THE CHALLENGES, RISKS, AND CONCERNS PERCEIVED BY IRAQI MEDICAL DOCTORS: A CROSS SECTIONAL STUDY

Abstract

Background: The current situation of the health system in Iraq, under the difficult conditions the country has been experiencing, generates great pressures on doctors because they are in the field of confrontation between the growing needs of patients day after day and the dilapidated capabilities and government neglect of the health sector with the absence of security and stability and weak law enforcement.The imposition of state authority has led to an increase in violence in the country in general and against doctors in particular. Moreover, there are other pressures that doctors are subjected to, such as security, economic, professional, social, and psychological pressures, which have led to the emigration of a considerable number of doctors or the exposure of some of them to physical liquidation. Aim: This study was conducted to determine the challenges, risks, and concerns perceived by Iraqi medical doctors, and to explore any possibility of associations to some socio-demographic and professional characteristics of the doctors. Method: A questionnaire form was structured after reviewing several international forms relevant to exploring the participants' opinions and measuring satisfaction. The form was validated by experts and the approved version was uploaded to the Internet and sent to candidate Iraqi medical doctors through Google Forms. A link to the questionnaire survey was sent to them via doctors' WhatsApp groups. Convenience sample was used to collect data from May 30 to June 17, 2020. Results: A total of 606 medical doctors from most of the Iraqi provinces sent their responses to the questionnaire. More than 92% of them held serious concerns,such as a tribal threat. Other challenges included being infected with a serious infection, more than 3 quarters had been exposed to violence, more than half of them have been involved in problems with the administrative and/or judicial authorities, more than 35% consider the government department where they work as the party who protects them. More importantly, about 92.7% of the respondents answered that they do not feel safe/secure. The social enhancers seen by most of the respondents were having a law to protect them, owning a house or a piece of land, and/or having an Association that defends them. Conclusions: The Iraqi medical doctors face considerable physical, economical, psychological, emotional, and social challenges that affect their professional performance and their life. If the same situation remained as such it may lead to the loss of one third of the Iraqi doctors. Especially, after COVID-19 pandemic, many countries are welcoming doctors from abroad, including Iraq. If this is added to the shortage in the doctor-population proportion in Iraq, it means there will be a jeopardizing shortage. Recommendations: Several recommendations have been put to reduce pressure on the Iraqi medical doctors aiming at improving performance, effectiveness, and efficiency. Keywords: doctor challenges, violence, Iraqi doctors, risk of infection, economic impacts