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This study aimed to measure the performance of primary health care centres in Eastern province, Saudi Arabia, using the WHO/International Network of Rational Use of Drugs patient care and facility-specific drug use indicators. In a cross-sectional study, 10 health centres were selected using systematic random sampling. A total of 300 patients were interviewed while visiting the centre from January to March 2011 and 10 pharmacists from the same centres were interviewed. Average consultation time was 7.3 min (optimal ≥ 30 min), percentage of drugs adequately labelled was 10% (optimal 100%) and patient's knowledge of correct dosage was 79.3% (optimal 100%). The percentage of key drugs in stock was only 59.2% (optimal 100%). An overall index of rational facility-specific drug use was calculated and applied to rank the health centres for benchmarking. Dammam, Dammam, Saudi Arabia (Correspondence to A.A. El Mahalli: aelmahalli90@gmail.com Indicateurs OMS/INRUD pour les soins aux patients et l'utilisation des médicaments par les établissements dans des centres de soins de santé primaires de la province orientale de l'Arabie saoudite RÉSUMÉ La présente étude visait à mesurer les pratiques des centres de soins de santé primaires dans la province orientale de l'Arabie saoudite, à l'aide des indicateurs pour les soins aux patients et l'utilisation des médicaments par les établissements de santé mis au point par l'Organisation mondiale de la Santé et le Réseau international pour l'usage rationnel des médicaments (INRUD). Dans une étude transversale, dix centres de soins de santé ont été sélectionnés par échantillonnage aléatoire systématique. Au total, 300 patients ont été interrogés entre janvier et mars 2011 alors qu'ils consultaient dans un centre, ainsi que 10 pharmaciens dans les mêmes centres. La durée moyenne de consultation était de 7,3 minutes (valeur optimale supérieure ou égale à 30 minutes), le pourcentage des médicaments correctement étiquetés était de 10 % (valeur optimale 100 %) et le pourcentage des patients connaissant la bonne posologie était de 79,3 % (valeur optimale 100 %). Le pourcentage des principaux médicaments en stock était de 59,2 % (valeur optimale 100 %). Un indice global d'usage rationnel des médicaments par établissement a été calculé puis appliqué pour le classement des centres de soins de santé à des fins de comparaison.‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫الثامن‬ ‫املجلد‬ ‫عرش‬ ‫احلادي‬ ‫العدد‬

Background:Integrated Management of Childhood Illness (IMCI) is a cost- effective strategy that improves the quality of care through the use of evidence- based management protocols for the most common causes of childhood death and illness. Evidence- based clinical guidelines are critical to promoting rational use of medicines. Despite the large number of studies that assessed process and outcome of care delivered to children utilizing IMCI protocol, there is a scarcity of studies that assessed the effect of adopting IMCI on the drug use.Aims:To examine the impact of adopting IMCI guidelines on drug use at one of the primary health care (PHC) centers, Alexandria, Egypt.Settings and Design:Retrospective cohort study, conducted in clinic “A” not adopting IMCI guidelines and clinic “B” adopting IMCI guidelines at one of the PHC centers in Alexandria, Egypt for the period from January-- end of June 2010.Materials and Methods:A data collection sheet was designed to collect the required variables (based on WHO/ INRUD selected drug use indicators) from the medical records of children under five years.Statistical Analysis Used:SPSS version 16 was used. Percentages, means, and standard deviations were measured. Chi square, t, and Fisher's exact tests were applied.Results:Correct drug choice, dose, dosage form, route of administration were significantly higher in the clinic adopting IMCI {clinic B} (89.3%, 87.3%, 91.3%, and 91.3%, respectively) than in the clinic not adopting it {clinic A} (78% each). Non pharmacological remedies prescribed were significantly higher in clinic B than A (64.7% vs 4.6%). Average no of drugs/ encounter was lower in clinic B than A (0.93± 0.2 vs 1.37 ± 0.6) and the difference between clinics was statistically significant. Difference between clinics regarding percentages of drugs prescribed by generic name, antibiotics prescribed, drugs prescribed from essential drug list, and drugs prescribed out of stock was significant.Conclusion:Adopting IMCI strategy improved prescribing performance and treatment regimen.

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The aim of this study was to assess mothers' knowledge on newborn care as well as factors associated with poor knowledge. The study setting was two maternity hospitals, one urban and other rural, which were randomly selected from the maternity hospitals in Alexandria and El Behera governorates. A convenience sample of 422 mothers of newborns was selected from the previously mentioned settings. A structured interview questionnaire was designed and utilized by the researchers to collect the data. Maternal knowledge on newborn care was assessed and a knowledge score was created by allocating 1 point for each correct response. Knowledge score was classified as 'good', 'satisfactory' and 'poor' scores. The study results showed that 59.5% of mothers had either satisfactory or good overall knowledge. More than half of the mothers (55.7%) demonstrated a poor knowledge about some breastfeeding practices, mainly on initiation of breastfeeding (43.7%), proper attitude towards hypogalactia (42.7%), giving pre-lacteal feeds (38.4%), non-timed lactation (19.9%) and only 17.7% correctly identified the duration of exclusive breastfeeding. Mothers demonstrated satisfactory and good knowledge about the newborn warning signs (67.8%), with more than 70% of mothers recognizing 8 of 9 symptoms and/or signs that needed the urgent attention of a healthcare provider. According to multivariate analysis, rural women (odds ratio (OR)= 1.62; 95% CI 1.43-2.12), primiparae (OR= 1.77; 95% CI 1.53-2.72), mothers with lower family monthly income (OR=2.04; 95% CI 1.33-3.32) and those who never attended schools (OR=2.00; 95% CI 1.28-3.11) were more likely to have poor knowledge. In conclusion, mothers had satisfactory or good levels of knowledge about care of the umbilical cord and recognition of dangerous signs, but knowledge about breastfeeding was poor. Maternal education programs should place more emphasis on first-time mothers and those having lower socio-economic level as evident by lower monthly family income and lack of education.

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Background: In Egypt, the total number of persons with diagnosed and undiagnosed Diabetes is expected to increase more than double from 3.80 million to 8.80 million by the year 2025.compared with the prevalence of depression among normal subjects. These reports indicate that >25% of patients with diabetes reach clinical criteria for depression, a rate far higher than in the general population. The comorbidity of diabetes and depression is associated with adverse diabetic outcomes, compared with nondepressed diabetic patients. Aim: To determine prevalence of depression among type II diabetic patients attending family health centers in Alexandria. Material and method: A sample size of approximately 303 adult diabetic cases of type II in the age category of (20-60) years old based on a prevalence of 27% of depression in diabetics, degree of precision of 5% and confidence level of 95%, will be randomly selected from the attendees of the studied family health facilities. Two days of the week will be selected randomly to visit the studied primary health care facilities till the allocated sample size is reachedAn interview questionnaire will be designed for depression assessment by using the Hamilton Depression Rating Scale (HAM-D) among type II diabetic patients. Results: 40.18% (n=135) of diabetic patients in our study showed moderate to severe depression, 12.2%(n=41) showed mild depression while 47.62%(n=160) showed normal values on HAM-D scale.Moderate to severe depression was present in 39.1% and 40.7% in males and females respectively.

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