Determinants of social accountability for medical schools in Iraq: A qualitative case study.

Background: The mandate of medical schools is to enrich the health system through education, research, and service to satisfy the health needs of the societies they serve. The social accountability (SA) movement aims to intensify the medical school's mission. Although the context of every school is unique, one of the increasingly significant roles of medical education is to develop the indicators that promote SA. The aim of this study is to define the determinants of SA in Iraq using AlKindy College of Medicine/University of Baghdad, Baghdad, Iraq as a case study. Methods: This is a qualitative research using open-ended questions through an online mode; data were analyzed using the content analysis technique. Results: Different themes related to the roles of medical schools, stakeholders, medical schools' mission, curriculum content, research characteristics, service characteristics, enhancers of SA, and accreditation role were identified. The themes are meant to characterize a socially accountable medical school within the context of Iraq. Discussion: The study needs to be replicated in different medical schools to successfully build the national determinants of SA.

Feasibility and acceptability of text messaging to support antenatal healthcare in Iraqi pregnant women: a pilot study.

OBJECTIVE: To determine the feasibility and acceptability of mobile health technology and its potential to improve antenatal care (ANC) services in Iraq. METHODS: This was a controlled experimental study conducted at primary health care centers. One hundred pregnant women who attended those centres for ANC were exposed to weekly text messages varying in content, depending on the week of gestation, while 150 women were recruited for the unexposed group. The number of ANC visits in the intervention and control groups, was the main outcome measure. The Mann-Whitney test and the Poisson regression model were the two main statistical tests used. RESULTS: More than 85% of recipients were in agreement with the following statements: "the client recommends this program for other pregnant women", "personal rating for the message as a whole" and "obtained benefit from the messages". There was a statistically significant increase in the median number of antenatal clinic visits from two to four per pregnancy, in addition to being relatively of low cost, and could be provided for a larger population with not much difference in the efforts. CONCLUSIONS: Text messaging is feasible, low cost and reasonably acceptable to Iraqi pregnant women, and encourages their ANC visits.

Health services in Iraq.

After decades of war, sanctions, and occupation, Iraq's health services are struggling to regain lost momentum. Many skilled health workers have moved to other countries, and young graduates continue to leave. In spite of much rebuilding, health infrastructure is not fully restored. National development plans call for a realignment of the health system with primary health care as the basis. Yet the health-care system continues to be centralised and focused on hospitals. These development plans also call for the introduction of private health care as a major force in the health sector, but much needs to be done before policies to support this change are in place. New initiatives include an active programme to match access to health services with the location and needs of the population.

Toward a healthier Iraq.

Health care in Iraq is the sector most influenced by variables such as political, cultural, social, and economic environments. The current status of national security, the deterioration of infrastructure, difficulty in accessing clean water and sewage services in some areas, and the national levels of poverty, malnutrition, and social fragility are all factors that negatively affect the health of the Iraqi people [1]. There is a real need for a solid national health policy that is able to match the available resources against the health needs of a growing population, as provided in the Constitution of Iraq and National Development Plan, and oriented to a set of strategies and objectives that can drive development of the Iraqi health sector in the future [2]. Establishment of a fair and comprehensive national health system requires sustainable commitment to this policy by all stakeholders and partners in order to focus efforts and achieve synergy in the optimal investment of available resources and to provide health care services and attain maximum effectiveness and efficiency of systemic response to the health needs of the Iraqi people and society.

Global health diplomacy in Iraq: international relations outcomes of multilateral tuberculosis programmes.

BACKGROUND: International development programmes, including global health interventions, have the capacity to make important implicit and explicit benefits to diplomatic and international relations outcomes. Conversely, in the absence of awareness of these implications, such programmes may generate associated threats. Due to heightened international tensions in conflict and post-conflict settings, greater attention to diplomatic outcomes may therefore be necessary. We examine related 'collateral' effects of Global Fund-supported tuberculosis programmes in Iraq. METHODS: During site visits to Iraq conducted during 2012 and 2013 on behalf of the Global Fund to Fight AIDS, Tuberculosis and Malaria, on-site service delivery evaluations, unstructured interviews with clinical and operational staff, and programme documentary review of Global Fund-supported tuberculosis treatment and care programmes were conducted. During this process, a range of possible external or collateral international relations and diplomatic effects of global health programmes were assessed according to predetermined criteria. RESULTS: A range of positive diplomatic and international relations effects of Global Fund-supported programmes were observed in the Iraq setting. These included (1) geo-strategic accessibility and coverage; (2) provisions for programme sustainability and alignment; (3) contributions to nation-building and peace-keeping initiatives; (4) consistent observation of social, cultural and religious norms in intervention selection; and (5) selection of the most effective and cost-effective tuberculosis treatment and care interventions. CONCLUSION: Investments in global health programmes have valuable diplomatic, as well as health-related, outcomes, associated with their potential to prevent, mitigate or reverse international tension and hostility in conflict and post-conflict settings, provided that they adhere to appropriate criteria. The associated international presence in such regions may also contribute to peace-keeping efforts. Global health programmes may frequently produce a wider range of 'collateral benefits' that conventional monitoring and evaluation systems should be expanded to assess, in keeping with contemporary efforts to leverage development programmes from a 'global health diplomacy' perspective.

Addressing the health-related SDGs in the Eastern Mediterranean Region: Regional Health Alliance strengthens collaboration towards better health.

The United Nations launched the Sustainable Development Agenda 2030 and its 17 Sustainable Development Goals (SDGs) in 2015, as a more detailed and ambitious follow-up to the Millennium Developments Goals (MDGs). Health and wellbeing of all, at all ages, is addressed by the third SDG (SDG3) and health-related targets of other SDGs. However, progress to date on the health-related SDGs in the Eastern Mediterranean Region (EMR) is not on track. Although there was progress in over half of the 50 health-related SDG targets and indicators between 2015 and 2019, there is still a long way to go. Progress is required, among others, in reducing maternal, child and neonatal mortality; increasing vaccination coverage; reducing the number of cases of malaria and HIV; and in tackling the increase in mortality rates due to noncommunicable diseases. Much progress is needed in many health-related SDGs considered as important social, economic and environmental determinants of health.