BackgroundThe environment for medical education in Iraq has been difficult for many years. The 2003 invasion of Iraq accelerated a steady emigration of faculty and graduates. Kidnappings and deaths of doctors became commonplace. To understand current career plans, expectations and perceptions of medical students, three Baghdad medical schools were surveyed.MethodsWritten questionnaires were completed by 418 medical students variously in their 4th, 5th and 6th (final)years of training. We asked about perceptions of the quality of their medical education, the quality of health services in Iraq generally, and about deaths, injuries and migration of faculty, classmates and family.ResultsThe average age of students was 22 years, with 59% women. Most students (90%) were originally from Baghdad. Although there were some positive responses, many students (59%) rated the overall quality of their medical education as fair or poor. Three-fourths of students believed the quality of hospital care in Iraq to be only fair or poor. A majority of students (57%) stated they were thinking frequently or all the time about leaving Iraq after graduation. Reasons given for leaving included the desire for further education, seeking a better lifestyle and fleeing conflict. Leading reasons for staying included the pull of friends and family, familiarity with the health system, and a sense of responsibility to the country. Nearly one in five (18%) students reported the death of a family member attributable to intentional violence, and 15% reported the violent death of a medical school classmate or faculty member since the 2003 invasion. Half the students reported at least one school faculty members had left Iraq because of the war.ConclusionMedical students hold a mediocre view of the quality of their medical education and of Iraq’s health system. Many of their faculty members have left the country. The majority of students may leave Iraq after graduation, afforded the opportunity. This poses a significant problem for staffing an already demoralized and stressed health system. Current circumstances suggest the situation will continue to deteriorate.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1156-8) contains supplementary material, which is available to authorized users.
Background The use of the hookah-smoking device is increasing at a large scale in the Eastern Mediterranean region. Hookah users are exposed to an array of chemical compounds and may suffer several chronic diseases as a result. The purpose of this study was to determine the prevalence of hookah use among male high school students in the region and to study different associated factors in order to provide local tobacco control officials with an understanding of this public health problem. Methods A convenient non-probability sampling study was conducted among students in three high schools in Al-Karkh district, Baghdad. The study period was from October 2017 till January 2019 and included 847 male students aged 15–18 years old. Using a simple random technique to select the high schools from a list of schools we chose one school from each directorate. Descriptive, chi-square test of significance, bivariate, and multivariate logistic regression analyses of data were carried out for identifying the risk factors associated with hookah smoking among these high school adolescent males. Results The overall prevalence of hookah smoking in the last 30 days among male high school students was 46.1% while in the past 6 months it was as high as 85.7%. More than two-thirds (70.6%) of the students thought that hookah smoking was more socially acceptable than cigarette smoking. Factors such as having first heard about it from friends, the media, or the presence of a hookah café near their residence were significantly associated (p > 0.05) with hookah smoking among the students. Similarly, being surrounded by friends who used hookah was also found to be significantly associated with hookah smoking, with an odds ratio of 0.18, 95% CI (0.087–0.394). Hookah smokers were less likely than non-hookah smokers to report its use as forbidden in Islam and more likely to say it is allowed in Islam. Conclusions We found an alarmingly high use of hookah smoking among male high school students in this study. Family members and peers had an important role in the prevention of hookah smoking among these students. There is a need for students to be educated about the toxicity of hookah tobacco smoking and its direct effect on their health.
Background The use of the hookah-smoking device is increasing at a large scale in the Eastern Mediterranean region and reaching to Western countries. Hookah smoke users are exposed to a lot of chemical compounds and several chronic diseases. The purpose of this study was to determine the prevalence of hookah use among male high school students and to study different associated factors linked with hookah smoking and provide tobacco control officials an understanding of this public health problem.Methods A descriptive cross-sectional study was conducted among students in three high schools in Al-Karkh District, Baghdad. The study period was from Oct. 2017 till Jan. 2019 and included 847 male students aged 15–18 years old. A convenient non-probability sampling within one of the two districts in Baghdad was selected to be place of study. Descriptive, chi-square test of significance, bivariate and multivariate logistic regression analysis of data was carried out for identifying risk factors associated with hookah smoking among high school adolescence.Results The overall prevalence of hookah smoking among high school male students was high (46.1%). More than two-thirds (70.6%) of them think that hookah smoking is acceptable socially more than cigarette smoking. Hearing first about it from friends, the media and presence of a café for hookah near residence were found to be significantly associated (p > 0.05) with hookah smoking among students. Similarly, having friends surrounding students who used hookah were found to be significantly associated with hookah smoking among students. Among hookah smokers, they were less likely to say it is forbidden in Islam and more likely to say it is allowed in Islam than non-hookah users.Conclusions Hookah smoking is high among high school students and becoming a socially acceptable behavior. Social and religious factors play a role in that. Family members, relatives and peers have an important role in prevention of hookah smoking among these students. Teenage students need to be educated about hookah effects on their health.
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