory symptoms, respiratory effects and skin health problems among female hairdressers in Hebron City, Palestine. The specific objectives were to study work conditions in the salons and investigate the knowledge among hairdressers about their exposure and potential adverse health effects of their occupation. Another specific objective was to give preliminary estimates of the association between exposure at work and those health problems. Methodology A cross-sectional study was conducted, using random sampling procedure, and including 170 (87% response) female hairdressers working in 56 salons in Hebron City. The participants filled in a modified version of an internationally accepted questionnaire which collected information about working history, health status and knowledge. Lung function test was performed and a checklist was filled in by the researcher for each salon, describing the conditions and chemicals being used. Results The prevalence of respiratory symptoms was as follow; 19% for wheezing, 31% for tightness in the chest, 25% for shortness of breathe, 17% for coughing and 22% for phlegm. Asthma prevalence was 5.9% and hand dermatitis was 13.5%. The mean FVC was 3.31 liters (SD = 0.44) which was 96.5% of predicted as compared to European standards. For FEV1, the mean value was 2.74 liters (SD = 0.60) which was 92.4% of predicted value of the European standards. Preliminary crude analyses showed, for some of the end points, significantly more self-reported respiratory symptoms among the group of hairdressers with high exposure level as compared to lower exposure level, and lower mean of the main two lung function measurements (FVC and FEV1). Little knowledge was found among the hairdressers about the chemicals they are using and its harmful effect on their health. However, high percent (74%) of the ones with hand dermatitis linked this problem to their work conditions. Conclusion Our study showed that female hairdressers in Hebron City, Palestine are exposed to chemicals that might have adverse effects on their health and that the health symptoms were worse among the highly exposed group with higher intensity of work. However, association between exposure and outcome should be further analyzed with multivariate techniques. There is clearly a need of increasing the awareness of occupational health hazards, as the knowledge was limited in this sample of female hairdressers. More research is needed in this field and more follow up studies would be useful to investigate the effect of exposure on health among this group of workers. Key words Hairdressing, occupational health, occupational asthma, hand dermatitis, chemical exposures. Source of financing This study was funded by NUFU "Building Competence in Epidemiology in Palestine- Pro 50-2002"

Lung Function and Respiratory Health of Populations Living Close to Quarry Sites in Palestine: A Cross-Sectional Study

Environmental exposure to dust from quarrying activities could pose health dangers to the population living nearby. This study aimed to investigate the health effects of dust exposure on people living close to quarry sites and compared them with those who live far from the quarry sites. A cross-sectional comparative study was conducted among 79 exposed participants, who lived less than 500 m away from the quarry sites, and 79 control participants who lived more than 500 m away. All participants answered a questionnaire on dust exposure at home and health effects, as well as performed a lung function test in which both reported and measured health effects were investigated. People who live in close proximity to the quarry sites reported exposure to dust at home (98%), land destruction (85%), plant leaves covered with dust (97%), and an inability to grow crops (92%). The exposed group reported significantly higher eye and nasal allergy (22% vs. 3%), eye soreness (18% vs. 1%), and dryness (17% vs. 3%), chest tightness (9% vs. 1%), and chronic cough (11% vs. 0%) compared to the control group. Lung function parameters were significantly lower among the exposed group compared to the control group; mean forced vital capacity (FVC) was 3.35 L vs. 3.71 L (p = 0.001), mean forced expiratory volume in the first second (FEV1) was 2.78 L vs. 3.17 L (p = 0.001). Higher levels of airway restriction were found among the exposed group. Among the exposed group, lung function parameters worsened with the increasing closeness of home to the quarry site. This study demonstrates the negative health effects of environmental dust exposure among two communities living near quarry sites in Palestine. The results highlight the importance of developing and strictly enforcing rules and regulations in Palestine to protect population health

Lung function and respiratory symptoms among female hairdressers in Palestine: a 5-year prospective study

Objectives Hairdressers are exposed to chemicals at the workplace which are known to cause respiratory symptoms and asthma. This study aimed to examine changes in self-reported respiratory symptoms over 5 years, as well as to examine the lung function decline and determine whether it is within the expected range, to assess the dropout rate and reasons for leaving the profession, and to examine the associations between occupational factors and lung function changes at follow-up. Design Prospective study. Setting Female hairdressing salons in Hebron city, Palestine. Participants 170 female hairdressers who participated in a baseline survey in 2008 were followed up in 2013. A total of 161 participants participated in 2013. Outcome measures Change in reported respiratory symptoms and change in lung function over follow-up. Dropout from the profession and reasons for it. Differences between current and former hairdressers in respiratory symptoms and lung function at follow-up. Ambient air ammonia levels in 13 salons. Results Current hairdressers reported more respiratory symptoms in 2013 compared with baseline. Former hairdressers reported fewer symptoms at follow-up. At follow-up, current hairdressers showed a significant decrease in forced vital capacity of 35 mL/year (95% CI 26 to 44 mL/year) and of 31 mL/year (95% CI 25 to 36 mL/year) for forced expiratory volume in 1 s (FEV1). 28 (16%) of the hairdressers quit the job during the 5-year follow-up, 8 (28%) because of health problems. Hairdressers who had been working for 4 years or more at baseline showed a stronger decline in FEV1 compared with those who worked less than 4 years (difference 13, 95% CI 1 to 25). Conclusions Current hairdressers developed more respiratory symptoms and larger lung function decline than former hairdressers during follow-up. Few hairdressers left their profession because of respiratory health problems. Working for more years is associated with lung function decline among current hairdressers

Gender Awareness in Healthcare: Contextualization of an Arabic Version of the Nijmegen Gender Awareness in Medicine Scale (N-GAMS)

Gender is one of the important social determinants of health known to be highly associated with health status. Despite the importance of gender awareness, it has not been addressed and researched in the Arab region, including Palestine. This study aimed to contextualize an Arabic version of the Nijmegen Gender Awareness in Medicine Scale (N-GAMS) and to assess the level of gender awareness and its associated factors among primary health care providers. The N-GAMS tool was translated and adapted through a gender expert consultation and a focus group discussion. Then, it was administered online to a sample of primary health care general physicians and nurses of all health care providing actors in Ramallah and al-Bireh Governorate. The reliability of the N-GAMS subscales using Cronbach’s alpha (α) was 0.681 for the gender sensitivity (GS) scale (9 items), 0.658 for the gender role ideology towards co-workers (GRIC) scale (6 items), and α = 0.848 for the gender role ideology towards patients (GRIP) scale (11 items). The results showed that participants had scored near the midpoint of the gender sensitivity subscale (M = 2.84, SD = 0.486). They also expressed moderate gender stereotypes towards patients (M = 3.11, SD = 0.624), where females held lower stereotypical thinking. Participants also expressed low to moderate stereotypes towards co-workers (M = 2.72, SD = 0.660) and females expressed less stereotypical thinking compared to males. Furthermore, the participant’s age had some effect on the outcome, specifically on the GRIP subscale, while gender was associated with both GRIP and GRID subscales. The rest of the social and other variables showed no association with the gender awareness subscales. This study adds to our understanding of gender awareness. Further tests are required to confirm the psychometric qualities of the instrument

Investigating the Association between Nutrient Intake and Food Insecurity among Children and Adolescents in Palestine Using Machine Learning Techniques

Food insecurity is a public health concern that affects children worldwide, yet it represents a particular burden for low- and middle-income countries. This study aims to utilize machine learning to identify the associations between food insecurity and nutrient intake among children aged 5 to 18 years. The study’s sample encompassed 1040 participants selected from a 2022 food insecurity household conducted in the West Bank, Palestine. The results indicated that food insecurity was significantly associated with dietary nutrient intake and sociodemographic factors, such as age, gender, income, and location. Indeed, 18.2% of the children were found to be food-insecure. A significant correlation was evidenced between inadequate consumption of various nutrients below the recommended dietary allowance and food insecurity. Specifically, insufficient protein, vitamin C, fiber, vitamin B12, vitamin B5, vitamin A, vitamin B1, manganese, and copper intake were found to have the highest rates of food insecurity. In addition, children residing in refugee camps experienced significantly higher rates of food insecurity. The findings emphasize the multilayered nature of food insecurity and its impact on children, emphasizing the need for personalized interventions addressing nutrient deficiencies and socioeconomic factors to improve children’s health and well-being