Quality assessment of the primary health care services provided for ARI control in Alexandria.
The aim of the present study was to assess the quality of services provided for acute respiratory infections (ARI) control in Alexandria after about five years of its integration into primary health care (PHC). The ARI training coverage of actively practicing physicians was only 35% and of nurses 37.5%, due to inappropriate allocation of trained human resources. The knowledge of trained PHC physicians was slightly better than that of untrained staff and both were unsatisfactory. The main deficiency was in detecting the dangerous signs and in classifying "cough or difficult breathing", which resulted in missing all cases of "severe pneumonia" and "very severe disease" needing referral to higher levels, in order to reduce the ARI specific mortality rates. The rate of oral antibiotic abuse reached about 55%, which was much higher than that found in the ARI annual report 1997 and is more likely to be the true figure. On the other hand, long acting penicillin was underutilized, due to fear of its allergic reaction and oral antibiotics were used instead of it. Therefore, the later were unavailable at the PHC facilities for about 7 months, mainly during winter and spring time.
Koura
M R
MR
High Institute of Public Health, Primary Health Care Division, Alexandria University. haa@alexcomm.net
Khairy
A E
AE
Abdel-Aal
N M
NM
Deghedi
B
B
Sabra
A A
AA
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000592:standards*; D003644:Death Certificates; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data; D004534:Egypt / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D007318:Inservice Training / Q000592:standards; D008330:Management Audit; D008485:Medical Audit; D008503:Medical Staff / Q000193:education / Q000458:organization & administration; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000592:standards*; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D019035:Rural Health Services / Q000592:standards; D011795:Surveys and Questionnaires; D019037:Urban Health Services / Q000592:standards
D000900:Anti-Bacterial Agents