Mapping 123 million neonatal, infant and child deaths between 2000 and 2017.

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.

In response to the Saudi healthcare reform: a cross-sectional study of awareness of and attitudes toward the public health model among health students.

Background: Saudi Arabia's health sector is experiencing a significant transformation toward an emphasis on the public health model. This model is a population-based approach to preventing and controlling disease, and its importance becomes evident during infectious outbreaks and pandemics, such as COVID-19. This study aimed to assess the awareness and attitudes of health students in Jazan toward the public health model. Methods: This study applied a cross-sectional online survey. Data were collected from 3-18 November 2020 using Google Forms. A convenience sampling method was used with a final sample of 425 participants. Results: Most participants (71%) were aware of the public health model, with an average score of 11.36 out of 16. Multiple regression analysis revealed a significant association between the awareness level of the public health model and participants' demographics, namely, gender, major of study, year of study, and prior training in public health. Participants who completed public health training (ß = 0.220) had higher awareness scores than others. On the other hand, participants from public health (ß = -0.342), medicine (ß = 0.164), and nursing in Jazan (ß = 0.128) had higher awareness of the public health model than the reference group (Nursing at Addayer College). Addayer is an area located in the rural northeast of the Jazan region. In addition, final-year students (ß = 0.113) had higher awareness of the public health model than the reference group (year 2 pre-final students). Female participants (ß = -0.142) had lower awareness of the public health model than male participants. Most participants (95.3%) believed that the clinical care and public health models are essential for promoting people's health. However, 4.7% of participants believed that clinical health care is more important than public health. Conclusion: Health students, who are future healthcare professionals, must understand and value the public health model to support the planned health system reforms. It is recommended to evaluate how the education and training of students in public health, medicine, and nursing in Jazan impact the understanding and views of this cohort on the public health model compared to those of students in other health-related majors.

Quality of work life among primary health care nurses in the Jazan region, Saudi Arabia: a cross-sectional study.

BACKGROUND: Quality of work life (QWL) is defined as the extent to which an employee is satisfied with personal and working needs through participating in the workplace while achieving the goals of the organization. QWL has been found to influence the commitment and productivity of employees in health care organizations, as well as in other industries. However, reliable information on the QWL of primary health care (PHC) nurses is limited. The purpose of this study was to assess the QWL among PHC nurses in the Jazan region, Saudi Arabia. METHODS: A descriptive research design, namely a cross-sectional survey, was used in this study. Data were collected using Brooks' survey of quality of nursing work life and demographic questions. A convenience sample was recruited from 134 PHC centres in Jazan, Saudi Arabia. The Jazan region is located in the southern part of Saudi Arabia. A response rate of 91% (n = 532/585) was achieved (effective response rate = 87%, n = 508). Data analysis consisted of descriptive statistics, t-test and one way-analysis of variance. Total scores and subscores for QWL items and item summary statistics were computed and reported using SPSS version 17 for Windows. RESULTS: Findings suggested that the respondents were dissatisfied with their work life. The major influencing factors were unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs, inadequacy of vacations time for nurses and their families, poor staffing, management and supervision practices, lack of professional development opportunities, and an inappropriate working environment in terms of the level of security, patient care supplies and equipment, and recreation facilities (break-area). Other essential factors include the community's view of nursing and an inadequate salary. More positively, the majority of nurses were satisfied with their co-workers, satisfied to be nurses and had a sense of belonging in their workplaces. Significant differences were found according to gender, age, marital status, dependent children, dependent adults, nationality, nursing tenure, organizational tenure, positional tenure, and payment per month. No significant differences were found according to education level of PHC nurses and location of PHC. CONCLUSIONS: These findings can be used by PHC managers and policy makers for developing and appropriately implementing successful plans to improve the QWL. This will help to enhance the home and work environments, improve individual and organization performance and increase the commitment of nurses.

The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia.

BACKGROUND: Quality of work life (QWL) has been found to influence the commitment of health professionals, including nurses. However, reliable information on QWL and turnover intention of primary health care (PHC) nurses is limited. The aim of this study was to examine the relationship between QWL and turnover intention of PHC nurses in Saudi Arabia. METHODS: A cross-sectional survey was used in this study. Data were collected using Brooks' survey of Quality of Nursing Work Life, the Anticipated Turnover Scale and demographic data questions. A total of 508 PHC nurses in the Jazan Region, Saudi Arabia, completed the questionnaire (RR = 87%). Descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression were applied for analysis using SPSS v17 for Windows. RESULTS: Findings suggested that the respondents were dissatisfied with their work life, with almost 40% indicating a turnover intention from their current PHC centres. Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by QWL, p < 0.001, with R2 = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, p < 0.001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables. CONCLUSIONS: Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes.

A Cross-Sectional Study of the Satisfaction with, Adherence to, and Perspectives toward COVID-19 Preventive Measures among Public Health Students in Jazan, Saudi Arabia.

The COVID-19 pandemic has had a significant influence on education systems, educational environments, teachers, and students. This study aims to assess the satisfaction with, adherence to, and perspectives toward COVID-19 preventive measures among public health students in Jazan, Saudi Arabia in order to enhance their campus experience. This study utilized a cross-sectional methodology. Data were collected using convenience sampling between 2-19 November 2020; this was accomplished using an online survey administered via Google Forms. The final sample consisted of 200 participants. More than half of the participants (55.0%) were dissatisfied with the preventive measures that had been applied on campus, while 19.0% had a neutral outlook. Interestingly, female participants showed a higher level of dissatisfaction toward the preventive measures (70.6%) than male participants (43.5%). The ordinal logistic regression analysis revealed a significant correlation between the degree of satisfaction with the COVID-19 preventive measures and the participant's gender and education level. Male students were more likely to be satisfied with the preventive measures (p < 0.029, OR = 2.199) than female students. In addition, final year students were 4.1 times more likely to be satisfied with the COVID-19 preventive measures (p < 0.004, OR = 0.242) than Year 2 students, and 6.2 times more likely to be satisfied (p ≤ 0.001, OR = 0.162) than Year 3 students. Efforts are needed to improve the students' satisfaction with COVID-19 preventive measures. Steps are also required to ensure that the procedures and actions introduced by the college extend to all students. In addition, further research is needed to recognize and understand the participants' experiences after moving to the new buildings, receiving COVID-19 vaccines, and returning to on campus study.

Knowledge, Attitudes, and Practices Toward COVID-19 Among the General Public in the Border Region of Jazan, Saudi Arabia: A Cross-Sectional Study.

Background: The Saudi government had implemented unprecedented preventive measures to deal with COVID-19. These measures included intermittent curfews, bans on public gatherings, limitations on many services, temporary suspension of Hajj, Umrah, and visit and launching awareness campaigns. Therefore, this study aimed to assess the KAP toward COVID-19 among residents of the border region of Jazan, Saudi Arabia. Methods: An online cross-sectional survey was distributed from May 4 to May 21, 2020, using a Google Form. The survey questionnaire covered demographic characteristics and KAP toward COVID-19. The KAP questions consisted of 17 items on knowledge, four items on attitude, and six items on practice. Results: A total of 597 participants responded to the survey questionnaire. Overall, participants demonstrated a good knowledge of COVID-19, correctly answering 77% of the knowledge questions. Most of the participants exhibited good attitudes and acceptable practices toward COVID-19. Multiple regression analysis revealed that participants with a university education (B = 1.75) or post-graduate education (B = 2.24), those with an income >SR 10,000-20,000 (B = 1.38) or >SR 20,000 (B = 2.07), and those who had received a personal health education (B = 1.19) had higher COVID-19 knowledge scores (p < 0.05). The ordinal logistic regression analysis found that compared to being female, being male was significantly associated with worrying about COVID-19 (p = 0.024, OR = 1.78), willingness to receive a COVID-19 vaccine (p = 0.003, OR = 1.81), and willingness to report potential symptoms of COVID-19 (p = 0.046, OR = 2.28). Worrying about COVID-19 was significantly associated with pre-university education vs. post-graduate education (p ≤ 0.001, OR = 7.94) and university education vs. post-graduate education (p ≤ 0.001, OR = 4.17). The binary logistic regression analysis found that compared to being female, being male was significantly associated with less face mask wearing in public (p = 0.009, OR = 0.31): Females were 3.23 times more likely to wear a face mask than were males. Conclusions: Most of the study participants had good knowledge, positive attitudes, and effective practices toward COVID-19. The findings of this study may help guide future awareness resources to the groups most in need in the Jazan region, particularly as the COVID-19 situation develops and changes. Further assessment should consider the groups omitted from this study, including immigrants and the elderly who have not adopted social media and technology.

Development of unit cost for the health services offered at King FAHD Central hospital Jazan, Saudi Arabia.

BACKGROUND: Efficiency remains one of the most important drivers of decision making in health care system. Fund allocators need to receive structured information about the cost healthcare services from hospitals for better decisions related to resource allocation and budgeting. The objective of the study was to estimate the unit cost for health services offered to inpatients in King Fahd Central hospital (KFCH) Jazan during the financial year 2018. METHODS: We applied a retrospective approach using a top-down costing method to estimate the cost of health care services. Clinical and Administrative departments divided into cost centres, and the unit cost was calculated by dividing the total cost of final care cost centres into the total number of patients discharged in one year. The average cost of inpatient services was calculated based on the average cost of each ward and the number of patients treated. RESULTS: The average cost per patient stayed in KFCH was SAR 19,034, with the highest cost of SAR 108,561 for patients in the Orthopedic ward. The average cost of the patient in the Surgery ward, Plastic surgery, Neurosurgery, Medical ward, Pediatric ward and Gynecology ward was SAR 33,033, SAR 29,425, SAR 23,444, SAR 20,450, SAR 9579 and SAR 8636 respectively. CONCLUSION: This study provides necessary information about the cost of health care services in a tertiary care setting. This information can be used as a primary tool and reference for further studies in other regions of the country. Hence, this data can help to provide a better understanding of tertiary hospital costing in the region to achieve the privatization objective.

Children Domestic Accidents Profile in Jazan Region, a call for new policies to improve safety of home environment.

High-frequency home accidents draw more attention to the protection of our home environment. WHO has reported that home deaths were among the first 20 causes of death in the 0-14 age group worldwide in 2012. This innovative research was designed to examine children under 15 years of age at home, in 2018 in the Jazan area of Saudi Arabia. Data were collected retrospectively from 19 hospitals in the Jazan area of southern Saudi Arabia during the period from September to December 2019. Data showed that, for the first time, the incidence rate of child home incidents in the Jazan area was 7.4 per 100 children in 2018. Falling, burning, swallowing foreign bodies, and domestic violence were among the most common types of injuries recorded. Home safety continued to be one of the main public health issues in the area with 29,812 home injuries in 1 year, 36.8% bone fractures, 31.6% body distortions, 9.2% distortion fractures and 5.3% child impairment. This study is a crucial step towards addressing the severity of home accidents in Saudi Arabia; troubling figures need further analysis, regular registry, informed policies and well-planned action to avoid these types of accidents.

Acceptability of the COVID-19 Vaccine and Its Determinants among University Students in Saudi Arabia: A Cross-Sectional Study.

COVID-19 vaccine hesitancy is a significant threat to the efforts that have been taken to combat the pandemic. This study assessed the acceptability of the COVID-19 vaccine among university students in Saudi Arabia. A cross-sectional online survey using a Google Form was conducted between 2 April and 23 April 2021. A snowball technique was used to recruit participants for this study. The final sample consisted of 407 participants. More than one-third of the participants (36.1%) had received the COVID-19 vaccine, and 13.3% had registered to receive the vaccine. Of the participants who were not yet vaccinated (n = 260), 90.4% indicated that they would like to be vaccinated when given the opportunity. Of the unvaccinated participants, 82.3% trusted the COVID-19 vaccines that had been provided in Saudi Arabia. The most reported reasons for the participants' acceptance to receive the COVID-19 vaccine included preventive purposes (95.8%), a belief in the safety of the vaccines (84.3%), and the availability of public awareness information regarding the vaccines (77.3%). A small portion of participants (6.1%) were refusing to receive the vaccine due to the potential long-term side effects (92.0%) and expedited vaccine trials (80.0%). Acceptability of the COVID-19 vaccine was strongly associated with participants who regularly received the flu vaccine (p < 0.05). All other demographic variables were not statistically associated with the acceptability of the COVID-19 vaccine. In conclusion, it would be appropriate for universities to launch peer programs to urge reluctant students to receive the vaccine voluntarily. In terms of further research, it is valuable to follow up with unvaccinated participants to investigate if they received the vaccine since the data were collected, and their reasons for doing so. This research would reveal changes toward vaccine acceptability over time and any related determinants. Future research should consider students from non-Arabic speaking backgrounds.

The public health care system and primary care services in Saudi Arabia: a system in transition.

BACKGROUND: Saudi Arabia has invested heavily in its health care system by establishing health care infrastructures to improve health of the nation. However, it remains to be seen whether it is efficient and effective in providing health care services needed. Primary health care, which is the basis of universal health coverage, needs to be assessed on its performance, challenges and future opportunities to serve the Saudi Arabian population. AIMS: This review aimed to identify challenges within the Saudi Arabian health care system with a focus on primary health care services, and to analyse the interrelated factors in order to suggest remedial reforms to further strengthen and improve the health care system. METHODS: A narrative review of previous studies and governmental reports was undertaken to extract, analyse, synthesize and report the findings. RESULTS: The review found a number of key areas for improvement in the primary health care system. These areas include: the scope, structure, infrastructure, financing, increased demand, increased costs and workforce capacity. Other critical challenges include inequitable access to health services, quality and safety of services, the growing burden of chronic diseases, lack of an effective information system, management and leadership issues, and gaps in the referral system. CONCLUSION: The Saudi Arabian health care system needs comprehensive reform with a focus on primary health care.

Effect of Health Education Programme on the Knowledge of and Attitude about Sickle Cell Anaemia among Male Secondary School Students in the Jazan Region of Saudi Arabia: Health Policy Implications.

This study was conducted to develop an instructional programme on sickle cell anaemia (SCA) and test the effect of the programme on the secondary school students' knowledge of and attitude towards sickle cell anaemia in the Jazan region of Saudi Arabia. A pretest/posttest one-arm interventional study was conducted at the Faculty of Public Health and Tropical Medicine, Jazan University, with a convenience sample of 120 male students. The intervention consisted of two interactive sessions about sickle cell anaemia and premarital screening. The mean student knowledge score was 6.04 ± 3.02 on the pretest, which improved to 10.73 ± 3.47 on the posttest, with a statistically significant difference (t = 15.2, p < 0.001). There was no significant difference in the responses pertaining to attitude before and after the health education intervention. The policy implications of these findings are discussed to improve the performance of the Saudi healthcare system in dealing with this costly inherited disease.