Farid Midhet

Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan

BackgroundPakistan has high maternal mortality, particularly in the rural areas. The delay in decision making to seek medical care during obstetric emergencies remains a significant factor in maternal mortality.MethodsWe present results from an experimental study in rural Pakistan. Village clusters were randomly assigned to intervention and control arms (16 clusters each). In the intervention clusters, women were provided information on safe motherhood through pictorial booklets and audiocassettes; traditional birth attendants were trained in clean delivery and recognition of obstetric and newborn complications; and emergency transportation systems were set up. In eight of the 16 intervention clusters, husbands also received specially designed education materials on safe motherhood and family planning. Pre- and post-intervention surveys on selected maternal and neonatal health indicators were conducted in all 32 clusters. A district-wide survey was conducted two years after project completion to measure any residual impact of the interventions.ResultsPregnant women in intervention clusters received prenatal care and prophylactic iron therapy more frequently than pregnant women in control clusters. Providing safe motherhood education to husbands resulted in further improvement of some indicators. There was a small but significant increase in percent of hospital deliveries but no impact on the use of skilled birth attendants. Perinatal mortality reduced significantly in clusters where only wives received information and education in safe motherhood. The survey to assess residual impact showed similar results.ConclusionsWe conclude that providing safe motherhood education increased the probability of pregnant women having prenatal care and utilization of health services for obstetric complications.

Chronic Venous Insufficiency: prevalence and effect of compression stockings

INTRODUCTION Chronic venous insufficiency (CVI) is a common disease affecting mainly lower limbs and significantly influencing the quality of life. This study aims to estimate the prevalence of CVI in the Qassim Region and test the effectiveness of compression stockings as an intervention option. METHODS A cross sectional study was conducted to assess the prevalence of CVI among patients visiting primary health care (PHC) centers in the Qassim Region. CVI patients were diagnosed and classified using the clinical, etiologic, anatomical, and pathophysiological (CEAP) scale. They were randomly divided into two groups, one using compression stockings and the other standard medical therapy. A clinical follow up was done using multiple scale system including CEAP scale. Data analysis was performed using SPSS. RESULTS Among the 226 screened patients, 138 (61.1%) were diagnosed as having CVI (69% female and 45% male, p<0.001). Compared to the baseline, both the clinical and venous scores for CVI at the follow-up were significantly lower among patients using compression stockings, p=0.002 and p=0.003, respectively. Regression analysis suggested that, after controlling for age, sex and body mass index, compliance was the main factor responsible for a significant reduction in the clinical score among CVI patients. CONCLUSIONS Chronic venous insufficiency is very common in the Qassim Region. Compression stockings are highly effective in improving clinical symptoms and signs of CVI. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov(NCT02050061).

Academic accreditation process: experience of a medical college in saudi arabia.

OBJECTIVE This study aims to describe effects of the accreditation process of the National Commission for Academic Assessment and Accreditation (NCAAA) and its impact on the quality of medical education in one medical college in Saudi Arabia. METHODS We conducted a mixed (qualitative-quantitative) study in Qassim University College of Medicine, where an accreditation exercise led by NCAAA was recently completed. Data pertaining to impact of the accreditation process were collected through self-administered questionnaires and focus-group discussion. Data were aggregated and analyzed and compared with the information from prior to accreditation, where available. RESULTS The accreditation process lasted about two years, culminating in the preparation of a self-evaluation report and a visit of external reviewers. The process itself brought significant changes in the educational processes and administration and implementation of the curriculum. Our analysis also indicated significant improvements in the quality of medical education in the College. CONCLUSIONS The accreditation process was successful in improving quality of medical education, without imposing radical changes in curriculum philosophy or orientation. Better monitoring of students learning outcomes and continuous quality improvement will improve the quality of medical education in the college.

Students' perceptions about the family medicine course in Qassim, Saudi Arabia

Abstract Background: This study explores students’ perceptions and attitudes regarding educational methodology, content and assessment methods in the Family Medicine (FM) Course at Qassim University College of Medicine (QUCOM) with a view to build innovations and improvements on its findings. Research design and methods: Three batches of undergraduate medical students attending FM Course – 2011/12 participated in a cross-sectional questionnaire-based study. Data collected through anonymous self-administered questionnaires were analyzed using Statistical Package for the Social Sciences (SPSS). Results: Participation rate was quite high; of the 79 students constituting the course cohort, 68 (86%) responded. Students’ perceived problem-based learning (PBL) tutorials positively while both male and female students rated classroom lectures negatively. Primary health care training activities and evidence-based medicine received high positive scores. Male students assigned high positive scores to consultation skills and breaking bad news (BBN) modules, and to a lesser extent the medical audit module. By contrast, female students rated them negatively and gave significantly lower scores. These were the only areas indicating significant differences between opinions of male and female students. Conclusion: Although the degree of students’ satisfaction with the different learning activities varied, students felt that having a variety of learning and teaching experiences was more appropriate.