Eastern Mediterranean Health Journal [2022; Vol.28, Issue 6]

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region.

المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه

La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région.

Inequalities in the geographical distribution and workload of obstetrics and gynaecology specialists by gender in Turkey

Background: Women often have a preference for female obstetrics and gynaecology specialists (ob/gyns). Following the policy allowing physician selection by patients in Turkey, distribution of ob/gyns by gender across provinces has been an important indicator of access to healthcare. Aims: To analyse ob/gyns distribution by gender across provinces in Turkey, with emphasis on the relationship with conservativeness of the province and resulting physician workload. Methods: We measured the number of male and female ob/gyns by province in 2016 and the number of outpatient visits and deliveries performed by male and female ob/gyns in 2015. Pearson and Spearman correlation of the female ratio with votes for conservative parties was used to assess the distribution of ob/gyns. We then analysed the correlation with resulting workload of female ob/gyns and ran linear regressions of these variables controlling the number of ob/gyns in a province. Results: More conservative provinces, measured by the vote share for conservative political parties, have a higher ratio of female ob/gyns. Linear regression showed that a 1 percentage point (pp) increase in the vote share corresponded to a 0.69 pp increase in female ratio. For workload, a 1 pp higher female ratio resulted in a decrease in workload, measured as outpatient visits per female ob/gyn divided by that per male ob/gyn, by 0.014. Conclusion: Conservative provinces have more female ob/gyns, but other provinces compensate for that with higher female ob/gyn workload. High workload may have adverse health effects and result in lower quality of care.

Access to safe, timely and affordable surgical, anaesthesia and obstetric care in Pakistan: a 16-year scoping review

Background: Very little is known about the state of surgical, anaesthesia and obstetric care in Pakistan. Aims: This study aimed to assess the literature available on surgical, anaesthesia and obstetric care in Pakistan to understand the strengths and weaknesses of this care based on the domains of the framework of national surgical obstetric anaesthesia plans, namely: infrastructure, workforce, service delivery, information management, governance and service delivery. Methods: Relevant studies in English published between 2003 and 2018 were identified by searching electronic databases including PubMed/MEDLINE, EMBASE and Scopus. Searches of the grey literature were also done for documents of various organizations. Thematic content analysis was conducted to collate, summarize and analyse the data. Results: A total of 2347 studies were identified and screened, of which 57 articles met the inclusion criteria. While national-level surveys, reviews and policy documents provided an understanding of the existing surgical, anaesthesia and obstetric care services in the country, most of the studies were limited in their scope and therefore were not representative of the situation at the national level. In terms of surgical, anaesthesia and obstetric care, the health care infrastructure, availability of services, workforce, financial protection, information management and governance frameworks have failed to develop at the same pace as the needs of the ever-growing population in Pakistan. Conclusions: Our findings can be used to guide future research activities as part of efforts to strengthen the surgical system in Pakistan. Recent government initiatives hold promise for future improvement in access to surgical care.

Эффективная перинатальная помощь и уход – руководство для директора курса

Пакет тренинговых документов по эффективном у перинатальному уходу разработан для улучшения качества перинатального ухода. В нем рассматриваются конкретные проблемы, имеющие место в странах Центральной и Восточной Европы, а также в странах СНГ. Тренинг разработан специально для акушерок, акушеров-гинекологов, неонатологов и педиатрических медсестер, которые работают в родильном стационаре. «Эффективная перинатальная помощь и уход» базируется на существующих материалах, которые были разработаны и использовались Региональным бюро ВОЗ в Европе и государ ствах-партнерах (Основная дородовая, перинатальная и постнатальная помощь и Основной уход за новорожденным и грудное вскармливание), а также на опыте, полученном в некоторых странах Европейского региона за последнее десятилетие. Пакет тренинговых документов был полностью обновлен в сотрудничестве с Европейским бюро ВОЗ, корпорацией JSI и Агентством США по международному развитию. Задачей тренинга по Эффективным перинатальным технологиям является улучшение качества и исходов ухода для матерей, их новорожд енных и семей путем обновления и совершенствования профессиональных и управленческих знаний и навыков медицинского персонала на всех уровнях помощи. В основе обновленных тренинговых материалов по эффективным перинатальным технологиям, а также в основе существующих материалов (Основная дородовая, перинатальная и постнатальная помощь и Основы ухода за новорожденным и грудное вскармливание ) лежат основные принципы и концепции программы Безопасное материнство Европейского бюро ВОЗ.

Effective Perinatal Care – common modules

The Effective Perinatal Care (EPC) training package is a tool developed to improve the quality of perinatal care and to address the specific challenges in the countries of central and eastern Europe and the newly independent states. It is developed specifically for midwives, obstetrician–gynaecologists; neonatologists and paediatric nurses working in maternity. The EPC is based on existing materials developed and used by the WHO Regional Office for Europe and partners (Effective antenatal, perinatal and post-partum care/EAPPC and Effective newborn care and breastfeeding/ENCBF), and the experience gained in several countries of the European Region in the past decade. The package has been fully updated in collaboration by the WHO Regional Office for Europe, JSI and the United States Agency for International Development (USAID). The objective of the EPC training course is to improve the quality and outcome of care for the mothers, the babies and their family by updating and upgrading the professional and managerial knowledge and skills of health care providers at all levels. The foundations of the updated EPC training package, as with the existing materials (EAPPC and ENCBF), are the fundamentals and principles for the WHO Regional Office for Europe Making Pregnancy Safer Programme.

Effective Perinatal Care – midwifery/obstetrical care

The Effective Perinatal Care (EPC) training package is a tool developed to improve the quality of perinatal care and to address the specific challenges in the countries of central and eastern Europe and the newly independent states. It is developed specifically for midwives, obstetrician–gynaecologists; neonatologists and paediatric nurses working in maternity. The EPC is based on existing materials developed and used by the WHO Regional Office for Europe and partners (Effective antenatal, perinatal and post-partum care/EAPPC and Effective newborn care and breastfeeding/ENCBF), and the experience gained in several countries of the European Region in the past decade. The package has been fully updated in collaboration by the WHO Regional Office for Europe, JSI and the United States Agency for International Development (USAID). The objective of the EPC training course is to improve the quality and outcome of care for the mothers, the babies and their family by updating and upgrading the professional and managerial knowledge and skills of health care providers at all levels. The foundations of the updated EPC training package, as with the existing materials (EAPPC and ENCBF), are the fundamentals and principles for the WHO Regional Office for Europe Making Pregnancy Safer Programme.

Effective Perinatal Care – neonatology

The Effective Perinatal Care (EPC) training package is a tool developed to improve the quality of perinatal care and to address the specific challenges in the countries of central and eastern Europe and the newly independent states. It is developed specifically for midwives, obstetrician–gynaecologists; neonatologists and paediatric nurses working in maternity. The EPC is based on existing materials developed and used by the WHO Regional Office for Europe and partners (Effective antenatal, perinatal and post-partum care/EAPPC and Effective newborn care and breastfeeding/ENCBF), and the experience gained in several countries of the European Region in the past decade. The package has been fully updated in collaboration by the WHO Regional Office for Europe, JSI and the United States Agency for International Development (USAID). The objective of the EPC training course is to improve the quality and outcome of care for the mothers, the babies and their family by updating and upgrading the professional and managerial knowledge and skills of health care providers at all levels. The foundations of the updated EPC training package, as with the existing materials (EAPPC and ENCBF), are the fundamentals and principles for the WHO Regional Office for Europe Making Pregnancy Safer Programme.

Effective Perinatal Care – facilitator guide

The Effective Perinatal Care (EPC) training package is a tool developed to improve the quality of perinatal care and to address the specific challenges in the countries of central and eastern Europe and the newly independent states. It is developed specifically for midwives, obstetrician–gynaecologists; neonatologists and paediatric nurses working in maternity. The EPC is based on existing materials developed and used by the WHO Regional Office for Europe and partners (Effective antenatal, perinatal and post-partum care/EAPPC and Effective newborn care and breastfeeding/ENCBF), and the experience gained in several countries of the European Region in the past decade. The package has been fully updated in collaboration by the WHO Regional Office for Europe, JSI and the United States Agency for International Development (USAID). The objective of the EPC training course is to improve the quality and outcome of care for the mothers, the babies and their family by updating and upgrading the professional and managerial knowledge and skills of health care providers at all levels. The foundations of the updated EPC training package, as with the existing materials (EAPPC and ENCBF), are the fundamentals and principles for the WHO Regional Office for Europe Making Pregnancy Safer Programme.

Effective Perinatal Care – course director’s guide

The Effective Perinatal Care (EPC) training package is a tool developed to improve the quality of perinatal care and to address the specific challenges in the countries of central and eastern Europe and the newly independent states. It is developed specifically for midwives, obstetrician–gynaecologists; neonatologists and paediatric nurses working in maternity. The EPC is based on existing materials developed and used by the WHO Regional Office for Europe and partners (Effective antenatal, perinatal and post-partum care/EAPPC and Effective newborn care and breastfeeding/ENCBF), and the experience gained in several countries of the European Region in the past decade. The package has been fully updated in collaboration by the WHO Regional Office for Europe, JSI and the United States Agency for International Development (USAID). The objective of the EPC training course is to improve the quality and outcome of care for the mothers, the babies and their family by updating and upgrading the professional and managerial knowledge and skills of health care providers at all levels. The foundations of the updated EPC training package, as with the existing materials (EAPPC and ENCBF), are the fundamentals and principles for the WHO Regional Office for Europe Making Pregnancy Safer Programme.