The Balanced Scorecard as a Performance Management Tool in the Healthcare Sector - The Case of the Medical Commission Department at the Ministry of Public Health, Qatar.

Background The balanced scorecard (BSC) system provides the basis for developing and executing a good strategy and successfully managing change at the institutional level. Moreover, developing a BSC performance system at the Medical Commission Department (MCD) in Qatar will enable stakeholders to approach their organization and work in a more strategic manner. Methods A descriptive cross-sectional survey was conducted to determine the need of employees at the MCD for the BSC, as a performance management tool, to attain the organizational objectives. Thus, a simple random sample was employed to enroll 199 participants. Also, a self-administered validated English and Arabic survey tool was employed to collect socio-demographic characteristics and encompassed 20 questions on the needs assessment for BSC. Results The response rate was high (97.5%) while the scoring indicates difficulty in successfully executing the MCD strategy and meeting the needs of their customers. The results showed a medium score of need to implement the BSC (score =59.9±9.7). The BSC needs score was strongly associated with the item "Our employees have a solid understanding of the mission, vision, and strategy" and it was higher among nationals as well as those with a higher level of education. Conclusion The BSC system provides the basis for properly executing a strategy and successfully managing change in an organization. Thus, building a BSC performance system at the MCD will enable employees to think in a more strategic way about their organization and their work. It will also bring change in the way things are done, as new policies and procedures will be developed and be implemented accordingly.

Knowledge and Practice of Emergency Physicians Regarding Food-borne Disease Surveillance at Hamad General Hospital in Qatar.

Introduction According to the World Health Organization (WHO), foodborne diseases (FBD's) have become a global health issue. In Qatar, foodborne diseases are among the top ten events reported to the Ministry of Public Health. Efforts to enhance FBD surveillance cannot succeed without involving the emergency department (ED), which is typically the first point of contact for the FBD victims with the healthcare system. Therefore, we aimed to explore the knowledge and practices of emergency physicians regarding stool sample collection as part of FBD surveillance efforts in Qatar. Methods A cross-sectional study was conducted at the ED of Hamad General Hospital (HGH) between July 22 and September 12 of 2018. The enrolled participants were invited to participate in an online survey at the "QSurvey" platform. The data was analyzed using Microsoft Excel (Version 2016). Descriptive statistics such as frequency tables, proportions, and percentages were applied as appropriate. Results A total of 65 responses (response rate: 29.27%) were received within the duration of the study. Most participants were specialists (45%), graduated between 2000 and 2013 (64%), and worked for one year or more at HGH-Hamad Medical Corporation (95%). Regarding their knowledge of FBD surveillance, most participants (80%) reported that a stool culture is a necessary laboratory investigation for patients with acute bloody diarrhea and fever. Also, a large percentage of physicians identified salmonella (75%), Clostridium difficile (70%), and E.coli O157:H7 (70%) as pathogens of nationally notifiable diseases. Regarding the respondents' practice towards FBD surveillance, almost three-quarters of the physicians (72%) who encountered a patient with acute diarrhea did not order a stool culture. Subsequently, about two-thirds (62%) of the participants who requested a stool culture reported not following up on the results of such request. Regarding the history taken from patients with acute diarrhea, a large percentage of respondents reported asking about the patient's travel history (100%), presence of any sick contacts (93.6%), and presence of any associated symptoms (abdominal pain, fever, bloody stool) as well as other details. Conclusion The current research identified several gaps regarding the knowledge and practice of emergency physicians towards the surveillance of foodborne disease. Such results serve as a basis for future research and intervention strategies to augment surveillance activities related to food-borne diseases in the State of Qatar.

An Evaluation of the National Brucellosis Surveillance System in Qatar, 2018.

Introduction Brucellosis is one of the most prevalent bacterial zoonoses and is considered an economically important infection that affects humans and livestock. The infection is usually transmitted to humans through direct contact with infected materials, such as the afterbirth, or indirectly through the ingestion of animal products. In addition, the consumption of raw milk represents a major source of the infection. In the Eastern Mediterranean region, the incidence of brucellosis ranges from one per 100,000 to 20 per 100,000; however, the actual figure is estimated at 20 to 25 times greater owing to the poor surveillance systems among countries in the region. For such reasons, this study is conducted to comprehensively evaluate the brucellosis surveillance system in Qatar, to identify potential strengths and limitations and, hence, inform decision-makers about future mitigation strategies. Methods A retrospective record review was conducted at the surveillance unit in the Ministry of Public Health (MoPH) to analyze all Brucella notification forms from January to November 2018 for the completeness of notification and timeliness of reporting. The principal investigators conducted data abstraction and analysis in November 2018. Results A total of 125 notification forms were analyzed. It was revealed that the internal completeness varied across the different data elements of the notification forms from 39% up to 100%. Also, the timeliness of the reporting ranged from one day for the T3 time point up to 16 days for the T1 time point. Conclusion Ultimately, the strengthening of the national Brucellosis surveillance system in Qatar demands the implementation of several strategies, including the establishment of veterinary surveillance, enforcement of livestock importation protocols, as well as routine compulsory vaccinations, devising a clear and sensitive case definition of the disease, and public education especially among high-risk groups (shepherds, slaughterhouse workers, and laboratory workers). In addition, continuous education of healthcare workers on the proper reporting of the disease and the electronization of the notification process are important steps to improve the surveillance system in the country.

Violence among Adolescents in Qatar: Results from the Global School-based Student Health Survey, 2011.

Background Despite being a neglected issue in adolescent health, interpersonal violence such as physical fighting constitutes a prominent cause of physical injuries in adolescents. Aim We aimed to study the prevalence of physical fighting and its associated factors among Qatar's adolescent population. Method We analyzed secondary data from Qatar's Global School-based Student Health Survey (GSHS) 2011 to determine the prevalence as well as the associated factors of being engaged in a physical fight in the last 12 months. Results It was found that almost half of the participants (49%) were involved in a physical fight; mostly males (60.5%) than females (37.6%). Being bullied, smoking, and having parental supervision were positively associated with physical fighting (OR = 3.97, 95% CI (3.68, 4.28); OR = 1.78, 95% CI (1.61, 1.97); OR = 1.14, 95% CI (1.05, 1.23), respectively). Conclusion Further behavioral research on adolescent violence will inform the development of youth-targeted violence prevention programs.

Evaluation of the Completeness and Timeliness of National Malaria Surveillance System in Qatar, 2016.

Background The high influx of migrant workers from malaria-endemic countries along with the presence of a malaria vector in Qatar has raised the alarm of the possible reintroduction of local transmission. Meanwhile, the Qatar Malaria Surveillance System aims to detect any local malaria transmission as well as to monitor trends in imported cases. Aim Evaluating the attributes of the Malaria Surveillance System in Qatar will help identify any gaps necessitating rectification. Method The completeness and timeliness of the malaria surveillance system were determined. The direct method was used to determine completeness. Timeliness was evaluated by calculating the time lag between the onset of disease and notification receipt by the surveillance team (T) or diagnosis (T1) and between the diagnosis and receipt of notification by the surveillance team (T2). Results The overall external completeness of Malaria surveillance system was yielded at 47% (219/493). The most frequently reported data fields were found to be age, gender, and nationality with a percentage of 99% or more. However, the least reported data components were found to be lab results, types of samples, sample collection, and travel destinations with percentages of 59%, 58%, 56%, and 41%, respectively.The overall median time lags was six days for T, four days for T1, and two days for T2. Conclusion Our study has identified several merits and areas of improvement in the National Malaria Surveillance System in Qatar. The attributes of evaluation, completeness and timeliness, need more quality improvement. Evaluation of other surveillance system attributes is highly recommended.

Knowledge, Attitude, and Practice Regarding Zika Among Travelers to Brazil: Qatar's Airport Study 2017.

Background The Zika virus has become an international health issue and poses a systematic risk for a growing number of travelers. Qatar is no exception to this status, where its Hamad International Airport (HIA) has become an important hub for many travelers to and from affected countries. Thus, it is a national necessity to determine the knowledge, attitude, and practice of travelers' regarding this emerging disease in the State of Qatar. Methods This was a cross-sectional study that employed a self-administered questionnaire (n=100) and was conducted at Hamad International Airport. Descriptive and inferential statistical tests were applied to analyze the data using the Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics 21, IBM Corporation, Armonk, NY, USA, 2014). Results The majority of travelers (75%) reported hearing about the Zika disease prior to their current flight, mainly from the media (73%) and the internet (46%). The majority of participants (69%) knew about the vector-borne transmission and symptomatology of a Zika infection while more than half (54%) correctly identified effective methods to prevent infection. Regarding their attitude, less than two-thirds (58%) of the participants agreed that pregnant women must postpone their travel to any Zika-affected area. Regarding their practice, only a quarter of the sampled travelers (24%) sought pre-travel medical advice before going to Brazil. Comparing the knowledge score among different education levels, we found that high-school students scored significantly better than those with diplomas and bachelors, p=0.042 and p=0.012, respectively. Conclusion The survey findings revealed that the knowledge of Zika infection is low among travelers to Brazil. Thus, stronger efforts to educate travelers about Zika are recommended. It is also vital that travelers be encouraged to seek proper medical advice prior to travel.

The Baby-friendly Hospital Initiative and Qatar, 2016.

Breastfeeding instills countless benefits that extend beyond the infant and child to the entire nation. One of the global targets set by the WHO to improve maternal, infant, and young child nutrition is to increase the rate of exclusive breast-feeding "in the first 6 months" up to at least 50% by 2025.3 Thus, as a global endeavor to promote and sustain breastfeeding, the WHO and UNICEF launched the Baby-friendly Hospital Initiative (BFHI) 1 year after the Innocenti Declaration of 1990. Regarding the State of Qatar, there was a 34% rate of early initiation of breastfeeding "within the first hour of birth" and a 29% rate of exclusive breastfeeding between 2010 and 2015. In Qatar during 2016, many obstacles in achieving the aforementioned global target remained. In addition, there are still no hospitals with a BFHI accreditation.

Assessing health beliefs about osteoporosis among women attending primary health care centres in Qatar.

OBJECTIVE: Osteoporosis is a global health problem, and its prevalence is rapidly increasing worldwide. Misconceptions about osteoporosis and the lack of preventive measures among women are still common, emphasizing the need for primary prevention at an early age. The process of planning an effective osteoporosis prevention programme requires sufficient information about women's osteoporosis health beliefs. The objective of this study is to assess the health beliefs of 20-44 year-old Arab women about osteoporosis at primary health care centres in the State of Qatar. METHODS: The researchers utilized a cross-sectional study design, where cluster sampling with proportionate allocation was employed to enrol 766 eligible women who were interviewed using a structured Arabic questionnaire. RESULTS: The majority of the participating women showed lower perceived susceptibility to osteoporosis (71.7%) but higher perceived benefits of preventive practices (91.7%). CONCLUSION: Despite lower perception of susceptibility to osteoporosis, women were highly motivated to take care of their health and believed in the benefits of a calcium-rich diet and regular exercise. The integration of osteoporosis prevention into women's health programmes at the primary health care level, as well as physical activity and nutritional programs, are recommended.