Lessons on the COVID-19 pandemic, for and by primary care professionals worldwide.

The COVID-19 pandemic has modified organisation and processes of primary care. In this paper, we aim to summarise experiences of international primary care systems. We explored personal accounts and findings in reporting on the early experiences from primary care during the pandemic, through the online Global Forum on Universal Health Coverage and Primary Health Care. During the early stage of the pandemic, primary care continued as the first point of contact to the health system but was poorly informed by policy makers on how to fulfil its role and ill equipped to provide care while protecting staff and patients against further spread of the infection. In many countries, the creativity and initiatives of local health professionals led to the introduction or extension of the use of telephone, e-mail and virtual consulting, and introduced triaging to separate 'suspected' COVID-19 from non-COVID-19 care. There were substantial concerns of collateral damage to the health of the population due to abandoned or postponed routine care. The pandemic presents important lessons to strengthen health systems through better connection between public health, primary care, and secondary care to cope better with future waves of this and other pandemics

Primary care healthcare policy implementation in the Eastern Mediterranean region; experiences of six countries: Part II

Background: Primary healthcare (PHC) is essential for equitable access and cost-effective healthcare. This makes PHC a key factor in the global strategy for universal health coverage (UHC). Implementing PHC requires an understanding of the health system under prevailing circumstances, but for most countries, no data are available. Objectives: This paper describes and analyses the health systems of Algeria, Kuwait, Morocco, Saudi Arabia, Jordan and Iraq to PHC. Methods: Data were collected during a workshop at the Wonca East Mediterranean Regional Conference in 2018. Academic family physicians (FP) presented their country; using the Wonca framework of 11 PowerPoint slides, with queries of the country demographics, main health challenges, and the position of PHC in the health system. Results: The six countries had achieved a significant improvement in populations’ health but currently face challenges of health financing, a small number of certified FPs, difficulties in accessing services and bureaucratic procedures. Primary concerns were the absence of a family practice model, brain drain and immigration of FPs. Countries differed in building a coherent policy. Conclusion: Priorities should be focused on: developing PHC model in Eastern Mediterranean region with advocacy for community-based PHC to policymakers; capacity building for strengthening PHC-oriented health systems with FP specialty training and restrict practising to fully trained FPs; engage communities to improve understanding of PHC; adopt quality and accreditation policies for better services; validation of the referral and follow-up process; and, develop public–private partnership mechanisms to enhance PHC for UHC

Support for UNRWA's survival

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland

Cardiovascular risk and fruit and vegetable consumption among women in KSA; A cross-sectional study

الملخص: أهداف البحث: تهدف هذه الدراسة إلى استكشاف مدى استهلاك الفاكهة والخضروات بين النساء السعوديات لتحديد الفوائد والعقبات المرجوة المرتبطة بالنظام الغذائي الصحي في الوقاية من مخاطر أمراض القلب والأوعية الدموية، ولربط نتائج مقياس فرامنغهام بالعقبات المتصورة. طرق البحث: تم تطبيق استبيان مستوحى من المعتقدات الصحية المتعلقة بمعيار الأمراض القلبية الوعائية، وتم تطبيقه على النساء اللواتي يراجعن مراكز الرعاية الأولية في المملكة العربية السعودية. بالإضافة إلى الإحصاءات الوصفية، تم استخدام اختبار مربع كاي والانحدار الخطي المتعدد لتحديد الارتباط بين تصورات الاستفادة والعقبات باستخدام فئات نتائج فرامنغهام، وبين متوسط نتائج مقياس فرامنغهام والعقبات المتصورة. النتائج: تم استقطاب ما مجموعه ٥٠٣ امرأة في هذه الدراسة، في حين كان ٧٥٪ منهن أكبر من ٤٥ سنة. كان أكثر من ٦٠٪ من النساء بدينات و٩٧٪ يستهلكن حصة إلى ٣ حصص يوميا من الفواكه والخضراوات، وفقط ٤.١٪ يستهلكن خمس حصص أو أكثر في اليوم. كانت غالبية النساء على دراية بفوائد اتباع نظام غذائي صحي للوقاية من الأمراض القلبية الوعائية. ولم يتم تحديد أي اختلاف كبير بين نتائج مقياس فرامنغهام والمنفعة الملموسة أو العقبات. وقد شملت العقبات عبر المجموعات المنخفضة المخاطر إلى العالية المخاطر، نقص المعرفة بالـ “النظام الغذائي الصحي”، وعدم توفر الوقت الكافي للطهي، وتحمل التكاليف، ووجود مشاكل أكثر أهمية. وكان لدى النساء اللاتي اختلفن في العقبات، معاملات بيتا سالبة على متوسط نتائج مقياس فرامنغهام. الاستنتاجات: كان تناول الفواكه والخضروات في هذه المجموعة الدراسية أقل مما هو موصى به في القواعد الإرشادية. وعلى الرغم من الوعي بفائدة اتباع نظام غذائي صحي في الوقاية من الأمراض القلبية الوعائية، فإن عددا قليلا من النساء كان يعرف ما هو “النظام الغذائي الصحي”. لذا لا يمكن التحقق من وجود ارتباط مباشر بين نتائج مقياس فرامنغهام والتصورات/ والعقبات. ولكن يمكن التعامل مع العقبات المتصورة من خلال دمج الحملات التعليمية المستحدثة مع النماذج الموجودة للخطة الغذائية الصحية. Abstract: Objectives: This study aims to assess fruit and vegetable consumption among Saudi women to identify perceived benefits and barriers associated with a healthy diet in cardiovascular disease (CVD) risk prevention and to correlate Framingham risk scores (FRSs) with the perceived barriers. Methods: A questionnaire adapted from the Health Beliefs Related to Cardiovascular Disease Scale was administered to women attending a primary care centre in KSA. In addition to descriptive statistics, a chi-square test and multiple linear regression analysis were used to determine the association between perceptions of benefit and barriers with FRS categories and between mean FRS and perceived barriers. Results: A total of 503 women were included in this study, and 75% of the women were older than 45 years. More than 60% of women were obese, and 97% consumed 1–3 fruit and vegetable servings per day, whereas only 1.4% consumed fruits and vegetables 5 or more times per day. The majority of women were aware of the benefits of a healthy diet in CVD prevention. No significant difference between FRS and perceived benefits or barriers was observed. Barriers across the low- to high-risk groups included a lack of knowledge about a ‘healthy diet’, insufficient time to cook, food affordability, and having more important problems. Women who disagreed on barriers had negative beta coefficients for the mean FRS (p < 0.03). Conclusions: In this study cohort, fruit and vegetable intake was lower than the recommended guidelines. Despite awareness of the benefits of a healthy diet in CVD prevention, very few women understood the true meaning of ‘healthy diet’. A direct association between FRS and perceptions/barriers could not be validated. Perceived barriers could be addressed by integrating innovative educational campaigns to existing models of the Healthy Food Plan. الكلمات المفتاحية: أمراض القلب والأوعية الدموية, النظام الغذائي, نمط الحياة, النساء, المملكة العربية السعودية., Keywords: Cardiovascular disease, Diet, Lifestyle, Women, KS

Small music programs for mental health and well-being: an evaluation framework

There is growing interest in the intersection of music and health, there is a lack of understanding of music’s broader, multifaceted effects on health. Group singing, in particular, has been reported to have benefits on physical, mental, and social health; but interactions between different effects to improve overall health and well-being are not well understood. This paper evaluated group singing programs to develop a three-category framework through organizing raw data to trace interactions amongst various effects of participating in group singing activities. The research population was two programs based in the Royal Borough of Kensington and Chelsea (RBKC), London, UK meant to meet demands for community-serving non-medical interventions: the Sing to Live, Live to Sing in 2016, an adult singing program based in community centers across RBKC, and the (G)uided (L)earning, (U)niting and (E)ducating (GLUE) Sings program, an adolescent music-making and singing program piloted by RBKC’s Tabernacle W11 in 2018. Both programs were found to improve the holistic well-being of participants. The three-category framework was useful in organizing data and showing interactions between effects of singing on health. The framework can be used in future research using mixed methodologies and increasing collaboration amongst funders, researchers, program managers, and policymakers. (PsycInfo Database Record (c) 2021 APA, all rights reserved