Health System in Iraq Post 2003 War

Background: War represents a major human crisis; it destroys communities and results in ingrained consequences for public health and well-being Objective: We set this study to shed light on the public health status in Iraq after the successive wars, sanctions, sectarian conflicts, and terrorism, in light of certain health indicators. Design: The primary source of data for this analysis comes from the Iraqi Ministry of Health, and The World Health Organization disease surveillance. Results: Most of the morbidity indicators are high, even those that are relatively declining recently, are still higher than those reported in the region. Common communicable diseases such as schistosomiasis, mumps, and measles continue to be a problem. Mumps showed two recent epidemics; in 2015, and in 2020. The same with respect to Measles. More than 40·% of the surveyed population showed both systolic and diastolic hypertension. Fasting glucose of 10·4% of the participants showed hyperglycaemia, only 6·5% of whom reported being diagnosed and treated as diabetic. The leading cancer in males is Bronchus and Lung cancer, followed by Colorectal, Urinary bladder, and Prostatic cancers while in females; Breast cancer is in the top of the list, followed by Thyroid, Colorectal, Brain, and Bronchogenic cancers. Rates for childhood cancers are obviously higher even than those in high-income countries. Conclusions: The struggling public health services in Iraq have been severely impacted by humanitarian and political crises and brutal armed conflict that resulted in restricted population access to food, clean water and basic services including healthcare and medicines

Prevalence of Alcohol Consumption among University Students in Baghdad: A Cross-section survey from Iraq

Background: Alcohol consumption is a well-known public health problem, especially among university students. It was poorly studied in Middle East, especially in Iraq, due to religious and social taboos. This study conducted to throw a light on the prevalence of Alcohol consumption among university students in Baghdad. Subjects and methods: A survey conducted in three universities (Baghdad, Al-Mustansiriyah and Al-Nahrain) from Baghdad city, in the duration between January and May 2015.A semi-structured questionnaire form used to collect the data from 1435 university students. The sample selected by multistage random sampling technique with probability proportion to size. Results: The average age (range) of the studied sample was 19.8 (18 - 24) years; more than a half of them were females 760 (53%). Alcohol consumption was reported by 9.7% (95%CI: 8.2% - 11.2%) of the participants (19.7% males vs. 0.8% females). Heavy Alcohol consumption was reported by 12.2% of consumers. Male students living out of their families or relatives and those of medical group colleges found to be risk factors for Alcohol consumption (PR= 2.65, 95% CI: 1.72 - 4.1) and (PR= 2.72, 95%CI: 1.48 - 5.01) respectively. No significant relations showed between demographic characters of female students and Alcohol consumption. Conclusions: Usage of Alcohol was relatively prevalent among university students in Baghdad, in spite of religious and social barriers in Iraq. Family and college staff supervision and education of the students with meetings targeting health risks and sequels of Alcohol hazardous consumption are the effective ways to control this practice

Effect of adverse childhood experiences on physical health in adulthood: Results of a study conducted in Baghdad city

Background: Studies have revealed a powerful relationship between adverse childhood experiences (ACEs) and physical and mental health in adulthood. Literature documents the conversion of traumatic emotional experiences in childhood into organic disease later in life. Objective: The aim was to estimate the effect of childhood experiences on the physical health of adults in Baghdad city. Subjects and Methods: A cross-sectional study was conducted from January 2013 to January 2014. The study sample was drawn from Baghdad city. Multistage sampling techniques were used in choosing 13 primary health care centers and eight colleges of three universities in Baghdad. In addition, teachers of seven primary schools and two secondary schools were chosen by a convenient method. Childhood experiences were measured by applying a modified standardized ACEs-International Questionnaire form and with questions for bonding to family and parental monitoring. Physical health assessment was measured by a modified questionnaire derived from Health Appraisal Questionnaire of Centers for Disease Control and Prevention. The questionnaire includes questions on cerebrovascular diseases, diabetes mellitus, tumor, respiratory and gastrointestinal diseases. Results: Logistic regression model showed that a higher level of bonding to family (fourth quartile) is expected to reduce the risk of chronic physical diseases by almost the half (odds ratio = 0.57) and exposure to a high level of household dysfunction and abuse (fourth quartile) is expected to increase the risk of chronic physical diseases by 81%. Conclusion: Childhood experiences play a major role in the determination of health outcomes in adulthood, and early prevention of ACEs. Encouraging strong family bonding can promote physical health in later life

A Novel Method for Verifying War Mortality while Estimating Iraqi Deaths for the Iran-Iraq War through Operation Desert Storm (1980-1993)

<div><p>Objectives</p><p>We estimated war-related Iraqi mortality for the period 1980 through 1993.</p><p>Method</p><p>To test our hypothesis that deaths reported by siblings (even dating back several decades) would correspond with war events, we compared sibling mortality reports with the frequency of independent news reports about violent historic events. We used data from a survey of 4,287 adults in 2000 Iraqi households conducted in 2011. Interviewees reported on the status of their 24,759 siblings. Death rates were applied to population estimates, 1980 to 1993. News report data came from the ProQuest <i>New York Times</i> database.</p><p>Results</p><p>About half of sibling-reported deaths across the study period were attributed to direct war-related injuries. The Iran-Iraq war led to nearly 200,000 adult deaths, and the 1990–1991 First Gulf War generated another approximately 40,000 deaths. Deaths during peace intervals before and after each war were significantly lower. We found a relationship between total sibling-reported deaths and the tally of war events across the period, p = 0.02.</p><p>Conclusions</p><p>We report a novel method to verify the reliability of epidemiological (household survey) estimates of direct war-related injury mortality dating back several decades.</p></div

Understanding context of violence against healthcare through citizen science and evaluating the effectiveness of a co-designed code of conduct and of a tailored de-escalation of violence training in Eastern Democratic Republic of Congo and Iraq: a study protocol for a stepped wedge randomized controlled trial

Abstract Background Violence against health care workers (HCWs) is a multifaceted issue entwined with broader social, cultural, and economic contexts. While it is a global phenomenon, in crisis settings, HCWs are exposed to exceptionally high rates of violence. We hypothesize that the implementation of a training on de-escalation of violence and of a code of conduct informed through participatory citizen science research would reduce the incidence and severity of episodes of violence in primary healthcare settings of rural Democratic Republic of Congo (DRC) and large hospitals in Baghdad, Iraq. Methods In an initial formative research phase, the study will use a transdisciplinary citizen science approach to inform the re-adaptation of a violence de-escalation training for HCWs and the content of a code of conduct for both HCWs and clients. Qualitative and citizen science methods will explore motivations, causes, and contributing factors that lead to violence against HCWs. Preliminary findings will inform participatory meetings aimed at co-developing local rules of conduct through in-depth discussion and input from various stakeholders, followed by a validation and legitimization process. The effectiveness of the two interventions will be evaluated through a stepped-wedge randomized-cluster trial (SW-RCT) design with 11 arms, measuring the frequency and severity of violence, as well as secondary outcomes such as post-traumatic stress disorder (PTSD), job burnout, empathy, or HCWs’ quality of life at various points in time, alongside a cost-effectiveness study comparing the two strategies. Discussion Violence against HCWs is a global issue, and it can be particularly severe in humanitarian contexts. However, there is limited evidence on effective and affordable approaches to address this problem. Understanding the context of community distrust and motivation for violence against HCWs will be critical for developing effective, tailored, and culturally appropriate responses, including a training on violence de-escalation and a community behavioral change approach to increase public trust in HCWs. This study aims therefore to compare the effectiveness and cost-effectiveness of different interventions to reduce violence against HCWs in two post-crisis settings, providing valuable evidence for future efforts to address this issue. Trial registration ClinicalTrial.gov Identifier NCT05419687. Prospectively registered on June 15, 2022

Raw number of siblings death by year and cause, Iraq 1979–1993.

<p><b>Source of data:</b> Survey of 4,287 adults in 1,960 households in Iraq between May and July of 2011,782 sibling deaths by cause between 1980 and 1993. Data provided by the University Collaborative Iraq Mortality Study, which collected household and sibling data from 2000 households across Iraq in 2011. Direct war-related injury deaths / total deaths = 45.3%. Among other deaths, 23.1% were attributed to cardiovascular disease, 22.2% to other injury, 10.7% to cancer, 37.0% to “other” and 7.0% to “don’t know.”</p

Estimates of numbers of adult deaths per week in Iraq, 1979–1993, by cause as reported by siblings.

<p><b>Source of mortality data:</b> Survey of 4,287 adults in 1,960 households in Iraq between May and July of 2011, reporting on 782 sibling deaths between 1980 and 1993. Data provided by the University Collaborative Iraq Mortality Study, which collected household and sibling data from 2000 households across Iraq in 2011; Event calendar collected from literature review. [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0164709#pone.0164709.ref024" target="_blank">24</a>–<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0164709#pone.0164709.ref027" target="_blank">27</a>]</p