SCOPH Newsletter

SCOPH NEWSLETTER Health Systems 2021

Feb - May 2021

Health Systems THEME:

A well-functioning health system responds in a balanced way to a population's needs and expectations.

Health

systems

have

hugely

contributed to better health and influenced the lives and well-being of billions of people, thus their role has become increasingly important.

This why we chose 'Health Systems' as the theme for this edition of SCOPH Newsletter!

Newsletter Team

Nada Moustafa (NPO DA ME) Coordinator

Nermeen Yousef Scientific team

Rafik Fouad Proofreader

Menna Ayman Scientific team

Dana Tarek Proofreader

Ahmed Alameen Scientific team

Samira Yasser Designer

Marawan Alaa Scientific team

SCOPH Newsletter

TABLE OF CONTENTS

NATIONAL UPDATES 4

NPO - Mr. Hamdy Shaheen

5

NPO GA - Ms. Menna Tarek

6

NPO DA ME - Ms. Nada Moustafa

7

NPO DA CB - Ms. Mai Elhenidy

8

AMR NC - Mr. Abdelrahman Al-Gaafary

ACHIEVEMENTS 13

National Achievements

ARTICLES 19

Lessons from the past paving the way to the future

21

Global health and Social Health Determinants

22

Primary Healthcare & Family Physicians

9

NCDs NC - Mr. Omar Hesham

23

9

MH NC - Ms. Sarah Dawood

Health Workforce

25

One Health Approach

11

Climate Change NIC - Ms. Rania Harhira

26

Digital Health

12

BGH NIC - Ms. Salma Moatamad

27

Preeclampsia

29

Asthma

SCOPH Newsletter

NATIONAL UPDATES NPO Mr. Hamdy Shaheen Attended OGA March Meeting 2021 MEETINGS

Attended EMR17 Represented IFMSA-Egypt in the UN Focus meeting.

Follow up the work with WHO in Mental Health & psychosocial support “MHPSS” collaboration.

Attended an evaluation meeting with IOM Represented IFMSA-Egypt in IOM End project Celebration Initiated Bridging Gaps in Health National initiative Followed up on Greenish collaboration in Climate Change & Health

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

NPO GA Ms. Menna Tarek Attended EMR17 Attended all LPO’s and national team Monthly meetings & took minutes Attended World Asthma Day Celebration Attended Mental Health TOT Conducted 2 sessions in Winter Camp XI Conducted a session in AMR TOT Conducted 2 sessions in LPOs & 2nd man competency modules National team representation at the local level through conducting local SCOPH sessions in “AMSA-Aswan, MSSA-Menofia, ZMSSA-Zagazig”.

Updated reporting and scoring system Monthly reporting and evaluation form for National team Monthly reporting for LPOs Monthly Scoring for LCs Updating SCOPH database Situation analysis of SCOPH strategic plan Open a MWG for SCOPH resource center “SCOPHub” as the coordinator of the mega working group

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

NPO DA ME Ms. Nada Moustafa Click to see

Work with COVID-19 Response Team (CAT)

Participation in World Immunization Week online campaign Conducting the third wave of the CAT online campaign

Introduction Video

World Immunisation Week

Vaccine Myths & Facts

Astrazeneca Vaccine

Sinopharm Vaccine

Moderna Vaccine

Pfizer Vaccine

Animals & COVID-19

COVID-19 Misconceptions

What Are Mutations?

SWGs & Courses Finalized the advanced level of SCOPH course Opened the call for Newsletter SWG

3000 MEMBERS On SCOPH Facebook group

104 TRAINERS Created SCOPH Trainers/Facilitators database and a Telegram channel with 16 old, 88 new, 44 graduated trainers

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

75 APPLICANTS FOR INTERNATIONAL OPPORTUNITIES Forwarded 12 international opportunities on the SCOPH server

World Days Celebration

World

World

Kidney Day

Hygiene Day

March 11

May 5

NPO DA CB Ms. Mai Elhenidy Attended March Meeting 21 Trainer in AMR TOT and Climate Change Workshop Conducted SCOPH 101 session during the 2nd man competency module Coordination of LPOs competency module through April and May Coordination of 2nd man competency module in May Finalizing the SCOPH Manual draft updates with the coordinator Follow up with LPOs manual coordinator to finalize the design edits

2O HOURS of Capacity Building sessions (SCOPH sessions, soft skills, and project management)

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

AMR National Coordinator Mr. Abdelrahman Al-Gaafary TOT Building the capacity of 27 IFMSA-Egypt members providing them with the knowledge needed about AMR, one health approach, infection control bringing the spot on the correlation with Sustainability development goals and global health. Moreover, providing them with the soft skills needed to graduate AMR qualified advocates.

Held over 4 days (8th-11th of April) AGENDA

Online Campaign Video Competition

SMSA - Sohag 16th of April Outreach = 3,834

BMSA - Beni Suef 17th of April Outreach = 3,126

Winners

AUSSS - Ain Shams 18th of April Outreach = 2,025

Click to watch

ZMSA - Zagazig 19th of April Outreach = 2,243

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

NCDs National Coordinator Mr. Omar Hesham Online Campaigns Click to see

World Hypertension Day 17th of May

Cancer Awareness Campaign 20, 21 & 22nd of May

World No tobacco Day 31st of May

Regional Representation Representing IFMSA-Egypt with active participation during SCOPH sessions in the EMR general assembly.

at

Mental Health National Coordinator Ms. Sarah Dawood Meetings Local Coordinators OLM for follow up & discussing the new opportunity/targets.

Second Phase OLM meeting for Local Coordinators.

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

TOT A new partnership was adopted with WHO regarding our conjoint goal to promote mental health status between students & health care workers in Egypt, especially after the pandemic.

MHPSS Training for 2 days for 36 members from IFMSA-Egypt & ENNSA that took place in Intercontinental Cairo Semiramis.

Follow up with our graduates regarding their graduation sessions & needs.

Updates Finalize MHPSS Training Package to be published (see achievements).

IEC Materials preparations & edits.

Obtaining a study survey about the effect of COVID-19 on mental health of medical students in Egypt and using it to advocate to decision-makers [with the help of RSDD].

Preparing for our national online campaign.

The Effect of COVID-19 on

Mental Health of Egyptian Medical Students

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

Climate Change National Initiative Coordinator Ms. Rania Harhira National Certified Workshop The workshop which graduated the firstever batch in IFMSA-Egypt specialized in climate change “The Planeteers”. They are 29 passionate activists gathered for 6 days

AGENDA

of active learning, group interaction, and discussions.

Click to see photos from the workshop!

World Days Celebration Global Recycling Day

International Day of Forests

March 18

March 21

International Participation Participated in MM21 SCOPH Fair & our project was one of the top 5 activities in the fair, February 27.

top 5

SWGs An SWG for recommendations for climate-friendly meetings and physical events has been formed. The final edition of the recommendations will be published soon.

External Collaborations

with Greenish

2 batches of medical students graduated from 2 camps we have conducted through the 1st and 2nd terms. These graduates or as we say “co-founders” are aware of all aspects of climate change and how we can solve this global problem.

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

BGH National Initiative Coordinator Ms. Salma Moatamad

12 SESSIONS

352

conducted nationally & locally with a total reach of

Discussing various topics in the Bridging Gaps In Health initiative, such as: Basics of Public Health

ATTENDEES

Health literacy Health literacy definition, importance, levels, red flags, and consequences of low quality health literacy.

Strategies to improve and develop health literacy quality.

Health system and UHC

Difference between public health and

Universal Health Coverage and Health

community medicine.

system Definition.

Community medicine domains and their

Health system Framework { Blocks -

definitions.

Levels - models - goals - function }

Public Health Definition

UHC from SDGs point of view.

Who is responsible for public health,

Myths around UHC.

public health stakeholders and partners

UHC principles.

Introduction to global health.

Strategies to achieve UHC and How to

How to define the health state of a

measure progress { UHC Cube}

community

Primary Health Care and Universal Health Insurance Levels of Healthcare.

PHC definition and Health For All concept.

Social Determinants of Health

PHC elements and Principles.

SDOH definition, elements and categories.

Challenges to implement PHC.

Public Health and Global Health.

New Health system in Egypt.

Health Indicators and determinants.

Role of PHC and Family medicine

SDoH effect on health.

Physicians.

World Day Celebrations

Sessions

World Health Day March 7

BGH Intersectionality session for LPOs competency module.

SCOPH Newsletter

ACHIEVEMENTS Won as one of the 5 finalists of the most impactful and innovative activities in the March Meeting SCOPH Activities Fair 2021.

top 5

Click to like/ comment on the activity and see other finalists!

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

IFMSA-Egypt collaboration with WHO EMRO & ENSSA in the Mental Health & Psycho-Social Support (MHPSS) Project

Conduct a rapid assessment on the role of the covid-19 pandemic on the mental health of medical and paramedical students Develop a training package based on the results of the assessment to enhance mental health coping techniques and psychological first aid Conduct TOT for medical and paramedical students on MHPSS training package Develop/adapt IEC materials to be disseminated in a number of medical and paramedical schools Conduct physical awareness campaigns in a number of medical and paramedical schools on MHPSS Conduct a baseline assessment of existing MH support units in 2 universities to identify opportunities and gaps of its services

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

Click to see the MHPSS Training Package!

Our proposal was successfully chosen by WHO EMRO from between multiple projects from the EMR region to receive a generous fund to support our efforts in the MHPSS project.

Over the next 2 months we created surveys, held workshops, campaigns, advocacy efforts and more, and we showcased our members' efforts to the WHO and stakeholders across the region!

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

SWGS We reached a number of 49 members representing 20 LCs having national exposure throughout 8 different SWGs.

SWG

SCOPHu

b

Gr ou p

SCOPHHub Mega Working Group

rk in g Me ga Wo

Members General Team

Yara Elsawy Mohamed Karem Yara Hamdy Menna Ragab Esraa Amr

NCDs Team

Salma Kandel Abdalla Magdy Mahmoud Fahim Mahmoud Abd Elslam Nada Hamada

AMR Team

Doha Agwa Mahmoud Ahmed Mohab El-Nabawy Rovan Emad Rania Sokkar

MH Team

Saif Ali Aya ElRawi Fatma Ahmed Rana Mohamed Ibrahim Farag

Climate Team

Rania Harhera Omar Elmowafi Moaaz Rafat Mohammed Osama Ahmed Hafez

MH Team

Saif Ali Aya ElRawi Fatma Ahmed Rana Mohamed Ibrahim Farag

BGH Team

Salma Moatamed Ahmed Sedky Kamal ElFadwa Elbaz Qalamawy

SCOPH Newsletter SWG Climate Friendly Meetings Recommendations

Ahmed Alameen Marwan Alaa

Nermeen Yousef Menna Ayman Dana Tarek

Rafik Fouad Sameera Yasser

Rania Harhera Menna Jamal Moaz Raafat Tasneem Abdelrahman

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

Creation of SCOPH Trainers Database

NEW OLD

16

88

GRADUATED

104

Trainers SCOPH

44

Created SCOPH Trainers/Facilitators database Created a Telegram channel

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

HEALTH SYSTEMS THEME

SCOPH Newsletter

ARTICLES

01

Lessons from the past paving the way to the future

02

Global health and Social Health Determinants: Are we different?

03

Primary Healthcare & Family Physicians

04

Health Workforce

05

One Health Approach: Integrating to Eradicate!

06

Digital Health: Integrating Technology and Healthcare!

07

Preeclampsia

08

Asthma

IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021

ARTICLES

HEALTH SYSTEMS THEME

ARTICLES

LESSONS FROM THE PAST PAVING THE WAY TO THE FUTURE SDGs & Health for All (UHC)

Sustainable Development Goals (SDGs) is a convoluted long term for some, with an interesting history for others. It all dates back to September 2000 when the historic Millennium Declaration was signed by the leaders of 189 countries gathered at the United Nations headquarters to achieve a set of eight measurable goals which are: (1) Eradicate extreme poverty and hunger; (2) Achieve universal primary education; (3) Promote gender equality and empower women; (4) Reduce child mortality; (5) Improve maternal health; (6) Combat HIV/AIDS, malaria, and other diseases; (7) Ensure environmental sustainability; and (8) Develop a Global Partnership for Development by 2015. These goals were made to be accomplished by the year 2015.

Indeed, applying the Millennium Development Goals (MDGs) resulted in impressive progress, but there was another side to the coin. Not all goals were met due to various

limitations,

causing

uneven

achievements.

Firstly, MDGs were developed exclusively by certain actors

with

little

contribution

from

developing

countries.

Secondly, while the goals were not challenging enough for the developed countries, they were too difficult to achieve for the developing ones. Thirdly, they missed important issues: reducing inequality between nations, providing political and human rights, ending gender inequality secondary

instead and

environmental

of

decreasing

post-secondary issues,

and

it,

neglecting

education,

improving

fighting

health

reducing poverty from all important aspects.

and

HEALTH SYSTEMS THEME

ARTICLES

Thus, the clock ticked, and time for

advancing

health

change arrived. The Rio +20 conference

workforce

status,

promoted the development of a new set

and increasing the

of goals that will continue the progress

capacity

made by MDGs, marking the birth of

countries

SDGs in history. SDGs are a people-

fighting

centered development agenda composed

health risks.

of 17 goals with 169 targets that should ultimately spread prosperity across all countries. Those goals, should be met by 2030, are: no poverty, zero hunger, good

health

and

well-being,

quality

education, gender equality, clean water and sanitation, affordability and clean energy,

decent

work

growth,

industry

infrastructure, sustainable

and

cities

economic

innovation

reduced

responsible

and

underwater,

climate life

and

on

communities, and

action, land,

strong

and

inequalities,

consumption

production, justice

and

life

peace

and

institutions,

and

partnership for the goals.

good health and well-being. Diving into targets

of

this

goal,

we

find

it

tackling a wide scope of issues. Those targets aim for lowering the rates of maternal mortality, neonatal mortality, premature mortality, and deaths as well as

injuries

accidents

caused

into

by

half.

road

Also,

traffic

they

are

concerned with ending epidemics such as AIDS, tuberculosis, neglected tropical diseases,

water-borne

Furthermore and

they

treatment

increasing

of

diseases,

include to

etc.

prevention

substance

access

reproductive

abuse,

sexual

health-care

and

services,

achieving universal health coverage, and combatting illnesses from pollution and contamination

hazards.

Other

targets

include implementing WHO convention for tobacco control, supporting research and

production

medication,

of

all for

global

Of vital importance to us is the eighth target, universal health coverage (UHC) which means providing essential health service to individuals and communities without Those

imposing health

promotion

financial

services

to

hardship.

include

prevention,

health

treatment,

rehabilitation, and palliative care across the life course. UHC seeks to strengthen the health system and ensure that the system’s

performance

accepted

levels

efficiency,

of

achieves quality,

accountability,

the

equity,

resilience,

and sustainability. Moreover, progress towards UHC will be essential to other SDGs: ending poverty in all its forms

Our main focus will be the third goal, the

of

vaccines

and

everywhere, education

inclusive and

equitable

lifelong

opportunities, providing

and

learning

gender

access

to

equality,

justice

,

and

are

the

building accountable institutions.

In

summary,

SDGs,

descendants

of

which

MDGs,

are

the

continuation of the progress on the path of a bright future. The SDGs cover a large number of development aspects to achieve

sustainable

advancement

for

both countries and individuals. Meeting the

targets

of

the

third

SDG,

good

health and well-being, is vital because a health community is a well functioning productive

community,

and

presents

a

golden

promote

a

comprehensive

approach to health.

UHC

opportunity

to

coherent

HEALTH SYSTEMS THEME

ARTICLES

Global health and Social Health Determinants

ARE WE DIFFERENT? Perhaps you are wondering why some

For example: Lack of education will be

areas

an obstacle in employment which will

have

high

rates

of

certain

diseases and others do not? What is

lead

the reason for this difference? Maybe

reduces access to health services and

to

low

income

which

in

turn

it’s that not all areas are the same, we

nutrition.

don’t live in the same environment or community and therefore do not have

N o w th a t w e k n o w S D H i s a m a j o r

the same health issues. "Social Health

factor in determining health outcomes

Determinants" are factors that affect

we have to ask: What can we do to

the

reduce its negative impact on us?

health

status

of

a

community

which differs from one community to

Organizations

another.

working hard to improve health and reduce

across

health

the

globe

are

disparities

addressing

The

physical, and economic environments

World

Health

Organization

SDH

create

that

factors that affect our health.

potential for health and well-being for

include

income

and

social

attaining

social,

(WHO) defines it as the non-medical They

promote

to

by

What are Social Health Determinants?

the

full

all.

protection, education, unemployment

Following the World Conference on

and

Social Determinants of Health, 19-21

work

life

conditions,

housing,

access to affordable health services of

October

decent quality.

Brazil, ILO, UNAIDS, UNDP, UNFPA,

2011,

de

UNICEF

work together on social determinants

power,

and

resources among a society.

have

Janeiro,

distribution

money,

WHO

Rio

These circumstances are shaped by the of

and

in

agreed

to

of health to reduce health inequities and

promote

development,

they

Just to help us imagine the impact of

agreed to work on the four themes,

SDH on us, various studies stated that

which

SDH account for between 30-55% of

Capacity

health

and, Country work.

outcomes

underlying societal

cause

health

heart

&

is

of

a

today’s

concerns

disease,

significant as

diabetes,

loops

among

determinants of health.

and the

strengthening;

Advocacy; Monitoring;

major And also in the US every decade, the

and

“Healthy People” initiative develops a new

interactions

exist

interlinked:

obesity,

depression.

Complex

are

set

of

science-based

10-year

feedback

national objectives with the goal of

social

improving the health of all Americans.

HEALTH SYSTEMS THEME

ARTICLES

PRIMARY HEALTHCARE & FAMILY PHYSICIANS In line with the 2030 Agenda, the Egyptian

Primary

care

Government has launched a working plan

doctors,

nurse

called Egypt’s Vision 2030 to implement

assistants.

sustainable

specialties

development

goals

(SDGs),

providers

(PCP)

practitioners,

There as

are

some

well.

or

may

be

physician

primary

care

Geriatricians,

and

setting universal health coverage (UHC) as

pediatricians are all primary care doctors;

a priority goal. But what is UHC? UHC

they just specialize in caring for a particular

simply

group of people.

means

communities they

that

all

receive

need

the

without

hardship,

individuals health

suffering

including:

health

and

services financial

promotion,

An essential part of primary health care is family

medicine.

speciality

in

Family

which

the

Medicine

physician

is

a

provide

curative, and preventive services. In short,

comprehensive care for the individual and

UHC equals prosperity of people’s health.

family

One of the most important approaches that

affected

can help us reach our goal is the “Primary

integrating

healthcare

as

a

unit

organ,

regardless

and

type

biological,

of

of

age,

sex,

disease

by

clinical,

and

on

behavioral sciences. It should be noted that

health

the difference between family medicine and

systems so that people can access services

general practice is that a family physician

for their health and well-being based on

receives extensive training in comprehensive

their needs and preferences, as quickly as

and continuous outpatient medicine.

possible,

everyday

The broad education and wide spectrum of

environments. Simply, Primary healthcare

medical knowledge family physicians have

(PHC)

on

allow them to provide a wide range of health

scientifically sound and socially acceptable

services in the primary health care setting.

methods

Beside diagnosing and treating illnesses, they

approach”

organizing

is

and

and

that

focuses

strengthening

existing

essential making

in

their

healthcare universal

based

healthcare

accessible to all individuals and families in

give

a community.

check-ups,

Most people are very familiar with primary

Also,

care. It is their first contact with the health

manage chronic diseases, such as diabetes,

sector.

cancer,

For

instance,

you

may

see

your

preventive

care

through

screening,

and

cooperate

with

they

stroke,

asthma,

etc.

assessment,

immunization. specialists

to

Furthermore,

primary care doctor when you notice a new

they adapt to meet the needs of their specific

symptom

community through understanding the social

or

are

concerned

that

you

contracted a cold, the flu, or some other

determinants

bacterial or viral disease or even muscle

Family

physicians

sore or skin rash. Also, primary care is

contact

and

typically responsible for coordinating your

case of the need for referral.

care among specialists and other levels of

A family physician's duties are influenced by

care for example, when you need referral

t h e n a t u r e o f h i s / h e r s o c i e t y. T h o s e w o r k i n g

to a more specialized institution.

with other specialists need to provide only

Studies helped us estimate the importance

comprehensive care while those working as

of Primary health care, it has shown that

the only speciality locally available, like in

primary

rural areas, have also to perform surgeries

care

providers

benefit

the

healthcare system as a whole by delivering about 80% of essential health services.

of

health act

coordinate

of

their

as

people’s

with

society. first

specialists

and take care of patients in critical status.

in

HEALTH SYSTEMS THEME

ARTICLES

HEALTH WORKFORCE We all need good health and well-being, and one the most important pillars of this goal is a competent healthcare system, so let’s talk briefly about the personnel responsible for providing the healthcare.

Who are exactly the health workers? They are all people engaged in actions whose primary intent is to enhance health,

as

doctors

and

nurses,

helpers,

laboratory

technicians, or even medical waste handlers.

Some are clinical jobs, such as physicians who diagnose and treat,

nurse

practitioners

(NPs)

who

are

authorized

to

diagnose illnesses, treat conditions, and provide evidencebased health education to their patients. NPs assess their patients physical

by

examining

evaluations;

medical and

histories;

ordering

(or

performing performing)

diagnostic tests. In many countries, nurses make up half of all health care professionals and have a vital role in how health actions are organized and applied, both at the frontline and managerial levels. They are often the first and sometimes only health professional a patient will see and the quality of their initial assessment and subsequent care is vital to strong health outcomes.

Also, one of the important people in the healthcare process is physician assistants (PAs) who work interdependently with physicians, PAs provide diagnostic and therapeutic patient care in virtually all medical specialties and settings.

They take patient histories, perform physical examinations, order

laboratory

and

diagnostic

studies,

prescribe

medications, and develop patient treatment plans. Their job descriptions are as diverse as those of their supervising physicians, and include clinical practice, patient education, team leadership, medical education, health administration, and research.

Dentists diagnose oral diseases and create treatment plans to maintain or restore the oral health. Pharmacists, who are involved in all aspects of medicine delivery to patients, prepare

and

package

medication

that

a

doctor

prescribed and also sell medication over the counter.

has

HEALTH SYSTEMS THEME

ARTICLES

Other healthcare workers include physical

ional

therapists,

pressure,

occupational

therapists,

stressors, a

which

high

include

workload

low,

time social

physical and behavior therapists, as well

support at work, uncertainty about patient

as

treatment,

applied

health

professionals

phlebotomists,

medical

scientists,

dieticians,

therapists,

speech-language

such

as

laboratory respiratory

and

pstrong

emotional

responses due to encountering suffering and dying patients.

pathologists,

and social workers.

Thus, health care workers are at a high risk

of

experiencing

severe

distress,

Yet those heroes face several economic,

burnout, and both mental and physical

occupational, and social issues on a global

illness.

scale

reported

including

low

wages,

workforce

In

Egypt,

higher

different

prevalence

studies

of

burnout

shortage, work overload, limited resources

among HCWs, which ranged from 66.0% t

or low expenditure on the health system,

in Tanta, a moderate level, to 63.1% in

and violence, all of which is present in

Suez canal. Consequently, work pressure

Egypt too.

affects the quality of care provided by healthcare institutions.

As

for

wages,

reports

pointed

out

an

enormous gap in wages for health workers

Next

between rich and poor countries. Thus,

generation of resources is an important

many health workers migrate to countries

challenge

with better wages, causing challenges for

efficient utilization of available resources.

the

The

reforms

healthcare

and

improvements

systems

of

poor

in

countries.

is

limited to

overcome,

healthcare

advancements

too

system

since

is

as the

has

made

President

Abdel

Fattah

since 2016 as many as 10,000 Egyptians

health insurance (UHI) law in 2018. Yet,

work

overall spendings on health care remains

due

to

low

wages.

Low

In

Sisi

so

Just

According to Egyptian Medical Syndicate, abroad

El

resources.

fact,

introduced

a

government

universal

income also drives many to have a second

low.

job in the private sector.

decreased from 5.4% of the total budget in

expenditure

WHO estimates a projected shortfall of 18

FY 2014/15 to 4.7% in FY 2019/20.

million health workers by 2030, mostly in low- and lower-middle income countries.

Lastly is a widespread phenomenon in the

There

this

healthcare sector: violence. Personnel at

shortage which are present in all countries

Emergency Departments (EDs) are known

to

to

are

various

various

causes

degrees,

behind

such

as

under-

be

at

higher

risk

of

exposure

to

investment in education and training, the

violence from patients and their relatives

mismatch

or

between

education

and

friends

compared

with

other

population needs, difficulties in deploying

departments. Violence caused healthcare

health workers to rural, and under-served

professionals

areas,

and

helplessness,

health

workers

international

experience

absence of rights and justice, all of which

according to World Bank figures, in 2018

may lead to increased errors, decreased

Egypt had an estimated 0.45 physicians

quality

per 1000 people. According to WHO there

productivity and performance.

for

of

dissatisfaction,

anger,

depression,

stress,

As

job

to

humiliation,

health

shortages

exacerbates

of

Egypt,

workforce

that

migration

care,

and

feeling

an

decreased

were 74,923 doctors in 2019 and the total number

was

While the government is working hard to

approximately 207,000. The ministry of

of

nurses

in

Egypt

tackle the various issues of the healthcare

health estimates that Egypt suffers from a

system, you too can contribute to this

shortage of 44.000 nurses at all levels.

effort!

Increase

awareness

about

the

importance of our heroes and advocate for Several

studies

have

shown

that

health

care professionals suffer several occupat-

more respect and less violence directed toward them.

HEALTH SYSTEMS THEME

ARTICLES

One Health Approach

INTEGRATING TO ERADICATE! and

Even chronic diseases, mental health, injury,

microorganisms are all intertwined in a one

occupational health, and noncommunicable

big network called mother nature; our lives

diseases

and fates are interconnected. Humans have

programs.

reached this realization, and are now acting

One

upon it.

communication

Humans,

Indeed,

animals,

a

simple

plants,

reflection

of

how

the

are

included

Health

collaborations

in

the

approach between between

One

Health

needs

strong

various

sectors;

professionals

in

environment functions grants us the proof.

human, animal, environmental health, and

For example, the majority of the emergent

other relevant disciplines; controlling public

zoonotic infectious diseases originating in

health

animals, especially wildlife, are associated

diseases

with

cause

enforcement and policymakers. In summary,

Some

One Health is not achieved by stand-alone

human

disturbances

activities in

the

that

ecosystem.

diseases, such as rabies, can effectively be prevented

only

by

targeting

the

threats

and

spread;

learning and

about

effective

how law

actions but rather by collective work.

animal

source. Vaccines are developed based on Information

on

the

selection

of

viruses.

One Health Approach aims to Strengthening monitoring, surveillance, and reporting systems to detect and prevent animal and zoonotic disease emergence and control disease spread Understanding risk factors for disease spread from wildlife to domestic animals and humans to prevent and manage disease outbreaks Reinforcing veterinary and plant health infrastructure Promoting for safe food and animal production practices Controlling environmental threats and disturbances that give rise to health emergencies and disease outbreak Expanding the capacities of the food and agriculture sectors to combat and minimize the risks of AMR Developing capacities at all levels for better coordination and knowledge exchange among institutions and stakeholders Forming effective policies and providing education on One Health and its goals

Drug-resistant microbes can be transmitted from

animals

contact

or

to

humans

indirect

through

contact

direct

such

as

contaminated food.

Thus,

it

is

crucial

to

develop

an

interdisciplinary approach of health that recognizes the interconnectivity of all life systems

on

planet

earth:

One

Health

approach. Its main goal is planning and implementing

programmes,

policies,

legislation, and research in which different sectors work together to achieve optimal health

outcomes.

The

World

Health

Organization (WHO) collaborates with the Food and

and the

Agriculture

World

Organization(FAO)

Organisation

for

Animal

Health (OIE) to create and support multisectoral operate

One at

the

Health

programmes

that

human-animal-ecosystem

interface.

One food

Health

approach

safety,

antimicrobial

is

concerned

zoonotic resistance,

with

diseases, vector-borne

In short, to save our beautiful mother nature, it

is

of

vital

importance

to

adopt

an

diseases, contamination, and other health

interdisciplinary approach that tackles health

threats shared by people, animals, and the

from all its aspects.

environment.

HEALTH SYSTEMS THEME

ARTICLES

Digital Health

INTEGRATING TECHNOLOGY AND HEALTHCARE! Nowadays,

technology

is

What is Digital Health?

taking a role in almost every

While digital health is a simple concept — using technology to

field in our daily lives. This

help improve individuals' health and wellness — it's a broad

can also be seen clearly in

and growing sector. It can cover everything from wearable

the

and

gadgets to ingestible sensors, from mobile health apps to

and

artificial

scope

of

healthcare. scale

up

health

The

of

use

digital

health

intelligence,

from

robotic

solutions can revolutionize

digital

how

change, to the healthcare sector.

people

worldwide

carers

to

electronic

records. In a nutn, early diagnosshell, it is about applying transformation,

through

technologies

and

cultural

achieve higher standards of

What Are the Benefits of Digital Health Technologies?

health, and access services

Digital tools are giving healthcare providers a more broad and

to promote and protect their

interconnected view of patient health through easier access to

health and well-being.

data and giving patients more control over their health. Digital health offers real opportunities to improve medical outcomes and enhance efficiency.

These technologies can empower consumers to make better-

Where can Digital health be found?

Digital health implementations can be spotted almost everywhere including our homes. Some the current examples are: Telemedicine: it is about digitization of medical records, remote care, appointment booking, self-symptom checkers, patient outcome reporting.

Wearable technology: it promotes self-monitoring and typically associated with fitness and sleep tracking.

Augmented and virtual reality: which are used to build smart devices for healthcare professionals.

informed decisions about their own health and provide new options for facilitating preventiois of life-threatening diseases, and management of chronic conditions outside of traditional health care settings. Providers and other stakeholders are using digital

health

technologies

in

their

efforts

to

reduce

inefficiencies, improve access, reduce costs, increase quality, and make medicine more personalized for patients.

Patients and consumers can use digital health technologies to better manage and track their health and wellness-related activities.

The use of technologies, such as smartphones, social networks, and internet applications, is not only changing the way we communicate, but also providing innovative ways for us to monitor our health and well-being and giving us greater access to information. Together, these advancements are leading to an

integration

of

people,

information,

technology,

and

connectivity to improve health care and health outcomes.

Long Term Aims with Digital Health Implementation By implementing digital health, organisations are aiming to improve health for everyone, everywhere by accelerating the development affordable,

and

scalable

adoption and

of

appropriate,

sustainable

person

accessible,

centric

digital

health solutions to prevent, detect and respond to epidemics and pandemics, developing infrastructure and applications that enable countries to use health data to promote health and wellbeing, and to achieve the health-related SDGs.

HEALTH SYSTEMS THEME

ARTICLES

May

PREECLAMPSIA Preeclampsia death

is

and

one

severe

of

the

leading

maternal

causes

morbidity.

of It's

prevalence is still underestimated in some places due to underreporting.

Preeclampsia Awareness Month

T h er e a r e a l s o s o m e o t h e r r i s k f a c t o r s t h a t w e c a r e to display which are 1. A p e r s o n a l o r f a m i l y h i s t o r y o f p r e e c l a m p s i a significantly raises risk of preeclampsia.

2. C h r o n i c h y p e r t e n s i o n .

3. T h e r i s k o f d e v e l o p i n g p r e e c l a m p s i a i s h i g h e s t

So what about the Symptoms & diagnosis?

T o d i a g n o s e pr e e c l a m p s i a , p a t i e n t h a s t o h a v e

d u r i n g t h e f i r s t p r e g n a n c y.

4. N e w

paternity.

Each

pregnancy

with

a

new

high blood pressure and one or more of the

partner increases the risk of preeclampsia more

following complications after the 20th week of

than does a second or third pregnancy with the same partner.

pregnancy: Preeclampsia comes with high blood pressure and complications

following

the

20th

week

of

pregnancy in women whose blood pressure had been normal. Such as

women

as

well

as

pregnant

6. R a c e .

Black

women

have

a

higher

risk

of

7. O b e s i t y . T h e r i s k o f p r e e c l a m p s i a i s h i g h e r i f

Low platelet count

you're obese.

Impaired liver function Pulmonary edema; fluid in the lungs resulting in shortness of breath disturbances

pregnant

women older than 35.

races.

Decreased urine output

of

young

developing preeclampsia than women of other

Proteinuria; Protein in urine.

New-onset

5. A g e . T h e r i s k o f p r e e c l a m p s i a i s h i g h e r f o r v e r y

severe

headaches

including

or

temporary

visual

loss

of

vision, blurred vision or light sensitivity.

8. M u l t i p l e

pregnancies.

common

in

women

Preeclampsia

who

are

is

more

carrying

twins,

Having

babies

triplets or other multiples.

9. I n t e r v a l

between

pregnancies.

less than two years or more than 10 years apart leads to a higher risk of preeclampsia.

1 0. H i s t o r y o f c e r t a i n c o n d i t i o n s . H a v i n g c e r t a i n conditions before you become pregnant — such

So what causes Preeclampsia?

It

is

a

result

of

several

as chronic high blood pressure, migraines, type

factors.

Researchers

1 or type 2 diabetes, kidney disease, a tendency

believe it begins in the Placenta; that nourishes

to develop blood clots, or lupus — increases

the fetus during pregnancy. Early in pregnancy, new

blood

vessels

evolve

to

efficiently

your risk of preeclampsia.

send

1 1. I n v i t r o f e r t i l i z a t i o n . Y o u r r i s k o f p r e e c l a m p s i a

blood containing oxygen and nutrients to the

is increased if your baby was conceived with in

placenta.

vitro fertilization.

In women with preeclampsia, these blood vessels are narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them.

Causes

of

this

abnormal

development

may

include:

Tendency of preeclampsia occurrence is around the

first

trimester,

third

A problem with the immune system

been

trimester.

This

proportion

of

pregnant

women may develop preeclampsia after 32 weeks

Certain genes

of gestation . However, there is an undeniable concentration

magnitude

of

the

social

and

economic impact of preeclampsia, and evident clinical

have

need to be reassessed in a late-second or early-

Damage to the blood vessels

the

models

fact that a huge proportion of pregnant women

Insufficient blood flow to the uterus

Considering

some

proposed in later gestational ages, based on the

consequences,

there

is

a

need

anticipate this condition before occurring.

to

Over

the

markers

of

years, were

effort

in

the

biophysical identified

as

first

and

trimester.

biochemical

possible

early

indicators of failures in the complex placentation process, which would lead to preeclampsia.

HEALTH SYSTEMS THEME

ARTICLES

Pathogenesis

Treatment

T h e p a t h o g e n e s i s o f pr e e c l a m p s i a i s c o m p l e x a n d

The most effective treatment for preeclampsia is

not fully understood, however, it is known to

delivery.

involve

You're

at

increased

risk

of

seizures,

systemic

placental abruption, stroke and possibly severe

inflammation, and oxidative stress as has been

bleeding until your blood pressure decreases. Of

described

course,

dysfunctional

placentation,

elsewhere.

Abnormal

placentation

occurs due to failure of appropriate remodelling of

the

spiral

resistance

arteries,

to

resulting

placental

in

blood

if

it's

too

early

in

your

pregnancy,

delivery may not be the best thing for the baby.

higher

flow

and

If a patient is diagnosed with preeclampsia, the doctor

will

chronic placental ischemia and reduced blood

visits,

more

flow to the developing fetus. These maladaptive

recommended for pregnancy. Along with more

processes

and

frequent blood tests, ultrasounds and nonstress

adverse outcomes including IUGR, preterm birth,

tests than would be expected in an uncomplicated

oligohydramnios,

pregnancy.

hypoperfusion

can

of

the

placenta.

precipitate

fetal

placental

This

causes

hypoxia

abruption,

fetal

increase

the

frequently

number than

of

what's

prenatal typically

distress, and fetal death in utero. The frequency of fetal complications differs depending on the

Possible treatment for preeclampsia may include

onset

Medications

of

preeclampsia.

preeclampsia

has

Early

been

onset

associated

of with

to

lower

blood

pressure,

Corticosteroids and Anticonvulsant medications.

significantly higher rates of adverse outcomes for

Bed rest used to be routinely recommended for

the fetus, including IUGR, oligohydramnios, and

women with preeclampsia. But research hasn't

fetal death.

shown a benefit from this practice, and it can increase

your

risk

of

blood

clots,

as

well

as

impact your economic and social lives. For most women, bed rest is no longer recommended.

Prevention

Severe preeclampsia may require that you be

So is there a way to prevent Preeclampsia?

Researchers continue to explore ways to prevent preeclampsia,but emerged.However,

no

clear

lowering

strategies the

risk

have of

Preeclampsia could be done by 1. L o s i n g w e i g h t i f y o u a r e o v e r w e i g h t .

2. S t o p p i n g s m o k i n g d u r i n g p r e g n a n c y 3. G e t t i n g b l o o d p r e s s u r e u n d e r c o n t r o l , i n c a s e s of chronic hypertension.

4. M a i n t a i n i n g a r e g u l a r e x e r c i s e r o u t i n e .

5. T a k i n g a b a b y a s p i r i n ( 8 1 m g ) d a i l y a f t e r 1 2 weeks gestation in high-risk pregnancies.

It is important to note that any supplements or medication should be prescribed by a doctor.

The best way to keep both mother and baby healthy throughout pregnancy is via scheduled prenatal visits for continuous checks on blood pressure and any other signs and symptoms of preeclampsia.

hospitalized. In the hospital, your doctor may perform regular nonstress tests or biophysical profiles to monitor your baby's well-being and measure the volume of amniotic fluid. A lack of amniotic fluid is a sign of poor blood supply to the baby.

If you're diagnosed with preeclampsia near the end

of

your

recommend

pregnancy,

inducing

your

labor

right

doctor

may

away.

The

readiness of your cervix, whether it's beginning to open, thin and soften also may be a factor in determining induced.

whether

or

when

labor

will

be

HEALTH SYSTEMS THEME

ARTICLES

Asthma is a common pathology, Leading to multiple

ASTHMA

hospital admissions and increased healthcare costs.

Thus

we

deaths

can

conclude

occur

countries,

in

low-

where

that and

most

asthma-related

lower-middle

under-diagnosis

and

income under-

treatment is a challenge.

Asthma affects around 15% to 20% of people in developed countries and around 2% to 4% in less Asthma is a major NCD, affecting both children and

developed

adults. It is a common disease that varies in severity,

common in children.

from a very mild, occasional wheeze to acute, life-

Of all the asthma cases, about 66% are diagnosed

threatening airway closure. It usually presents in

before the age of 18 years. Almost 50% of children

childhood and is associated with other features of

with

atopy (refers to the genetic tendency to develop

disappearance of symptoms during early adulthood.

allergic diseases) such as eczema and hayfever.

Of all the asthma cases, about 66% are diagnosed

countries.

asthma

have

It

a

is

significantly

decrease

in

more

severity

or

before the age of 18 years. Almost 50% of children The

key

which

feature

can

be

is

airway

triggered

by

hyper-responsiveness,

with

many

disappearance of symptoms during early adulthood.

factors

(called

asthma

have

a

decrease

in

severity

or

triggers). If not treated promptly, asthma has a high mortality. According to the WHO asthma affected an estimated 262 million people in 2019 and caused

Management

461000 deaths.

So how does a patient manage Asthma?

There Asthma comprises a range of diseases and has a variety

of

heterogeneous

phenotypes.

The

recognized factors that are associated with asthma are a genetic predisposition, specifically a personal or family history of atopy. It's also associated with exposure to triggers such as

that

are

Inhaled corticosteroids are considered the most effective

long

managing

term

asthma.

As

usage they

medication decrease

for

airway

inflammation and prevent asthma flare-ups. Eg: Fluticasone beta-agonist

(LABA).

that

are

LABAs

are

helpful

in

only in combination with a corticosteroid to

Grass and tree pollen

treat asthma. (Inhaled form)

Animal fur & feathers

Anticholinergics:

Strong soaps & perfume is

lines

opening airways. N.B: LABAs should be taken

Changes in the weather

cause

treatment

symptom-controllers

Dust, smoke & fumes

overall

some

long-acting

Viral infections (colds)

The

are

recommended by doctors such as

complex

and

not

fully

understood, but it is agreed that asthma is influenced by both genetics and environmental exposure.

they

are

also

known

as

antimuscarinic agents, they target the junction between nerves and muscle cells in the airway to maintain bronchodilation and reduce mucus production. They are taken by using an inhaler.

Eg: tiotropium Leukotriene modifiers; leukotriene antagonists.

Oppose the effects of leukotrienes. N.B: Where

Asthma could be classified into types according to its onset and triggers: Exercise-induced

asthma

(EIA)

or

exercise-

induced bronchoconstriction (EIB), where people develop

asthma

exercise,especially

symptoms high

intensity

during (strenuous)

exercise.

Allergic Asthma. People with a family history of allergies or asthma are more prone to developing asthma.

Nonallergic

Asthma.

Commonly

triggered

by

illnesses, environmental factors and medications.

Occupational asthma is caused by inhaling fumes, gases,

dust

or

other

potentially

harmful

substances while on the job.

Childhood asthma

asthma;

before

the

where age

of

children five.

This

millions of children and their families.

develop impacts

leukotrienes

are

inflammatory

chemicals

released when the body's immune system senses an allergen causing the tightening of airways as well as excess mucus and fluid production.

Another way to manage asthma is via Exercise.

Exercise is important for overall health as well as lung

health,

and

there

are

many

benefits

of

physical activity for people living with asthma.

Daily exercise helps to improve lung capacity; the maximum amount of oxygen your body can use.

Exercise also increases blood flow to our lungs, promoting blood flow to the heart which pumps oxygen throughout your body. Ie;people who exercise have more ability to pull oxygen from the lungs and into the blood that feeds the muscles that keep us going.

"Our health care system has failed when a doctor fails to treat an illness that is treatable.”

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