Wars, terrorism, and embargos destroyed facilities and shattered the public health system of Iraq. Today, there is limited documented knowledge about the health situation of the Iraqi population, particularly because health data are not systematically collected. Therefore, the capacity of the health system to address the major health problems of the population is considerably reduced. This report describes the implementation, started in 2015, of an electronic system for epidemiological monitoring and health surveillance, designed to collect and manage health care data in Iraqi Kurdistan. The aim of the program is to network all of the main health centers and hospitals of the region, then of the whole country, and to train medical and administrative staff in the management and analysis of health data. In countries recovering from war, a functioning health monitoring system is essential in guiding the development of appropriate public health interventions, a key instrument to prepare the health system to respond to future emergencies.

Background: Iraq has endured several conflicts and socio-political tensions that have disrupted its public health system. Nowadays, because health data are not collected on a routine basis, the country still lacks proper statistics and, consequently, response plans to meet present and future health needs of its population. An international partnership is developing in the Iraqi Kurdistan a Health Monitoring System with the aim of supporting evidence-based health policy decisions. Methods: The pilot phase for assessing the feasibility of the programme was launched in 2015. In 2018 the implementation phase began. The first step was to choose the software platform and the coding system, as well as to identify the public hospitals (PH) and Public Health Centers (PHC) to be included in the e-health system. The technical infrastructure of each PHC or PH was updated. The staff of each center was trained in the use of the e-health system and in disease coding. Several seminars introduced regional and district health managers to the basic concepts of data-driven decision making. A local team of experts was trained to create a highly specialized staff with the objective of "training the trainers" and ensuring the future self-sufficiency of the system. Results: By September 2019, 59 PHC and PH were entering data in the Health Monitoring System, while 258 health operators (medical doctors, administrative staff, nurses, statisticians, IT and public health specialists, pharmacists) have been already trained. Currently, more than 600,000 disease events have been collected. Additionally, further 734 medical doctors, statisticians, and health managers have been trained on the basics of public health practice. The goal during the next 3 years is to reach 120 operative centers within the region, envisaging a subsequent expansion of the system to all Iraq. Emberti Gialloreti et al. Health Monitoring System in Iraq Conclusions: The creation of a functioning health monitoring system is feasible also in regions characterized by socio-political tensions. However, multiple stakeholder partnerships are essential. The provision of an e-health information system, coupled with the establishment of a team of local experts, allows the routinely and timely collection of health information, facilitating prompt responses to present and emerging needs, while guiding the formulation and evaluation of health policies.

The availability of models for predicting future events is essential for enhancing the efficiency of systems. This paper attempts to predict demographic variation by employing multi-layer perceptron network. Here we present the implementation of a system for predicting the number and causes of deaths, for a future 2-year period. The system was built using predictive models and data that is as accurate as possible under the current conditions of the northern Region of Iraq (the Autonomous Region of Kurdistan). Our predictive model is based on quarterly periods, with the intention of providing predictions on the number of deaths, classified by gender, cause of death, age at death, administrative district (governorate), and hospital where the death occurred. The data was collected from birth and death registry bureaus and forensic medicine departments for the years 2009–2020. The python programming language was used to test the designed multi-layer perceptron network with backpropagation training algorithm. With learning rate 0.01 and 500 epochs we were able to obtain good results, as the neural network was able to represent the string, and predict future values well, with a mean squared error of 0.43, and we found that number of deaths is quite stable, with a slight increase.

BackgroundResearch about the impact of war and displacement experiences on the mental health of Internally Displaced People (IDPs) has recently grown. However, a limited number of studies focus on minorities. The objective of the present preliminary study was to estimate the prevalence of posttraumatic stress symptoms (PTSSs) among IDPs who live outside camps and belong to the Christian minority in Iraq, and to identify possible predictors.MethodsOverall, 108 internally displaced Christians (54 married couples) participated in the study. Traumatic events and PTSSs were assessed using the Harvard Trauma Questionnaire. Multivariable linear regression models were used to investigate possible predictors of PTSSs. Multivariable logistic regression models have been developed to estimate the odds of presenting PTSSs.ResultsResults demonstrated high rates of trauma exposure, with all participants having experienced at least three traumatic events. The estimated prevalence of PTSSs was 20.3%. A low economic status, the number of traumatic events, and a second experience of displacement were associated with increased PTSSs. Five traumatic events were identified as the main predictors of PTSSs.ConclusionFindings from the current preliminary study indicated the impact of war-related traumatic events on IDPs' mental health and the negative effects of post-displacement experiences. These findings may have important implications for setting up psychosocial interventions, as well as for further promoting physical and mental health services among these populations.

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