Primary Health Care Centers Research Articles

Satisfaction of Mothers on Accessibility to Basic Health Units in Rawalpindi

Objective: The goal of the study was to evaluate the satisfaction of mothers with Accessibility to Basic health units of Rawalpindi. Methodology: A descriptive study was conducted at the basic health units of Rawalpindi to assess the mother's expectations, experiences, and satisfaction regarding accessibility to primary health care centers. 275 patients participated in the study by answering the structured questionnaire. Results: The study revealed that most patients are not satisfied with Accessibility to Basic Health units with an overall dissatisfaction score of 46%. Conclusions: Improvement in accessibility to the health care center will reduce the gap between satisfaction and expectations. This study will help know the in-depth views of patients regarding accessibility to the basic health units. It can provide an opportunity to healthcare providers and policymakers to be more appreciative of patient views. Based on the findings, recommendations are made for improving the Accessibility of patients. Key Words: Patient satisfaction, accessibility, and primary healthcare center.

Impact of the COVID-19 lockdown on the O'Sullivan test and gestational diabetes mellitus diagnosis in pregnant Spanish women

ObjectiveTo analyze the impact of COVID-19 lockdown on serum glucose levels of pregnant women. DesignA retrospective analysis of O'Sullivan test in pregnant women who underwent COVID-19 lockdown compared to controls. SitePoniente Primary Health Care center in Córdoba (Spain). Participants235 pregnant women from 23+0 to 25+0 weeks of gestation without diabetes mellitus. InterventionsGestational diabetes mellitus screening with O'Sullivan test and 3-h oral glucose tolerance test. Main measurementsPregnant women who underwent gestational diabetes mellitus screening with O'Sullivan test before (control group) and during COVID-19 Lockdown (Lockdown group) in Córdoba (Spain) were investigated. Lockdown group was divided in early and late lockdown. An additional, control group from data of the same months of the Lockdown in the previous year were recorded to discarded seasonally (adjusted seasonally control) this group was also divided in early and late seasonally adjusted.A logistic regression model for O'Sullivan test has been performed to analyze potential cofounders. Kolgomorov–Smirnov and Kruskal–Wallis test comparing pregnant women who underwent COVID-19 lockdown with the two types of controls. ResultsStatistically significant differences were found in serum glucose after O'Sullivan test between lockdown group and control group (123.51±26.02mg/dL and 112.86±31.28mg/dL; p=0.017). When early lockdown group and control group were compared no differences were found (119.64±26.18mg/dL vs. 112.86±31.28mg/dL; p>0.05) whereas differences were observed in late lockdown group and control group (127.22±25.59mg/dL vs. 112.86±31.28mg/dL; p=0.009). Statistical trends were also found between lockdown group and seasonally adjusted group and between lockdown and late seasonally adjusted group (p=0.089). A higher proportion of positive O'Suvillan pregnant women who were subsequently diagnosed with GDM were found in lockdown group compared to the seasonally adjusted control group (60% vs. 26.06% respectively; p<0.05). ConclusionsThe COVID-19 lockdown was associated with an increase in serum glucose levels after the O'Sullivan test as well as a higher GDM diagnosis risk in pregnant women. The findings of our study emphasize the essential requirement for comprehensive maternal services and the accessibility to community's health assets during future lockdown scenarios to pregnant women.

Factors Influencing Officer Compliance in the Implementation of Integrated Management of Childhood Illness (IMCI) at Community Health Center in Banda Aceh City

Integrated Management of Sick Toddlers (IMCI) is an integrated approach to improving child health and well-being, which aims to reduce morbidity and mortality and promote growth and development of children under five. Despite its importance, challenges in the quality of IMCI implementation in PHC centers still exist. This research aimed to identify factors that influence staff compliance in implementing IMCI at health centers in Banda Aceh city. This research method used an analytic observational research with a cross-sectional design, involving 64 IMCI service providers from November 2023 to June 2024. Data were collected using questionnaires and analyzed using the chi-square test and multivariate logistic regression. The results showed that staff compliance in implementing IMCI was 39%. Internal factors that significantly influenced compliance were motivation (OR=14.3, 95% CI: 3.039-67.505) and knowledge (OR=8.63, 95% CI: 1.694-43.978). External factors included the availability of complete logistics facilities (OR=8.05, 95% CI: 1.706-38.04). This research identified Ulee Kareng Health Center as having the highest number of PIA service providers (17%), while Banda Raya Health Center had the lowest number (7%). Most of the PIA service providers were aged 19-44 years (68.8%), mostly female (96.9%), and had high educational qualifications (93.7%). The implications of this research underscore the important role of motivation, knowledge, and logistical support in improving staff adherence to IOP protocols. The results of this research have implications for strengthening health care systems and improving the quality of IYCF implementation to meet the health needs of children under five in Banda Aceh city.

Knowledge and attitudes of nurses toward caring of older people in primary health-care centers at South of Jordan

Purpose This study aims to assess the knowledge and attitudes of 420 nurses toward caring for older people in primary health-care centers in the southern region of Jordan. Design/methodology/approach Data collected through an electronic survey was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23.0. Findings The findings revealed that 91.0% of nurses had limited knowledge, with only 7.1% demonstrating average knowledge and 1.9% showing good knowledge about older people care. Furthermore, 85.2% of participants held neutral attitudes toward aged care, while 12.4% had positive attitudes and 2.4% exhibited negative attitudes. A significant correlation was observed between knowledge and attitude scores (p-value = 0.000). Gender and marital status were found to influence attitudes, with significant statistical relationships (p-values: gender = 0.000, marital status = 0.004). These results emphasize the importance of improving nursing education in geriatric care and promoting positive attitudes toward caring for older people patients. Practical implications The study highlights the need for ongoing professional development to enhance patient outcomes and the quality of care for the older people population. Further longitudinal research and comparative analyses are recommended to deepen the understanding of knowledge and attitudes across various health-care settings. Originality/value The study revealed a significant correlation between nursing practitioners’ knowledge and attitudes toward geriatric care, with gender and marital status significantly influencing attitudes, while age did not. This underscores the need for further research.

Readiness of primary healthcare and community markets for joint delivery of cardiovascular disease prevention services in Kenya: an observational feasibility study of Health Kiosks in Markets (HEKIMA)

ObjectivesThe increasing burden of cardiovascular diseases (CVDs) in Kenya threatens its healthcare system. There is a need for innovative models that improve equitable access to CVD prevention services. Community markets...

Machine Learning Approaches to Predict No-Shows in Saudi Arabian Primary and General Healthcare Settings

Introduction Frequent no-shows in health care appointments pose significant challenges, leading to wasted resources and suboptimal patient outcomes. Traditional mitigation methods, such as reminder messages and phone calls, often fall short, particularly in regions with less robust healthcare infrastructures. This study leverages machine learning techniques to develop a predictive model that identifies patients at high risk of missing appointments using data from the Mawid scheduling system in Southern Saudi Arabia. Methods A retrospective cross-sectional design was employed, focusing on visits to primary healthcare centers [PHCCs] and general hospitals. Data spanning 10 months from June 2023 to March 2024 were collected from Mawid, encompassing over one million observations and 18 features, including appointment details, patient demographics, and weather conditions. Machine learning models, such as Decision Trees, Random Forests, Naive Bayes, Logistic Regression, and Artificial Neural Networks [ANN], have been developed and evaluated based on accuracy, precision, recall, F1 Score, and Area under the curve (AUC). Results The findings revealed that 55.07% of appointments were not attended. The Random Forest model exhibited superior performance with an accuracy of 0.765 and an AUC of 0.852, particularly when weather-related features were included. The ANN models also performed robustly with an AUC value of approximately 0.836. This study identified significant regional, seasonal, and environmental factors affecting no-show rates, with higher no-show rates occurring during certain months and under specific weather conditions. Regular appointments and PHCCs showed different attendance patterns than hospitals, while walk-in appointments did. Conclusion Machine learning models, particularly Random Forests and ANNs, can effectively predict healthcare appointment no-shows, thereby allowing for better resource allocation and patient care. Recognizing the influence of regional and environmental factors is crucial for developing targeted interventions to reduce the no-show rates. Future research should explore integrating more contextual data to further refine these predictive models and to enhance healthcare delivery and operational efficiency.

Prevalence and Antibiotic Susceptibility Profile of Uropathogenic ESBL-producing Klebsiella pneumoniae in Keffi Metropolis, Nigeria

Urinary tract infection (UTI) remains the most common bacterial infection in humans despite the widespread availability of antibiotics. Exteded spectrum beta-lactamase production is an important mechanism of antibiotic resistance in the Enterobacteriaceae. Antibiotic resistance is a rising dilemma of significant implications on global public health. Few data exist for the prevalence and trends of Klebsiella pneumoniae antibiotic resistance in Keffi metropolis Nigeria. This study was done to determine the prevalence of ESBL-producing K. pneumoniae as well as its antibiotic susceptibility pattern regarding some predisposing factors. Aim: This study was carried out to determine the prevalence and antibiotic susceptibility pattern of uropathogenic K. pneumoniae in Keffi metropolis, Nigeria. Methodology: The current study was a carried out in Keffi, Nasarawa state, Nigeria from July to October 2024. It was a cross-sectional study comprising of 160 early morning urine samples randomly collected from consenting participants in the six selected hospitals. Isolation and identification of K. pneumoniae was done using standard microbiological methods. The antibiotic susceptibility profile of isolates was carried out using the Kirby-Bauer disc diffusion method and interpretation was done following the Clinical and Laboratory Standards Institute protocol. Results obtained in this study were analysed using Smith’s Statistical Package (version 2.8, California, USA) and P value of ≤ 0.05 was considered statistically significant. Results: The result of this study revealed an overall prevalence of 20/160 (12.5%). The highest prevalence of the isolate was seen in females 14(8.75) compared to males 6 (3.75%), while the highest prevance regarding age was recorded among the 15-34 age group 12 (7.5%) while the least was recorded among those greater than 65 years 0 (0%). Furthermore, the highest number of isolate was recorded at FMCK 7 (4.4%) followed jointly by GHK and PHC TK 4 (2.5%) with PHC, KP and PHC AJ 1 (0.63%) beign the least respectively. There was a high level of resistance to ceftazidime 20 (100%), followed jointly by ceftriaxone, cefurexime and treptomycin 19 (95%) and augmentin 18 (90%) but low to amoxicillin 6 (30%) and ofloxacin 6 (30%) respectively. Most of the isolates tested were multidrug resistant and all were extended spectrum beta lactamase (ESBL) producing. Conclusion: The relatively high detection rate of multidrug resistant uropathogenic K. pneumoniae in this study calls for concern. More concerning is the isolation from primary health care centers (PHCs) signifying the importance of universal health coverage and the place of PHCs in antimicrobial stewardship (AMS) programs as one of the strategies to control the spread of antimocrobial resistance.

Physiotherapists as first-contact practitioners for patients with low back pain in French primary care: a pragmatic cluster randomised controlled trial.

A new model of care enables French physiotherapists (PT) working in collaboration with family physicians (FP) to expand their usual scope of practice for patients with acute low back pain (LBP). The aim of our study is to evaluate the impact of this new first-contact physiotherapy (FCP) advanced practice model compared to usual FP care. A multicentre pragmatic non-inferiority cluster randomised controlled trial (RCT) has been conducted in six multidisciplinary primary healthcare centres in France. Patients from 20 to 55 years old with acute LBP consulted either the PT or the FP. PT independently assessed and managed patients including medication prescription. The primary outcome measure was disability at six weeks (Roland Morris Disability Questionnaire, range 0-24). Secondary outcomes include pain, risk disability prognosis, satisfaction with care, healthcare resources use and wait times. Data were collected at baseline, six and twelve weeks. Outcomes across arms were compared using mixed models regression analysis. Except for non-inferiority analysis of the primary outcome measure, other analyses were performed with a two-sided significance level of 0.05. Sixty patients were recruited (PT: 32, FP: 28). The adjusted mean difference between groups for disability at 6 weeks was 0.39 in favour of the FP group (95%CI: -2.03; 2.81, p = 0.753). Considering a 5 points minimal clinically important difference, the FCP-led model of care was not inferior to usual FP care for the primary outcome. There was no statistically significant difference between groups in disability at 3 months and pain at 6 weeks and 3 months. PTs prescribed significantly less medications than FPs (p < 0.001). No statistically significant difference was found for other healthcare resource use outcomes, patients' satisfaction and wait times. This is the first RCT to evaluate the impact of a FCP advanced practice model of care including medical delegated acts in a primary care setting. Our results suggest that the FCP-led model of care is not inferior to usual FP care regarding disability at 6 weeks. The FCP model could result in possible benefits in terms of healthcare resources use. Further adequate powered studies with larger sample size are needed to draw stronger conclusions. The study has been registered in ClinicalTrials.gov (NCT05200533) on the 20th of January 2022.

Assessing Associations of Nurse-Managed Hypertension Care on Pharmacotherapy, Lifestyle Counseling, and Prevalence of Comorbid Cardiometabolic Diseases in All Patients With Hypertension That Are Treated in Primary Care in Stockholm, Sweden.

The aim was to study if nurse-managed hypertension care was associated with differences in pharmacotherapy, lifestyle counseling, and prevalence of comorbid cardiometabolic diseases among patients receiving care at primary health care centers. To assess the extent of nurses' involvement in the hypertension care, a questionnaire was distributed to all primary health care centers in Region Stockholm. Age-adjusted logistic regression models were used to analyze the results, odds ratios with 99% confidence intervals. Data was acquired from VAL, the administrative databases of Region Stockholm in Sweden, encompassing all individuals 30 years or older with a registered hypertension diagnosis who attended to the primary health care center they were registered at. Our analysis comprised 119267 patients diagnosed with hypertension registered in one of the 224 included primary health care centers. Of the 81 primary health care centers that responded to the questionnaire, 54 reported having nurse-managed hypertension care. Nurse-managed hypertension care was not significantly associated with differences in pharmacotherapy or patients' comorbidity, except for diabetes. Primary health care centers with nurse-managed hypertension care had a 10% greater adherence to national guidelines for lifestyle counseling (33.5%) compared to those without nurse-managed hypertension care (22.5%). Regardless of the organizational form of hypertension care management, more men received lifestyle counseling according to guidelines compared to women. In-house routines for hypertension care, with designated nurses, and booking systems were associated with more lifestyle counseling, which has been associated with signs of better hypertension care.

Increased use of Dermoscopy in Primary Healthcare Following the Implementation of Teledermatology in Southeast Sweden: A Retrospective Cohort Study of 2,137 Patients.

In the last 5 decades there has been a steady increase in skin cancer incidence globally. As patients wait for treatment before or after referral, the prognosis for those with melanoma worsens. Teledermatology was introduced to help reduce waiting times. The objective of this study was to investigate how the introduction of teledermatology affected management of skin tumours, from primary care physicians to dermatologists. A retrospective cohort study was performed 1 year before and 1 year after introduction of teledermatology in Östergötland County, Sweden. Patients were included from 3 primary healthcare centres by 3 independent observers. A total of 2,139 patients were included in the study. The 2 cohorts were well matched. At 2 of the 3 primary healthcare centres there was a significant increase in the use of dermoscopy, and almost 66% of all referrals were teledermatological in the year following its introduction. There was a trend towards higher diagnostic accuracy in the post-teledermatology cohort. No apparent effect on melanoma referral times was observed. The results of this study confirm previous findings showing the value of teledermatology as well as a novel finding of an increase in dermoscopy use in primary healthcare settings.

The effect of interhospital transfer on pediatric burn injury mortality in a resource-limited setting.

The World Health Organization's burn mortality estimate is 180,000 annually. Ninety-five percent of all mortality caused by fire-related burns worldwide occurs in low- and middle-income countries (LMICs). Prior studies have shown that transfer status (direct transfer from an injury scene to a trauma center vs. indirect transfer from another health facility) affects patient outcomes. We evaluated the effect of interhospital transfer on burn mortality. We analyzed a burn database of pediatric patients admitted to the Kamuzu Central Hospital (KCH) burn unit in Lilongwe, Malawi. We performed a bivariate analysis based on their transfer status and mortality and a logistic regression analysis to determine the effect of transfer status on mortality after burn injury. A total of 2301 patients were analyzed, with 1095 (47.6%) being in the transfer cohort from referring hospitals. The median age was 3years (IQR 1-4). The transfer cohort had more patients presenting to the hospital more than 48h after injury. Upon multivariate logistic regression, controlling for pertinent variables, including time to presentation, burn-injured patients in the transfer cohort had increased odds of mortality (OR 2.26, 95% CI 1.22-4.19, and p=0.01) compared to patients who were not transferred. The predictive probabilities of burn mortality by TBSA showed significant differences in mortality based on transfer status at TBSA between 20% and 80%. Ensuring district hospitals and other primary health care centers in resource-limited settings are sufficiently equipped to provide initial burn resuscitation and care may decrease mortality rates associated with transferred patients.

Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia.

Despite recent behavioral interventions aimed at reducing the burden of dengue, persistent unfavorable related behaviors in the Indonesian community suggest that vaccination could be effective. However, before this is implemented nationally, public perception and acceptance of the vaccine should be assessed in addition to health providers' points of view. This study aimed to assess the knowledge, attitudes, and practices (KAP) of community members and health providers in Indonesia. A cross-sectional survey was conducted in six districts of three Indonesian provinces. Respondents included both community members and health providers living within the territory of the selected primary health care centers. Pretested questionnaires were used to gather information on the sociodemographic characteristics and KAPs regarding dengue vaccines. An independent t-test was performed to compare the mean KAP scores between community members and health providers, while a logistic regression analysis was used to identify the predictors in each domain. Only 18.5% of health providers possessed high knowledge of the dengue vaccine versus only 12.5% of community members. Approximately one-third of the health providers versus one-fourth of community members displayed a high to moderate score for attitudes about dengue vaccines. Dengue vaccination practices demonstrated a more favorable score for both health providers and community members at 59.1% and 41.1%, respectively. No individual sociodemographic characteristics were associated with KAPs; rather, only education was correlated with better dengue vaccination practices. We also found that good knowledge of dengue was the only factor associated with all domains. Our findings highlight the urgent need to deliver educational interventions to health providers and community members in Indonesia to improve their awareness of dengue vaccines.

Study protocol of the ALMA-CKD trial; an electronic triggering decision-support system to improve the detection, recognition, and management of patients with chronic kidney disease in primary care

BackgroundChronic kidney disease (CKD) is a global health problem affected by under-recognition and under-treatment in primary care settings. Electronic clinical decision support (CDS) triggering systems have the potential to improve detection and management of people with CKD by assisting clinicians in adhering to guideline recommendations. We aimed to test whether an electronic CDS triggering system would improve the detection, recognition, and management of patients with CKD in primary care.Method/DesignThis is a pragmatic cluster-randomized controlled trial where 66 primary healthcare centers from the Stockholm Region, Sweden were randomized 1:1 to receive either a new expanded CDS-triggering system offering kidney-specific advice or to continue with their current CDS-triggering system. The expanded CDS system reminds and provides practical facilitators of the processes of CKD screening, recognition with a diagnosis, management and referral to specialist care. The trial duration is 24 months and it is embedded into the Stockholm CREAtinine measurements (SCREAM) project, a repository of healthcare data from the region, which minimizes disturbances with healthcare praxis due to the trial and makes it fully pragmatic. The primary outcomes are the number of eligible patients screened for creatinine and albuminuria once annually and the re-testing of these labs within 6 months in patients with abnormal eGFR or albuminuria. Secondary outcomes are the proportions of issued clinical diagnoses among those fulfilling criteria, proportions of patients with significant albuminuria receiving prescribed nephroprotective medications, proportions of accepted referrals to nephrologist care among those fulfilling criteria and proportion of referrals for ultrasound of the kidneys.DiscussionPrior pragmatic trials of CDS-systems in CKD has shown an improvement in quality indicators primarily in patients already diagnosed with CKD. This study expands this evidence by focusing on the process of screening, identification, monitoring and diagnostic work-up.ConclusionThis pragmatic trial will assess the value of CDS for improved adherence to CKD guidelines in primary care. Clinicaltrials.gov registration: NCT06386172, submitted 2024-04-23.

Healthcare and Pharmacy Staffs' Experiences on Medication Management for Migrants-A Qualitative Exploratory Case Study in Primary Health Care.

To explore what healthcare staff and staff in pharmacies experiences, as challenges, and possibilities in handling and use medications by foreign-born persons or their relatives, and how necessary information is exchanged between different units in the healthcare chain to prevent medication errors. A qualitative explorative single-unit case study in a primary healthcare centre, with connected home care and pharmacies in an immigrant-dense area. Individual semi-structured interviews with 17 respondents, including pharmacists, physicians and registered nurses, were conducted between May and December 2022, in Sweden. Inductive qualitative content analysis was applied. Six categories were identified: limited knowledge about medications, lack of knowledge about the Swedish system for medication prescriptions and pharmacy regulations, insufficient time to develop trusting relations, communication to support medication management, tools for facilitating safe use of medications and problems in exchange of information in the healthcare chain. Good communication is both a challenge and a prerequisite for safe medication management by well-informed patients. To ensure patient safety, it is crucial to establish ways to communicate with patients about their medications, regardless of their language skills. Improving communication within the healthcare chain is essential to prevent medication errors. Understanding the complexity of medication management and preventing medication errors requires staff to communicate effectively with patients at all steps in the healthcare chain to identify their informational and educational needs. This study provides a comprehensive understanding of the importance of communication within the healthcare chain, including prescribing physicians, nurses, pharmacists and patients, to prevent medication errors. COREQ checklist. This study focused on staff at a healthcare centre and two pharmacies.

Integrating digital behavioural therapy for insomnia into primary care: A feasibility mixed-methods study.

Digital cognitive behavioural therapy for insomnia has been developed to increase capacity and scalability for patients with insomnia, but implementation in primary care remains limited. The aim of the trial was to evaluate the implementation of digital insomnia therapy into primary care practice for patients with insomnia. We conducted a single-arm feasibility trial of digital behavioural therapy for insomnia (SleepFix) providing sleep restriction therapy with insomnia patients in primary care. Healthcare professionals (comprising General Practitioners, community pharmacists and nurses) were enrolled into the trial and, when deemed clinically appropriate, prescribed SleepFix to patients with insomnia. The primary outcome was uptake assessed by the number of downloads of SleepFix. Interviews with primary care healthcare professionals explored their attitudes towards implementing/using insomnia digital therapeutics in clinical practice, and patients about their experiences with SleepFix. Insomnia symptoms, mood and sleep quality were measured before and after the trial. This trial was prospectively registered (ACTRN12620000055909). Thirty healthcare professionals and 105 patients were enrolled into the trial. Fourteen healthcare professionals administered at least one insomnia digital therapeutic prescription between November 2021 and March 2022. Fifty patients downloaded and used SleepFix (47.6% uptake). In post-trial interviews, healthcare professionals felt they could incorporate digital sleep health into clinical practice and patients found SleepFix acceptable. There were significant improvements in insomnia symptoms, mood and sleep quality at week 6 (all p < 0.05). This trial shows a real-world implementation of a digital insomnia therapy into primary care that could provide a framework for prescribing digital sleep interventions.

Pregnant women and healthcare workers' perceptions on tuberculosis and screening: a cross-sectional study in Indonesia.

There is a scarcity of studies regarding the obstacles in tuberculosis (TB) screening in pregnant women. This study aimed to assess the perceptions of TB as a disease and TB screening among pregnant women and healthcare workers, describe pregnant women's perceptions on specific TB screening methods and explore associations between the perceptions of TB with the intention to have TB screening by pregnant women. A cross-sectional study was conducted at six primary healthcare centres in Yogyakarta Municipality, Indonesia among 240 pregnant women and 126 healthcare workers interviewed with a structured questionnaire about their perceptions. Perceptions were analysed as percentages and associated factors were tested by multivariable logistic regression. Most pregnant women and healthcare workers supported TB screening in pregnant women based on their perceptions of the susceptibility to or severity of TB and the benefits and risks of TB screening. Women who perceived the high susceptibility of TB disease and the benefits of TB screening were significantly more likely to have high intentions to accept TB screening in the future. Pregnant women's perceptions of TB and TB screening influenced their intention to be screened; however, appropriate testing methods for universal TB screening in pregnant women in areas with a high prevalence of TB require further studies.

Challenges in delivery of Bhutanese Traditional Medicine (Sowa Rigpa) services at Primary Healthcare Centres in Bhutan

Bhutanese Traditional Medicine (Sowa Rigpa) and allopathic medicine are integrated and state-funded in the three-tier healthcare system of Bhutan. Bhutanese Traditional Medicine services are available in all three levels of the healthcare system offering a range of services, from consultations to therapies and drug dispensations. Except for the National Traditional Medicine Hospital in Thimphu, all the centres across the country offer only outpatient services. Out of 81 traditional medicine centres, 55 centres are located at the primary level, serving people in different geographical areas of the country. Despite an increasing number of patients availing the traditional medicine services, the facilities at the primary level continue to face several challenges. The challenges include delayed and disruptive medicine supply chain, lack of an effective and systematic patient referral system, misconceptions and lack of awareness of traditional medicine services and inadequate infrastructure. All of these impede the provision of traditional medicine services in the communities. We recommend a technology-based drug delivery system in addition to resilient production centres, an effective patient referral system in traditional medicine practice by leveraging on the guideline and electronic patient information system, advocacies in the communities to dispel the myths and misconceptions regarding the Bhutanese Traditional Medicine, and adequate and architecturally smart infrastructure. Implementing these solutions could enhance access and utilization of traditional medicine services, leveraging the best use of this important component of the healthcare system.

Assessing Dietary Habits of Saudi Patients With Type 2 Diabetes at Primary Healthcare Centers in Jeddah, Saudi Arabia

Assessing Dietary Habits of Saudi Patients With Type 2 Diabetes at Primary Healthcare Centers in Jeddah, Saudi Arabia

A cluster randomised controlled trial investigating the efficacy of family-centred obesity management program in primary care settings: A study protocol.

The study aims to test the efficacy of a family-centred healthy lifestyle program in primary care health centres among children with overweight or obesity, evaluating the results at 3, 6, and 9 months post-intervention. A single-blind, randomised controlled cluster study where participants will be blinded to group assignment to reduce bias will be followed. The intervention comprises a 6-month program with intensive and maintenance behavioural therapies, including dietary modifications and guidelines for physical activity, administered by a multidisciplinary team. Participants will be assigned to an intervention group or a treatment-as-usual control group. Primary health centres in Seeb Wilayat, serving densely populated areas and willing to participate, will be included. Randomisation will be conducted at the cluster level to improve recruitment efficiency. A sample size calculation will ensure adequate power to detect significant differences. Ethical approval is granted and informed consent/assent will be obtained from all participants. The proposed study focusses on testing the efficacy of a family-centred healthy lifestyle program in primary care centres through a controlled, randomised study. Successful outcomes could lead to informed interventions, improvements in the health system, policy recommendations, positive community impacts, information on behavioural therapies, and improved long-term health outcomes for affected children and their families. This study will contribute to the literature by providing a culturally sensitive and evidence-based solution to a pressing public health issue, which can be adapted to similar contexts in Oman and beyond.

Patient Satisfaction with Primary Health Care Services in Qatar: A Quality Improvement Study in a Government Staff Clinic

Introduction: Patient satisfaction (PS) is a crucial measure of healthcare quality to ensure effective healthcare systems. Most previous studies focused on PS in primary health care centers, tertiary hospitals, or other settings while only a few addressed PS in staff/employee clinic settings. This study aimed to measure PS and identify factors affecting PS in a government staff clinic in Qatar. Methods: A cross-sectional quantitative research design based on a self-administered validated questionnaire was employed. The study population consisted of employees who visited the “Primary Health Care Corporation” staff clinic for a “physical” consultation between January and November 2023. Phone numbers were extracted from 942 patients’ electronic medical records. SMS texts containing links to the online questionnaire were sent. SMS and telephone reminders were conducted to reach a sufficient sample size. Results: 262 participants yielded a 28% response rate. 92% were satisfied with the overall primary health care services with aspects involving clinic accessibility (86%), physicians’ skills (84%), consultation duration (90%), condition explanation (87%), screening recommendations (80%), and shared decision-making (86%). These variables correlated significantly with the overall PS. Multivariate logistic regression analysis identified two key predictors of PS in the staff clinic: satisfaction with overall GP performance (OR=5.00; 95% CI=1.27–19.78; p=0.022) and satisfaction with overall nursing care (OR=27.88; 95% CI=5.83–133.27; p&lt;0.001). Conclusion: The primary health care services provided in the staff clinic exceeded expectations across structural, clinical, and technical aspects. These results align with the “Qatar National Vision 2030” to foster a mentally and physically resilient population.