The hypertension cascade of care in the midst of conflict: the case of the Gaza Strip.

Although hypertension constitutes a substantial burden in conflict-affected areas, little is known about its prevalence, control, and management in Gaza. This study aims to estimate the prevalence and correlates of hypertension, its diagnosis and control among adults in Gaza. We conducted a representative, cross-sectional, anonymous, household survey of 4576 persons older than 40 years in Gaza in mid-2020. Data were collected through face-to-face interviews, anthropometric, and blood pressure measurements. Hypertension was defined in anyone with an average systolic blood pressure ≥140 mmHg or average diastolic blood pressure ≥90 mmHg from two consecutive readings or a hypertension diagnosis. The mean age of participants was 56.9 ± 10.5 years, 54.0% were female and 68.5% were Palestinian refugees. The prevalence of hypertension was 56.5%, of whom 71.5% had been diagnosed. Hypertension was significantly higher among older participants, refugees, ex-smokers, those who were overweight or obese, and had other co-morbidities including mental illnesses. Two-thirds (68.3%) of those with hypertension were on treatment with one in three (35.6%) having their hypertension controlled. Having controlled hypertension was significantly higher in females, those receiving all medications for high blood pressure and those who never or rarely added salt to food. Investing in comprehensive but cost-effective initiatives that strengthen the prevention, early detection and timely treatment of hypertension in conflict settings is critical. It is essential to better understand the underlying barriers behind the lack of control and develop multi-sectoral programs to address these barriers.

Impact of an educational program on knowledge and practice of health care staff toward pharmaceutical waste management in Gaza, Palestine.

UNLABELLED: In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. Poor knowledge about their potential downstream impacts may be a primary factor for improper disposal behavior. The objective of this study was to determine the impact of an intervention program on knowledge and practice of health care staff regarding pharmaceutical waste management. The study was designed as a pre/posttest intervention study. Total sample size was 530 in the pre-intervention phase, and then a subsample of 69 individuals was selected for the intervention and the post-intervention phases. Paired-sample t test was used to assess the difference between pretest and follow-up test results. A statistically significant improvement in knowledge and practice was achieved (P<0.001). Poor knowledge and poor practice levels (scores<50%) were found to improve to satisfactory levels (scores≥75%). Therefore, educational programs could be considered as an effective tool for changing health care staff practice in pharmaceutical waste management. IMPLICATIONS: In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. A lack of knowledge about the potential impacts of this type of waste may be a leading factor in improper disposal behavior. Following an educational program, statistically significant improvement in knowledge and practice of health care staff as regards to pharmaceutical waste management (PWM) was achieved. It is thus recommended that authorities implement training-of-trainers (TOT) programs to educate health care staff on PWM and organize refreshment workshops regularly.

Weaning practices of mothers attending United Nations Relief and Works Agency health centres in the Gaza Governorates.

AIM: To report a study about weaning patterns and practices among Palestinian mothers attending health centres managed by the United Nations Relief and Works Agency in the Gaza Strip. BACKGROUND: Although breastfeeding and weaning are important domains in child health, weaning has gained little attention from healthcare providers and researchers. In Arab culture, weaning practices are problematic and information gaps exist in relation to how and when weaning takes place. DESIGN: A descriptive/analytical cross-sectional study. METHODS: A multi-stage stratified random sample of 285 mothers of infants from 6-24 months, attending six health centres, was selected and completed an interviewed questionnaire in 2009. The Statistical Package for Social Sciences Program was used to conduct descriptive and analytical analysis. RESULTS: The rate of exclusive breastfeeding for infants from 0-6 months of age was low. Pregnancy was reported as the main reason for weaning. The mean weaning age was 13.5 months. The vast majority of mothers used sudden weaning, from them, the majority used traditional methods. The most popular traditional methods used by mothers were putting substances with bad taste especially aloe vera (Subra Murra) on the nipples, using of alternatives as pacifiers, putting red substances, and placing coffee on the nipples. Variations were found in the use of traditional methods in reference to mothers' demographic characteristics. CONCLUSION: During counselling mothers, nurses should focus on promoting gradual weaning practices and abstain from using traditional methods. Also, nurses should receive training and supervision on the appropriate weaning practices.