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- ItemEvaluation of the Use of se of Health Information System in Decision Making in Non Governmental Organizations – Gaza Governorates(Al-Quds University, 27-06-2011) Akram Hasan Nassar; أكرم حسن نصارThe demand for timely, accurate and relevant information for decision making in health is more than ever before. In a fragmented health system like the Palestinian one, where resources are scarce and health problems are complex, the need for information is even more crucial than elsewhere. Little is known about the extent of use of information in decision making in the Non-Governmental Organizations (NGOs) in the Gaza Strip. This study aims to examine the extent to which local health NGOs follow an evidence-based decision making approach through using health information systems (HIS). The study utilized descriptive, analytical cross sectional design with a quantitative approach. Two interviewed questionnaires were used for data collection from two diverse sources; the NGO as an organization (organizational questionnaire) and the managers working in these organizations (individual questionnaire). In this census study, of the eligible 24 health NGOs, 21 NGOs had positively responded. Response rate among managers was 83.3%. The developed questionnaires were based on the Health Metrics Network (HMN) assessment tool for national HIS with adaptation to fit the Palestinian NGO context. The overall reliability coefficient for both the organizational and the individual tools were very high (0.954 & 0.904 respectively). Findings revealed adequate total HIS performance for the organizational questionnaire (57.65%) and the individual (managers) one as well (62.02%). Low performance was found regarding the use of indicators (40.47% &48.6%; organizational then managers respectively) and in the HIS data sources (53.46% & 47.27%) whereas HIS data management (61% & 68.4%) and the information dissemination and use in decision making showed high results (69.13% & 60.96%). Lesser performance was found in the evaluation of HIS resources (52.11% & 69.48%) and in HIS information products (64.0% & 45.53%). However, the main strengths could be summarized in the highly positive managers’ attitudes, the young age of most of the NGOs managers, the effective internal communications and the commitments of top managers towards computerization of the system. The main weaknesses were the lack of HIS policies & regulations, lack of HIS training activities, inadequate standardized use of performance indicators, poor use of external data sources, inadequate data presentation capacities at the operational levels and inadequate information sharing with the community. Participants working in hospitals revealed lower perceptions in all HIS components in comparison to other groups with statistically significant differences (P<0.05). Similarly, computer users elicited higher HIS performance than non-users at all components with statistical significant differences (P<0.05). Top managers elicited higher scores in information products and the availability of resources than mid and low level managers and the differences reached statistically significant levels (P < 0.05). To enhance the information based decision making, the researcher recommends developing a set of indicators and supporting their monitoring. Also, enhancing a culture conducive to the use of information in decision making is essential. Last but not least, reinforcing capacity building skills in HIS is extremely
- ItemReproductive health and family planning survey on knowledge, attitude and practice among male adolescents in the Gaza Strip(Al-Quds University, 2002-02-16) Jamal abd el lateef; جمال عبد اللطيف
- Itemjob satisfaction among employed dentists the gaza strip palestine(Al-Quds University, 2002-05-28) Hanan Suhail Diab; حنان سهيل دياب
- ItemThe use of antibiotics in pediatrics acute respiratory inflections in primary health care centers in Gaza Strip(Al-Quds University, 2002-08-15) Samar Riyad El Khoudary; سمر رياض الخضري
- Itemoccupational lead exposure in battery and auto-radiator workers in Gaza governorates(Al-Quds University, 2003-06-29) Fayeq Ibrahim El-Madhoun; فايق ابر اهيم رباح المدهون
- ItemOrganizational climate at UNRWA as perceived by clinical staff working in the West Bank field(Al-Quds University, 2004-02-16) Maysoon Mousa Said Obeidi; ميسون موسى سعيد عبيدي
- Itemjob satisfaction among managers working in gazas hospitals(Al-Quds University, 2004-06-06) Sanaa Sabbah Thabet; سناء صباح ثابت
- ItemGaza Strip Nurse Managers' Leadership Styles(Al-Quds University, 2004-06-16) Ghada mohammed hamed Al.Najjar; غادة محمد حامد النجارNursing management is an important issue for promoting nurses' performance. Perhaps, leadership styles among nurse managers are most important in contributing to the promotion of performance and skills of nursing staff consequently improving the health services provided for the public. The topic was chosen because of the scarcity in the studies dealing with it besides its impact on policy making and planning in selecting and employing nurse managers with managerial behaviors and skills contributing to the profession development and preparing programs for developing a cadre of leaders among nurse managers which ultimately affect the performance and service.The study aimed to identify the leadership styles of nurse managers in health institutions belonging to government, UNRWA and NGO's in PHC and SHC. The study includes all levels of nurse managers: First level of management (head nurses), second level of management (supervisors) and top level(nursing directors).. The present study is an analytical, comparative and cross sectional study of nurse mangers working in health institutions in Gaza strips at all management levels. The study sample was 318 female and male nurse managers including government, UNRWA and NGO's in both hospitals and health centers. Data were collected by using a questionnaire containing personal, managerial and professional data which may influence the leadership styles patterns among nurse managers. Response rate was 94.3%. Data were analyzed by using "SPSS". The contents were validated by experts. The reliability using Cronbachs' alpha coefficient was 0.879. Findings revealed that 71.3% of participants are males, 55.3% aged from 31-40, 92% are married, 26% were from Mid-Zone and 57.3% had B.Sc. Seventy-nine point four are working in governmental sector and 73.3% in hospitals. Thirty-nine point seven percent worked in Gaza city and 71.3% worked more than 10 years. Sixty-two point seven percent were first line of management (H.N). Sixty-one percent had more than five years of experience in current position. Seventy-four point percent three worked previously in other places and 50.7% didn't choose the job. Also, 61.7% had no job description. Fifty point seven percent continued their education. Fifty percent of the respondents aren't satisfied in their job and 79.7% work in non preferable department. The findings also, showed that the dominant leadership style was the participative leadership style for both females and males. In UNRWA 33.3% of male nurse managers demonstrated the political leadership style, and 33.3% of them demonstrated the laissez-faire leadership style. In Khanyounis and Rafah city, female managers showed political leadership style. Chi-Square test showed no significant differences between male and female on most of variables. However, there were significant differences in males leadership style and the availability of job description. Also, there were significant differences in females leadership style and the following variables: place of residence, continuing education in the last three years, years of experience in the current position and the applying of the current job. Finally, the results showed that there were statistically significant differences between mean concern for people and work. Gaza nurse managers showed generally concern for people more than work. However, there was an inverse relationship between age and concern for people. There was also positive relationship between years of experience and concern for people. Moreover, there were significant differences between managers concern for work and organization type (hospitals and clinics) Recommendations and suggestions are aimed at enhancing management of human resources. Training courses can be designed to help managers in developing their leadership capabilities. Policy and decision makers shall provide opportunities for females to be promoted to managerial positions at all levels
- Itemthe effect of waste water treatment plant effluent chemical quality on underground water in Gaza city(Al-Quds University, 2005-05-15) Sami Hussain Lubbad; سامي حسين لبد
- Itememotional problems in orphanage children in gaza strip(Al-Quds University, 2005-05-29) Lamia Abed - El Rahmman Thabet; لمياء عبد الرحمن سالم ثابت
- ItemEvaluation of Hepatitis B Immunization Program for Children in Gaza Governorates, Palestine, 2007(Al-Quds University, 2007-01-02) Shehda Khalil Ali Barhoum; شهدة خليل علي برهومHepatitis B virus (HBV) is one of the major diseases of mankind, a silent, unnoticed killer destroying or stimulating development of liver cancer in someone who thinks he is completely well. Vaccination is the most successful tool for HBV prevention, over 90% of susceptible children develop Anti-HBs (≥10 mIu/ml) following three doses of vaccine, approximately 5 to 15% of infants fail to produce protective levels of anti-HBs (<10 mIu/ml). This study is based on a sero-survey for Measles Rubella and HBV conducted in year,2003, carried out among Palestinian children aged 18-30 months old. HBV Level shows that, the non-respondent to HB vaccination child numbers were, 66 in West Bank and 63 in Gaza Governorates. The purpose is to evaluate HB immunization program for children in Gaza governorates, Palestine, 2007 and to study the associated factors lead to a poor response for HB vaccination among vaccinated children in year 2001 in Gaza Governorates, Palestine. The study population includes all (63) identified as nonrespondents to HB vaccine and (126) respondents as controls, carried on Governmental and UNRWA public health centers in Gaza Governorates. The study is a quantitative, case-control, retrospective. The vaccine non-respondents are coming from the five Gaza governorates. For each "non-respondent" case, two "respondent" controls selected by systematic random sampling method, from the same sex and local health center. Closed ended questionnaire filled from vaccination files. For non-recorded data (15.9%), child mother interviewed face-to-face and supported by immunization cards. This step is followed by designing an entry model using computer software SPSS, where data was entered and analyzed. Several factors increase the risk of non- response to HB vaccination studied and classified into Socio-demographic factors: residency, sex, mother education level and type of immunization place, were all found not statically significant on non-response to HB vaccination; additionally response to HB vaccination did not correlated with family size. Health status factors: Birth weight, history of hospitalization before vaccination, history of infection, nutrition status, feeding during immunization and suffering from adverse event after vaccine, none is statically significant. Immunization factors: all children in the study received three doses of vaccination; the manufacture and difference of lot numbers of vaccines (1st, 2nd & 3ed) doses were not statistically significant. In addition, response to HB vaccination not correlated with the interval from birth to first vaccine, interval between first and second dose, interval between second and third dose. While the interval between last vaccination dose and Blood sample testing date was found to be negatively correlated and statically significant (P-value= 0.024). Environmental factors, the change of seasons of (1st, 2nd & 3ed) vaccinations and the presence of a sewage net in area was not statistically significant. Tentatively, this study could be a model to define further risks factors, which are not included in this study, and may affect non-response to HB vaccination in developing community as Gaza Governorates. Such study and similar studies will help in institute successful intervention program to reduce the non- respondent percentage of infants to HB vaccination in Gaza, Palestine and other similar countries
- Itemتقييم برامج التأهيل المبني على المجتمع المحلي في مخيمات اللاجئين– قطاع غزة(جامعة القدس, 2007-01-14) حسين حسين أبو منصور; Hussein Hussein Abu MansourThe present study aims to evaluate the Community Based Rehabilitation (CBR) programs in the Gaza Strip Camps. It also aims identify the level of CBR services, recognize the problems faced by the CBR in the provision of its services to the disabled, highlight the strength and weakness points in its programs, provide necessary data which will help the decision makers to plan for developing the rehabilitation services. The study population was composed of 305 disabled individuals who benefit of the services of the rehabilitation programs in the Gaza Strip camps (151 males, 154 female). The population was selected through the random simple sample. The population also included 151 male/female employees whom are the rehabilitation services providers in the CBR centres in the Gaza Strip refugee camps (47 male, 104 female) with various age and education levels. The study findings suggested that the level of the rehabilitation services is very effective and more than 60% of service providers have a university degree or higher while 57.6% have practical experience in the rehabilitation field for more than 4 years. The study results showed that 82.8% of the services providers’ age are less than 39 years. On the other hand, 84% of the beneficiaries of the rehabilitation services have preparatory education or less, 81.6% have monthly income less that 1500 NIS, 75.5% unmarried, 31.1% of the service providers are males and 68.9% are females. No significant statistical differences were found between the study population according to gender and income level. However, significant statistical differences were found in relation with education level, age categories and marital status. On the one hand, no significant statistical differences were found according the gender of rehabilitation service providers. On the other hand, significant statistical differences were found in relation with education level, age categories and years of experience among service providers. Recommendations: to encourage the service providers to conduct specialized studies, to urge continuing education and training based on need assessment, to introduce external experts, to equip the centres with modern equipment, to enhance the cooperation & coordination with international, governmental & non-governmental organizations. Moreover, to support the beneficiaries' needs, specially, services' fees, meeting the beneficiaries & to support forming rights pressure committees. In addition, to make a brave decision concerning the process of implementation of disabled individuals' rights law & follow up of the implementation. Also, to conduct evaluative studies of the rehabilitative services in Palestine & their impact on the disabled persons & their needs
- ItemThe Quality Of Life For Hypertensive Patients In Gaza City : Case Control(Al-Quds University, 2007-06-07) Tamer Wajeeh Ibraheem Younes; تامر وجيه ابراهيم يونسHypertension affects approximately 1 billion individuals worldwide, this associated with an increased risk of mortality and morbidity, And the fifth-leading cause of cardiovascular diseases deaths in Palestine 2004, So there is importance to assess the Quality Of Life for those people . Quality Of Life (QOL) is a temporal concept that reflects the moment at which it is evaluated; thus, respondents are more likely to respond consistently to measures of tangible capital.. The aim of this study was to assess the quality of life among hypertensive patients who were recorded in UNRWA clinics in Gaza city . The population study include all hypertensive patients who are 20 years and above and registered in UNRWA centers in Gaza City, as case control study we select 99 casse and 99 controls, The highest prevalence of hypertension in married people and follow them who didn’t work , After that low income people, In the group age above 50 years higher than less age ,In female more than male , In low educated people higher than educated . In Physical domain the Control mean is higher than case and this difference reach statistically significance. There is slight difference between Social domain means in case and control but didn’t reach statistically significance , Nearly there is no differences between Psychology and Environment domain means . Quality of life domain in Control is slightly better than case and this difference didn’t reach statistically significance. In both cases and controls the Physical domain of who his monthly income from 1500 to 2500 NIC mean is higher than less and more income and these differences highly statistically significance In both cases and controls the total domain of high educated group mean is higher than less educated and these differences reach statistically significance .
- ItemEvaluation of Current Screening Test for Asymptomatic Bacteriuria during Pregnancy at First Antenatal Visit in Rimal Health Center UNRWA ,Gaza 2007(Al-Quds University, 2008-01-26) Rasmiya Khamis Ghsoub; رسمية خميس غصوبUrinary tract infection is a common problem during pregnancy and if it is not diagnosed and treated properly, bad sequels could occur affecting the mothers and their outcome of pregnancy. The main objective of this study is to determine the prevalence of urinary tract infection (UTI) and asymptomatic bacteriuria (ASB) during pregnancy, as well as to evaluate the validity of current screening test (nitrite dipstick) at first antenatal visit. This is a cross sectional study conducted among pregnant women in Rimal Health Center which is a Primary Health Care Center; UNRWA in Gaza City. The total study population was 160 pregnant women attending antenatal care at first antenatal visit from 12th April 2007 to 25th July 2007. Midstream urine was collected and tested with culture, dipstick and microscopic examinations. Validity of tests was measured by sensitivity, specificity, positive predictive value and negative predictive value. Antibiotic sensitivity was also done. Thirty one out of 160women were identified positive urine culture with prevalence of 19.4%, 18/160 was asymptomatic (11.25%) while 13/160 was symptomatic (8.15%). Among the 31 culture positive, the commonest organism was staphylococcus aureus (29%), followed by E-coli (25.80%) and klebsiella (22.58%). Ciprofloxcine was shown as the 1st sensitive drug in all cultures (93.54%) followed by cefuroxim (83.87%) and co-amoxiclave and norfloxacine were equal (70.96%) while amoxicillin, co-trimoxazol and erythromycine had the lowest sensitivity. Maximum resistance was seen to co-trimoxazol (67.74%) followed by doxycycline (29.03%). Symptoms of UTI, weeks of gestation and the previous history of premature deliveries were statistically significant risk factors for the occurrence of ASB. Age, gravidity, parity, educational level, previous CS, history of urinary catheterization and previous history of UTI were not significant risk factors for this disease. Nitrite dipstick had low sensitivity (29%), high specificity (97.7%), with positive predictive value of 75% (PPV) and negative predictive value of 85% (NPV). Asymptomatic bacteriuria in pregnancy is a major public health problem and nitrite dipstick reagent is not sufficiently sensitive to be of use in screening of asymptomatic bacteriuria in pregnancy and many of patients would be missed for management. So, the researcher recommends the use of urine culture for screening of all pregnant women at first antenatal visit.
- ItemPossible Effects of X-Ray Films Processing on Respiratory Functions of Medical Radiographers in Gaza Governorates: Case-Control Study(Al-Quds University, 2008-12-15) Yasser Alajerami; ياسر صالح مصطفى العجرميAs early as 1980s, there were an increasing reports and concerns about diverse health problems and complains among medical radiographers (MRs) who are involved in processing X-ray films in darkroom of the radiological departments. The present case control study was designed and aimed at the investigation of possible effects of X-ray film processing on the respiratory function tests, complete blood count, and IgE levels of MRs as compared to a control group of physiotherapists (PTs).Questionnaires were distributed to the 84 MRs and 100 PTs. Appreciatively, 76 MRs and 91 PTs filled the questionnaire which indicated a response rate of 90.5% and 91.0% respectively. Results showed a significant proportion (73.7%) of MRs who reported current health problems mainly (91.1%) in terms of respiratory complains. About 76.8% of the complained MRs significantly related their current health problems to work demands, which reduced in holidays in about 89.7% of them.The mean health complains score percentage (MHCSP) of MRs (53.95 27.60%) was significantly higher than MHCSP of PTs (21.06 19.53%). The most predominant health complains addressed by MRs were discomforted breathing in closed/smoky/dusty rooms (98.7%), recurrent headache (78.9%), difficulties in nose breathing (73.7%), wakeup symptoms (68.4%), intermittent sleep (65.8%), eye symptoms (65.8%), and sneezing during working hours (63.2%). A significantly higher MHCSP was reported in MRs who are working at primary health care canters (PHC) as compared to MRs who are working at governmental hospitals, and in MRs of experience range of 25-32 years. Direct and significant correlations were reported between MHCSP and both the years of experience of MRs and number of weekly processing hours at darkrooms.For complete blood count (CBC) results, statistically significant differences were reported only in platelets count (PLT) and platelet-related indices. PLT count and platelets distribution width (PDW) of MRs showed significantly decreased values as compared to PTs, while mean platelets volume (MPV) showed significantly higher levels in MRs as compared to the control group of PTs. MRs showed a significantly higher concentration of IgE as compared to the PTs. Significantly higher IgE concentrations were reported in MRs who have additional working schedule with private sector; in MRs where darkroom ventilation systems is not available; and in MRs who do not use fume hood during chemical preparations. Highly significant correlation (r = 0.671 and p <0.0001) was reported between MRs IgE serum concentration and the weekly hours he/she spent at darkrooms.Almost all spirometric parameters revealed better value for control group as compared to MRs group, while respiratory restrictions were the major MRs spirometric diagnosis. MRs with experience group (25-32 years) showed the worst spirometric results as compared to other less experience groups. A significantly inversed correlations were reported between % of the predicted spirometric parameters and number of weekly hours at processing darkrooms. Poor designs together with operational deficiencies were major features of the radiology departments. Safety and quality control measures in darkrooms are usually unavailable, or inapplicable or not used by MRs, where 98.7% of them reported health complains during chemical preparations. In conclusion, the present assessment study revealed an exaggerated health status of the of Palestinian MRs at the Gaza strip. The responsibility about the deviation in MRs health could be attributed on one hand to the irresponsible practices and less awareness of the MRs towards the problems and risks of the x-ray processing darkrooms, while on the other hand the responsibility is attributed to poor design of radiographic departments and darkrooms operational and ventilation deficiencies. The present health status of the Palestinian MRs at the Gaza governorates justifies the necessity for a comprehensive revision and evaluation of radiology departments in general and darkrooms in specific. The proposed evaluation should include all parties that considerably interested and concerned in public and occupational health problems. منذ ثمانينات القرن الماضي لوحظ زيادة في أعداد و حجم الدراسات والاهتمامات المتعلقة بالمشاكل و الشكاوى الصحية عند مصوري الأشعة الطبية (فنيو الأشعة) الذين يعملون في غرف التحميض الخاصة بأقسام الأشعة. هدفت الدراسة الحالية إلى فحص تأثير تحميض الأفلام الإشعاعية على اختبارات وظائف الجهاز التنفسي, التعداد الدموي الكامل و على مستوى الأجسام المضادة من نوع (IgE) لدى مصوري الأشعة الطبية و مقارنتهم مع مجموعة ضابطة من فنيو العلاج الطبيعي. قام الباحث بتوزيع استبانه الدراسة على 84 من مصوري الأشعة الطبية و كذلك على 100 أخصائي علاج طبيعي كمجموعة ضابطة. وبكل امتنان قام 76 من مصوري الأشعة الطبية و 91 من أخصائي العلاج طبيعي بتعبئة الاستبانة و بنسبة استجابة 90.5% و 91.0% على التوالي.أظهرت نتائج هذه الدراسة بأن هناك نسبة عالية (73.7%) من مصوري الأشعة الطبية يعانون من مشاكل صحية حالية و كانت غالبية (91.1%) هذه المشاكل الصحية تتعلق بالجهاز التنفسي وهناك ما يقارب من 76.8% من هذه الشكاوى مرتبطة بشكل كبيير بطبيعة عمل مصوري الأشعة الطبية مع العلم أن هذه المشاكل الصحية تنخفض أو تختفي عند 89.7% منهم في الإجازات و أيام العطل.سجلت النسبة المؤوية لمعدل الشكاوى الصحية لدى مصوري الأشعة الطبية (53.94 27.60 %) قيما اكبر و ذات دلالات إحصائية جوهرية مقارنة مع ذات القيم (21.0 19.53%) لدى أخصائيي العلاج الطبيعي. و كانت أكثر الشكاوى الصحية لدى مصوري الأشعة الطبية على النحو التالي : عدم ارتياح في عملية التنفس في الغرف المغلقة/المدخنة/المغبرة (98.7%), صداع متكرر بنسبة (78.9%), صعوبة التنفس من الأنف ( 73.7%), مشاكل خاصة بالجهاز التنفسي عند الاستيقاظ من النوم (68.4%), تقطع في النوم بنسبة (65.8%), العطس المتكرر خلال ساعات العمل (63.2%). من ناحية أخرى كان هناك نسه عالية و ذات دلالة إحصائية جوهرية للنسبة المؤوية لمعدل الشكاوى الصحية لدى مصوري الأشعة الطبية الذين يعملون في أقسام الرعاية الأولية مقارنة مع المستشفيات, و لدى مصوري الأشعة الطبية ذوي سنوات العمل ما بين (25 إلى 32 سنة). كما و وجدت علاقة طردية عالية و جوهرية بين النسبة المؤوية لمعدل الشكاوى الصحية لدى مصوري الأشعة الطبية وكل من سنوات العمل وساعات العمل الأسبوعية في غرف التحميض المظلمة. بالنسبة لنتائج التعداد الدموي الكامل وجد أن هناك اختلافات ذات أهمية إحصائية فقط في تعداد الصفائح الدموية ومؤشرات هذه الصفائح، فكانت أعدد الصفائح الدموية و مقدار توزيع عرض الصفائح (PDW) كانت أقل بشكل كبير لدى مصوري الأشعة الطبية مقارنة بأخصائيي العلاج الطبيعي, بينما كان معدل حجم الصفائح الدموية(MPV) أعلى عند مصوري الأشعة الطبية مقارنة مع أخصائيي العلاج الطبيعي. كما و أظهرت الدراسة أن هناك زيادة كبيرة و ذات قيمة إحصائية جوهرية في مستوى الأجسام المضادة من نوع IgE عند مصوري الأشعة الطبية مقارنة مع أخصائيي العلاج الطبيعي. كما و كان هناك زيادة كبيرة و ذات قيمة إحصائية جوهرية في مستوى IgE لدى مصوري الأشعة الطبية الذين يعملون عمل إضافي في القطاع الخاص, و لدى مصوري الأشعة الطبية الذين يعملون في غرف تحميض رديئة التهوية وكذلك عند مصوري الأشعة الطبية الذين لا يستخدمون أدوات و سبل الوقاية إثناء عملية تحضير الأحماض. من ناحية أخرى كان هناك علاقة مباشرة و ذات دلالة إحصائية جوهرية بين مستوىIgE عند مصوري الأشعة الطبية وعدد ساعات العمل الأسبوعية في غرف التحميض (r = 0.671 and p <0.0001).أما فيما يخص قراءات كفاءة الجهاز التنفسي ((Spirometric parameters فكانت هذه القراءات و النتائج أفضل عند أخصائيي العلاج الطبيعي مقارنة بمصوري الأشعة الطبية, بينما لوحظ أن اغلب التشخيص عند مصوري الأشعة الطبية حسب جهاز قياس كفاءة الجهاز التنفسي كان درجات مختلفة من ضيق المجرى التنفسي. أما بالنسبة لمصوري الأشعة الطبية ذوي سنوات العمل الطويلة (25-32 سنة) كانت نتائج التشخيص حسب الجهاز سيئة مقارنة مع نظرائهم الأقل في سنوات العمل. كما و أظهرت النتائج علاقة عكسية بين النسبة المئوية لقراءات جهاز كفاءة الجهاز التنفسي المتوقعة وعدد ساعات العمل الأسبوعية في غرف التحميض. إن التصميم السيئ لأقسام الأشعة بالإضافة إلى النقص في المتطلبات التشغيلية لعمليات التحميض كانتا الطابع المميز لأقسام الأشعة قيد الدراسة, بالإضافة إلى أن معايير ضبط الجودة والأمان غالبا ما كانت غير متوفرة أو غير مطبقة في غرف التحميض وان توفرت فإنها لاستخدم من قبل مصوري الأشعة الطبية, حيث أن 98.7 % من مصوري الأشعة الطبية يعانون من أعراض ومشاكل صحية خلال تحضير الأحماض. وفي المحصلة, فإن الدراسة التقيمية الحالية كشفت عن وجود تدهور أو تردي في الحالة الصحية لمصوري الأشعة الطبية العاملين في قطاع غزة. إن المسئولية في تدهور صحة مصوري الأشعة الطبية تعزى في احد أبعادها إلى الاستهتار و عدم الحرص في ممارسات مصوري الأشعة الطبية والى قلة الوعي تجاه المخاطر والمشاكل التي تحدثها غرف تحميض الأفلام كما أن المسئولية تعزى في بعد أخر إلى التصميم السيئ والرديء لأقسام الأشعة و النقص و عدم كفاءة أجهزة و أنظمة التهوية و الأنظمة التشغيلية في غرف التحميض المظلمة.إن الوضع الصحي الحالي لمصوري الأشعة الطبية في محافظات قطاع غزة لابد و أن يكون مبررا و دافعا لمراجعة ولإعادة تقيم شاملة لأقسام الأشعة بشكل عام وغرف التحميض بشكل خاص. هذا التقييم الشمولي المقترح لا بد أن يشمل جميع الأطراف المعنية والتي لها علاقة الصحة العامة و بمصوري الأشعة الطبية والمؤسسات التي تهتم بالصحة المهنية.
- ItemAssessment of Tyres Waste Disposal Processes In Gaza Governorates(Al-Quds University, 2008-12-17) Khalil Ibraheem Hassanein; خليل ابراهيم احمد حسنينTyre waste and its disposal is a worldwide problem. Tyres are not biodegradable; hence the time required for their decomposition is undetermined. Due to their chemical composition, when tyres are burnt, they release organic and inorganic pollutants to the air and soil, including hydrocarbons, dioxins, and other toxic substances. Tyre disposal requires special and expensive technology. The purpose of this research is to assess the current situation of waste tyres disposal process in the Gaza Governorates, in order to provide data base for future interventions. The study was carried out through tow questionnaires that targeted the owners of the tyres repair-shops and the professionals working at relevant local institutions, over a period of three months. The total sample was 101 owners of tyres' repair-workshops and sixteen professionals from different ministries and municipalities. The study illustrates that in Gaza governorates there are weaknesses in all stages of the waste tyres management process which includes collection, storage, transportation and treatment. The study revealed that there is no activities done in the fields of recycling and energy recovery. The absence of a national strategy for waste tyres management is represented in the lack of cooperation among the institutions who issue the work license and the repair-shops owners. No specific regulation had been developed, absence of database system and no enforcement activities from the government to regulate this field. The absence of monitoring system for the waste tyres disposal activities is an additional weak point that makes the possible alternative methods for end use of waste tyres difficult to implement. There is a potential for future waste tyres industry in Gaza since there is about 250,000 tyres or more that can be collected every year. This study is the first to be conducted in Gaza Governorates and provides first-hand data in the field of waste tyres disposal process. It's recommended that an integrated process for waste tyres management including establishment of new collection system, storage facilities, cooperation among the stakeholders, treatment options and the bylaws for waste tyres disposal. Among the recommended treatment options are reuse and recycling of waste tyres in several fields such as engineering constructions and recreational areas.
- ItemEvaluation of Phenylketonuria and Congenital Hypothyroidism Newborn Screening Program in Gaza Governorates(Al-Quds University, 2008-12-21) Niveen Talal Jadallah; نفين طلال عبد الحميد جاداللهNewborn screening is a public health program that aims at the early identification of conditions in which early and timely interventions can lead to the elimination or reduction of associated mortality, morbidity, and disabilities. The evaluation of Phenylketonuria and Congenital Hypothyroidism newborn screening program in Gaza governorates which could and will aid in the improvement of health services and support controlling and preventing their deterioration. The study design was a cross sectional, considering three different component of the newborn screening program; parents, Guthnie screening card, and health care providers. A geographically, proportional stratified sample was used to select parents (400) and a simple random sample technique was used to select cards (300) while the study involved all health care providers(107) who provided vaccination services and newborn screening test. The findings of this study showed that the cards filled with required data represented 34.7 % cards while 65.3 % had missed data in an area or another. Among cards that were completely documented 81% were from UNRWA clinic while 19% were from governmental clinics. There was a statistical significant relationship between sample collection date and governorate. The percentage was 7.1 in North, 57.1% in Gaza 62.7% in middle zone, 26.7 % in Khanyouis and 57.1% in Rafah. The suitability of blood sample for test was assessed and the results showed that the UNRWA samples were more suitable than governmental clinics; they were 87.4%, 59.4% respectively. There was apparent knowledge deficit regarding the newborn screening tests among both the health care providers as well as the parents. Only 24% of parents knew what was done for their newborns before drawing the specimen. Health care providers who revealed to be familiar with congenital hypothyroidism test were limited (46.4%) in congruously knowledge about PKU was high (92%). The study reflected that 38% of health care providers give health education before drawing the sample and 47% claimed to give health education during antenatal care. On the other hand, a clear gap was observed between health care provider's claims and the parent's opinion of the information they have received. The parents who showed to receive information during pregnancy were 1% for PKU and 20.5% for hypothyroidism. Parents received information before tests were 20.5% PKU and only 3% congenital hypothyroidism. This might reflect a communication gap between health care providers and clients that require further research. Study revealed poor follow up of results and registration in such a program. The researcher observation during the visits to the health centers revealed lack of standardizations as procedures are not done in standardized way a cross department and centers. Health care providers directly involved in this program must be continuously trained educated and updated about issues related to the newborn screening programs and quality control and assurance in sample withdrawal and data recording. Health care providers must pay more efforts in follow up of the screening tests results, their reporting to parents, and proper registration in the child medical files. Parents, especially mothers must be well instructed during pregnancy about the advantages of conducting the newborn screening programs as soon as possible of the child birth.
- ItemPerformance Evaluation of Pre-hospital Emergency Management in Gaza Governorates:Health Providers' Perspectives(Al-Quds University, 2009-01-02) Raed Yousef Sabbah; رائد يوسف عبد الفتاح صباحتقييم أداء إدارة الخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى من وجهة نظر مقدمي الخدمات يتناول هذا البحث الوضع الحالي للخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى في محافظات قطاع غزة من وجهة نظر مقدمي تلك الخدمات. ولقد تم إجراء هذا البحث في النصف الثاني من العام 2008.يهدف البحث لإجراء تقييم لأداء إدارة الخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى بهدف تحديد فعالية النظام ومواضع قوته وضعفه. وتقييم جاهزية الخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى وجوانب التنسيق بين ذوي العلاقة لهذه الخدمات. الدافع الرئيسي لهذه الدراسة هو الخروج بتوصيات تساهم في تطوير الخدمات الصحية للمرضى خارج إطار المستشفى حيث أن محافظات قطاع غزة تتعرض بشكل مستمر لحوادث طارئة تشكل في معظمها سبباً رئيسياً للوفاة بين الأشخاص من مختلف الأعمار. تتمحور تلك الحوادث في السقوط من نقاط عالية على الأرض، الإجتياحات العسكرية من قبل قوات الاحتلال الإسرائيلي، الحوادث الطبيعية المحتملة وحوادث الطرق وحوادث أخرى. وفي سبيل الوصول إلى أفضل النتائج فإن الباحث قد استخدم مزيجاً من الأدوات الوصفية التحليلية والتي تعتمد على كلا المنهجين النوعي والكمي. وقد شملت الأدوات إجراء استبيان يستهدف العاملين في الخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى إضافة إلى إجراء مقابلات ومجموعات بؤرية مع عدد من صانعي القرار والذين يعملون أو عملوا في مجال الخدمات الصحية الطارئة. إضافة إلى ذلك فإن الباحث استند على المعلومات المنشورة في الأبحاث الأكاديمية، التقارير المنشورة في المجلات العلمية والكتب ذات العلاقة. الخلاصة الرئيسية لهذا البحث هي أن الخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى يقوم بها ستة من مزودي الخدمات الصحية الطارئة. في الوقت الذي تم تكليف الهلال الأحمر الفلسطيني بمهام مرحلة ما قبل الوصول للمستشفى وفقاً لقرار رئاسي. ولكن هذا لم يمنع الاخرين في الاستمرار في تقديم الخدمات الصحية الطارئة لمرحلة ما قبل المستشفى. لقد خلص الباحث إلى أنه لا يوجد أي من التشريعات أو المعايير أو الإجراءات المنظمة التي تنظم عمل الإسعافات، آليات التوظيف، ومعايير التدريب المهنية. إضافة إلى ذلك فقد أشار الباحث إلى عدم وجود وحدة عمليات مشتركة الأمر الذي يعيق الوصول إلى أفضل الممارسات للخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى مما يؤدي إلى تأخر الاستجابة أو توزيع المرضي على المستشفيات. فيما يتعلق بالجانب الفني فإن الباحث خلص إلى أن هناك إلتزام محدود في فحص تجهيزات الإسعافات من الأجهزة والإسعافات إضافة إلى فحصها التقني. وبالرغم من أداء الخدمة نسبياً مقبول عن أداء الإدارة الحالية للخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى، إلا أن إستمرار الوضع الحالي من غياب التشريعات، وعدم كفاية مؤهلات الطاقم الفنية يساهم بشكل كبير في إضعاف الأداء الإداري العام. وبناءاً على ذلك يختتم الباحث بعدد من التوصيات والتي من شانها تطوير الوضع القائم، ومن أهمها القيام بخطوات عاجلة لمواجهة التحديات لإدارة الخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى. لقد شملت التوصيات على تأسيس جهة مركزية واحدة لقيادة الخدمات الصحية الطارئة لمرحلة ما قبل الوصول للمستشفى، وحدة عمليات مشتركة، معهد تدريبي، معايير لتجهيزات الإسعافات، الأجهزة الطبية ومؤهلات الطاقم.
- ItemHypertensive patients' satisfaction with services provided at Gaza governmental primary health care centers(Al-Quds University, 2009-01-02) Yaser Nasr Alla Salem Ibrahim; ياسر نصرالله سالم ابراهيمNo one can deny that client satisfaction is crucial central concept in assessing the quality of health care, it have gained increasing attention in the recent days and future. Also it is considered as important indicator for quality improvement of health services. This study aimed to assess hypertensive patients' satisfaction with services provided at Gaza governmental primary health care centers. A cross sectional study design with accidental sample was used. A standardized structured questionnaire was developed and distributed to patients who attended non communicable department for receiving treatment and care for hypertension in two different localities, Rafah Martyr's clinic and Rimal Martyr's clinic. The selected sample was 370 clients (300 from Rafah and 70 from Gaza). The response rate was 100%. Psychometric methods and tests were applied and their (results approved the reliability and validity of the questionnaire (Cronbacks Alpha) was 0.760). The study explored six dimensions of satisfactions including general satisfaction, health education, accessibility, communication and interaction, medical counseling and direction respect. The study results were general satisfaction (68.6%), satisfaction with health education (25.1%), satisfaction with accessibility to services (53.2%), satisfaction with communication and interaction (19.7%) and satisfaction with medical counseling (70%). The highest level of satisfaction was expressed toward direction respect (75.9%) which is reflecting client trust toward providers. The study showed that female, older age, villagers, divorced, illiterate, unemployed and smokers showed high level of satisfaction. Male, other ages, city citizens, educated, employed, married and non smokers show low level of satisfaction. The study showed that improving communication styles and improving health education programs in primary health care centers are important factors to improve patient satisfaction. Moreover, health managers and health planners in the ministry of health could use the findings of the study to know the factors that lead to dissatisfaction and work to improve them to increase client satisfaction.