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Under the Patronage of

H.H. Sheikh Hamdan Bin Rashid Al Maktoum Deputy Ruler of Dubai, Minister of Finance, UAE. President of Dubai Health Authority

in collaboration with World Federation of Public Health Associations

1st Arab World Conference on Public Health 4 – 6 April, 2013

Jumeirah Creekside Hotel, Dubai, UAE

Conference Book

11 CME Hours Accredited by www.publichealthdubai.com Organized by:

Supported by:

Conference Secretariat: Public Health and Safety Department of DHA, Email: publichealthdubai@mci-group.com

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MCI Middle East, Tel: +971 4 311 6300, Fax: +971 4 311 6301

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His Highness Sheikh Khalifa Bin Zayed Al Nahyan President of the U.A.E

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His Highness Sheikh Mohammed Bin Rashid Al Maktoum Vice President, Prime Minister and Ruler of Dubai

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H. H. Sheikh Hamdan bin Mohammed bin Rashid Al Maktoum Crown Prince of Dubai

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His Highness Sheikh Hamdan Bin Rashid Al Maktoum Deputy Ruler of Dubai, Minister of Finance, UAE President of Dubai Health Authority

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Table of Contents

Welcome Messages................................................................................................ 12 Committees Steering Committee ................................................................................................ 15 Scientific Committee ............................................................................................... 16 International Advisory Committee ........................................................................... 17 General Information ................................................................................................ 18 Exhibition Venue Layout ......................................................................................... 20 Scientific Program ................................................................................................... 21 Keynote Speakers .................................................................................................. 25 Speakers ................................................................................................................. 36 Abstracts ............................................................................................................... 44 Poster Presentation................................................................................................ 80 Experience Dubai ..................................................................................................... 99 Notes ....................................................................................................................... 101 Acknowledgement.................................................................................................... 104

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Welcome Message

Dear Colleagues,

On behalf of the Government of Dubai and the Dubai Health Authority, the strategic health authority for the Emirate of Dubai, we are delighted to be your host for the 1st Arab World Conference on Public Health and we welcome you to the UAE, Dubai city. Dubai offers excellent healthcare services to its population and visitors, and in line with the Dubai Strategic Plan 2015, as envisioned by His Highness Sheikh Mohammad Bin Rashid Al Maktoum, VicePresident and Prime Minister of UAE and Ruler of Dubai and as per the Dubai Health Strategy, we are working on a multifaceted approach to ensure we further improve the level of health and healthcare in the Emirate and provide healthcare services that are at par with the best in the world. We are pleased that Dubai is hosting this vital conference, which is taking place for the first time in the region. A robust public health system is crucial to ensure a healthier population. Arab countries in the world are faced with communicable as well as a high prevalence of non-communicable diseases such as diabetes, obesity etc. Therefore, it is pivotal that we come together through such conferences, to jointly address the public health challenges and opportunities and to follow-up on post-conference recommendations. Dubai Health Authority is working at various levels to ensure better health for the population of Dubai. We have implemented several public health policies such as the unified immunization guideline for the Emirate of Dubai; we also developed several nutritional guidelines for school children in the Emirate. In terms of public outreach, the DHA actively undertakes public health awareness campaigns. This multifaceted approach towards public health is vital for better health for all sections of our society. Hosting conferences, such as this one, is part of our strategy; as such conferences bring together health professionals from the region and abroad and provide an opportunity to exchange state-of-the-art information on new developments in the field. With this, I wish you a successful conference and a pleasant stay in Dubai.

His Excellency Engineer Essa Al Maidoor Director-General Dubai Health Authority

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Welcome Message

Dear Colleagues,

Invited remarks by the President of the World Federation of Public Health Associations (WFPHA) Your Excellencies, Distinguished Delegates, and Participants at the 1st Arab World Conference on Public Health, On behalf of the over 75 member national public health associations and other member organizations of the World Federation of Public Health Associations, it is my honour and my pleasure to extend a warm welcome to all of you, who have come together for the first time to discuss the status of public health and the role of civil society as a partner to improve and safeguard the public’s health in the Arab world. The United Arab Emirates and specifically the Emirate of Dubai are certainly one of the most suitable places to hold such a meeting. I congratulate and thank the Dubai Health Authority for taking the initiative for this ground breaking event. The World Federation is the only non-governmental global body representing public health professionals. It is officially affiliated with the World Health Organization, and plays a leadership role in the quest for a healthy global society comprising the right to health, diversity and inclusion, partnership and ethical conduct. The risks and challenges to the health of our populations are multiple and obvious: ecosystem health issues such as climate change, civil unrest, poverty and hunger, poor access to and quality of health services, the lack of attention to the social determinants of health, and the double burden of infectious and non-communicable diseases, including the emergence of resistant strains of Tuberculosis and the increase in premature death due to myocardial infarction, diabetes, stroke, and cancer, all of which are largely preventable. I strongly believe that this conference will provide an opportunity to exchange experience on public health concerns and advance communication at national, regional, and international levels. WFPHA looks forward to collaboration with our Arab colleagues not only during this high level conference but even more so during the months and years to come. I wish you a pleasant stay in hospitable Dubai and a dynamic development of your public health network with its common vision oriented towards a future of ‘Health for All’.

James Chauvin President, World Federation of Public Health Associations

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Welcome Message

Dear Colleagues,

It gives us great pleasure to welcome you to the 1st Arab World conference on Public Health. This conference is built upon the hope that it will bring in all the Arab World together in prompting excellence in public health services. Our Department of Public Health and Safety under the Health Policy and Strategy Sector, of Dubai Health Authority has pioneered to take the initiative of organizing the 1st Arab World Conference on Public Health, being held in Dubai from April 4 to 6, 2013. The objective of the conference are to: • • • •

Serve as a regional forum for exchange of success stories and experiences on key public Health issues in the Arab countries. Contribute towards promoting and protecting public health at regional and national levels. Create a better understanding and discussion of the Arab world major public health challenges within the global public health community. Facilitate and support the development of the Arab World Public Health Association (AWPHA) and Dubai Public Health Declaration which may be used for implementing and following up the outcome of this conference.

We acknowledge that organizing such a conference is important but we also acknowledge that post conference follow up may be equally if not more vital in implementing its objectives. In view of this notion, PHSD has drafted a 5 year plan to host similar scientific events, each year, to keep the momentum of determination in providing excellence of health care services in the Arab World. The Arab world which constitutes 22 countries, is very unique as the countries in it are markedly heterogeneous. With increasing urbanization, countries are consequently facing a double burden: Communicable diseases while simultaneously responding to Non Communicable Diseases. Therefore the continuous challenge to Public Health and safety remain enormous. Communications revolution that redefines the geographical and social boundaries for exchange of health information and health services are essential. Coming together to understand what works, why it had an effect and how the approach can be customized for other countries is one of the conference’s key mission. We anticipate all Arab countries will take this opportunity and come closer in sharing their accomplishments and challenges such that we may all benefit from each other. We look forward to your active participation during this stimulating program. Dr. Wasif Muhammad Alam Director, Public Health and Safety Department (PHSD) & Member of the conference Steering Committee. Dubai Health Authority, UAE

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Steering Committee Members

Ms. Laila Al Jassmi

Dr. Khalil Ibrahim Qayad Director, Department Medical Education, Dubai Health Authority

Dr Marta Lomazzi World Federation of Public Health Associations

Dr. Wasif Muhammad Alam Director of the Department of Public Health and Safety Dubai Health Authority

Mr. Ghanim Abdullah Lootah Acting Director of Institutional Marketing and Communications Department, DHA

Dr Mouza AlSharhan Vice President Emirates Medical Association, Emirates Medical Association

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Scientific Committee

Dr. Lubna Al Shaali Head of Scientific Committee Public Health Specialist Dubai Health Authority (DHA)

Dr. Rasha Salama Senior Specialist Public Health Dubai Health Authority (DHA)

Dr. Farida Ismail Al Hosani Manager of Communicable Diseases Department Health Authority Abu Dhabi (HAAD)

Dr. Mahera Abdulrahman Medical Education Department Dubai Health Authority (DHA)

Dr. Saif Albedwawi Consultant Infectious Diseases , Head of Infection Control Dept. Zayed Military Hospital. Medical Services Corps- Armed Forces

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Prof. Mustafa Hassan Dean e-School of Health and Environmental Studies Hamdan bin mohammed e-university - Dubai

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Prof. Ulrich Laaser, Germany Immediate past president World Federation of Public Health Associations (WFPHA)

Dr. Syed Shah United Arab Emirates University (UAEU)

Dr. Jamal Al Mutawa Health Authority Abu Dhabi (HAAD)


International Advisory Committee

Prof. Tawfik A. M. Khoja, KSA Director General, Executive Board, Health Ministers’ Council for Cooperative Council States

Prof. Salman Rawaf, UK Prof. Ulrich Laaser, Germany Director of WHO Collaborating Immediate past president Centre School of Public Health, World Federation of Public Faculty of Medicine, Imperial College Health Associations (WFPHA)

Dr. Tewabech Bishaw, Ethiopia Executive Director African Federation of Public Health Associations (AFPHA)

Dr. Mohammed Bin Hamad J. Al Thani, Qatar Director, Department of Public Health, Supreme Council of Health

Prof. David D. Celentano, USA Charles Armstrong Chairman and Professor, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205

Prof. Laura L. Morlock, USA Associate Dean for Education. Professor, Health Policy and Management, Johns Hopkins Bloomberg School of Public Health Baltimore, MD

Prof. Samer Jabbour, Lebanon Associate Professor of Public Health Practice, Faculty of Health Siences American University of Beirut

Dr. Mariam Jalahma, Bahrain Assistant undersecretary for Primary care & Public Health, Ministry of Health

Prof. Vesna Bjegovic-M kanovic, Serbia, President elect Association of Schools of Public Health in the European Region (ASPHER)

Dr. Ahmed Javed Rahmanzai, Afghanistan Member Governance Council World Federation of Public Health Associations. Founding Member Afghanistan National Public Health Association.

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General Information Registration Desk: Registration desks for name badge collection and Onsite registration will be operational as below: 4 April 2013, 7:30 AM onwards 5 April 2013, 7:30 AM onwards 6 April 2013, 7:30 AM onwards For Delegates: Registration fees entitles participants to attend all the general & concurrent sessions, entrance to exhibition, Opening Ceremony, daily coffee breaks, daily lunch and conference materials. For Accompanying Persons: Accompanying Persons are entitled to opening ceremony Badges: Name badges must be visible and used at all times at the Conference Venue. Badge Colors:

Gold : Committee (all access) Red : Faculty/Speaker (all access) Black : Organizer (all access) Violet : Media (all access) Blue : Delegate (all access except speaker preview room) Green : Exhibitor (all access except speaker preview room)

Conference Bags: Conference bags will be distributed to registered participants at the Registration Desk CME Certification: 11 CME hours accredited by DHA . Speaker Registration & Preview Room: There is a dedicated registration room for speaker registration and badge collection at the Speaker Preview Room and is operational during same time as the registration desks. NOTE: All speakers are requested to report at least 1 hour before their session for a final check on their presentation material. Food & Beverage: • •

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Coffee Breaks and Lunch will be open to all registered delegates ONLY. Lunch will be served in Grand Atelier

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General Information Exhibition: The 1st Arab World Conference on Public Health exhibition will be located in the Ground floor Foyer area next to the back entrance Language: English is the official language of the congress. Rules: Smoking Policy: Jumeirah Creekside is a non-smoking venue. Participants are requested to exit the building when smoking is desired to designated smoking corners. Mobile Phones: Delegates are kindly requested to keep their mobile phones in the off mode in meeting rooms when scientific sessions are in progress. Parking: 24 hours courtesy valet parking is available at the congress venue. Emergency Contact: While in Dubai during the conference, for any emergency, please contact the following people from the congress secretariat:

Fadi Dannoura +971 50 890 2626

Eyad Zerba +971 55 203 5000

Congress Secretariat: Public Health & Safety Department of DHA Email: publichealthdubai@mci-group.com MCI Middle East LLC P.O. Box: 124752 Dubai, United Arab Emirates Tel: +971 (4) 311 6300 Fax: +971 (4) 311 6301

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Exhibiton Venue Layout


Scientific Program Day 1 (April 4, 2013) Hall 1, 2 & 3 07:30 - 09:00

Registration and Welcome Coffee

09:00 - 10:00

Opening Ceremony Plenary Session

10:00 - 10:30 10:30 - 11:00 11:00 - 11:30 11:30 - 12:00 12:00 - 12:30 12:30 - 13:00 13:00 - 14:30 Session Theme

Tawfik A. M. Khoja -(Health Ministers’ Council for the GCC States)-The Way Forward to Arab Public Health: Vital need of Public Health Laws and Systems in the GCC Countries Ulrich Laaser- The Universal Renaissance of Public Health (World Federation of Public Health Associations WFPHA): From Marginality to Relevance and Structure Coffee Break Salman Rawaf (UK) - Public Health Training: From academic to service competencies Tewabech Bishaw (Ethiopia) - Role of Public Health Associations in National, Regional, and Global Health Development Pannel Discussion: Moderator - Laura L. Morlock (USA) & Hala AboTaleb (WHO-EMRO) Lunch Break Night Ballroom Session 1 Health Information

14:30 - 14:50

Linda Dimitropoulos (USA) – Applying Information Technology to build capacity and improve quality in public health

14:50 - 15:10

Mohannad Hammami (USA) Health Information Exchange: A Public Health Necessity

15:10 - 15:30

Mohammad Al Redha (UAE) DHA ehealth: The vision for centralized registries

Moderator David D. Celentano (USA) 15:30 - 16:00 Session Theme

16:00 - 16:20

16:20 - 16:40

Day Ballroom Session 2 Public Health: a new perspective Omniyat Mohammed AlHajeri (UAE) Public Health Challenges and Opportunities in Emirate of Abu Dhabi

Grand Studio Session 3 Public Health Surveillance Farida Alhusani (UAE) Public Health Surveillance Systems development and evaluation

Manal Labib Fahim (Egypt) Bothaina Ahmed Al-Tall (Yemen) Upgrading virological influenza Public Health Within A Changing epidemiological Influenza-like Context Illness surveillance: steps and public health value, Egypt, 2009 - 2012

Bettina Borisch (WFPHA)Millennium Development Goals

Moderator Redha Hassan Salman (UAE) & Bettina Borisch (WFPHA)

Jens Thomsen / Yousuf Naqvi (UAE) A New Electronic Surveillance Program to Monitor Antimicrobial Resistance in Human Pathogens Moderator Farida Alhusani (UAE)

Coffee Break Night Ballroom Session 4

Day Ballroom Session 5

Public Health services in the Arab World Samir Banoob (USA) Planning and development of human resources for health in the Arab World challenges of Quality, shortage and oversupply Khalid Sharif Alawadhi (UAE) – Food borne diseases surveillance system in the Emirate of Dubai

Health Promotion

Grand Studio Session 6 Essential Public Health interventions

Sherein Tareef Elnossery (Egypt) Healthy lifestyle of middle aged attending outpatient clinics in Alexandria, Egypt, 2009

Khalifa Elmusharaf (Bahrain) Participatory Health System Research: Knowledge Translation and Multilevel Capacity Building

Amy Elizabeth Roussel (USA) Health Promotion in the 21st Century: How can We Make the Healthy Choice the Easy Choice?

Nargis Albert Labib/Rasha Aziz (Egypt) A Comparison Of The Egyptian Public Rankings Of Key Public Health and Environmental Issues by Occupation and by Gender (Pilot Study)

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Scientific Program 16:40 - 17:00

Heba M. Mamdouh (UAE) Healthcare Investment In Dubai: Values, opportunities And Challenges

Ruth Mabry (Oman) – Addressing Physical Inactivity In The GCC: A Population Health Imperative

17:00 - 17:20

Syed M Shah (UAE) Awareness, medication use and control of blood pressure in an immigrant population of United Arab Emirate

Basmah Faisal Kattan (KSA) Knowledge, Attitudes, and acceptance of HPV vaccine among Paediatricians and Gynaecologists in Riyadh, Saudi Arabia

17:20 - 17:40

Heitham Mohammed Ibrahim Awadalla (Sudan) – Quality Assurance Program (QAP) implementation in Sudanese hospitals: lessons learned

Mahbub Ali Abdukie (Ethiopia) Assessment of HIV counselling and testing service in Bahirdar town, Ethiopia

Kadhim Alabady (UK) Mental Health Needs Assessment for Norfolk / UK

Moderator Amy Roussel (USA)

Moderator Syed Shah (UAE)

Moderator Moustafa Hassan (UAE)

Jalaa Asaad Taher (UAE)Cervical cancer preventionHPV vaccination Nahed Jaafar Al Yousef (UAE) Traveller’s health

Scientific Program

Day 2 (April 5, 2013)

Hall 1, 2 & 3 07:30 - 08:30

Registration and Morning Coffee

08:30 - 09:00

Maryam Jalahma (Bahrain) - The intelligent inspection: Towards a country free from food poising, a model of excellence in performance

09:0 - 09:30

David D. Celentano (USA) - The current state of epidemiology in the Arab World: Prospects for the future

09:30 - 10:00

Sheikh Mohammed Al Thani (Qatar) - Public Health Development and challenges in Qatar

10:00 - 10:30

Ahmed Javed Rahmanzai (Afghanistan) - Promoting Regional Collaboration through establishment of network of Public Health Professional Associations

10:30 - 11:00

Coffee Break

11:00 - 11:30 11:30 - 12:00 12:00 - 12:30 12:30 - 14:30

Lindsey Davies (UK) – Current concepts and issues for Public Health in the UK

Session

Laura L. Morlock (USA) - Public Health in the Arab World: Closing the Gap between Evidence and Action Pannel Discussion: Moderator - Tawfik Khoja (Health Ministers’ Council for the GCC States) & Bettina Borisch (WFPHA) Lunch and Prayer Night Ballroom Session 7

Grand Studio Session 9

Screening & Surveillance – A Critical Public Health Service

Injury- Epidemiology and Prevention

Wasif Muhammad Alam (UAE) – Occupational health: Is it a priority in the Arab World?

Idris Alobaidani (Oman) Future Vision on Public Health Surveillance

Michal Grivna (UAE) Principles of injury prevention: The United Arab Emirates perspective

14:50 - 15:10

Hana Taha (Jordan) Her health is a priority, Men’s perceptions about breast cancer and their role in women's screening decisions: a qualitative study from Jordan

Lamees Abu Hlaiqa (UAE) Observations on Premarital Screening and Counselling Program in Abu Dhabi Emirate

15:10 - 15:30

Hanan Ali Obaid (UAE) – Tobacco Use and Associated Factors among school students in Dubai, 2010: Intervention Study

Theme

14:30 - 14:50

Healthy lifestyle in the Arab Countries

Moderator Rasha Salama (UAE) 15:30 - 16:00

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Day Ballroom Session 8

Khawla Belhoul (UAE) Hemoglobinopathy Carrier Prevalence in the United Arab Emirates: First Analysis of Dubai Health Authority Premarital Screening Program Results Moderator Mahera Abdelrahman (UAE)

Coffee Break

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David Cheng Min Huang (UAE) Burden of Injuries in Abu Dhabi and the development of injuries notification system Ali Salem Al Qaiwani (UAE)Challenges of Occupational Health and safety in UAE

Moderator Michal Grivna (UAE)


Scientific Program Session Theme

Night Ballroom Session 10

Day Ballroom Session 11

Non-communicable diseases

Communicable diseases: epidemiology and prevention

Aaesha Ebrahim A Mehairi (UAE )– Metabolic Syndrome Among Emirati Adolescents: A Population Based Study

Grand Studio Session 12 Oral Health: reflections from the Arab World

Ali Ahmed Jaawal (Yemen) Dengue or Chikungynya Fever Outbreak?

S. Al Bulushi (Oman) Oral health and workforce issues – reflections from Oman

16:20 - 16:40

Habiba Alsafar (UAE) The Prevalence of Type 2 Diabetes Mellitus in the United Arab Emirates: Justification for the Establishment of the Emirates Family Registry

Nasser Hamed (Egypt) Identification of contaminated water source for Gastroenteritis outbreak, Menofeya Governorate Egypt 2012

Mohamed Al Rafee (KSA) Oral health challenges from Saudi Arabia

16:40 - 17:00

AlJohara AlQuaiz (KSA) Predictors of low bone mass density in high risk Saudi women: a community based survey

Fuad Mohammed Shamsan (Yemen) Epidemiology of rabies in Sanaa city, 2011

Mariam Alfarhan (KSA) School based dental programs – where we need to go now

Maisa Mohamed Omara (Egypt)Risk factors for oropharyngeal cancer in selected cancer institutes in Egypt

Ghada Shouna (Sudan) Factors leading to self-medication with antibiotics in Sudan

M. Al Darwish (Qatar) Dental caries, oral health and life style variables - reflection from Qatar (followed by questions and answers)

16:00 - 16:20

17:00- 17:30

Moderator Saif Albedwawi(UAE)

Moderator Lubna Al Shaali(UAE) 17:30- 19:00

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Moderator Raman Bedi(UK) Oral Health Working Group Meeting

Scientific Program

Day 3 (April 6, 2013)

Hall 1, 2 & 3 Plenary Session 08:30 - 09:00

Mohannad Al Nsour (Jordan) - Great Challenges lead to great Opportunities: A New Agenda for Public Health in the Arab World

09:00 - 09:30

Samer Jabbour (Lebanon) - Public health in the Arab world at a crossroad

09:30 - 10:00

Vesna Bjegovic - Mikanovic (ASPHER) - Future perspectives of education and training for public health in Europe

10:00 - 10:30

Hala Abou-taleb (WHO- EMRO) & Genevieve Howse (Australia) - Public Health law in the Middle East and North Africa Considering a model law for the Region (Joint Presentation)

10:30 - 11:00

Pannel Discussion: Moderator - Samer Jabbour (Lebanon) & David D. Celentano (USA)

11:00 - 11:30

Coffee Break

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Scientific Program Night Ballroom Session 13

Session Theme

Public Health Capacity

Grand Studio Session 15 Public Health Training and WFPHA Q&A

Lindsey Davies (UK) Public Health Training and professional regulation in the UK

Samia Abdullah Al-Moither (KSA) Survey of Dental caries among preschool children, Riyadh

WFPHA Q&A Meeting

11:50 - 12:10

Lubna AlShaali (UAE) Assessment of immunization services Delivery of Health Facilities in Dubai

Ahlam Saleh Salem (Yemen) Trends in Maternal Mortality at the Mukalla City, Yemen, 2000-2010

WFPHA Q&A Meeting

12:10 - 12:30

Rasha Salama (UAE) Health care workers screening in health care facilities of Dubai: A public health strategy

Shamma Jauaan Al Muhairi (UAE) Vitamin D Deficiency among healthy adolescents in Al Ain, United Arab Emirates.

WFPHA Q&A Meeting

12:30 - 12:50

Mohammed Shaheen (Palastine) Ethical Issues in Community Health Interventions: A critical Perspective

Arwa Al Modwahi (UAE)Vitamin D Dificiency: A Publc Health Problem In Abu Dhabi

WFPHA Q&A Meeting

Moderator Hala Abou-Taleb (WHO-EMRO)

Moderator Bettina Borisch & Laetitia Bourquin (WFPHA)

11:30 - 11:50

Moderator Vesna Bjegovic (ASPHER) 12:50 - 13:50

Closing Ceremony

13:50 - 15:00

Lunch

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Day Ballroom Session 14 The non-communicable diseases Epidemic

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Keynote Speakers

Prof. Tawfik A. M. Khoja Director General, Executive Board, Health Ministers’ Council for Cooperative Council States KSA Currently, he is the Director General, Executive Board, Health Ministers’ Council for the Cooperation Council States, Family and Community Medicine Consultant, in addition to other job responsibilities including overall development and implementation of PHC programmes, conduction and coordination of field studies and research in PHC. The last job held was Director General of Health Centers, Ministry of Health, Kingdom of Saudi Arabia. He has been appointed lately in March, 2013 as the Secretary General of the Arab Hospitals Federation. He got the bachelor degree of medicine and surgery (General Physician) from King Saud University in 1982, High diploma as a GP in Family Medicine, same university in 1986. He is the fellow of the Royal College of General Practitioners (FRCGP) since 1989 and the fellow of the Faculty of Public Health (FFPH) since 2003. He has been awarded in June, 2003 the Professorialship in health systems and quality (Adjunct Professor) from Oklahoma University, USA. Lately, he got the fellowship in medicine in 2007 (FRCP), He was the author and co-author of many books and manuals which were over (40), he published more than 70 research and scientific articles in various international scientific journals which contributed in depicting health policies and work protocols in family medicine, PHC and health services quality. He has got a lot of international and regional awards, just to mention a few: • • • • • • •

Outstanding Arab Personality in the field of health, for the year 2010. Professorialship from Imperial College, London. International Arch of Europe Award in Quality, Golden Category, 2010. International Star for Leadership in Quality Award (Platinum Category) received for outstanding business achievements, for perseverance and leadership in excellence, and quality in accordance with the QC 100 Criteria in the “International Star for Leadership in Quality B.I.D. – QC 100 Paris 2011 Convention” on 11th of April, 2011 at Paris. The Majestic Five Continents Award for Quality & Excellence from the President of Association Otherways Management & Consulting at Pairs – France on 18th July 2011. European Award for Best Practices 2011 (Gold Category) received from the Executive Director of ESQR (European Society for Quality Research) at Brussels – Belgium on 4th December, 2011. International Star for Leadership in Quality Award (Diamond Category) received for outstanding business achievements, for perseverance and leadership in excellence, and quality in accordance with the QC 100 Criteria in the “International Star for Leadership in Quality B.I.D. – QC 100 Paris 2012 Convention” on 25th of June, 2012 at Paris.

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Keynote Speakers

Prof. Salman Rawaf Director of WHO Collaborating Centre School of Public Health, Faculty of Medicine,Imperial College UK

Professor Salman Rawaf qualified in medicine with training in pediatrics and public health. Prof Rawaf is Professor of Public Health Director of the WHO Collaborating Centre for Public Health Education and Training and is well known for his international work and contribution to global health. He is an adviser to the World Health Organization on primary care, public health, health systems, medical education and human resource for health development. The Collaborating Centre supports several WHO Regions and their Member States. Professor Rawaf is a Fellow of the Royal Colleges of Physicians London and the UK Faculty of Public Health and Member of the Faculty of Public Health Medicine Ireland. He served the British NHS at Executive level for 26 years (as Medical Director and Director of Public Health). He is the UK Faculty of Public Health Global Health Adviser, a Member of WHO Advisory Committee for Health research, and Program Leader of the Postgraduate Diploma/MSc in Family Medicine Middlesex University. He is an Honorary Professor at Ghent University, Belgium. Salman’s contributions to public health and primary care in research and service delivery are well known. He is recognized for his work in supporting countries to strengthen their health systems and service development including Bahrain, Brazil, Iran, the Kingdom of Saudi Arabia, the State of Kuwait, Libya, Malaysia, Maldives, Malta, Oman, Poland, Tunisia, Uzbekistan, Iraq, Palestine, Qatar and Yemen. Prof Rawaf is the Founder and Editor-in-Chief of the journal Public Health Medicine and a member of a number editorial boards and has published several scientific papers, two books and many international reports.

Prof. Ulrich Laaser Immediate past president World Federation of Public Health Associations (WFPHA) Germany

Head (since 1998), Section of International Public Health at the Faculty of Health Sciences, School of PuÂŹblic Health, University of Bielefeld. Principal investigator of the Stability Pact Project on Public Health Training and Research in South Eastern Europe (2000-2010). Visiting professor at the School of Public Health in Belgrade, honorary professor in Sofia and Tirana. Advisor on Strengthening Public Health Workforce Capacities in the European Region (2011), Member of the Advisory Group for the European Action Plan/Public Health Services (EAP/PHS, 2012), and member of the WHO-WG on Public Health Workforce in the European Region. Member of the executive boards of the World Federation of Public Health Associations (president until May 2012) and of the German Association for Health Sciences and Public Health (until 2012). Co-editor of the book series on International Public Health, Hans Jacobs Editing Company, Lage, Germany and of the (German) Journal of Public He-alth; international editor of Universitas Indonesia Health Series; associate editor of the (American) Journal of Public Health Policy. Degrees 1970 from the Johns Hopkins Bloomberg School of Public Health, Baltimore, USA (Master of Public Health) and 1969 from the London School of Hygiene and Tropical Medicine (Diploma of Tropical Medicine & Hygiene). For the last decade various public health projects in South Eastern Europe, Central Asia, the Near East and in the Pacific Region.

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Keynote Speakers

Dr. Tewabech Bishaw Executive Director African Federation of Public Health Associations (AFPHA) Ethiopia Dr. Tewabech Bishaw, a female Ethiopian, is the Founder and Managing Director (since 2006) of Alliance for Brain-Gain and Innovative Development (ABIDE). ABIDE is an Ethiopian indigenous NGO, non-governmental, nonprofit development organization engaged on brain-gain for national capacity building. She is a founding member and the first President of the Ethiopian Public Health Association (in 1989) as well as the Current President of the Association (since 2009). She is also among the founding members and the Secretary General of the African Federation of Public Health Associations (since 2011). In addition she also serves as Executive Committee and Governing Council member of the World Federation of Public Health Associations (since 2010) Dr. Tewabech Bishaw has worked for over 20 years years with United Nations Children’s Fund UNICEF in different countries and capacities providing Managerial and Technical Leadership: in Botswana, as a UNICEF Deputy Country Director, Leadership and Guidance for all UNICEF Programme Sections; in Namibia, as Programme Director for Health / Nutrition / Water and Sanitation; in India, as Chief of the Health Section and Programme Director for the Child Survival and Safe Motherhood Programme Nationwide; and in Ethiopia, as Chief of Health Section and Director for the Accelerated Maternal and Child Health Services Programme Countrywide . Before joining UNICEF she worked for about 17 years for the Ministry of Health in Ethiopia, first in Services Provision and Program Management at the sub-national level and later in Senior Management and Executive Leadership position at the national level. In the latter function she was responsible for: National Health Man-Power Development and Health Education Programmes; the National Integrated Maternal and Child Health Services; and National Disease Prevention and Control Programme. Preceding these she has also served for two years as a School Teacher at Sub-national level. Dr. Tewabech Bishaw holds a Bachelors degree from Addis Abeba University Gondar College of Public Health; Master of Public Health. Post Graduate Diploma, and a Dr. of Health Sciences, degrees from Loma Linda University School of Health, in Loma Linda, Ca. USA..

Dr. Tewabech Bishaw is married with four children

Dr. Mohammed Bin Hamad J. Al Thani Director, Department of Public Health, Supreme Council of Health Qatar Dr. Mohamed has been graduated from Faculty of medicine – Cairo University 1998 , and received an Arab fellowship in Community Medicine in 2006, Currently he is Director of Public Health Department in Supreme Council of Health in the State of Qatar since2008. During that period of time he developed Department’s programs and it’s system to achieve to perform its functions more effectively and efficiently.

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Keynote Speakers Dr. Mohamed headed number of national committees, His other affiliation include being the Assistant Professor of Public Health ( Courtesy ), Weill Cornel Medical College, Qatar Executive board Member, Executive board of Health Ministers’ Council , Gulf Collaboration Council (GCC) states. And participated in many research and which have had a positive impact on public health programs in the countries of the region.

Dr. Mariam Jalahma Assistant undersecretary for Primary care & Public Health Ministry of Health Kingdom of Bahrain

Dr. Mariam Al-Jalahma is a consultant family physician. She is currently holding the position of the Assistant Undersecretary for Primary Care and Public Health in the Ministry of Health in the Kingdom of Bahrain, and an assistant professor in the college of medicine in the Arabian Gulf University and a formal member of the Sura Council, and is currently a member of the of National Institute of Human rights in Bahrain. In 1994 she achieved the high studies diploma in medical education from the university of Dundee in Scotland, and was working as a medical tutor in the family practice residency program in the ministry for 13 years. Dr. Al-Jalahma is a member of the Executive Board of The Health Ministers’ Council for GCC States since 2007. In 2000 she was awarded the Academic Excellence and Honors Diploma of health care management from the Royal College of Surgeons in Ireland, and in 2009 she was awarded by Her Highness Shaikha Sabika Bent Ebrahim Al-Khalifa the Princess of Bahrain and Chairperson of Woman Supreme council the award of National Woman day Celebration, the award is presented to women leaders in health. In June 2011 she is awarded by the regional office for eastern Mediterranean of the WHO the Anti-tobacco award of the region. In December 2011 she was awarded an honoree medal of efficiency by his majesty the king of Bahrain. Dr. Al-Jalahma had worked extensively in the area of the prevention of non-communicable disease and the antismoking programs and maternal and child health in the Bahrain, and works as an advisor for mother and child department in the world health organization.

Prof. David D. Celentano Charles Armstrong Chairman and Professor Department of Epidemiology Johns Hopkins Bloomberg School of Public Health USA David Celentano, ScD, MHS is Professor and Charles Armstrong Chair of the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. He received his doctoral degree in Behavioral Sciences from Johns Hopkins in 1977 while conducting epidemiological research with George W. Comstock, the father of tuberculosis research. He subsequently joined the faculty at Johns Hopkins in 1978. Professor Celentano was originally trained in chronic disease epidemiology, focusing on alcohol consumption patterns in communities, and particularly among women. He worked on developing the first comprehensive cancer control program for the State of Maryland from 1978-1983. He was funded by the National Cancer Institute in the mid-1980’s to better understand age disparities in cervical cancer, and conducted a case-control study of invasive cervical cancer in Maryland, conducted surveys of healthcare providers on needs for cervical cancer screening, and addressed hospitals as a locus for cancer screening. Dr. Celentano became involved in HIV research in 1983, when he helped develop the Baltimore site of the Multi-Center AIDS Cohort Study. He has worked in HIV prevention since then, most notably in Thailand

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Keynote Speakers (since 1990) and India (since 1998), and more recently in Tanzania on an Office of the Global AIDS Coordinator/United States Agency for International Development and Bill & Melinda Gates Foundation’s evaluation of HIV prevention in Iringa, Tanzania. He is the faculty advisor to eight current JHU MPH/DrPH cohort students working on their doctoral research, and he is an advisor to the Health Authority of Abu Dhabi

Prof. Lindsey Davies President, Faculty of Public Health Faculty of Public Health UK Professor Davies is the President of the UK Faculty of Public Health. After qualifying in medicine at Nottingham University, Lindsey worked in community paediatrics before training in Public Health. She subsequently became Director of Public Health for Southern Derbyshire and, later, for Nottingham before moving to the Department of Health’s NHS Executive as Head of Public Health. She became Regional Director of Public Health/Regional Medical Director for the Trent region (later the East Midlands region) in 1995 and remained in that post until 2006 when she moved to the Department of Health in London as the National Director of Pandemic Influenza Preparedness, leading the UK’s preparations for a flu pandemic. In early 2010, she spent six months as the interim RDPH for London and the Health Advisor to the Mayor of London, and retired from the civil service in 2010. She holds an Honorary Professorship in Public Health Medicine and Epidemiology at Nottingham University.

Prof. Laura L. Morlock Associate Dean for Education. Professor, Health Policy and Management, Johns Hopkins Bloomberg School of Public Health USA Laura Morlock, Ph.D. is a professor in the Department of Health Policy and Management and Associate Dean for Education at the Johns Hopkins Bloomberg School of Public Health. She is a sociologist with primary research interests in how organizational and managerial factors affect the quality and costs of health care. Currently she is collaborating in a cooperative agreement with the Administration for Children and Families, DHHS to develop a National Human Services Interoperability Architecture as a framework to support common eligibility determination and information sharing across programs, departments and agencies to achieve better outcomes for children and families. Her research projects have included evaluations of a number of quality improvement and patient safety initiatives in teaching hospitals, rural hospitals, community health centers and community mental health centers. She recently led a team of Johns Hopkins faculty who collaborated with the U.S. Pharmacopeia in the analysis of medication error reports and other efforts designed to reduce medication errors and promote patient safety. She has led or collaborated in health reform efforts in the State of Maryland as well as Taiwan, Ecuador, Turkey, and Romania, and has led educational initiatives in Taiwan, Trinidad and Tobago, and Abu Dhabi, U.A.E. She is the Director of the Doctor of Public Health (DrPH) program in Healthcare Management and Leadership. The focus of the program is on measuring, monitoring and improving the clinical, services and financial performance of health services organizations. The program includes student cohorts in the US, Taiwan and Abu Dhabi, U.A.E.

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Keynote Speakers

Dr. Idris Saleh Al-Abaidani Dept. of Communicable Disease Surveillance & Control Ministry of Health Sultanate of Oman

Prof. Vesna Bjegovic-Mikanovic President elect Association of Schools of Public Health in the European Region (ASPHER) Serbia Professor Bjegovic-Mikanovic is Head of the Centre School of Public Health (since 2005) and Vice-Dean of the Medical Faculty (Belgrade, Republic of Serbia) since 2012. Main activity of the Centre is teaching and research for the practice of public health as well as consulting the Serbian Government and health institutions in Serbia on Public Health. Master programmes on Public Health, on Health Management, and a doctoral programme are offered. The research is carried out in close cooperation with institutes of the Faculty of Medicine, especially with the Institute of Social Medicine. Her international research environment covers such areas like health systems research and strategic development in South Eastern Europe, hospital management and health economics, health literacy, and development and evaluation of teaching programmes. Vesna Bjegovic-Mikanovic is member of the Executive Board of ASPHER since 2007. Professor Bjegovic-Mikanovic was scientific adviser of many students’ theses, and published more than 200 scientific publications in English and Serbian. She has gained experience as a lecturer, researcher, administrator, and health policy advisor. Most recently she focused on the analysis of the institutional public health infrastructure in Europe, the labour market for public health professionals, and continuing and blended learning for public health.

Dr. Mohannad Al Nsour Executive Director The Eastern Mediterranean Public Health Network (EMPHNET) Jordan Dr. Al-Nsour is an internationally recognized expert in field epidemiology, research and public health systems. As a current PhD fellow at the International Agency for Research on Cancer (IARC), and Glasgow University, Scotland, U.K., Dr. Mohannad AL-Nsour holds a Medical Degree from Ukraine and an MSc in Epidemiology from the American University of Beirut (AUB). Since 1999, Dr. Al-Nsour assumed several positions as a clinician, advisor, and director in Jordan. He also served as a consultant on several assignments with the US Centers for Disease Control and Prevention (CDC), the World Health Organization and the AUB. Before becoming EMPHNET’s Executive Director, Dr. Al-Nsour was the Director of the Field Epidemiology Training Program (FETP) in Jordan (2006 -2009) and the Head of Surveillance Department of Balga Health Directorate – Jordan. Dr. Al-Nsour also served as a CDC consultant for the FETP in the Eastern Mediterranean Region.

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Keynote Speakers Dr. Al-Nsour has been leading EMPHNET since 2009, by providing strategic and operational responsibilities, and guiding the enrichment of FETPs in the region. Under Dr. AL-Nsour’s leadership, EMPHNET emerged as a regional entity that leads initiatives to promote public health, advance field epidemiology and improve performance of FETPs in the region. In the research arena, Dr. Al-Nsour stands as one of the leading figure in advancing research in Jordan, and has 16 publications on various public health topics. Dr. Al-Nsour is a speaker at national and regional level covering public health topics such as leadership, field epidemiology, and creating new opportunities. As a certified trainer, Dr. Al-Nsour has extensive experience in training both at the national and regional levels, with outstanding teaching and epidemiological investigation skills. His areas of expertise are Infectious Diseases, Non-Communicable Disease and Cancer Epidemiology.

Prof. Samer Jabbour Associate Professor of Public Health Practice Faculty of Health Sciences American University of Beirut Lebanon Professor Jabbour completed a medical degree (MD) at the Aleppo University Faculty of Medicine, a Master degree in public health (MPH) at the Harvard School of Public Health, and a fellowship in cardiology at Brigham and Women’s Hospital (a Harvard affiliate) in Boston. As such, he pursues a dual career path in public health and medicine/cardiology. He is currently Associate Professor of Public Health Practice in the Faculty of Health Sciences, American University of Beirut (FHS/AUB). Professor Jabbour is the lead editor of the book ‘Public Health in the Arab World’ (Cambridge University Press, 2012) which has been “Highly Commended” in the British Medical Association Medical Book Awards in 2012. The book, the fruit of the largest international scholarship collaboration on the subject, is part of a larger initiative to promote a new public health in the region. Professor Jabbour coordinates several other regional initiatives at FHS/AUB including the Secretariat of the Eastern Mediterranean Regional Academic Institutions’ Network for Public Health (EMRAIN) which aims to strengthen academic public health and its engagement in public health and health system change, and the Nodal Institute for the Eastern Mediterranean Region which promotes capacity development and regional collaboration in the area of health policy and systems research (in collaboration with WHO Alliance for Health Policy and Systems Research). Professor Jabbour is a member of WHO’s Eastern Mediterranean Advisory Committee on Health Research and the Regional Technical Advisory Group on Non-Communicable Diseases.

Dr. Hala Abou Taleb Health and Human Rights World Health Organization Eastern Mediterranean Regional Office Egypt Dr. Hala Abou-Taleb is a medical doctor by training and received a Master Degree in Public Health followed by a Doctorate Degree in Community Medicine and Social Science from Kasr El Aini, Cairo University. Dr. Abou-Taleb was awarded an Epidemiology Master Degree from London School of Hygiene and Tropical Medicine. Prior to joining WHO, Dr. Abou-Taleb started her career working with both governmental and nongovernmental organizations before working with Family Health International. Throughout her career she gained extensive experience in population policies and public health programmes, reproductive health, health sector reform, monitoring and evaluation, HIV/AIDS prevention and coordinated multi-sectoral response. As an epidemiologist she focused on action oriented research and advocacy to guide policies and action oriented strategic planning.

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Keynote Speakers Since 1999 Dr Abou-Taleb worked for various United Nations organizations including UNFPA, and UNAIDS Regional Office for Middle East and North Africa. Finally she joined WHO Regional office for the Eastern Mediterranean region, in Cairo, in January 2005 when all this came together for her; at first to work on health promotion and injury prevention, then adolescent health, and today as regional focal point for health, human rights and diplomacy. Dr Abou-Taleb is currently focusing on strengthening health governance and promotion of right to health principles and elements and policy coherence in the Eastern Mediterranean Region in the process of realizing universal health coverage.

Dr. Ahmed Javed Rahmanzai Member Governance Council World Federation of Public Health Associations. Founding Member Afghanistan National Public Health Association. Afghanistan A Fulbright scholar, an Entrepreneur and a Public health professional from Afghanistan, with more than 10 years of experience in the field of humanitarian and development work in a post conflict environment. A visionary yet practical leader, equipped with sound human skills. A self starter and self motivated individual, passionate about my work. Honest and dedicated and strongly bound to work ethics, and human values. Enjoy work in teams and believe in team achievements. Knowledge of different research designs, protocols and hypothesis development, questionnaire design, data collection, compilation, analysis and interpretation. Have managed grants over 10 million dollars. His contributions to the health care system in Afghanistan include: leading a team of professionals to establish the Midwifery and Nursing Education Accreditation System for the first time in the country, working as an active member of the working group to establish the Afghanistan Medical Council, Serves as the founder and executive committee member for Afghanistan National Public Health Association, contributed in the development of National Health Policies and Strategies, including, National Strategy for Improving Quality in Health Care, National Reproductive Health Policy and Strategy, National Policy on Education of Midwives and Nurses, National Human Resources Policy, National Midwifery and Nursing Policy and Strategy He is also the founding member for Afghanistan Fulbright Alumni Association and Kabul Research and Advisory Association, a small think tank charged with policy analysis and recommendation. In 2006, he was awarded with prestigious award of Fulbright Scholarship to undertake masters in Public Health. His areas of expertise include, Development of Human Resources for Health, Environmental Health including, solid and medical waste management, and Health of Population afflicted by armed conflict. He has extensive knowledge of research designs and protocols and has served as principle investigator and co-principle investigator in many research projects. He is currently working with Johns Hopkins University as an International Independent Contractor. After establishment of the interim administration back in 2002, he returned to Afghanistan to serve his country. Soon after arrival, he was offered the position of Provincial Public Health Officer in one of the very remote and underserved areas of Afghanistan in the central region by the Aga Khan Health Services-Afghanistan. There, he pioneered established and management of a community based health care project for the very first time in the history of the local population. During his tenure, he was able to establish a sound working relationship with local communities. To this end, he was able to secure 30% cost from local communities to sustain operations of four health centers. In 2005, he returned to Kabul to join other organizations, charged with training of mid level health workers, supporting establishment of reference diagnostic laboratory in Kabul and five regions. While working with University of Massachusetts, he led establishment of the first government run, master of public health program at Kabul Medical University. There, he served as the chair of joint taskforce between Ministry of Public Health and Ministry of Higher Education. The taskforce was formed to oversee development of the program. During his 10 years of experience with many international organizations and educational institutions, he has served in leadership positions, and has managed grants over 10 million dollars.

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Keynote Speakers

Dr. Mohammed Shaheen Associate Professor in School of Public Health AlQuds University Palestine Co-founder of the school of public health and the Center for Development in Primary Health Care - Alquds University. Former Dean of School of Public Health and currently teaches at the school of public health and director of the Center for Development in Primary Health Care at AlQuds University. Head of the Ethical Research Committee at AlQuds University. One of the leading public health professional in Palestine and directed several community based health, psychosocial projects in the West Bank and Gaza Strip. A local, regional and international consultant in several public health and research projects. Former board member and vice president of Childwatch International (International Child Research Network). Participated in several national health initiatives aimed at reforming the Palestinian health care system. Co-founding member of the Palestinian Health Policy Forum as well as member of the MENA health policy forum. Dr. Shaheen has several publications in maternal child and reproductive health. Initiated a community mobilization model in designing, implementing and evaluating different community health interventions in the Palestinian Territories.

Dr. Amy Elizabeth Roussel Vice President, Public Health and Environment research division RTI International USA Amy Elizabeth Roussel, PhD. is the Vice President of RTI International’s Public Health and Environment research division. She is an organizational sociologist with over 20 years of professional experience in public health services research. She currently leads a large, multi-year project analyzing the implementation of policy, system, and environmental change as a means of improving public health. Before joining RTI in 1998, Dr. Roussel was at the University of Washington, where she conducted research on managed care in a local market setting. She has experience with both qualitative and quantitative research in the areas of health services research, health policy and management, substance abuse treatment, and program evaluation. She has led and contributed to multidisciplinary teams in a variety of research studies, encompassing tasks such as primary data collection, case study analysis, analysis of secondary data, and policy analysis.

Prof. Bettina Borisch Professor at the University of Geneva Director of the Office of the World Federation of Public Health Associations (WFPHA) Switzerland Dr Borisch is an MD and a Histopathologist, MPH and Fellow of the Royal College of Pathology (UK). Her scientific research work delves into neoplastic lesions of the immune system and breast cancer. Her interests also include community-based oncology, as well as health communication and global health.

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Keynote Speakers She ist he Editor in Chief of „Pathobiology“ and the Co-Editor of „Journal of Public Health Policy“. In addition to her academic work she acts as the Director and Head oft he World Federation of Public Health Associations and helds positions at several Committees of Public Health oriented institutions. She was president of Europa Donna – The European Breast Cancer Forum and Founding President oft he Swiss Forum of Europa Donna. She teaches at the University of Geneva, the Swiss School of Public Health and she also teaches patient support groups. She is authour of over 120 scientific papers and 2 books.

Omniyat Al Hajri, MD, MRCPI, MPH Director, Public Health and Research. Health Authority, Abu Dhabi UAE

Dr. Linda Dimitropoulos Director, Center for the Advancement of Health IT RTI International USA Dr. Linda Dimitropoulos is the director of the Center for the Advancement of Health Information Technology (CAHIT) at RTI International. Dr. Dimitropoulos has 18 years of experience designing and managing both qualitative and quantitative research studies in health services and health IT. She currently leads the Health IT Horizon Scanning contract for the Agency for Healthcare Research and Quality (AHRQ), and she recently led several key federal contracts for AHRQ, including Technical Assistance to Implement Health IT and HIE in Medicaid and CHIP contract. She also serves as the program director for the AHRQ National Resource Center for Health IT 4 domain contracts. Over the past 5 years, Dr. Dimitropoulos has successfully led the Privacy and Security Solutions for Interoperable Health Information Exchange contract and the Health Information Security and Privacy Collaboration contract for the Office of the National Coordinator for Health IT (ONC), which studied the variation in federal and state health information privacy laws and policies governing electronic health information exchange. She has served as the senior advisor on numerous contracts and grants, including the ONC-funded State Health Policy Consortium, the Professional Services Contract to Develop Model Anti-Fraud Requirements for Electronic Health Records (EHRs), and the AHRQ Partnership Strategy Development contract. She has served on a number of technical expert panels including the panel on Health IT and Mental Health: the Path Forward, sponsored by AHRQ and the National Institute of Mental Health (NIMH). Dr. Dimitropoulos is frequently invited to speak at regional and national conferences and has testified before multiple federal advisory committees. Dr. Dimitropoulos is a social psychologist with expertise in attitude change, measurement, and persuasive communications with applications to consumer behavior and decision making

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Keynote Speakers

Dr. Mohannad Hammami MD Health Officer Chief of Health Operations Health and Human Services Wayne County, Michigan USA

A graduate of Aleppo University, Syria, Dr. Hammami completed his postdoctoral research in Pediatrics at the Newborn Center of the University of Tennessee in Memphis, and then accepted a faculty appointment at Wayne State University School of Medicine in Detroit, Michigan and a research position at the Detroit Medical Center, Department of Pediatrics. Dr. Hammami was involved in many clinical studies ranging from the effect of infant formula on bone mineralization in newborns to new childhood vaccine trials. In 2006 he was granted the American Medical Association (AMA) foundation for Excellence in Medicine and Leadership award for his public health advocacy and community work. He is listed in the Marquis 2006-2007 Who’s Who in Medicine and Healthcare, Strathmore’s 2006-2007 Who’s Who in Healthcare and Madison’s Who’s Who in the World 2008 - 2009. He was awarded the “Health Policy Champion Award” by the Michigan Department of Community Health in 2011. Dr. Hammami served as Executive Director of the National Arab American Medical Association (NAAMA) from 2006 to 2009 and then elected as national president for 2011. He currently serves as the Chief of Health Operations of Wayne County Department of Health and Human Services and Chief Health Officer for Wayne County where he oversees all health related operations for the 13th largest County in the Nation. Dr. Hammami is responsible for promoting and assuingres health and quality of life by providing, maintaining, developing and coordinating a wide-range of innovative and fiscally responsible educational and health services including technology intitatives. Dr. Hammami is a member of several professional and honor societies and has had many publications in various peer reviewed medical journals.

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Speakers

Dr. Farida Al Hosani Manager of Communicable Diseases Department Health Authority Abu Dhabi (HAAD) UAE Dr. Farida joined HAAD in 2008. She was the lead person in the establishment and implementation of the Visa Screening electronic system in addition to Infectious Diseases e-notification system. The two programs are the source of the infectious diseases surveillance data. She is the lead of communicable diseases programs in the Emirate of Abu Dhabi including: Vaccination program, Tuberculosis control program, Visa Screening program, Infectious diseases e-notification, HIV control Program, and Malaria Control program. Dr. Farida worked and participated in forming the policies and standards related to infectious diseases in the Emirate of Abu Dhabi. She is a member of national committees for strategic planning and regulation of different programs in the national level. Prior to joining HAAD, She spent five years in Preventive Medicine Department practicing medicine and dealing with infectious diseases mainly. Dr. Farida is a physician graduated from Faculty of Medicine and Health Sciences (FMHS) in Al Ain University and she had MPH degree from in John Hopkins Bloomberg School of Public Health. She is currently enrolled in DrPH program in the same University

Dr. Mohammad Al Redha Director - Health Data & Information Analysis Department Health Policy & Strategy Sector Non Resident Fellow Dubai School of Government UAE

Dr. Mohammad Al Redha is the Director of the Health Data and Information Analysis Department at the Dubai Health Authority. His main responsibility is to develop the necessary standards for implementing and managing the health information systems in the Emirate of Dubai. Before joining the Health Policy & Strategy Sector, Dr. Mohammad was a Research Fellow in Clinical Informatics at the Division of Clinical Informatics, Harvard Medical School in Boston (2008-2009). His main focus was redefining the standards of healthcare to meet international standards while creating a very patient-focused, research-enriched environment. Prior to joining the field of informatics, Dr. Mohammad was the Assistant Chief Operating Officer at Rashid Hospital – a 600 bed trauma facility serving Dubai since 1973. Dr. Al Redha is a graduate and postgraduate of the Royal College of Surgeons in Ireland and holds a Masters Degree (MSc) in Healthcare Management. He is also a member of the Mohammed Bin Rashid Program for Leadership Development Programme and a Fellow at the Dubai School of Government.

Dr. Wasif Muhammad Alam Director Public Health and Safety Department Health Policy & Strategy Sector UAE Dr. Wasif Muhammad Alam is a medical doctor with a Doctor of Medicine (MD) and a Master of Science in Public Health (MSPH) degrees from USA. He has also earned subspecialty in Occupational Medicine from the University of South Florida, College

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Speakers of Medicine, USA. He has over 25 years of experience working in the health related fields in the USA, Middle East and Bangladesh. A big portion of the work has been conducted with organizations like the Johns Hopkins University, United Nations, and Ministries of Health. His experience working with multiple health disciplines has made him a competent expert in the management and implementation of health programs. Through his knowledge and experience he has made significant contribution in the Public Health globally. He has authored chapters in various renowned books on Public Health and has published several research articles in the scientific medical journals. Dr. Alam’s biggest strength is having wide range, multi-discipline education and experience in health arenas. He had been working as a Professor for over seven years at renowned Universities of USA where he taught courses on Critical Issues in Global Health besides Bioterrorism and basic sciences. Prior to his assignment in Dubai as a Director of Public Health and Safety under Dubai Health Authority, he has been working for five years as an Occupational Health consultant to the Supreme Council of Health, Qatar. Dr. Alam is a U.S. citizen married with 3 children and is currently residing in Dubai, UAE.

Prof. Samir N. Banoob President, International Health Management, LLC., USA Professor& Senior Consultant of Health Policy and Management USA - Professor and senior consultant of International Health Policy and Management. - Founding professor and director of international health programs at the university of South Florida college of Public Health, and visiting or adjunct professor at Johns Hopkins, New York State and many European Schools of Public Health, received the Universities of Florida Professorial Excellence Award in Teaching, Research & Service - Dean and Director, Global Health Development Program, European Center for Peace & Development, UN University for Peace, Belgrade, Serbia - Consultant and advisor on Health policy and planning, health reform, human resources planning and education, senior management training, primary health care and quality of care with WHO, UNICEF, UNDP, World Bank, US-AID, EU in 78 countries - Team Leader and Senior Expert, EU Delegations for Identification and Formulation of Health Reform Projects in Libya, Sudan, Syria ( 2010-2012) and member of the National Committee on Health Insurance in Egypt, 2012 - Founder and Director of the Office of National Health Planning in Kuwait, and adviser for Health planning to the Arab Gulf Countries, 1976-1983 consulting with all GCC countries on health planning, human resources, primary care, hospital development and quality of Care - Assisted in health reform and policies in most of the eastern/ central European states, Russia, Balkan states, and the Caribbean states - Past chair of the American Public Health Association/ International Health, received its Lifetime Achievement Award of Excellence in International Health, 2008 - Participated in planning and development of the US Affordable Health Care Act 2010 in the US and received recognition by President Obama. - Team Leader and Senior Expert, EU Delegations for Identification and Formulation of Health Reform Projects in Libya, Sudan, Syria - Holding an M.D degree, Diplomat of internal medicine, master of hospital administration and PhD in health administration from Egypt and the US - -- Currently the President and CEO of International Health Management consulting firm at Florida, USA

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Speakers

Dr. Lubna Al Shaali Public Health Specialist Department of Public Health and Safety - Health Policy and Strategy Sector UAE

Dr. Lubna Al Shaali is a physician from United Arab Emirates. Graduated with MBBCH (2000) and Arab Board of community Medicine, 2011 (Distinguished Thesis Award of the Arab Board Of Health Specialization). She also has a Master degree of Quality & Safety in Healthcare Management from Royal College of Surgeons in Ireland (2009). Joined Dubai Health Authority in 2001 and currently working in Public Health and Safety Department within Health Policy and Strategy Sector. Dr. Lubna is the representative of DHA in the Health and Safety sectoral subcommittee at the executive council. She participates in assessment of health needs of the community and definition priorities, conducting researches through studies addressing the most important public health issues and developing policies to address health protection including control and prevention of communicable and non-communicable diseases. She participated in developing healthcare workers screening policy among healthcare workers in Dubai (2012). She had also participated in development of approved injury prevention and control and cardiovascular disease prevention and control policies and presented them to the executive Council in Dubai. She has also assisted in developing the unified immunization policy and criteria for vaccination qualified clinics in Dubai, participated in developing food poisoning surveillance system and guidelines 2012, participated in developing the National Public Health law in collaboration with ministry of health and participates in developing the National Communicable disease law in collaboration with Ministry of health.

Dr. Rasha Salama Senior specialist of Public Health Department of Public Health and Safety Health Policy and Strategy Sector Dubai Health Authority UAE

Dr. Rasha is a physician (MB BCH in Medicine and Surgery- 1995) with a PhD in Public health since 2003, a master degree in Public health in 2000 from Suez Canal University, a master degree in endocrinology from Cardiff University – UK, and Nutrition Diploma from Oxford University. She joined DHA in 2011 in the Health Policy and Strategy Department, Public Health and Safety Department/ Preventive Medicine Section-as a senior specialist and worked actively to achieve the strategic goals of Dubai health sector strategy through reducing the burden of non-communicable diseases, communicable diseases and injuries in the Emirate of Dubai. As a part of promotion of physical activity in the Emirate, she and the team conducted a survey to assess the situation of Physical activity in all schools of Dubai. Participated in development of the policy of Injury prevention and policy of cardiovascular diseases control and prevention approved by Dubai Executive Council. She is a member of the national Public Health Law committee in collaboration with ministry of health and a member in the Occupational Medicine Committee working on the initiative of promotion of occupational health in the Emirate of Dubai. Prior to joining DHA, She spent five years in Community Medicine Department – Hamad Medical Corporation – Qatar, as a consultant training candidates for the Community medicine Arab Board and supervising public health thesis dissertations for postgraduates, as well as publishing many papers in reputed public health journals. She was awarded Best Public Health Trainer Award for four consecutive years for Community medicine Department in HMC-Qatar (years 2006 throughout 2010) Dr. Rasha is also currently designated as a lecturer in Faculty of Medicine –Suez Canal University- Community Medicine Department, since 1995.

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Speakers Dr. Michal Grivna Associate Professor Institute of Public Health College of Medicine & Health Sciences UAE University UAE

Dr. Michal Grivna, before becoming a member of the Faculty of Medicine & Health Sciences UAE University, was actively involved in establishing injury control efforts in Central and Eastern Europe. After founding the Childhood Injury Epidemiology and Prevention Center (later Center for Injury Prevention) at Charles University in Prague, Czech Republic in 1997, he played a leading role in the European Child Safety Alliance and implementation of Safe Community Program - a project of the World Health Organization. Activities of the Center culminated in acceptance of a National Child Injury Prevention Program by the government of the Czech Republic and also implementation of mandatory bicycle-helmet and child-car seat regulations. Dr. Grivna´s research included topics related to school traffic safety, bicycle related injuries, baby walker injuries, child vehicle occupant protection, playground injuries, trauma registration and other public health issues such as HIV/AIDS prevention and smoking in UAE. He is collaborating as a consultant with various public health and preventive medicine institutions in the United Arab Emirates and abroad, including HAAD and Dubai Health Authority. He was a team leader for preparing a profile of child injuries in the UAE for the SafeKids Worldwide, an international non-governmental organization focusing on injury prevention in children. He is a member of several Scientific Committees and Associations (eg. International Society for Child and Adolescent Injury Prevention (ISCAIP), International Union for the Scientific Study of Population (IUSPP), Association for Medical Education in Europe (AMEE), European Public Health Association (EUPHA), International Epidemiological Association (IEA) etc.

Dr. David CM Huang Senior Officer Occupational and Environmental Health Section Public Health and Research Division UAE Dr. David CM Huang, MD, MHS, is a senior officer in Occupational and Environmental Health Section, Health Authority – Abu Dhabi (HAAD). He received his M.D. from the National Cheng Kung University and obtained his MHS in International Health from Johns Hopkins University. He has been working on injury prevention and control in several countries since 2009 and joined HAAD in 2012. Dr. Huang’s work focuses on injury surveillance system as well as information and communication technology (ICT). He has published articles and contributed chapters of books in the international literature.

Dr. Ali Salem Al Qaiwani Director of Occupational Health and Safety Ministry of Labour UAE

Physician. Masters in Disaster Medicine. Former UAE army officer. Trauma physician in Rashed Hospital – DHA. Disaster Management committee member – DHA. Currently Director of Occupational Health and Safety, Dubai – Ministry of Labour.

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Speakers

Dr. Mohammed Al-Rafee General Director of Dentistry Ministry of Health KSA Dr mohammed Al-Rafee is Consultant Prosthodontist and currently he is the General Director of Dentistry, Ministry of Health, Saudi Arabia. He obtained his Bachelor’s Degree in Dentistry from the College of Dentistry, King Saud University, Riyadh at 1991. At the year of 1998 he finished his Certificate and Master Degree (MS) in Prosthodontics from Marquette University, Milwaukee, Wisconsin, U.S.A. 2003 he became a fellow of the Royal College of Dentists of Canada, in Prosthodontics. Dr Al-Rafee is a member of different professional scientific committees for the Saudi Dental Board Programs. He is also Visiting Part-time Teaching Staff, Riyadh Colleges of Dentistry & Pharmacy.

Dr. S. Al Bulushi Oman

Dr. Mariam Alfarhan UAE

Dr. Mohammed Sultan Al- Darwish UAE

Ms.Genevieve Howse Adjunct Associate Professor in Public Health Law La Trobe University Australia Dr mohammed Al-Rafee is Consultant Prosthodontist and currently he is the General Director of Dentistry, Ministry of Health, Saudi Arabia. He obtained his Bachelor’s Degree in Dentistry from the College of Dentistry, King Saud University, Riyadh at 1991. At the year of 1998 he finished his Certificate and Master Degree (MS) in Prosthodontics from Marquette University, Milwaukee, Wisconsin, U.S.A. 2003 he became a fellow of the Royal College of Dentists of Canada, in Prosthodontics. Dr Al-Rafee is a member of different professional scientific committees for the Saudi Dental Board Programs. He is also Visiting

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Speakers Part-time Teaching Staff, Riyadh Colleges of Dentistry & Pharmacy.a Genevieve Howse is an Adjunct Associate Professor in Public Health Law at La Trobe University in Australia and an internationally recognised lawyer and specialist consultant, working in the area of public health law and health policy development. Since 2005, She has been Principal of Howse Fleming Legal which has enabled her to take a range of contracted consultancies in legislation development and legal policy development. Her work as a legal consultant has seen her undertake reviews of health legislation and health policy in Australia, Papua New Guinea, Fiji, the Solomon Islands, Vanuatu, the United Arab Emirates, Yemen, the Sultanate of Oman, Botswana and Zimbabwe for governments, the World Health Organisation and the UNDP. She has been called upon to develop legislation policy, and to draft legislation, including creating and delivering the change management strategies which support its implementation. This has included communication, stakeholder and risk management. From 2008-2011, she was the Principal Investigator on an AusAID funded La Trobe University research project to examine the feasibility of a model public health law for the Pacific Region. She is currently collaborating with Dr Hala Abou Taleb from EMRO on projects to advance tools to asssist development of public health laws in the Eastern Mediterranean Region.

Dr Kadhim Alabady UK Hold a Doctorate degree in Public Health and Epidemiology, Master degree in Clinical Epidemiology (MSc),Master degree in Public Health (MPH), all from The Netherlands Universities. Worked in Public Health since 1999 at different levels such as: - Academic (Erasmus university - The Netherlands, Queen Marry University - UK). - International (United Nations),National Health Authority (Qatar). - National Health Service (NHS), UK. - others Registered as Epidemiologist Grade A with The Netherlands Epidemiological Society. Working with National Health Service (NHS)since 2007. Leading, and conducting different pieces of work (needs assessments or equity audits) related to Coronary Heart Disease (CHD), Stroke,Diabetes Mellitus (DM), Mental illness, Suicide, Dementia, Autism,and others. All this work is published in the UK or presented in conferences or different meetings. Since October 2008 working as Principal Epidemiologist for NHS Norfolk and Waveney / County Council, a county with a population around 1 million.

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Speakers

Mr. Khalid Mohamed Sharif Alawadhi Head of Dubai Food Safety Strategic Plan Committee Dubai Municipality UAE

Qualifications: Msc. of Environmental Risk Analysis Management (Food Hygiene). University of Wales, United Kingdom. 1996 Bachelor of Science (Chemistry & Zoology), University of United Arab Emirates. 1987 Current Position: Director, Food Control Department Members: Member of the International Association of Food Protection (IAFP) Contributions & Initiatives: • Dubai strategic plan (2006-2010) – (2010 – 2014) (setting the objectives and performance indicators). Achievements: • Implemented ISO 17020 standard on the Food Control Department which became the first authority in the region that implements this standard on all scope of food control Committee Memberships: • Member of the National Food Safety Committee in UAE. • Member of the National Food Safety Committee of the GCC Countries. • Head of the Food Safety Committee in UAE. • Head of Dubai Food Safety Strategic Plan Committee (2010 – 2014)

Nahed Jaafar AlYousef UAE

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Speakers

Dr. Jalaa Assad Taher Head, Cancer Control & Prevention Section, Non Communicable Disease Department, Public Health And Research Division, Health Authority Abu Dhabi UAE Academic Qualifications: • Mph Healthcare Leadership & Managment, John Hopkins, Baltimore- 2011 • Msc Mother & Child Health- 2000, Institue Of Child Health, University College Of London, United Kingdom • Mbbs- 1993, College Of Medicine & Medical Sciences, King Faisal University, Saudi Arabia Professional Work Experience Head, Cancer Control & Prevention Public Health And Policies Health Authority Abu Dhabi. November 2010-Untill Date Senior Program Manager Global Initiative For Breast Cancer Awareness In Partnership With Susan G Komen And Institute Of Internastional Education, San Francisco Public Health Programmes, Health Authority Abu Dhabi. March 2008- October 2010 MCH Specialist Health Screening Program For Women & Children- Minstery Of Health National Breast Cancer Screening Program National Breast Cancer Screening Program January 2000 – March 2008 Senior House Officer- General Surgery: Al Jazeira & Centeral Hospitals Ministery Of Health December 1994 – September 1999

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Abstracts

Day 1 (April 4, 2013)

Plenary Session 1 The Way Forward to Arab Public Health: Vital need of Public Health Laws and Systems in the GCC Countries Tawfik A. M. Khoja, Health Ministers’ Council for the GCC States Public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.” (1920, C.E.A. Winslow) . It is concerned with threats to the overall health of a community based on population health analysis. The New Public Health is a contemporary application of a broad range of evidence-based scientific, technological, and management systems implementing measures to improve the health of individuals and populations. Its main objectives are the political and practical application of lessons learned from past successes and failures in disease control and the promotion of preventive measures to combat existing, evolving and re-emerging health threats and risks. The essential elements and functions of public health, the key elements, importance of evidence-based public health as well as the barriers for use of evidence-based decision making in public health will be presented. Public health law is very instrumental in public health. It is the study of the legal powers and duties of the government to assure the conditions for people to be healthy. Law plays a very crucial role in protecting the health of populations, whether the public health threat is pandemic influenza, injury prevention, drugs or tobacco intake, obesity, chronic disease, occupational safety, environmental health or mental health. Actually all public health topics require public health laws which have proved considerably they are effective tools in reducing harm to public health. The vital need for good public health systems and laws in the Gulf countries is highlighted and a scenario for GCC public health system is proposed with the expected outcome and impact of such national public health system as well as the cost of new public health legislation will be discussed.

The Universal Renaissance of Public Health: From Marginality to Relevance and Structure Ulrich Laaser, World Federation of Public Health Associations (WFPHA) Founded in 1967 during the 20th World Health Assembly, the World Federation of Public Health Associations (WFPHA) is the global umbrella organization of multi-professional and interdisciplinary national and regional public health associations. WFPHA represents >75 full members with ca. 250.000 public health professionals and several regional associations (APHA, EUPHA, ASPHER etc.). WFPHA is accredited as an NGO in official relations with WHO The Keynote will refer to the task profile for public health in a global perspective and to the regionalization of WFPHA. We are confronted with threatening global health risks: Global Warming, Global Divides, Global Security, and Global Instability re the financial crises. Furthermore health is still not recognized as a human right for all. The task profile of public health associations (PHAs) can be described as integrating voices, taking care of professional development by organising a conference, a journal and professional standards and ethical orientation. PHAs are also engaged in professional certification, public representation and defending professional interests. WFPHA supports national Public Health Associations to group into regional associations or federations, examples are the African Federation of Public Health Associations, the Asia-Pacific group, and the European Association.

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Abstracts Public Health Training: From academic to service competencies Salman Rawaf, Centre School of Public Health, Faculty of Medicine, Imperial College, UK Introduction: Public health is the science and art of promoting health, preventing disease and prolonging life through the organised efforts of society. Preparing public health workforce (both medical and non-medical) is challenging to many countries around the world. The number needed to meet the public health challenges of the 21st Century; the competencies required; the infrastructure required to deliver the services; the status of public health practitioners; and their leadership role in the decision making process. Many countries are relaying on academic degrees such Masters and Doctors of Philosophies. Should these qualifications be considered as an end points in providing the competencies in delivery effective public health service? Methods: To address the above questions we have looked at the various training systems around the world and its effectiveness in delivering the public health workforce needed. Findings: Very few countries have developed well the professional (services) training programmes for their public health workforce. Membership and Board Licensing qualifications (UK, US, Arab Board, Australia, New Zealand) are the ultimate in achieving all the competencies required from public health specialists and practitioners. We found that failure in many countries to develop and progress professional training could be attributed to the lack of political support and academic blockage based on ideology and lack of understanding of service public health. There are very few countries where the public health academia have dual roles in service delivery and academic work. Some countries have incorporated the academic education (masters) as part of the public health training programme (no more than 25%). Conclusion: The paper will describe the best approaches to prepare the next generations of public health specialists and practitioners. It will also address the confusion about the role of public health medicine and community medicine.

Role of Public Health Associations in National, Regional, and Global Health Development Tewabech Bishaw, African Federation of Public Health Associations (AFPHA), Ethiopia Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity; and, the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, and political belief, economic or social condition.2 Public health has been defined as the science and art of promoting health, preventing disease and prolonging life through the organized efforts of society. Public health associations hence evolved as voluntary associations that seek to take leading role in advocating for and being instrumental in helping to shape the development of evidence based sensible and effective policies and strategies. They also aim to assist the progressive improvement of professional competencies and standards, and organized efforts of society by being informed collaborators for health. However with the ever expanding social determinants of health, the boundaries of public health have extended into many other sectors with multiple partners and actors that influence health opportunities and health outcomes. Furthermore, globalization, demographic and epidemiological transitions, high mobility, close interdependence of economies, population, changing lifestyles and behavioral transitions, unparalleled technological changes, environment and intense communication and commercialization have increased the complexity of public health in both developed and developing countries. More so in developing countries where the health systems are inadequate to carry the burden of communicable, non communicable and emerging new diseases with unprecedented impact on their economies. In this regard, stronger and strategic engagement of public health associations is imperative to influence the fulfillment of the attainment of equitable and sustainable health for all. Public health associations at national, regional and global levels need to be interconnected and networked for better synergy. They also require establishing strategic collaboration and partnership with the various players and stakeholders at different levels. This paper will (i) examine the increasing trend and opportunities for public health associations to play strategic role in shaping health development (ii) highlight the significant role regional and global public health associations can play in regional and global advocacy and knowledge exchange, and, in supporting national associations for enhanced individual and collective actions to effectively influence equitable health for all.

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Abstracts Session 1 Health Information Applying Information Technology to build capacity and improve quality in public health Linda Dimitropoulos, USA Many countries face common challenges related to capturing, structuring, sharing and acting upon various sources of information to improve public health. Information science, and information and communications technologies (ICT) such as online communities and cloud-based services, can be used to address many of these challenges. This presentation will focus on how informatics and ICT have been used to address challenges related to disease surveillance and practice improvement in the U.S. focusing on the lessons learned from these efforts which have implications for other countries. Monitoring and sharing information on disease incidence, particularly infectious agents, is challenging. Information to assess emerging disease threats may come from many sources – hospitals, pharmacies, schools, and even social media. Effective characterization and response to threats requires timely collection and analysis upon receiving this information. This requires the appropriate infrastructure, policies, practices, and staff. This presentation focuses on how these challenges to disease surveillance have been addressed by the syndromic surveillance system in the U.S. called BioSense 2.0. BioSense combines a community-based governance model, shared cloud-based resources, and a user-friendly application to provide public health organizations across the U.S. with a uniform, Web-based set of disease surveillance capabilities. Informatics can also be used to help healthcare systems to adopt effective practices for detecting, monitoring, and responding to communicable and chronic conditions. The presentation will explore how a public health quality improvement exchange, where practitioners submit and share best practices through an online portal, can provide the mechanisms necessary for capturing, structuring, and sharing the lessons learned at the local and community level nationwide in uniform, cost-effective ways. Target audience members include public health practitioners, informatics professionals, and officials within health authorities. This discussion aims to help audience members understand how new approaches and Web-based technologies can create highly reliable and widely accessible services for critical public health capabilities such as syndromic surveillance, quality improvement, and data sharing.

Health Information Exchange: A Public Health Necessity Mohannad Hammami, USA

Health information technology (HIT) enables patients and providers to support better health and health care by providing targeted information meant to inform, educate and allow for improved decision making. Evolution in HIT has led to personal health records (PHRs) as part of the Electronic Health Records (EHRs) where patients have access to their records and are engaged in the decision making. This added access can be used as a tool for better healthcare in the underserved and vulnerable population. It will allow for patient education, support and self management of a healthy lifestyle, which leads to a better quality of health care. Even with such rapid evolution in HIT and Health Information Exchange (HIE), the digital divide remains a barrier to full participa-

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Abstracts tion of underserved communities and must be recognized and addressed. Most attempts of HIEs have centered on sharing data that is electronically available to multiple sites, generally from either large organizations (hospitals) or entities that provide ancillary care data (laboratory information, pharmacy information). These efforts, though conceptually useful, are very difficult to implement and sustain due to multiple cultural and financial barriers in highly competitive markets. Many of these “networks” have limited exchange and accessibility within the same affiliation and are firewalled to outsiders and non-affiliates that might care for the same patient. The usefulness of a “meaningful” HIE is to facilitate doctor-doctor communication across silos of care including a unique on-demand specialty care access around a quality model. The ideal scenario for an underserved and vulnerable population such as ours is that when an individual is being treated at a free clinic, the healthcare provider at this clinic and with the patient’s authorization is able to pull and in real time all and complete health information from previous visits to an emergency room, community health center, check on drug allergies and medication interactions and reconciliation and get results of mental health assessments upon previous incarceration at the County Jail. Such a complete picture would benefit the patient, the provider and overall health status of the community. It will lead to improving quality, safety, efficiency, care coordination, population and public health as well as reducing health disparities; and it will engage patients and their families in managing their health records.

DHA ehealth: The vision for centralized registries

Mohammad Al Redha UAE

Dubai Health Authority has set forth an eHealth Roadmap that includes the development of Centralized Registers. This session will be exploring the challenges related, including: specific criteria for content, quality and validity, accessibility, unique identification, technical capacity and administration.

Session 2 Public Health: a new perspective Public Health Challenges and Opportunities in the Emirate of Abu Dhabi

Omniyat Mohammed AlHajeri UAE

Public health challenges are complex, interdisciplinary, inter-professional, and often international and the challenges facing the public health department in Emirate of Abu Dhabi is no exception. The population-based health data collected by the HAADPublic Health and Research Division indicates that the pattern of non-communicable diseases and injuries among the citizens and residents of the Emirate of Abu Dhabi and their cost burden on the health care system are similar to those encountered in the western part of the world. Research tells us that 70% of the deaths attributed to these conditions are preventable through modification of risky behaviors. Hence, the role of HAAD-Public Health and Research Division to maximize the Abu Dhabi population’s health in will continue to expand significantly with the increasing awareness of the existing challenges and opportunities in the Abu Dhabi community and interrelation of the influencing forces.

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Abstracts Public Health Within A Changing Context

Bothaina Ahmed Al-Tall Yemen

Background: Although maternal mortality in Yemen fell by 63% during 1990-2008, it is unlikely that Millennium Development Goal 5 will be achieved. While maternal mortality is a national priority, the national policy for maternal health was not assessed. The following paper assesses the national maternal health policy within the country’s turbulent political and economic environment. Methods: Maternal health policy was assessed using the Maternal Health Policy Score (MHPS), a 51-item 6-likert scale questionnaire covering 9 policy components: health policy toward safe pregnancy and delivery, financial investment, service delivery and utilization, information, education, and communication, training, and monitoring and evaluation (M&E). Sixteen national experts were interviewed in 2009 and 2012 to elicit their perception about the national maternal health policy on the index year and 3 years prior. The findings are presented on a 0-100 point scale. Data on media coverage and financial investment in maternal health were gathered and incorporated into the analysis. Results: The policy scores were generally low. Only 4 of the 9 components scored in the average range (2.5-3.5/5) in 2012. There was an overall, although modest, increase of MHPS scores at an average of 9 points from 2009 to 2012 with an exception of financial investment which decreased by 1. The components of policies toward safe pregnancy and delivery, utilization of services, and information, education, communication, and networking increased by 7, 13, and 14 points respectively. The perceived increased utilization of maternal health services is interesting within the weak policy environment. This could be linked to ongoing public mobilization events and increased social media coverage of maternal health issues which could well increased the community awareness. Conclusion: Experts perceived a limited improvement of maternal health policy and a drop of financial allocation but interestingly an increase

Millennium Development Goals

Bettina Borisch WFPHA

The WFPHA executed a quali-quantitative survey to explore the opinion of public health professionals worldwide and their experience concerning the implementation and achievement of the MDGs with a focus on sub-Saharan Africa. We received 427 completed questionnaires, from 71 countries. Almost 9 out of 10 (88%) of respondents were involved in MDGs-related activities collaborating mainly with the national government, multilateral organisations and local NGOs. The respondents’ main activities focused on MDGs 4 (child mortality), 5 (maternal health), and 6 (Aids/Malaria). Their answers do not differ significantly across respondents’ employment position, WHO regions, and country’s GNI[1]. All 8 MDGs were considered as relevant by some in the public health community. However, the importance assigned to each MDG varies significantly, with MDGs 4 and 5 considered most important in the African Region, and MDGs 7 (environment) and 8 (global partnership) in the Western Pacific Region. Respondents from lower-income countries (LIC) attach high relevance to MDG1 (poverty).

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Abstracts Session 3 Public Health Surveillance Public Health Surveillance Systems development and evaluation Farida Alhusani UAE • • • • • •

Review of the current surveillance systems available The use of Electronic health records to monitor communicable diseases Early warning systems for outbreak detection Evaluation of surveillance system Learning from experience: e-notification of communicable diseases in Abu Dhabi Review of the current challenges for public·health surveillance systems in the arab region

Upgrading virological influenza epidemiological Influenza-like Illness surveillance: steps and public health value, Egypt, 2009 – 2012 Manal Labib Fahim Egypt Background: Historically, purpose of sentinel influenza surveillance in the Middle East has been to obtain influenza virus isolates from outpatients with influenza-like-illness (ILI) for vaccine planning. In Egypt, 2009 surveillance was upgraded to realtime epidemiological surveillance to monitor influenza trends and early detect influenza outbreaks. Evaluation was conducted regularly to determine whether surveillance is accomplishing its goals. Methods: Initial evaluation was conducted in 2009 using structured questionnaires for all sites and laboratories to identify changes that would allow surveillance to provide real-time epidemiological data of influenza and ILI. Follow up yearly evaluation visits are being conducted to ensure system operates efficiently. Results: Initial evaluation revealed that large differences in numbers of ILI cases enrolled between sites (20-50/month), ILI case definition used at each site varied and no consistent method was used to ensure representative sampling. The total number of ILI outpatients and total number of outpatients were not reported, and specimens were often delivered to the laboratory at intervals of a month or longer and no feedback. By the end of 2012, all sites are using WHO case definition for ILI cases enrollment, representative samples are being collected with mean number of cases/week collected by all sites =83.8±23 compared to 73.3±16 in 2010 (p Conclusion: The changes being implemented in Egypt build on a surveillance platform for vaccine planning. This added an awareness of current trends in ILI activity and frequency of influenza by type, subtype and strain and succeeded to early detect changes in influenza activity which will contribute to informed decision-making.

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Abstracts A New Electronic Surveillance Program to Monitor Antimicrobial Resistance in Human Pathogens Jens Thomsen / Yousuf Naqvi UAE Purpose/Objective: A new mandatory electronic surveillance program to monitor levels and trends of antimicrobial resistance in human pathogens has been developed and implemented in all public hospitals in Abu Dhabi Emirate. The AD ARS will also help and facilitate to • assess the relationship between local antimicrobial consumption and development of antimicrobial resistance, • develop targeted awareness and education activities for physicians, pharmacists and the general public, • conduct cluster and outbreak analysis of multi-drug-resistant organisms (MDRO), • exchange antibiotic resistance surveillance data with other emirates and countries, and • make informed decisions regarding prescription policies for antimicrobials, antimicrobial stewardship programs, and infection prevention and control programs. Material/Methods: The Health Authority – Abu Dhabi (HAAD) has in 2010 established a working group, which has developed and implemented the Abu Dhabi Emirate Antimicrobial Resistance Surveillance Program (AD ARS). AD ARS is utilizing medical and other data routinely generated in microbiology departments of participating healthcare facilities and reported to HAAD as mandated by a related HAAD standard. Relevant data is extracted from hospital information systems (HIS, e.g. Malaffi/Cerner), then imported into and analyzed using specialized data analysis software (WHONET, by World Health Organization). Statistics and reports are developed and communicated back to the concerned community. Results/Conclusion: The AD ARS is a very useful surveillance system for antimicrobial resistance data and has resulted in a wealth of high quality data on levels and trends of antimicrobial resistance. The presentation will provide an overview of the AD ARS system, the planning, development and implementation process, and related policies and procedures. Furthermore data on antimicrobial resistance levels and trends in all Abu Dhabi Emirate public hospitals for 2010-2012 will be presented. This is the first surveillance system for antimicrobial resistance in the UAE, and the second in the GCC region, after Oman.

Session 4 Public Health services in the Arab World Planning and development of human resources for health in the Arab World challenges of Quality, shortage and oversupply Samir Banoob USA Goals and Objectives: - Identifying the major challenges of Human Resources for Health (HRH) planning and development in the Arab world to facilitate facing defects affecting health systems. - Promoting cooperation between the national and educational and health sectors to achieve national objectives for adequate and quality health care - Exploring collaboration among the Arab countries to strengthen HRH education and adequacy Methodology: - Analysis of the existing statistics of HRH, unpublished statistics, and consultations on health reform and HRH in several Arab countries conducted by the author. - Proposing a set of recommendations at the national and Arab world levels to ensure qualitative and quantitative adequacy of HRH

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Abstracts Target Beneficiaries Health planners, health policy makers, educators and academicians in the health field, human resources directors and specialists, public health professionals Good practices: - National planning, education and training of health professionals - Resource planning, evaluation and quality of care in the health field. This paper presents findings and observations of human resources planning at the national level concluded by the author during recent consultations in Egypt, Libya, Sudan and Syria as an EU senior consultant, and earlier in Arab Gulf States consulting on national health planning and human resources development. In spite of the differences between the Arab countries, the major challenges are common and need aggressive interventions to correct major deficiencies that impact negatively on the health systems. These include: - - - - - -

Lack of appropriate long range planning that can ensure adequate supply of HRH, avoiding shortages or oversupply especially of physicians. In adequate training, motivation and retention of family practice specialists and primary care physicians. Inappropriate methods for training, motivation and retaining of the nursing staff at the national level, using different types of institutions in the ministries of education and health The poor collaboration between the educational and the health sectors to determine the actual needs or designing the proper curricula for education at the under graduate and postgraduate levels for health professionals Variable and or defective cooperation to ensure graduate and continuing education Lack and/or inadequacy of training of public health and health managers specialists

The paper will also present certain strategies for: - National HRH planning for quantitative and qualitative adequacy of HRH. Through the national councils of HRH for annual intake, curriculum design and educational methods. - Establishing national criteria for licensing and accreditation of educational institutions and professionals at the Arab world level - Strengthening education and training in public health and health management.

Food borne diseases surveillance system in the Emirate of Dubai

Khalid Sharif Alawadhi UAE

Access to safe and wholesome food is a basic requirement to ensure that we are protected from adverse health effects and illnesses. There is no all-encompassing solution to completely prevent foodborne diseases. However, appropriate and timely control measures will reduce human suffering and financial loss. Effective surveillance is the key to tracking foodborne diseases and the data that we obtain from such surveillance activity serves as a basis for developing, implementing and evaluating risk based food safety measures. We started our work to establish a foodborne disease surveillance system in 2010 in collaboration with Dubai Health Authority, World Health Organisation (WHO) and the Centres for Disease Control (CDC) in the United States. In three years time, we have made significant developments in the way we conduct disease surveillance and investigate foodborne disease outbreaks. My presentation will focus on how Dubai Municipality built the system for the surveillance of foodborne diseases and how the program has contributed to the improvement of our food safety system

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Abstracts Healthcare Investment In Dubai: Values, opportunities And Challenges

Heba M. Mamdouh UAE

Introduction: Over the past few years, Dubai healthcare sector has witnessed rapid development. The government has made substantial investments in healthcare infrastructure, building hospitals and clinics and promoting a more modern approach to tackling diseases. Objectives: This paper aims to present evidence supporting that the value of improved health in Dubai over the past few years significantly outweighs the additional healthcare expenditures that accompanied the improvements. Materials and Methods: Available literature on investment in healthcare was identified by searching in Medline and in websites of organizations involved in capacity building in the Middle East and in UAE. Data were sought from Annual Health Statistics Book of Dubai Health Authority and UAE National Bureau of Statistics. Included also were relevant reports on investment in the health sector in UAE. Results: Data showed that while healthcare spending has increased over the past years in Dubai, the resulting gains to patients and society through better health have been far greater. Significant health gains were noticed in the form of increased life expectancy from birth (has risen to 76 years in 2011), reduced annual death rates (44% decline in death rate during the last decade), and in particular lowered mortality rates (remarkable decline in under-five mortality rates and death rates from some communicable diseases), as well as reduced hospitalization days (the hospital discharge rate dropped by more than 2 folds in the past decade, reached 93.4 discharges per 1000 population). The current article also presents some challenges that may face the healthcare sector. Still, there are many new opportunities are open for the private providers that include development of public private partnerships and moving toward medical tourism’s potential. Conclusion: This article suggests that healthcare investment in Dubai emirate adds value to the population over the past few years.

Awareness, medication use and control of blood pressure in an immigrant population of United Arab Emirates Syed M Shah UAE Background and Objectives: With unacceptably high rates of obesity hypertension is becoming a major public health problem the United Arab Emirates (UAE). This study was conducted to determine the prevalence, awareness and control of hypertension in adults in Al Ain, United Arab Emirates. Methods: This was a population-based cross-sectional study. Study participants were recruited as part of a global health project to identify risk factors for non-communicable diseases. Trained nurses measured blood pressure (BP), height, weight, waist and hip circumference and draw blood of the study participants (n=622) who were fasting overnight before collection of blood by venipuncture. Inadequate BP control was defined as greater than or equal to 140/90 mmHg. Results: Mean age of the study subjects was 43 years (54% females). Ethnic composition included native Emirati (52%), immigrant Arabs (46%), and others (2%). The overall prevalence of hypertension was 18.3% (96%CI, 15.3-21.6). It varied by ethnicity, 14.4% (Emirati), 21.9% (Arab immigrants) and 38.5% (other immigrants). Of those with hypertension, 34.8% were not aware of their hypertension status. The lack of awareness was 40.9% in Emirati, 30.2% in immigrant Arabs and others and 40.0% in others. Those with hypertension 54.4% did not use medicine in the last two days. Of those who reported use of medicine in last one month, 49% had inadequate BP control. Conclusion: A high proportion of adults in the UAE with hypertension had inadequate control of blood pressure. There was ethnic disparity in hypertension prevalence and awareness in the study subjects.

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Abstracts Quality Assurance Program (QAP) implementation in Sudanese hospitals: lessons learned Heitham Mohammed Ibrahim Awadalla, Sudan Background: Different approaches have been exercised to implement QAP in hospitals in different countries. No single approach approved to be effective in every country. Adaptation to local context is always required. Sudan has started its national QAP in health sector in 2001. Nonetheless, obstacles facing the program have led to poor and ineffective implementation. Objectives: The aim goal was to identify possible interventions to improve the implementation of the QAP in public hospitals in Sudan. The four objectives were to: discuss the implemented QA policies and strategies; analyze the current challenges, search for possible interventions; and then giving practical recommendations. Methodology: It was a review study of the existing QAP in Sudan. The ‘Policy Triangle Framework’ was used for the analysis of current situation and for discussion of findings. Secondary data were collected from different sources through electronic and manual search from: electronic databases, specialized quality journals, and Sudan Federal Ministry of Health reports. The search was limited to articles published in English and Arabic Language after 1990. Sixty-seven articles have been studied. Findings: Different types of challenges have been revealed. The most important ones were: the QA policy formulated at federal level has not been well communicated with the lower levels. The limitations of the top-down approach (the implementation process) have not been tackled. The main contextual factors were related to: poor financial and technical capacities, disparities between the states, and non-supportive contextual culture. The main key actors like: physicians and hospitals’ managers were not well involved in QAP implementation. Conclusion: To improve the implementation of the QAP in Sudan, three sets of comprehensive interventions could be followed: Strengthening the QA system through establishment of QA committees involving different stakeholders at all levels; gradual implementation, in vertical and horizontal levels; and sustainability through training programs and reallocation of resources.

Session 5 Health Promotion Healthy lifestyle of middle aged attending outpatient clinics in Alexandria, Egypt, 2009 Sherein Tareef Elnossery Egypt Background: Aging is lifelong process where early and mid-life events and behaviors have an important influence on health and functions of individuals as they age. Adoption of healthy lifestyle (HLS) is important at all stages of life particularly middle age. One of myths of ageing is that it is too late to adopt HLS in later years. On the contrary, physical activity PA, proper nutrition, avoiding smoking, and practicing health seeking behavior can prevent diseases and functional decline at any age. HLS is affected by wider range of factors as environment in which we live, values, beliefs, traditions, and education. Also Knowledge about benefits of HLS is crucial motivation to achieve successful active aging. Objectives: It aimed to assess HLS including physical activity, personal, dietary habits, smoking and health seeking behavior among the middle aged and evaluate their knowledge about impact of their lifestyle upon active aging.

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Abstracts Methodology: Cross sectional study design was used to carry out the study at four randomly selected out -patient clinics to represent all governmental sectors that provide health care for adults. A structured pre-coded questionnaire was used to collect data. Results: Study included 400 patients (260 females, 140 males) most of suffered from chronic diseases (83.2%). Mean age was 53.5 ±3.6. Less than half of sample had fair score of practicing dietary behavior, PA, the majority were non -smokers, while most of the cases had bad score of practicing health seeking behavior. The total score of practicing HLS was bad among the majority of patients (77.3%).Less than half of them (45.8%) had fair total score of knowledge about HLS. This was more common among males than females. Conclusion: Most of middle aged patients have bad practice and fair knowledge about HLS.

Health Promotion in the 21st Century: How can We Make the Healthy Choice the Easy Choice? Amy Elizabeth Roussel USA Community-based efforts to promote healthy behaviors, and discourage unhealthy choices, increasingly rely on changes in policies, systems, and environmental contexts. We recognize that the environments where people live, learn, work, and play shape their behavior. Choices about nutrition, physical activity, and tobacco use have significant impact on promoting health and preventing serious health problems, such as heart disease, stroke, diabetes, and cancer. This presentation will outline a model of the process of implementation of such system and environmental changes. Drawing on RTI’s research on a number of U.S.-based community health promotion initiatives, we will explore the process of implementation, the challenges of moving evidence-based health promotion approaches into practice, and effective strategies for accelerating uptake of effective strategies for health promotion.

Addressing Physical Inactivity In The GCC: A Population Health Imperative Ruth Mabry Oman Introduction: The increasing prevalence of diabetes, the metabolic syndrome, overweight and obesity in the Member States of the Gulf Cooperation Council (GCC; Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates) is a growing concern. The prevalence of physical inactivity, one of the key behavioral risk factors of chronic disease, is high, about 60% for men and over 70% for women. To engage health decision makers in addressing inactivity in Oman, a semi-structured interview study with 10 mid-level public health managers was conducted. Methods: Interviews began with presentation of recent prevalence data on inactivity in Oman and then sought to elicit barriers and culturally relevant solutions to increasing physical activity among Omani men and women. Interviews were audio-recorded and transcribed. Thematic content analysis was carried out, guided by an ecological model of health behavior. Results: Barriers for physical inactivity were grouped around four themes: intrapersonal (lack of motivation, awareness and time), social (norms restricting women’s participation in outdoor activity, low value of physical activity), environment (lack of places to be active, weather) and policy (ineffective health communication, limited resources). Solutions focused on culturally-sensitive interventions at the environment (building sidewalks and exercise facilities) and policy levels (strengthening existing interventions and coordinating actions with relevant sectors). Discussion: Results are considered in light of recommendations outlined in the Toronto Charter for Physical Activity. Urgent intersectoral action focused on a shared goal and a more deliberate public health response addressing physical inactivity as a key strategy for the prevention of chronic diseases is required. Further research on the determinants of physical inactivity in the GCC is needed to guide policy makers.

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Abstracts Knowledge, Attitudes, and acceptance of HPV vaccine among Paediatricians and Gynaecologists in Riyadh, Saudi Arabia Basmah Faisal Kattan KSA Introduction: Human papilloma viruses (HPVs) are infectious and oncogenic viruses that cause cervical and anal cancers. HPV vaccination is effective in reducing the risk of acquiring the disease. This vaccination is still not obligatory in Saudi Arabia. Aim To evaluate the knowledge, attitudes and acceptance of physicians toward HPV vaccine and document their recommendation to improve the uptake of HPV vaccination. Methods: A questionnaire-based cross sectional study will be conducted in 5 main hospitals in Riyadh in September 2012. The pilot phase has already been conducted in King Abdul-Aziz Medical City, which it is a tertiary care Centre. The population of interest included all Pediatricians and Gynecologists who are working on full-time basis. A simple random sample of 30 doctors was invited to complete a questionnaire twice two days apart. Doctors were also asked to complete an evaluation form of the questionnaire. Results: About 73% of participants indicated that they have not experienced any difficulties it. All, except one, agreed that the language of the questionnaire was understandable. Reliability tests showed a “good” reliable data collection tool for two of the core questions (Kappa = 0.714) and a moderate reliability for a third core question (Kappa = 0.57). Preliminary results based on analysis of data collected in the pilot phase showed excellent attitudes towards the vaccine, but less than acceptable level of knowledge among physicians. Discussion & Conclusion: This questionnaire has good face validity and test-retest reliability. Assuming that our results from the pilot phase are true and confirmed following the actual study. Doctors should be offered training sessions to improve their knowledge about the disease and the vaccine. However, their excellent attitude towards the vaccine is a good indication of willingness of doctors to contribute in our future intervention to promote for the vaccination.

Assessment of HIV counselling and testing service in Bahirdar town, Ethiopia

Mahbub Ali Abdukie Ethiopia

Problem Statement: Voluntary HIV counseling and testing service is important and effective as an entry point for HIV/AIDS prevention and control programs. One of the underlying principles of VCT is provision of high quality service. However, very little has been done in Ethiopia and specifically in Bahir Dar to assess the quality of VCT services. Objective: This study aims to assess the quality of voluntary HIV counseling and testing services in Bahir Dar town. Methodology: The study utilized both qualitative and quantitative designs. A cross sectional survey was carried out using a standardized questionnaire adopted from a tool developed by UNAIDS. The study included five counselors, five VCT focal persons and 272 clients from five VCT sites found in Bahir Dar town. Session observation and exit interviews conducted for clients. For most of the variables descriptive statistics were computed. Logistic regression and non parametric tests were done for some of the variables using SPSS version 13. Result: All sites have separate counseling room; provide pre test and post test counseling. None of the sites provide follow up counseling. Half of the counselors were self motivated to be counselors. None of the counselors have received follow up refresher training. Only a quarter of counselors are a member of counselors support group. Most, 70%, of clients cited to “Know myself” as a reason to take HIV counseling and testing service. Waiting time to get test result was shorter in private clinic and duration of counseling was longer in government sites. Not having VCT in the past is significantly associated negatively with service satisfaction (AOR=0.3, 95%CI: 0.10, 0.86). Those aged 25-29 years are also less satisfied by the service (AOR=0.14, 95%CI: 0.02, 0.98).Over 90% of clients were generally satisfied by the service they received.

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Abstracts Conclusion: All sites have fulfilled most of the minimum requirements to undergo VCT services according to WHO/UNAID recommendation. Follow up counseling was not available in all sites. There was lack of support and ongoing refresher counseling training for counselors. However, generally there was a high satisfaction rate by clients. Recommendation: A counselor support group should be formed and all counselors should be members of this group. Refresher trainings must be offered for counselors when appropriate. Follow up counseling should be routinely provided for those clients in need. The regional health bureau and all stake holders involved in the VCT service provision should take actions to enhance the quality of VCT services

Session 6 Essential Public Health Promotion Health interventions Participatory Health System Research: Knowledge Translation and Multilevel Capacity Building Khalifa Elmusharaf Bahrain Background: Participatory Health Systems Research can ensure integrated knowledge translation, and build the capacity of researchers, policy makers, providers and local people in South Sudan. Approach: Fourteen marginalized women in Renk County in South Sudan conducted a Participatory Ethnographic Evaluation Research (PEER) which included developing their skills to design research instruments, conduct interviews, collect narratives and stories, and analyse the data. Twelve months later, 10 of them worked together with 12 university researchers, 2 employees of NGOs, and 10 theatrical band members in an “Innovative Participatory Health Education (IPHE)” project, to prioritize women’s health issues, develop action messages, and create culturally appropriate health education materials. They delivered this to their community in the form of pictograms, songs, and drama. A parallel training workshop was conducted on Reproductive Health Project Management (RHPM) that targeted 10 senior officers in Renk Ministry of Health. They used the list of maternal health issues generated by the (IPHE) participants to develop two reproductive health project proposals. In the last day of the workshop the local people and senior officers were brought together to discuss maternal health issues in the area. The senior officers presented the two proposals to the IPHE participants who gave them feedback and comments. Outcome: The women believed that PEER enhanced their credibility - when they returned to their social circles people were more accepting of what they said. They are more confident about their ability to influence change. The senior officers said that this approach helped them to identify the maternal health issues through the views of the local population which will influence their future decision making. Conclusion: This approach strengthened the capacity for researchers and policy makers to ensure integrated knowledge translation, engaged the community and enhanced their contribution to identify health needs, plan and design future health services.

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Abstracts A Comparison Of The Egyptian Public Rankings Of Key Public Health and Environmental Issues by Occupation and by Gender (Pilot Study) Nargis Albert Labib/Rasha Aziz Egypt Improving health necessitates information about the most pressing and challenging public health problems in the community. Purpose examines the public’s opinions on the priorities of public health and environmental health issues in Egypt, to explore the differences in the ranked orders based on occupations and gender. Cross sectional survey was conducted in AlFayuim, 2009 to2010. Anonymous self administrative questionnaire was used to collect data from 318 participants after acquiring their consent with assured confidentiality. A weighted ranking score system was used to compare the distribution of ranks among the public health and environmental issues. Principal component analysis and Varimax rotation method were used for better interpretation of results. Top ranked public health and environmental issues were compared with the latest available reports from the WHO. Results showed that maternal health and drinking water had the highest level of concern respectively from public health and environmental issues, while accident prevention and ground drinking water were ranked as the least important issues. Slight difference between the health and non-health professional groups for both public health and environmental issues. The difference was significantly larger between men and women in their rankings of the public health issues only which could be attributed to the inequality of the social roles between genders. Four factors were found to explain 66.9% variations among the ten public health issues namely; maternal health and education (25.4%), disease control (18.7%) nutrition and environment (12.9%) and immunization (10.0%). Drinking water was selected as the important issue to be explored across the six nations in North Africa as it belonged to the first extracted factors that had the highest percentage (19.23%) of the total variance among all issues. Health practitioners and governments should survey the opinions from various groups of people in order to make the best strategic policy and planning decisions.

Cervical cancer prevention- HPV vaccination

Jalaa Asaad Taher UAE

Cervical cancer is the second most common type of cancer found in women and it is the third leading cause of cancer related deaths worldwide. In Abu Dhabi, United Arab Emirates (UAE), cervical cancer accounts for 7% of cancer cases found in females, following breast cancer with 44 %, and it ranks amongst the top 10 cancers resulting in deaths. Almost 50% of all women diagnosed with cervical cancer are between the ages of 35 to 55 years, the majority of which are detected at a late stage. The Health Authority Abu Dhabi (HAAD) cervical cancer prevention and control strategy includes: HPV vaccination for females between the ages of 15 to 26 years, in addition to cervical cancer screening for women between the ages of 25 to 65 years. In 2008, HAAD introduced a voluntary school-based vaccination program for adolescent girls between the ages of 15 to17 years. The program is publicly funded and implemented in both public and private schools across Abu Dhabi. The overall uptake of the HPV vaccine in 2012, reached almost the 80% mark which is comparable to other successful programs such as the one implemented in Australia. To maximize the impact and benefits of the vaccination, HAAD will be introducing the HPV vaccination program for the catch up cohort for females between the ages of 18 to26 years, by mid-2013. The program will be delivered at various healthcare facilities providing the following services; premarital, which is a mandatory program in the UAE, pre-college admission and cancer screening. HPV vaccination recommendation is part of the Standard Immunization Schedule for School Children and Thiqa Preventive List, a health insurance scheme for UAE Nationals that includes a wide range of comprehensive medical coverage.

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Abstracts Traveller’s Health

Nahed Jaafar Al Yousef UAE

Rates of international travel have continued to grow substantially in the past decade, More than 900 million international journeys are undertaken every year. They are seeking out areas that have rarely been visited in the past. The reasons for travel are also varied, including, tourism, business, study abroad, visiting friends and relatives, adventure, or mjssion work. Travelers range in age from very young infants to centenarians. Their health conditions are also diverse, including those who have preexisting medical, conditions, are immunosuppressed, or are pregnant. Global travel on this scale exposes many people to a range of health risks. Many of these risks, can be minimized by precautions taken before, during and after travel to ensure healthy travel, we should start from pretravel planning and preparation, as counseling travelers about healthy behaviours that may decrease risk of disease and injury abroad, vaccination,against infectious diseases, country specific disaess information & recommendations, and other preventive measures and precautions

Mental Health Needs Assessment for Norfolk / UK

Kadhim Alabady UK

Background: Mental illness affects people in all ages and stages of life, across society, impacting upon family life, friends and relationships, education, finding work, working, caring for others, leisure pursuits and retirement, as well as the impacts purely characteristic of the disorder. The severity, duration and impact of mental illness varies hugely, and so prevalence data alone for the various disorders will not provide all of the information required to estimate medical and social care needs, or the extra considerations for education, employment, acceptance, understanding and accommodation by society plus the reasonable adjustments that are required for routine services for people who suffer with mental illness. All services need to be flexible so that they can be tailored to the circumstances of individuals. Objectives: The data and datasets set out and explored here will contribute to a wider assessment of population-based need which also requires discussion with commissioners, service providers, patients, carers and others to: • Evaluate existing services. • Understand capacity and pathways, in relation to evidence of best practice. • Understand patient perspectives. • Take account views of patients and their carers on different aspects of care and support. Method: Where possible we have compared local data to national or regional figures; it will also be useful to compare with situations and services and pathways in other parts of the country, to understand whether our patients and clients get care that is equitable. Recommendations: • Further analysis will be undertaken, comparing the data from the different chapters of this report, and also looking at services and pathways in counties that are achieving better outcomes in relation to their local population needs. • This will be taken forward in the next financial year 2013/14 and it is expected that this will be done in liaison with commissioners of services.

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Abstracts

Day 2 (April 5, 2013)

Plenary Session 2 The intelligent inspection: Towards a country free from food poising, a model of excellence in performance Maryam Jalahma, Ministry of Health – Kingdom of Bahrain This Paper highlights the implementation of a project in food control section in the department of public health to Strengthen the network of consumer protection. The project succeeded in achieving the concepts and values of excellence in providing services focusing on the safety of the consumer (citizen, resident or tourist) through availability, quality and high efficiency of the inspection process. The project is based on strengthening the role of the health inspector through the following: Reprogramming the role of the Inspector to shift from «Police inspection» which seeks to highlight the errors and apply sanctions on food handlers to “intelligent inspection “ which deals with food handlers as partners and works to gain their trust and improve their services. Effective application of a new culture with the partner based on the exchange of knowledge in network protection. Implementation of practical risk management through successful inspection models. Strengthening the role of the consumer as a partner in the health inspection and take advantage of their feedback to identify the error. Moving from estimation phase to forecasting phase. Working by priorities through focusing on the availability of inspection in the most required areas. Practicing a comprehensive inspection process that includes counseling, education, sampling, training in addition to guidance to ensure the safety of the food provided to the consumer. The project was implemented with no additional resources compared to the added value achieved. Instead of requesting extra resources, the team focused on Smart catchment, proper Utilization of knowledge and through Optimizing the resources. The results showed reduction of food poising incidents in the catchment area by 39% in 2012 compared to 2011. The results also showed that the project‘s overall productivity increased from 3% to 11% after one month implantation period. Currently the Project is implemented in two governorates with a plan to start its application in other Governorates.

The current state of epidemiology in the Arab World: Prospects for the future David D. Celentano, Johns Hopkins Bloomberg School of Public Health Epidemiology as a discipline enjoys widespread popularity among medical communities in the Arab World. This presentation restricts its focus to the Middle East, where epidemiology is commonly promoted in medical schools rather than formal education in schools of public health. The major exception is the American University of Beirut which offers a Master’s degree in epidemiology. In this presentation, we review the current state of the published literature on the epidemiology of major health conditions focused on the Middle East countries of Saudi Arabia, Kuwait, Bahrain, Qatar, United Arab Emirates, Oman, Yemen as well as Jordan, Syria, Lebanon and Iraq. A search of PubMed of the Library of Medicine, National Institutes of Health from 1951 through January 2013 shows a total of 28,061 unduplicated references on health conditions in the region. Of these publications, studies of genetics and congenital malformations were most common, closely followed by investigations of blood-related conditions, and then by infections. The leading causes of death in the region vary widely (with data reviewed for the year 2010 from the World Health Organization), but systematically are represented (in age-standardized rates) in cardiovascular disease, stroke and hypertension. There are significant differences by member states in the leading causes of death, but life expectancy in the region is relatively stable and long. Lung diseases have been widely studied. Among cancers (the

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Abstracts fourth most common papers), lung, breast and colorectal cancers – among the leading causes of death – are well represented in the regional literature. Road traffic accidents/injury are commonly cited. Type 2 diabetes mellitus and kidney diseases are commonly referenced. Less frequently investigated are pediatric and neonatal issues, sexual dysfunctions and diarrhoeal diseases, which are often in the top ten leading causes of death in the region. Of interest, war is the second leading cause of death in Iraq, although only 94 citations were found in the world’s literature for the entire region over the past 60+ years, and most were confined to the Palestinian area of control. Clearly, the evidence from the region shows an upsurge in obesity, smoking, diabetes and the metabolic syndrome. Smoking rates among men are high, and tobacco use among young adults is increasing. With increasing urbanization and attendant air pollution, global climate change, and changes in diet, cardiovascular and cancer will increasingly pose many challenges for the future. Prospects for the development of epidemiology in the Middle East are bright, as medical education is rapidly expanding, preventive medicine is on the rise, and the existence of multiple population-level biobanks and health insurance cohorts are being investigated, which offer huge promise for better understanding risk factors and the course of human health and illness in the future.

Public Health Development and challenges in Qatar Sheikh Mohammed Al Thani, Department of Public Health- Qatar As one of the GCC countries, Qatar experiences several health care challenges that, when realized, called for marked public health measures to permit facing the current and future health care demands. Qatar has been ranked first for the prevalence of obesity, among all GCC countries, and sixth globally (45.3%). Qatar was also reported to have the highest rate of obesity among boys in the Middle East and North African region. Furthermore, according to recent estimates, Qatar has high prevalence rates of hypertension (32%), metabolic syndrome (27%), hyperglycemia (13%) and diabetes and cardiovascular diseases (~240 cases/100,000 for both conditions) among other countries in the Middle East, North Africa and East Mediterranean Region. It is anticipated that this current disease prevalence profile – when linked to the projected increase in treatment demand – will result in a 100% growth in demand for hospital beds in Qatar by 2025 compared to the present situation. In light of the current and future magnitude of the health-related challenges, the Qatari government planned to focus on policymaking and regulation while maintaining its role in health service delivery and to take a leadership role to develop, coordinate and implement public health issues, policies and actions, including improving public health legislations. As such, the Public Health Division was established as a part of the Supreme Council of Health in Qatar, led by a Director of Public Health. The Strategy of the Division is to work with partners to strengthen the Qatari, regional and international public health workforce and deliverables. The Division also aims to achieve program sustainability through key strategies that emphasize on applying public health science and practices and demonstrating measurable public health impact \to improve the health of the population

Promoting Regional Collaboration through establishment of network of Public Health Professional Associations Ahmed Javed Rahmanzai, World Federation of Public Health Associations Introduction: Globalization, advances in technology and ever-lasting conflict and social unrest poses greater challenge to public health infrastructure in some of the countries in the region of EMRO. Broken public health infrastructure, resurgence of infectious disease, and eventually an epidemiological transition are common issues that have challenged the already stretched public health infrastructure in these countries. Recent uprising in the region has further complicated the situation, leading to mass population displacement, and disruption of the public health system. Objectives: Promote dialogue among policy makers, researchers, public health professionals from public and private sector institutions to identify public health priorities in the region Conduct research and analysis of the existing public health capacity in the target countries Explore options for dissemination of information related to activities that strengthens the network Establish mechanisms for systematic monitoring of cooperation activities in order to provide feedback to further strengthen

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Abstracts the collaboration Approach: These public health associations can get involved in different types of collaboration including, exchange programs for researchers and public health professionals through scholarship programs, collaboration between public health education institutions, collaborative research projects. Other forms of collaboration include organization of regional workshops, conferences and hands-on trainings i.e. field studies, internships, volunteer activities that can implemented at the regional level. However, irrespective of the nature and type of collaboration, the key to successful collaboration is to implement activities that are complementary and synergistic in nature. Initially collaboration can be explored in selected fields of public health through involvement of subject matter experts in the collaboration effort. Once established, the network can be expanded to include policy reform efforts at the regional level. Benefits of this collaboration: There is convincing evidence from other settings that suggests how beneficial professional networks can be in enhancing organizations performance and their responsiveness to the communities’ needs. Below is a summary of potential benefits of establishing such regional network. Benefits to the population in the region, Greater responsiveness to the community needs in these countries, Addressing gaps in delivery of public health services, Provision of tailored and more comprehensive public health services to population in the region, Benefits to Public Health Associations, With the establishment of a collaboration, many new initiatives, ideas and projects will emerge that associations can pursue, It is believed that the regional collaboration will not only allow associations to mobilize and access internal resources but also outside resources Forming allies and collaborative can increase their stability and survival in the longer run

Current concepts and issues for Public Health in the UK Lindsey Davies, Faculty of Public Health, UK Public health has been defined as ‘The science and art of promoting health and well-being, preventing ill-health and prolonging life through the organised efforts of society ‘, encompassing the three ‘domains’ of health protection, health improvement/ill health prevention and securing equitable access to appropriate, cost-effective health care services. But what does this mean in the context of 21st century health needs, demands and resources? Rapidly changing demography, longer lives, increased prevalence of non- communicable disease, new and emerging infections and technological developments combine to offer new challenges - and new opportunities for meeting them. This in turn has implications for public health systems and for the public health specialists and leaders working within them. Enthusiasm for the impact of coordinated public health action is growing, particularly in areas where economic or demographic challenges are putting pressure on health care systems, driving the exploration of new ways of reducing and managing demand. Quality assurance of public health delivery is challenging, as business and managerial models for public health vary widely and it is difficult to define an ideal public health ‘service’ as such. The four UK countries, for example, now have four quite different models for their statutory public health services. It is, however, possible to define some characteristics of an effective public health system, acknowledging the many inputs required to protect and improve health. Public health systems can be large or small, serving, for example, whole countries, local communities, or small workplaces. To be successful each should: address all three domains of public health; engage all sectors; have strong leadership, clear accountabilities and levers for change; work transparently; encourage cooperation; develop, use and disseminate evidence; insist on high professional standards; pay attention to training; have sufficient resources; and embrace new contributors and innovation.

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Abstracts Public Health in the Arab World: Closing the Gap between Evidence and Action Laura L. Morlock, Johns Hopkins Bloomberg School of Public Health There have been substantial investments globally in basic, clinical, and population-based health research. Many believe, however, that the process of translating this knowledge into policy and practice to improve the public’s health has been at best inefficient, and at worst ineffective. In virtually all countries, including those in the Arab World, we have far more evidence available than we have been able to translate into policies, programs and practices that affect public health outcomes. In recognition of these gaps in the health sector between research evidence, policy and practice, many public and private organizations are devoting resources to developing a better understanding of the science of knowledge translation and implementation. We know much about factors that influence the “uptake” of evidence from the medical literature on clinical translation, the political science literature on factors influencing the translation of evidence to policy, and from the sociological literature on the adoption and diffusion of innovations as well as on change management strategies. These three literatures can be viewed as forming the basis of “implementation science,” defined as the study of methods to improve the uptake, implementation, and translation of research findings into routine and common practices—thus addressing the “know-do” or “evidence-to-program” gap. How can we build better bridges across the public health “evidence to action” gap in the Arab World? Although many differences exist by country, there is a common need for focused policies and programs to improve public health through reducing the burden of non-communicable diseases such as diabetes, cardiovascular disease and cancer. Regulatory efforts, screening for early detection, and behaviour change programs to modify underlying risk factors such as inadequate physical activity, unhealthy diets and tobacco consumption, are high priorities. Childhood obesity is a growing concern in some countries. Much of the region has seen great progress in the control of infectious diseases, although continued vigilance through improved surveillance systems, as well as screening and early detection programs for Tuberculosis and emerging infectious diseases must remain a high priority. There is increasing attention to school-based programs that encourage immunization uptake as well as lifestyle modifications. Another common concern across the region is reducing the burden of injuries, especially preventable injuries due to road traffic accidents. Although the need for key initiatives in these areas is apparent across the region, what is less clear is how best to implement policies and programs for maximum impact. There Is a very important role for conferences such as this one in which policy makers, researchers and other stakeholders come together to identify and spread awareness of “best practices” with respect to policy and program interventions. Coming together to understand what works, why it had an effect, and how the approach can be customized for other countries will help advance the science of implementation and can be an important strategy for improving public health within this region.

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Abstracts Session 7 Healthy lifestyle in the Arab Countries Occupational health: Is it a priority in the Arab World? Wasif Muhammad Alam UAE The ILO Convention (No. 161) defines “occupational health services” essentially preventive functions, responsible for establishing and maintaining a safe and healthy working environment which will facilitate optimal physical and mental health. It is multidisciplinary and multi-sectoral and it warrants workers participation. Harvard University study found that for every $1.00 spent on workplace prevention and wellness programs: medical costs fall by = $3.27 and absenteeism costs fall by = $2.73. This presentation will discuss the basis for employing occupational health in the western word and to see if it is different from the Arab World, including its challenges. Availability of Occupational Health Services in the Arab World, severe scarcity of OH Physicians, Quantity Vs Quality and OH educational institutions will be highlighted. What is the need of occupational health bodies in Public Health? Can’t labor dept. fulfill its objectives? What is the future of OH globally and what are we doing in the Arab World will also be focused. The Functions and Activities of Occupational Health Services (ILO) and its holistic approach will also be outlined

Her health is a priority, Men’s perceptions about breast cancer and their role in women’s screening decisions: a qualitative study from Jordan Hana Taha Jordan

Background: Breast cancer the most common malignancy afflicting women and the most common cancer overall in Jordan. A woman’s decision to go for screening is influenced by her social support network. This study aims to explore Jordanian men’s perceptions about breast cancer and their role in women’s screening decisions. Methods: An explorative qualitative design was used to purposively recruit 28 male participants aged 22 to 65 years (median 40 years) from four governorates in Jordan. Data in the form of interview transcriptions was subjected to latent content analysis. Results: Three themes were identified: a) Supporting one’s wife; b) Marital needs and obligations c) Constrained by a culture of destiny and shame. The first theme was built on the men’s feeling responsible for the family’s health and wellbeing, their experiences of encouraging the wife to seek health care and their providing counselling and instrumental support. The second theme emerged from the men’s views about other men’s rejection of a wife inflicted by breast cancer, their own perceptions of diminished femininity due to mastectomy and their own concerns about protecting the family from the hereditary risk of breast cancer. The third theme was seen in the men’s perception of breast cancer as an inevitable act of God that is far away from one’s own family, in associating breast cancer with improper behaviour and in their readiness to face the culture of Eib (shame). Conclusions: Jordanian men perceive themselves as having a vital role in supporting, guiding and encouraging the wife to follow breast cancer early detection recommendations. Breast health awareness campaigns better involve husbands to capitalize on family support.

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Abstracts

Tobacco Use and Associated Factors among school students in Dubai, 2010: Intervention Study Hanan Ali Obaid UAE

Background: Tobacco use is one of the biggest public health threats the world has ever faced. It is the most preventable cause of death. Objectives: to measure the prevalence rate of current tobacco use and its associated factors; in addition to determination of the impact of intervention program on knowledge and attitude of students towards tobacco use and its hazards. Subjects and methods: A school-based intervention study (Quasi experiment) was carried out among school students in Dubai (grade 7 to 12). Data were collected through self administrated questionnaire. Intervention heath education program was carried out with a re-assessment of student’s knowledge and attitude. Results: It was found that, 14.6 % was tobacco users, 11.2 % were cigarette smokers, 2.2 % were using shisha, and 29.1 % were passive smokers. The most common cause of smoking was taking experience (29.4 %) , followed by to relieve stress (22.5 %), then peer smoking (21.9 %) and 6.4 % was related to social problems. Stepwise logistic regression delineated six predictors for tobacco use; increasing age , being in secondary grade of education, students in governmental schools, locals, males, with low knowledge score. There is a significant improvement in knowledge and attitude level after the intervention program. Conclusion & recommendations: Adolescent tobacco use constituted a real public health problem. Continuity of campaigns with the involvement of teaching staff, medical staff of the schools and the active participation of parents\family members in these campaigns. Encouraging student smokers to attend the counseling sessions in the smoking cessation clinics.

Session 8 Screening & Surveillance – A Critical Public Health Service Future Vision on Public Health Surveillance Idris Alobaidani Oman This presentation outlines the scope of public health surveillance and the essential activities of public health surveillance systems. It also highlights how to establish priorities of what should be under surveillance. The presentation discusses the sources and methods of data collection and analysis. The presentation illustrates different types of surveillance and importance of each. Then, it identifies the evaluation criteria for any public health surveillance system (i.e. simplicity, flexibility, acceptability, sensitivity and specificity, representation and timeliness). Then, a brief description of the surveillance system in Oman is highlighted with focus on communicable diseases surveillance, its content and output with illustration of some disease surveillance data. The last part of the presentation emphasizes the global surveillance networks and the future promises and challenges of public health surveillance.

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Abstracts Observations on Premarital Screening and Counselling Program in Abu Dhabi Emirate Lamees Abu Hlaiqa UAE Background: In 2005 a new UAE personal status law was issued (UAE Personal Status Act No. 28, Article 27, 2005). It edicts that a compulsory premarital medical screening report must be obtained by couples who are planning to marry in the UAE. Upon this law the premarital screening and counseling program (PMS) was launched in Abu Dhabi in April 2011. This is part of a National Program for PMS in UAE. Methodology: PMS is operated through an electronic system that is linked directly to Health Authority in Abu Dhabi (HAAD) .All demographics, laboratory results are entered electronically and made available in a life stream program in HAAD. Objectives: The main Aim of this program was to decrease the congenital anomalies & risk of transmission of major infectious diseases, reduce the mother to child transmission of diseases, and educate the couples about healthy life style. Target audience: All couples planning to marry in U.A.E. Results: Through analyzing data obtained we found that between periods from April 2011 – December 2011 Number of applicants was 13952. 79.3 % were marrying first time 19.7% first degree consanguinity upon nationals, 8.7 % first degree consanguinity upon non-nationals. 1.78% carriers to B-Thalassemia, 1.1% carriers for sickle cell anemia. Challenges: There are other congenital diseases that run in certain families in UAE that need to be addressed in future premarital screening. Another challenge will be implementing culture change with regards to consanguinity marriage in the society. Conclusion: PMS program is an important program in Public health. Main objective of this program is to reduce the percentage of congenital blood disease and decrease the risk of transmission of infectious diseases. Research opportunities are available through analytic data obtained from the electronic system which will help researcher identify potential health care concerns.

Hemoglobinopathy Carrier Prevalence in the United Arab Emirates: First Analysis of Dubai Health Authority Premarital Screening Program Results Khawla Belhoul UAE

Background: The aim of this study was to determine the prevalence of hemoglobinopathy carriers in United Arab Emirates (UAE) nationals subjected to mandatory premarital screening in Dubai over a 4-year period. Methods: Data from UAE nationals who underwent premarital screening by the Dubai Health Authority between January 2007 and December 2010 were collected and analyzed. Premarital screening in Dubai is based on complete blood counts and hemoglobin high-performance liquid chromatography. Results: Among the 6,420 UAE nationals screened, 8.5% (n=545) were suspected as carriers. The following traits were observed: beta thalassemia, 4.56% (n=293); HbS, 2.9% (n=186); HbD, 0.78% (n=50); Hb Lepore, 0.17% (n=11); HbE, 0.03% (n=2); and hereditary persistence of fetal hemoglobin, 0.016% (n=1). HbE-Sickle and HbE-beta thalassemia also occurred at a rate of 0.016% (n=1), and 0.87% (n=56) subjects were suspected of having silent beta thalassemia. Discussion: The prevalence of the beta thalassemia trait was consistent with the prevalence published by others in the region. Silent beta thalassemia is challenging for screening programs, and is expected to arise in populations with a high prevalence of beta thalassemia carriers. The prevalence of HbS trait observed in this study was lower than that in other reports for the region. New cases of thalassemia major still arise because many fertile couples got married before screening implementation,

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Abstracts and pregnancy termination is not widely practiced in the UAE due to religious restrains. Moreover, some couples choose not to have prenatal diagnosis or pre-implantation genetic diagnosis (PGD), even if they are aware of their risk status. Conclusion: The prevalence of beta thalassemia trait in the UAE is high. This justifies efforts to control the disease by holding regular community-awareness and screening programs, performing premarital screening and genetic counseling, and making prenatal diagnosis and PGD available to couples who request it.

Session 9 Injury- Epidemiology and Prevention Principles of injury prevention: The United Arab Emirates perspective Michal Grivna UAE Injuries are one of the main causes of death in the United Arab Emirates (UAE) with a sizeable burden to society. During 20002008, 10 079 people died from injuries with an incidence rate (IR) of 27.3 per 100.000 person/years (traffic: IR 18.3, falls; IR 2.3; and drowning; IR 0.9). Adequate mortality and morbidity data is needed to improve injury prevention. In Abu Dhabi, a new Safety and Traffic Solutions Committee focusing on legislation, enforcement, engineering and education has been introduced recently. As a result, new measures were initiated to improve safety such as legislation for child restraints. The Ministry of Interior established a High Committee for Child Protection to prevent violence and child abuse. Dubai and Abu Dhabi Health Authorities are working on introduction of a new injury prevention program based on systematic injury surveillance. Recent cases of deadly falls initiated changes to improve window safety. Several campaigns on traffic, school, home and pool safety were introduced. Despite the current safety promotion efforts in the UAE, there is great lack of coordination between the different emirates.

Burden of Injuries in Abu Dhabi and the development of injuries notification system David Cheng Min Huang UAE Injuries are a major contributing factor to the burden of disease, disability and death in Abu Dhabi Emirate. According to HAAD statistics for 2011, the total numbers of fatal injury deaths in the Emirate were 587 cases, which have ranked as the second leading cause of deaths in Abu Dhabi, after cardiovascular disease. Last year, around 1.5 million people encountered injury and went for medical help in Abu Dhabi. The medical cost on fatal and non-fatal injuries during 2010-2011 was 568 million AED. In line with the Health Authority – Abu Dhabi’s public health vision and mission to improve community health by preventing injuries and injury-related consequences (e.g. disabilities, death) HAAD identified the need to develop and implement an Injury & Poisoning Notification and Surveillance (IPNS) System. The IPNS system will create the necessary evidence base on the local epidemiology of injuries and poisoning and will allow the concerned HAAD Public Health Departments, in partnership with the healthcare facilities and other stakeholders, to develop targeted, evidence-based public health injury and poisoning prevention interventions, and to monitor the implementation of these interventions and their effects on community health.

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Challenges of Occupational Health and safety in UAE Ali Salem Al Qaiwani UAE Definition of occupational health and safety. Focus on occupational health and its importance. Challenges facing the stakeholders. What can be done.

Session 10 Non-communicable diseases Metabolic Syndrome Among Emirati Adolescents: A Population Based Study Aaesha Ebrahim A Mehairi UAE Background: Population-based data on metabolic syndrome (MetS) among children is lacking in the United Arab Emirates which has among the highest rates of diabetes in the world. In this study we determined the prevalence of MetS and its correlates in a sample of adolescents. Methods: A cross-sectional school-based study was conducted on 1,018 adolescents (491 females) aged 12-18 from Al Ain, Abu Dhabi Emirates. A self administered questionnaire was used to assess socio-demographic characteristics, physical activity and dietary habits. Blood pressure, height, weight, waist circumference, fasting glucose, HDL-cholesterol and triglycerides were measured. MetS was defined using the International Diabetes Federation (IDF) criteria. Results: The prevalence of metabolic syndrome was 13%. Boys compared to girls were more likely to have MetS (21% Vs 4% odds ratio [OR]: 6.57 [95% confidence interval (CI): 4.01 to 10.75). The prevalence of MetS increased with increase in body mass index and reached 59 percent in obese males. After multivariable adjustment boys who were overweight (adjusted [A] OR: 4.21 [1.81 to 9.82]), or obese (AOR: 22.85 [11.25 to 46.39]), or eat at fast food restaurant for more than three days in a week (AOR: 2.76 [1.07 to 7.12) were more likely to have MetS. Girls who were overweight (AOR: 5.28 [1.16 to 24.13] or obese (AOR: 12.54 [2.87 to 54.66] were more likely to have MetS. Conclusions: Metabolic Syndrome is a significant burden among youth, particularly among boys. Population-based strategies are needed to address the high burden of metabolic syndrome targeted at the identified risk factors.

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Abstracts The Prevalence of Type 2 Diabetes Mellitus in the United Arab Emirates: Justification for the Establishment of the Emirates Family Registry Habiba Alsafar UAE This project was conceived with the aim of studying the prevalence of Type 2 Diabetes Mellitus (T2DM) in a population of United Arab Emirates (UAE) residents through the creation of the “Emirates Family Registry” (EFR). This resource is the first of its kind as it focuses on the indigenous populations of the Arab world. It will allow researchers to collect and collate data from patients with T2DM and healthy volunteers to assess features that may contribute to disease progression among populations of the Middle East. Methods: Major hospitals and diabetes centres in the UAE were contacted to establish a bio-banking facility referred to as the EFR. Through assistance made available by the Ministry of Health and collaborators of this network, demographic data of T2DM patients were collected and collated in a database for analysis and longitudinal studies into the future. Clinical specimens were collected for biochemical profiling (such as; glucose, lipids, HbA1c levels). Results: In the first 24 months of the operation the EFR recruited 23,064 adult volunteers from three major hospitals and nine primary care centres throughout the UAE. Within this cohort, 88% were patients classified as T2DM patients from the medical records. The cohort was divided into age categories with 59% of T2DM patients aged between 40 and 59 years old. UAE nationals comprised 30% of the database of which 21% were diagnosed with T2DM. However the percentage of adults with T2DM was higher in other ethnic groups effecting almost 33% of the Indians who live in the UAE. A total of 741 UAE Nationals consented to donate blood; in phase I of the study; for biochemical testing after which 23% were diagnosed with T2DM, 30% with pre T2DM and 47% were healthy. Conclusion: This study is consistent with the previously reported high prevalence of T2DM

Predictors of low bone mass density in high risk Saudi women: a community based survey AlJohara AlQuaiz KSA Background: Low bone mass density is a public health problem in Saudi Arabia. The objective was to determine the prevalence and risk factors for low bone mass density in high risk Saudi women in Riyadh city. Methods: Phase 1: women >40 years of age were identified through community based cross sectional survey and invited to primary heath care centers for interviews and screening through quantitative ultrasound technique. Phase II: women with positive screening test were referred to King Khalid University hospital for measurement of bone mass density through Dual energy x-ray absorptiometry (DXA) and blood tests. Results: Phase I; Screening found 53% women with low bone mass density. Phase II; DXA for lumbar spine found 58.5% and for femur 28% with low bone mass density. Multivariate analysis found 61 to 70 years (OR 2.75 95% CI: 1.32-1.48), illiteracy (OR 2.97, 95% CI: 1.44 - 6.12), primary level education (OR 4.12; 95% CI: 2.05- 8.29), history of fractures (OR 2.20; 95% CI: 1.03 to 4.69) and not using laban (OR 2.81, 95% CI: 1.47 to 5.37) as significant risk factors. Conclusion: Low bone mass density has high prevalence in Saudi women. Risk factor identification in women with positive screening test can help in designing targeted interventions.

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Risk factors for oropharyngeal cancer in selected cancer institutes in Egypt Maisa Mohamed Omara Egypt Introduction: Oropharyngeal cancer (OPC) is the eighth most common type of cancer worldwide. Most cases are detected at late stage, requiring complex, costly and often ineffective therapies. In Egypt, approximately 4,500 OPC cases are detected each year and result in a 50% case fatality rate. This study aimed at identifying major risk factors of OPC to develop prevention strategies in Egypt. Methods: Matched case-control study was conducted in three of largest Cancer Institutes, July−September, 2012. All patients diagnosed with OPC were enrolled. Two controls matched by age (±5) and sex were selected from nearest general hospitals. Subjects were interviewed using standardized questionnaires that included demographics, clinical picture, medical and family history and potential risk factors. Results: A sample of 50 cases and 100 controls was enrolled. Median age was 52 years. Male to female ratio was 3.5:1. Statistically significant risk factors identified were : illiteracy (ORMH 15.0, 95% CI: 1.8– 124.3), smoking (ORMH 3.9, 95% CI: 1.5–9.8), history of gingivitis (ORMH 3.0, 95% CI: 1.4–6.6), monthly income Conclusion: Although several risk factors identified from our study can be modified, effort to change risk behavior and lifestyle needs to be encouraged through regular educational campaigns. MOHP needs to develop strategy to promote healthy lifestyle behavior at all educational levels to reduce risk of OPC particularly among low income population.

Session 11 Communicable diseases: epidemiology and prevention Dengue or Chikungynya Fever Outbreak?” Ali Ahmed Jaawal (Yemen) Background: Since 2002, dengue has caused multiple outbreaks in Yemen. In October 2010-January 2011, a large outbreak suspected to be dengue was reported in Hodeidah; however, PCR analysis confirmed this to be the first chikungunya fever outbreak in Yemen. In April 2012, Hodeidah reported a suspected dengue outbreak. We investigated the outbreak to confirm its etiology. Methods: We used WHO case definitions for dengue and chikungunya fevers and investigation forms to collect data on suspected cases. Blood specimens from 179 cases were tested using IgM ELISA; 12 specimens were tested using rt-PCR in Thailand. Data were analyzed using EPI-INFO. Results: During January–June 2012, 1148 suspected cases were reported; 1057(92%) met the dengue case definition, and 854(74.4%) met the chikungunya case definition; 85(7.4%) had hemorrhagic manifestations. Male to female ratio was 1.6:1 and was statistically significant (P-value < 0.005). Overall incidence rate was 41.9/100,000, and was 66.4/100,000 among those aged 22-29 years. All cases reported fever. Dengue cases reported less joint pain (96.4%), than chikungunya cases (100%); headache (93.6% and 92%) and myalgia (93% and 92%) were similar for dengue and chikungunya cases, respectively. Fifty-five (47%) specimens tested dengue IgM positive; and 15 (21%) chikungunya IgM positive; six cases were rt-PCR positive

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Abstracts for 3 dengue virus serotypes (1,2,3) and one case was rt-PCR positive for chikungunya. Conclusion: This is the first investigation to confirm a dengue outbreak caused by multiple serotypes in addition to chikungunya. The presence of 3 serotypes indicates that future outbreaks are likely to be severe; therefore efforts to prevent dengue need to be strengthened including early outbreaks detection and response; increased community awareness to eliminate breeding sites and filtering water through cloths to eliminate larva. Keys: Dengue, outbreak, chikungunya, multiple serotype, Hodeidah, Yemen.

Identification of contaminated water source for Gastroenteritis outbreak, Menofeya Governorate Egypt 2012 Nasser Hamed Egypt Introduction: On August 20, 2012 Egypt’s Ministry of Health and Population (MOHP) was informed of an increase in cases of gastroenteritis in Menofeya Governorate. Fifty cases of gastroenteritis were reported from one village. Available epidemiological information indicated a water-borne epidemic. While water samples had already been collected and sent to MOHP’s central laboratory, results were not available for another few days. Methods: A rapid, retrospective cohort survey was conducted in the village to identify affected households and describe their water supply sources. The village was divided into six sectors and stratified randomized sampling was used: 256 households were selected. The case definition used for an affected household was the presence of >1 members of the household with >2 of the following symptoms: fever, diarrhea, vomiting or abdominal pain. A Standardized questionnaire was used to collect data from households. Specimens of patient blood, foods, and water from the village were collected. Data were analyzed using Epi Info 7. Results: Of the 256 households included in the survey, 168 (56.6%) households had >1 members that met the case definition. The village obtained water from >4 sources and RR was 4.16 (95% CI 1.9-9.3) for using governmental water supply. The governmental water supply was immediately chlorinated and then the number of cases significantly declined. The last case was reported on August 24, 2012. Lab results became available on August 28, 2012 and identified salmonella typhimurium in the main governmental water supply network. Conclusion: The investigation verified the outbreak and confirmed the association between the outbreak and the governmental water supply. The epidemiological survey was more timely than awaiting lab results to identify the source of outbreak.

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Epidemiology of rabies in Sanaa city, 2011 Fuad Mohammed Shamsan Yemen Introduction: Rabies is a highly fatal zoonotic disease with about 55,000 annual deaths worldwide. In Yemen, 36 deaths were reported in 2011. This is the first study to describe the epidemiology of rabies and assess the adherence to the proper administration of post-exposure prophylaxis (PEP) Methods: We used data collected on human rabies in log books at the Al-Jumhury Hospital in Sana’a. Of 1801 cases reported in 2011, we selected every fourth case listed for entry into a database resulting in 394 cases. We excluded 56 cases with missing data. We used Excel and OPEN-EPI for analysis. Results: Of 394 cases; 12 (3.05%) died. Most cases, 296 (75.13%) were males. Children aged 5-14 years were most affected, 205 (52.03%). Bites distributions were in the lower limb, 150 (40%), upper limb, 133 (34%), and head and neck, 49 (12%). Forty cases (10.11%) did not receive PEP treatment and 165 (41.88%) received only one dose. Of those who died, bites in the head and neck were more common odds ratio (OR) = 5.49 (P-value < 0.01). Deaths were also higher among those who did not seek medical care OR=14.86 (P-Value < 0.01); five deaths received PEP more than 30 days after exposure. Conclusions: Rabies is high in Sana’a city and is expected to be higher in other regions with higher number of stray dogs/ animals. Young male children are at higher risk because they have more access to outdoor activities. Bites in the head and neck indicate severe injury. All deaths could have been prevented with adequate PEP administration. Increasing awareness of rabies dangers and the need to use PEP among the population is needed, including teaching children to avoid stray dogs/ animals. Key words: Rabies, Sana’a. post-exposure prophylaxis, bites, deaths

Factors leading to self-medication with antibiotics in Sudan Ghada Shouna Sudan Background: The growing problem of antimicrobial resistance, with the decline in the development of new antibiotics, is becoming a global threat. Self-medication, one of the major factors contributing to this problem, is as high as 49 % in Sudan. The aim of this study was to investigate the beliefs, behaviour and factors in the community that lead to such practice in order to formulate appropriate interventions to ensure the rational use of antibiotics. Methods: It was a qualitative study using focus group discussions. The participants were adults from non-medical background - who have used antibiotics within the past 6 months. They comprised administrators, workers, school teachers and mothers. The discussions looked into their current practices with regard to antibiotic use and the factors that led to using them without prescriptions. It also looked into their awareness about the safety of antibiotics and antimicrobial resistance. Findings: Out of the 31 participants approached, 27 participated; 54 % were females and 46 % males. Ages ranged from 18 to over 50 years and the levels of education varied from higher education to illiterate/uneducated. Knowledge about antibiotics generally was found to be very poor. Reasons for using antibiotics without prescription included dissatisfaction with health services and doctors’ attitudes. Other factors included cost of accessing doctors, easier access to pharmacies, and waiting time. Most of the participants regarded antibiotics as safe medicines. Awareness on antimicrobial resistance was very poor.

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Abstracts Conclusion: This study yielded important information about the behavior towards antibiotics and the factors that lead to their use without medical advice. Misconceptions and lack of knowledge about antibiotics seemed to contribute greatly to their inappropriate use. The term antimicrobial resistance is not understood at all. However, further quantitative studies are needed to determine if these results can be generalized and formulate interventions accordingly.

Session 12 Oral Health: reflections from the Arab World Oral health and workforce issues â&#x20AC;&#x201C; reflections from Oman S. Al Bulushi Oman

Oral health challenges from Saudi Arabia Mohamed Al Rafee KSA Despite the fact that dental services have been improved tremendously over the last decade but still prevalence of dental caries in children remains a significant clinical problem in Saudi Arabia . Epidemiological studies done in Saudi Arabia proved that dental caries prevalence among children exceeded 90%. The prevalence of dental caries is translated into a higher dental treatment needs. There is great need to do changes from restorative-oriented dental services to preventive-oriented dental services. This presentation will highlight the current situation in the country. It will address also the challenges and the obstacles encountered.

School based dental programs â&#x20AC;&#x201C; where we need to go now Mariam Alfarhan KSA

Dental caries, oral health and life style variables - reflection from Qatar (followed by questions and answers) M. Al Darwish Qatar

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Day 3 (April 6, 2013)

Plenary Session 3 Great Challenges lead to great Opportunities: A New Agenda for Public Health in the Arab World Mohannad Al Nsour, The Eastern Mediterranean Public Health Network The Arab World has long been a region of challenges. Although the uprisings of 2011 brought about a different set of obstacles, especially to achieving health in this region, overcoming challenges with creative and innovative thinking is nothing new for the Arab World. How to meet the new demands of an ever changing public health landscape in the midst of civil strife, political crises, and diverse populations requires fresh perspectives and new approaches; a new agenda for public health. The Eastern Mediterranean Public Health Network (EMPHNET) sees new opportunities emerge from these challenges. The need for epidemiology to provide sound data for decision making, the importance of developing global partnerships to provide the expertise and resources necessary to build capacity in the region, and the growing significance of non-communicable disease among the Arab World’s population are just a few of the initiatives EMPHNET is implementing as part of a new agenda for public health in this region. EMPHNET recognizes as the challenges in the Arab World increase and become more diverse, so do the opportunities and this gives way to a new agenda for public health in the Arab World.

Public health in the Arab world at a crossroad Samer Jabbour, American University of Beirut The Arab world has been undergoing transformative changes. These changes are not limited to countries that have seen profound political change in the past two years but include also a wide range of important social, economic, environmental and demographic, transitions over the preceding few decades. Combined with the presence of profound heterogeneity and inequalities, these changes have profound implications for population health outcomes and for public health in the region. This is true whether public health is viewed as a professional field or as a space for competing visions of the future in the region. In this talk I review some of the aforementioned changes and discuss their implications for population health status, for health systems, and for public health more broadly. I propose that public health in the region stands in front of a crossroad today. The choices are maintaining status quo which is based on a narrower vision of public health vs. charting a new path that leads to a new public health movement in the region based on a stronger sense of social purpose and mission and on principles of rights, justice and joint responsibility.

Future perspectives of education and training for public health in Europe Vesna Bjegovic – Mikanovic, Association of Schools of Public Health in the European Region Objective: To identify the needs and capacities for public health training, research and practice in Europe. Methods A wide array of documents and websites was analysed. The methods used for data collection were: (1) review of the existing written reports, the relevant legislation and other documents, and (2) Internet searches accessing the websites of Ministries of Health, Education, Science and Technology as well as websites covering thematic areas in European and global education, research and development. Use has also been made of the results of the European Union projects done in the field of public health, particularly the Tempus programmes on “Postgraduate Studies in Public Health Sciences”.

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Abstracts Findings The most important role in the field of change in public health is played by the School of Public Health (SPH) and the Institutes of Public Health (IPH). Although at the managerial level the need for change has been perceived, in general there is not a shared, clear vision of what the change should be and how this should happen. The reorganisation of the IPHs is greatly needed given their poor present performance and the expectations of the government to reach EU standards and to increase the health status of the population. The main obstacles are seen to be inappropriate legislation, lack of financial resources and insufficiently trained staff. Three areas with priority for future development have been identified: (1) doctoral programmes in public health and in health policy and management, (2) expansion of continuing and life-long learning in good governance and public health management, and (3) increasing the research base in public health and management. Conclusion: The need for a better trained workforce especially in the fields of public health, health management and health promotion is clearly recognised by public health professionals. Therefore, in addition to Master programmes already introduced, efforts towards doctoral and life-long learning schemes should be intensified in order to complete the Bologna scheme. Keywords: Public Health, Master Studies, Curricula, Workforce Development

Public Health law in the Middle East and North Africa Considering a model law for the Region Hala Abou-taleb, World Health Organization & Genevieve Howse, La Trobe University

(Joint Presentation)

The Eastern Mediterranean Regional Office of WHO has identified health system strengthening as a priority for action in 2013 and has already embarked on strategies and programs to address this working closely with MemberStates. This presentation serves to inform and consult regional leaders and experts about EMRO activities and to identify health laws as an important part of a strong and well functioning health system Development of policies and laws to support the protection and promotion of public health is slow, complicated, resource intensive, potentially controversial and not for the faint hearted. It requires integration of government health policy, any existing laws affecting public health, relevant constitutional provisions, any other relevant law including Sharia law or case law, compliance with international treaty obligations, consideration of current WHO and other literature on essential public health functions, some consideration of the role of local customary approaches to social organisation and customary law and resource and implementation issues. It is acknowledged that the nations of the Eastern Mediterranean Region are sovereign countries with unique histories, customs and ethnicity. Countries as diverse as the Sultanate of Oman, the Republic of Yemen, the Kingdom of Saudi Arabia and the Kingdom of Morocco and the federated United Arab Emirates have different health issues, different levels of available resources and different social and political contexts. Furthermore, most of the countries in the region are either facing a political unrest, in conflict or recovering. This negatively impacted health care delivery and increased the disparities of access to quality care. On the other hand few countries are either in process of developing their new constitutions or in a transition ready to review their respective governance. This could be seen as an opportunity to reform the health governance and the legal framework, including rules, legislations, policies and code of practice. One model of legislative reform in public health cannot be seriously contemplated as appropriate to address the various legislative and policy goals in such different countries, each of which has different characteristics relevant to the development of public health legislation. In this effect, World Health Organization for the Eastern Mediterranean Region is currently in process of regionally assessing public health laws as the first step in creating an enabling supportive environment to promote right to health. In this context will be supporting countries to institutionalize, draft and amend their public health laws and respective legal framework. Is there a place for a regional model law to be used as a starting point for countries in the Eastern Mediterranean Region to consider a public health law which is tailored for the regional context? It should also be remembered that legal reforms that

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Abstracts have not been specifically designed to fit the context in which they must operate have limited or even, possibly, negative value. A recent project in the Pacific considered the same question for the Pacific Region. The outcome was not a model law, but rather legislative text set out in a series of modules in a document entitled “Public Health Law in the Pacific – A Legislators’ Companion”. Each module of legislative text is presented with a discussion of how the present laws address the issue, the policy implications of adoption of the text and preconditions for implementation. The concept of the legislative text may be adapted to the regional context. This presentation will introduce WHO’s regional work on public health laws and stimulate the discussion around the value for the individual countries considering laws as an intervention to strengthen health systems and reform legal frameworks to serve in health promotion and care to achieve right to health and comply with international laws and commitments to diminish disparities in addressing problems of availability, affordability, accessibility of quality services in a time of diminishing resources and in a Region with unique cultural, economic, social and geographic characteristics.

Session 13 Public health training and professional development in the UK Lindsey Davies UK Public health in the UK is a multidisciplinary profession. Training is competency based and applicants from a wide range of backgrounds, including medicine, are recruited through a single national process. Following a national recruitment exercise, involving several different assessments and interviews, each recruit is allocated to a local 4 - 5 year training programme during which they study for an MPH or equivalent ‘Masters’ examination , take the two parts of the Faculty’s membership examination and gain practical experience in a range of different settings. This presentation will describe the training programme and other routes to specialist and practitioner registration in the UK and discuss opportunities for shared learning

Immunization services Delivery of Health Facilities in Dubai: Assessment and Implementation Lubna AlShaali UAE The quality of immunization services provision can be strengthened and updated through standardized policy, guidelines and establishing a unified system for recording and reporting of vaccination practices. Policy and operational guidelines are required for private sector immunization practices that adress critical subject area , such as capacity building , monitoring and evaluation . The presentation will cover the following points: Review current immunization services, Presenting the results of the field survey to asssess immunization services in Dubai conclusion and lessons learned.

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Abstracts Health care workers screening in health care facilities of Dubai: A public health strategy Rasha Salama UAE Health care workers (HCW) screening is cruical in providing a healthy, safe environment free of risk of transmission of infection between patient and health care provider and ensuring means of prevention, such as providing immunization services and changing the workplace in some required cases. Hepatitis B, C , HIV and Pulmonary tuberculosis are amongst the diseases that must be screened with some criteria used HCW jobs have been classified into different categories depending on the risk of transmitting the infection to the patient. Application of health care workers screening policy for workers in the public and private health sectors ensures the quality of health services provided by the healthy care workers in the health sector . Success of the policy of health workers screening depends critically on the quality and accuracy of screening procedures The presentation will cover the following points: Blood-borne virus screening in health care workers: is it worthwhile? - Health Care Workers Screening Policy in the Emirate of Dubai - Initiatives and procedures following screening of HCW

Ethical Issues in Community Health Interventions: A critical Perspective Mohammed Shaheen Palastine Community-based health and research interventions in many instances take people for granted in terms of relevance, efficacy and appropriates of these programs with little considerations to the cultural, social and economic context of the targeted people. The speech will discuss the general ethical framework of the public health interventions including risks and mitigation measures that may minimize the unfavorable consequences of public health interventions. The discussion will cover the contextual, legal and cultural factors in designing, planning, implementing and evaluating such projects. The speech will present also challenges in implementing the ethical framework of public health in the light of the current health systems. The talk will discuss the role of the political orientation, researchers, health policy makers, modes of community involvement and service delivery, role of donors in the current health systems in the region on equity, safety, privacy, efficacy and effectiveness of these health interventions.

Session 14 The non-communicable diseases Epidemic Survey of Dental caries among preschool children, Riyadh Samia Abdullah AL-Moither KSA Aim and objective: To plan and implement an appropriate dental caries intervention program for preschool children we must define the extent of the dental health problems. The objective of this study is to determine baseline data on the prevalence of caries, mean dmft**, oral hygiene level and treatment needs of preschool children of National Guard (NG) families living at King Abdul Aziz Housing City (KAHC), Riyadh, Saudi Arabia.

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Abstracts Methodology: cross sectional study conducted in (School Dental Health program) dental clinics, KAHC, Riyadh, Saudi Arabia. Children were examined under standardized conditions for dental caries using World Health Organization (WHO) diagnostic criteria (dmft). Their caretakers answered a questionnaire about Oral Hygiene (OH) habits, diet habits, past dental experience and parent’s behavior and knowledge (this information will be used in another paper). Results: A total of 361 children, mean age of 5.2 years SD 0.99 (54%) girls and (46%) boys, were examined. The prevalence of dental caries among those children was 83% and only 17% were without active caries at the time of survey. Only 14% of the children have never experienced caries (dmft = 0). As for oral hygiene 70% scored 1 or more in OH index ( maximum score= 2). 58% of children brush sometimes and only 15% brush twice a day. 56 % of children scored 1 in treatment needs, meaning 100% need for dental treatment. The corresponding mean dmft was 6.3 for the children and considered high with decayed teeth as major component. 48% of children never visited the dentist. Conclusion: caries prevalence, dmft and poor oral hygiene are high and mostly untreated in the study population. There is a big need for administrative regulations to organize an early intervention program, prevention and awareness programs for children and care takers to promote dental health in preschool children.

Trends in Maternal Mortality at the Mukalla City, Yemen, 2000-2010 Ahlam Saleh Salem Yemen The Yemen is a signatory of the Millennium Development Goals (MDGs) and one of 10 countries chosen for the UN Millennium Project. Reduction in maternal deaths by 75% in 2015 is a cardinal target of the millennium development goals .Yemen’s figures remain unacceptably high, around 200 per 100 000 live births in 2011 . Although this figures show a decrease from 365 per 100 000 live births in 2006, this should not be taken as indicative of a trend. However, the numbers do emphasize the need to address the issues contributing to maternal mortality. The aim of this study is to highlight the main cause of avoidable death that leads to maternal mortality. The data were collected from medical records at Al-Mukalla Teaching Hospital. This is a tertiary care referral hospital in the costal Hadhramout with the main obstetrics and gynecology department Data analyzed by using SPSS programme version 16 and then to obtain relations between the maternal death and prenatal factors and others occurred during labour and postnatal Results: Of the total 39,651 live birth recorded in the hospital during the 10 years study period, 42 maternal deaths were recorded giving an average maternal mortality ratio of 106 per 100,000 live births Bleeding was among the top causes of maternal mortality (28.6%) followed by hypertensive disorder, pulmonary embolism, and anemia (21.4%, 9.4%, 9.4%, respectively). Conclusion: There was a downward trend in the maternal death ratio, but it is still far from rates in developed countries whereas the majority of these deaths were preventable. Efforts must be made on the part of health care providers, hospital managers, individuals, and government to maintain the current downward trend in maternal mortality ratio to meet the globally accepted level.

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Abstracts Vitamin D Deficiency among healthy adolescents in Al Ain, United Arab Emirates. Shamma Jauaan Al Muhairi UAE Background: Although vitamin D deficiency has been studied in various adult populations, there are few data on the prevalence of this nutritional deficiency among healthy adolescents in the United Arab Emirates (UAE). Objectives: This study was conducted to determine the prevalence of vitamin D deficiency and to examine its correlates in adolescents aged 15 to 18 years. Methods: This was a cross-sectional study in urban schools. Healthy adolescents (N=315) from a sample of 8 schools were randomly selected from the 142 schools in Al Ain, Abu Dhabi Emirate. Outcomes measured included serum concentrations of 25-hydroxy vitamin D (25OHD), plasma lipids, blood sugar, blood pressure and anthropometric data, nutrition and lifestyle variables. Results: Fourty-one participants (19.7%) were vitamin D deficient (serum 25OHD level ≤15 ng/mL [≤37.5 nmol/L]. Using a cutoff level of 25(OH)D of ≤20 ng/ml [≤50 nmol/l] 143 participants (45.4%) were vitamin D insufficient. Overall 65.1% of study participants were either vitamin D deficient or insufficient. The prevalence of vitamin D deficiency varied between boys (10%) and girls (28%). In a final multivariate model, serum 25(OH)D concentrations were inversely correlated with female gender, consumption of fast food per week, and body mass index and positively correlated with physical activity scores after adjustment for age. Conclusion: Vitamin D deficiency and insufficiency were highly prevalent in adolescents, and more common in girls.

Vitamin D Dificiency: A Publc Health Problem In Abu Dhabi Arwa Al Modwahi UAE Purpose: Analyze adequacy of Vitamin D, which promotes calcium and phosphorous absorption to build and maintain bones, and is also an important transcription factor in most cells of the body. Relevance: Vitamin D deficiency is a worldwide health problem. Lower levels of vitamin D have been associated with a greater risk of osteomalacia, and other related illness in adults. Environmental factors lead to lower vitamin D concentrations. Vitamin D deficiency can be a major issue as there are limited food varieties that contain Vitamin D. Participants: During the time period July through December 2011, 9422 Emirati males and females ages 18-92 had a physical measurement of vitamin D. Methods: Health Authority- Abu Dhabi (HAAD) collected direct physical measures of health and wellness from a representative sample of Emirati nationals residing in the Emirate of Abu Dhabi. The measured form of Vitamin D in the blood samples was 25-hydroxyvitamin D which is in line with international recommendations. Results: The mean concentration of 25(OH)D among Emirate’s aged 18 to 92 years was 37 nmol/L. Mean concentrations ranged from a low of 22.2 nmol/L among females aged 18 to 19 years to a high of 51 nmol/L among females aged 60 to 79 years. For both sexes, 25(OH)D concentrations by age group was highest among seniors, and lowest at ages 18 to 19 years. Overall Concentrations were higher among males than females.

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Abstracts Analysis: An estimated 35.9% of the sample had concentrations below 25 nmol/L, indicating that they were deficient in vitamin D. The highest prevalence of deficiency was among females aged 18 to 19 years. 51.4% had concentrations 25 -60 nmol/L which is considered insufficient. Only 12.7% had normal levels of vitamin D. Conclusion: There is a high prevalence of vitamin D deficiency with the majority not having concentrations adequate for bone health.

Session 15 Public Health Training and WFPHA Q&A

WFPHA Q&A Meeting

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Poster Presentation Anemia prevalence and sociodemograhgic factors among patient with cardiovascular disease in Gaza strip occupied Palestinian territory Amal jamee Palestine Background: Chronic anemia is risk factors for cardiovascular disease outcome in patients with heart failure, dilated cardiomyopathy and uncontrolled hypertension. This study was performed to analyze the prevalence of anemia in cardiovascular disease patient and explore main sociodemograhgic factors, which can explain the relation. Objectives: 1- To determine the frequency of anemia among adult patients who were hospitalized with a diagnosis of cardiovascular disease. 2 -To determine the relation between anemia and socio demographic factors, of patient with cardiovascular disease. Methods: The study design is a cross sectional study based on the cardiac patients admitted to cardiology department in Shifa hospital (Gaza strip), 300 patients (51% males and 49% Females) aged 19-78year at recruitment were enrolled for a period of 3months during the year 2012. The data for analysis include sociodemograhgic data, age, gender, education level, size of family, residence of patient (camp or city) and refugee or citizen. Others traditional risk factors characteristics were determined, cigarette smoking diabetes, hypertension and body mass index. Laboratory test included haemoglobine and clearance creatinine measurement. Drugs use (aspirin, clopidogrel and combination of aspirin clopidogrel). Anemia is defined as haemoglobine less than Results: Among 300 patients 181patients (60.3%) were anemic. Anemia was more common in female (71.4%), older age (71.1%) and low education level (64.5%). the analysis of prevalence of anemia showed the highest proportion belonged to valvular heart disease(77.8%),congestive heart failure(74.6%) followed by hypertension (54%) and coronary artery disease(46.%). Patients with risk of hypertension (65%), diabetes (70%), and low clearance creatinine level (70%) increase the incidence of anemia, the main of BMI is higher in anemic group and Smokers had lower prevalence of anemia (38%). Conclusion: Anemia is common among cardiovascular disease patients, and worsens the prognosis of their clinical condition. Intervention policies to minimize the risk factors are needed.

Dengue Outbreak in a Refugee Camp in Haradh City at the Border with Saudi Arabia, 2012. Ahmed Al-Shahethi Yemen Background: Dengue, an arthropod-borne viral disease, exists in many Yemen border governorates. Haradh city borders Saudi Arabia, and houses immigrants from Horn of Africa. In May 2012, Haradh District reported a dengue outbreak involving refugee camp. Investigation conducted to characterize outbreak and confirm diagnosis. Methods: WHO case definition for suspected dengue cases and WHO form for collecting clinical and demographic data from April 1 to May 25, 2012 were used. Surveillance records reviewed for suspected cases beginning January, 2012. Comparisons between positive and negative cases analyzed. Blood specimens collected from 120 cases, tested using IgM ELISA, Rapid test for dengue NS1,IgM and IgG and rt-PCR. Quantitative data entered and analyzed using Epi info 3. Results: Between January and March, 2012, 45 suspected dengue cases reported among Ethiopian refugees; first cases (2) occurred March 15. Between April 1 to May 28, 2012, 220 cases reported; 208 met case definition; 130 (62.5%) from refugee camp and 78 (37.5%) from Haradh district. Total cases hospitalized, 106; 83 Ethiopians, 23 Yemeni. Three Ethiopians died. Most cases, 167 (80.3%), were 15 to 29 years, 56 (66%) and 110 (91%) were 15 to Conclusion: Outbreak due to dengue sero-type-1.High burden of disease among males and camp residents suggests outdoor infection and predominance of young males in camp. Recommended sentinel surveillance in border towns for early detection of outbreaks.

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Poster Presentation Traumatic Injection Neuropathy (TIN), Yemen, 1998-2012 Ali Ahmed Jaawal Yemen Background: Traumatic injection neuropathy (TIN) is an injury to a nerve –mostly sciatic or radial - caused by un-necessary injection and leading to acute flaccid paralysis of the associated limb. Un-necessary injections are estimated to be as high as 75% of the 12 billion injections given globally each year Intramuscular injections are common practice in the health care and community setting in Yemen. This study aims at identifying the incidence of TIN in Yemen from1998- 2012 and to describe the epidemiology of the disease. Methods: Data of the acute flaccid paralysis surveillance system ( AFP) for Yemen1998-2012 was used to identify cases of TIN ,.Records at the surveillance central level was reviewed. Available data included: age, sex, governorate of residence, clinical picture, differential diagnosis and final laboratory confirmation. TIN cases were identified by Physician using the WHO case definition of TIN .Data analysis performed using Ms-excel and EPI-INFO. Results: From January 1998 to June 2012 a total of 4294 cases of AFP were reported in Yemen. Among them, 759 (17.7%) were TIN, their mean age was 3.7±3.2, and 67% were males. The disease was significantly higher in males (p< 15 years old in 2012. Rate increases over years, it increased 11 times 1998 to 2012). Rate differs by governorate, it was highest in Almahrah (17.3), Alhodeidah (12.9) and Mareb(10.8) per 1000.000 population. . Conclusion: High rate of TIN was identified in Yemen, and is causing a significant health problem in Yemen. Raining awareness on the community level and training of health care workers to avoid un-necessary injections is crucial to prevent TIN in Yemen. Key words: Traumatic Injection Neuropathy, Yemen, unnecessary injections

Eat Right and Get Active Program at Abu Dhabi Schools Arwa Al Modwahi United Arab Emirates Goal: The goal of the Eat Right & Get Active (ERGA) Program is to reduce the risk of co-morbidities related to bad eating habits and low physical activity levels. Objectives: At least 3 of the following interventions to be implemented within one year after initiation of the ERGA program in participating Schools: 1. Healthy meal choices available in the school cafeteria; 2. Routine messages sent to parents about physical activity and healthy lunches that can be prepared for their children; 3. Posters that reinforce social norms related to physical activity and healthy eating are displayed in the school venues; 4. Training for teachers and other school staff on physical activity and nutrition education is held at least once per semester; 5. Series of extra-curricular sessions for students, staff and parents are conducted for physical activity and preparing specific healthy and safe meals and completing dietary self-assessment. Methodology of the Program: The program was piloted from January 2011 to May 2011. Program consisted of the use of educational materials. The education was provided by different media such as web based interactive tools, animated video and school presentations. Target Beneficiaries: During the pilot phase, 26 private and public pilot schools in the Emirate of Abu Dhabi participated in the ERGA Program, including 500 students from fourth and fifth grades ages 8 to 10 years. Highlights Observed: ERGA Program was associated with improved strategies that promote healthy eating and physical activities among participating schools, and was associated with statistically significant increased availability of nutrition and physical activity policies at participating schools and increased use of tools that promote healthy eating (P = .03) and (P = .06) respectively. There was a 60 % increased intake of 7 servings or more fruits among participating students.

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Poster Presentation Viral Etiology of Acute Gastroenteritis among Hospitalized Patients Asma Al-Thani, Maide Baris, Najah Al-Lawati, Said Al-Dhahry, Qatar Background: Acute gastroenteritis (AGE) remains a common cause of clinic visits and hospitalizations, though its aetiology has not been determined in Qatar. Methods: We performed a prospective, emergency departmentâ&#x20AC;&#x201C;based study of 288 children and adults with AGE. Whole stool specimens were collected at presentation. Faecal specimens were tested, using real-time PCR, for a panel of four viral (norovirus, adenovirus, astrovirus and rotavirus) and bacterial pathogens. Results: Viral, parasite and bacterial pathogens were detected in 131 (45.5%) and 34 (12.2%) of the 288 patients recruited. The most commonly detected pathogens were norovirus (28.5 %), rotavirus (10.4 %), followed by adenovirus (6.25 %) and astrovirus (0.30 %). Norovirus was the most commonly detected viral pathogen amongst all the age groups with an almost even distribution in all age groups. Rotavirus and adenovirus were more common in children under 5 yr. Astrovirus was found in only one person. Conclusions: Viruses, especially noroviruses, play a major role as agents of severe diarrhoea in children and adults in Qatar. Further studies to confirm the findings and to explore the causes of illness among patients from whom a pathogen cannot be determined are needed. Key Words: Norovirus, Rotavirus, Adenovirus, Astrovirus, acute gastroenteritis

A Survey For Potential Risk Factors For Susceptibility To Chronic Kidney Disease In Hail Region, Ksa Awdah M. Al-Hazimi KSA Introduction: Chronic kidney disease (CKD) is becoming an emerging and public health problem worldwide. Epidemiological studies show an increased risk for CKD, among individuals with certain clinical and sociodemographic characteristics. Therefore, the aim of this pilot study was to provide data about risk factors for CKD in Hail region, KSA to plan for a comprehensive survey in the area. Material and Methods: A survey was performed, employing household visits, covered 299 individuals, selected from two areas in Hail region to fulfill the planned sample for this pilot setting. A questionnaire was used to obtained information about CKD risk factors. Data were analyzed by SPSS 16.0. Results and discussion: All 299 individuals of age (15 to 100) distribution was relatively similar between males and females. The high percentages of risk factors were indicated in a family history of DM representing 72%, followed by family history of hypertension, recurrent urinary tract infection etc. The high frequencies of risk factors were found to increase with increase of age reaching the peak at age ranges 41 to 50 and 51+ years. The relationship between the risk factors and education, most smokers were found among persons with secondary level of education followed by primary level. The increasing frequencies of UTI, DM, herbal use, hypertension, analgesic abuse and renal stone were shown among females. Among employee, UTI and hypertension were predominant. Conclusion: This study shows increased risk factors for CKD in Hail area. There is an urgent need for more detailed measurement for these risk factors through a comprehensive survey to evaluate individuals with risk factors, to enable earlier detection, and risk factor reduction through rising of awareness.

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Poster Presentation Utilization of Family Planning Methods in Sudan Dafa Alla Mohamed Mohamed Ahmed Dafa Alla Sudan Goal: - To assess the level of utilization of contraceptive methods among women in the reproductive age (15-49 years) in Sudan. Specific objectives - To examine the differences in utilization between regions in Sudan; - To examine the differences in utilization between urban and rural areas in Sudan; - To identify the family planning methods that are used. A survey covering ten states was conducted in Sudan during the period January to July 2012 where a sample of 1333 women in the reproductive age was selected following a proportional stratified sampling method and a carefully designed pre coded questionnaire was used to collect the data. The results indicate a contraceptive prevalence rate (CPR) of 17.7% which is more than double the national CPR of 7.9% reported during 2006 before Southern Sudan Secession. Findings clearly pointed the presence of significance variations in utilization of Family Planning Methods (FPM) between regions ranging from 26.2% in Khartoum to 10.5% in Kordofan , in addition to significant variation in utilization rates between urban and rural areas ranging from 26.4 % to 11.9% respectively. Utilization of modern methods is highly associated with urban areas where women in rural areas still stick to traditional methods. The utilization of Pills and IUDs is 65% and 78.9% in the urban areas compared to 35% and 21.1% respectively in the rural areas. The results of the study reflect great disparities in utilization of FPM between different regions and rural urban settings in Sudan, therefore the results are useful in designing programmes which will contribute in making family planning services more available and accessible to Sudanese women, moreover they can be used as important inputs into strategic planning and program design since they give a clear picture of the current state of the demand for family planning services and environment.

Community Memberâ&#x20AC;&#x2122;s Perceptions About Medical Errors In Jazan Region 2010-2011 Hussain Ahmed M Darraj KSA Background: Medical errors are inaccurate or incomplete diagnosis and/or treatment of a diseases; injuries; syndromes; behaviors; infections or other ailments.The awareness level about the medical error and magnitude among the consumers of health care system lead to strong effect on the community confidence and trust of health care system and reflect on compliance and care continuity which ultimately leads to affect outcome. Objectives: (1)To assess community perceptions about medical errors.(2)To determine how the community perceives the medical errors magnitude.(3)To identify the sources of population information about medical errors.(4)To measure confidence level of health care system. Methodology: Descriptive cross-sectional study In Jazan city, the city population is about 211,917 inhabitants. During 20102011.The Sample size 124 participants. PHCCs visitors were selected according by quota technique from all PHCCs. Study Questionnaire used in interviews with the family head. Result: The total participants 124, they all males. The participants majorities were well educated and married, and the majority heard about medical errors, and the most common information sources were friends and television. Most of participants think they know medical errors meaning. Only third of participants refer to the correct definition. About quarter of participants assume their family members suffered of medical error during last year. And 12% believe that they suffered of medical error of medicine that prescribed by doctors.

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Poster Presentation Conclusion: The majority of participants think they know medical errors meaning. Only third of participants refer to the correct definition. Community surveys about medical errors should be supported by clinical audits in order to show the exact prevalence of medical errors in the system.

HIV/AIDS Education, Different approach Elfatih Eltyib Mohammed Abdelraheem Sudan Background: Sudan Household Health Survey II (SHHS II) revealed that only 5.3% of young people age 15-24 have comprehensive HIV/AIDS Knowledge, and only 8.7% of the same age group have accepting attitudes towards people living with HIV/ AIDS, about 11-14% know where to get tested and less than 1% took the test, which indicate alarming situation among young people. Objective: This abstract highlights a unique experience of integrating the globally recognized and tested life skills in reaching out to Sudanese students in the age group 12-18 with accurate HIV/AIDS information and skills, an experience that can be replicated. Methodology: Using learners-centered approach, life skills framework and important community and religious values, the –activity based- HIV/AIDS information and skills (knowledge, attitudes and practices) were incorporated in a comprehensive curriculum using a simple, adolescent friendly language, other related topics such as growing up, drug abuse and sexually transmitted infections were also included. A cascade training programme was designed and implemented through training of 120 senior teachers as trainers who rolled out the training in the 15 states of Sudan reaching more than 8,000 teachers represent about 40% of schools, ultimately close to a million Students were reached with the curriculum. Moreover, the activities of the curriculum had been incorporated in the National School’s competition to maximize the impact and increase the outreach to young people. Lessons Learnt: Involvement and participation of the key ministries, national center for curriculum development and high level advocacy, lead to ownership and commitment demonstrated by allocating 10% time slot be used for HIV/AIDS curriculum activities. Conclusion: Despite the success in the process, an evaluation must take place to assess the impact on the knowledge gained in addition to the practice, which can be obtained through the upcoming SHHS III planned in 2013.

Effectiveness of Pediatric Asthma Education on Beliefs of Mothers Erna Judith Roach India Background: Asthma-related beliefs are linked to both behavioral and clinical outcomes. Positive parental beliefs on asthma management behaviors may lead to better health status and decreased asthma morbidity in children. Objectives: (i) to assess the beliefs of mothers of asthmatic children on childhood asthma (ii) to assess the effectiveness of pediatric asthma education on beliefs of mothers. Method: A quasi- experimental pretest posttest control group design was used. The study was done in the Pediatric outpatient departments of selected hospitals and at homes. Mothers having asthmatic children between 5 and 12 years of age diagnosed with persistent asthma were enrolled. Block randomization was used to assign mothers to both the experimental (n=40) and control (n=40) groups. The data collection instruments used was Baseline Proforma, Clinical Proforma and Belief Rating Scale. The beliefs regarding causes/triggers of asthma, effect of asthma, medications and prevention and control were assessed. Data were collected at baseline and at six months. A video CD and information booklet was used to educate mothers on pediatric asthma.

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Poster Presentation Results: The post-test mean belief scores in the experimental group 61.50 ± 4.14 were higher than the mean pre-test scores 51.30 ± 3.86. The Wilcoxon Signed Rank test for change in belief score from pretest to posttest was significant only in the experimental group (z = 5.52, p< 0.01) and not in the control group (z = 0.15, p>0.01). The Mann Whitney U test showed significant difference between the experimental and control group (p Conclusion: Structured pediatric asthma education can enable mothers to know the facts about asthma and help them change their negative beliefs. It can also help them take the right decisions while caring for their asthmatic children at home.

Dengue Outbreak in Gail Bawazeer District, Hadramout Governorate, Yemen, 2012 Faisal Ahmed Daraan Yemen Background: Dengue fever (DF) has caused multiple outbreaks in recent years in Yemen. Hadramout Governorate especially Gail Bawazeer district had several outbreaks since 2005 due to the adequate water source (the meaning of Ghail). In July 2012, an outbreak characterized by fever was reported from Gail Bawazeer district. We conducted an investigation for the first time to characterize the outbreak and confirm the diagnosis. Methods: We reviewed reports of fever and hemorrhagic fever in the surveillance system, laboratories and hospitals from May- July 2012 using WHO case definition. We interviewed 7 cases collecting clinical and demographic data. 59 blood specimens were collected and tested using IgM ELISA. Results: Of a total 203 cases reviewed , 98% met the case definition, 2% were DHF, 56% was male with 1% case fatality. Most affected age groups were 10-19 years (38%). 69% of cases was from Gail Bawazeer city with 32/10000 incidence. Of 59 specimens tested, 64% were ELISA positive for DF with no gender differences. Conclusion: The investigation confirmed a dengue outbreak in Gail Bawazeer district. The high burden of disease is among males, and young adults suggests outdoor infection. As most cases reported from Gail Bawazeer city, efforts to contain dengue to prevent their spread to other part of district. Keys: Dengue, outbreak, Hadramout, Yemen

Sir Model of Swine Infuenza Epidemic in Abu Dhabi: Estimation of Vaccination Requirement Fathalla A. Rihan | M. Naim Anwar Mohamud Sheek-Hussein, Srdjan Denic UAE Abstract: Pandemic or epidemic influenza has a major impact on the economy, through illness, absenteeism, lost production and increased mortality. Mathematical models could be used to analyse dynamics of epidemic infections and create a better insights into the measures that could prevent future epidemics. In this paper, we develop a basic SIR model and fit it to real data from previous influenza A (H1N1) epidemic in Abu Dhabi from May 2009 till April 2010. The cases reached a first peak in August 2009 and subsequently the number of cases peaked for a second time in October 2009. The overall case fatality rate was 1.4/100,000 population. The spreading of influenza can be prevented or reduced by various control measures like vaccination (immunization) and timely use of specific antiviral agents. Vaccination reduces the pool of susceptible individuals and could be either constant (conventional) or intermittent (seasonal). If an adequate percentage of susceptible population is immunized, infectious disease cannot spread within the population. This is due to the fact that vaccination does not only protect immunized person but confers protection of other members of the population. The main objective of the study is to estimate the fraction of the population that needs to be vaccinated in order to achieve adequate control of disease in similar future epidemic. We estimate values for the threshold reproductive number which prevent outbreak of swine influence infection. Results of our simulation and analysis indicate that around 55-60% of population should be vaccinated to make infections die out and prevent spread of the disease. The obtained results could guide future public health measures in the United Arab Emirates. 0 R Keywords— Influenza A (H1N1), Mathematical modelling, Parameter estimation, Simulation, Stability, Steady states, Vaccination

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Poster Presentation Integrated vaccines and community measures on controlling yellow fever outbreak in Darfur states, Sudan 2012, National response Ismail Tibin ADAM ISMAIL Sudan

The purpose of this study is to lights on success results of implemented integrated methods aiming at controlling yellow fever outbreak occurred recently in Darfur region in Sudan, Recently, some cases of severe neurologic and multi-organ systemic disease have been described in individuals who received yellow fever vaccine in several parts of Sudan during the previous outbreak of yellow fever occurred in June 2012 These events have focused attention on the need to define criteria for judicious use of yellow fever vaccine and to describe the spectrum of adverse events that may be associated with yellow fever vaccine, in addition to describing host factors that would increase risk of these events and identifying potential treatment modalities for yellow fever and yellow fever vaccine-associated adverse events are subjects of intense investigation. In Sudan however effective vaccines against yellow fever have been available only for 12% of targeted population but the new product (conjugated vaccine) is responsible for a significant reduction of occurrences of the disease worldwide. Currently, available vaccines protect against all yellow fever virus strains and are attenuated live virus vaccines derived from a virus originally isolated in 1927. This virus strain was attenuated by passage in mouse embryo tissue culture and then in chicken embryo tissue culture, resulting in the 17D strain from which all current vaccines are derived. In Darfur where CMR reached 25.3% an integrated model of Early Warning Alert and Response System (EWARS) have been activated coupled with community-based measures being locally adjusted purposely to contain yellow fever outbreak that was highly adopted and yielded in controlling the diseases and bringing the situation to its normal position in 3 months’ time field assessments and studies were undertaken to learn how effective is that model to be adhered on routine diseases control system

Implementation Of Congenital Heart Disease Screening For Newborns In Abu Dhabi Jennifer Moore UAE Background: Congenital heart disease (CHD) is the most common birth defect and affects approximately 8 per 1000 births and three per 1000 for critical CHD (CCHD). Despite antenatal screening and at least one examination before discharge, up to 39% of infants diagnosed postnatally with CCHD are not detected and are diagnosed after being admitted to the emergency department in distress, or at the time of autopsy. Objective: Abu Dhabi Emirate was one of the first regions in the world to include the congenital heart disease screening as a mandatory screening test in local policy and implement the screening in all maternity hospitals. The protocol includes the screening of both the preductal (right hand) and postductal (either foot) extremities after 24h of life. The purpose of this presentation is to describe the implementation of CCHD screening across the Emirate of Abu Dhabi, United Arab Emirates. Results: The Health Authority – Abu Dhabi, in collaboration with Children’s National Medical Center, successfully implemented CCHD screening at the emirate level using a “train-the-trainer,” approach, starting with two pilot hospitals then rolling the program out to all birthing facilities. In 2011, CCHD screening was added as a mandatory test to the HAAD Newborn Screening Standard, implemented in most birthing facilities, and occurred for the majority of infants (86%) in Abu Dhabi. This led to the identification of 10 newborns with CHD. Conclusion: Based on the successful identification and mitigation of barriers to implementation, the approach may be adapted for similar programs in other populations.

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Poster Presentation Sociopofessionnels Study Of The Determinants Of Mental Suffering At Work Kandouci Chahrazed Algeria Objectives: The objectives of this study were to assess the importance of the mental suffering of employees in the service sector of a city in western Algeria and to identify risk factors and moderators of this suffering in order to develop a effective prevention. Population and Methods: Standardized questionnaires were subjected to 753 employees in the tertiary sector. These questionnaires include three categories: A social and professional record (21items), Maslach Burn Out Inventory: MBI (22items), Job Personal Interaction Scale: JPIS 35 questions on the perception of the work environment by the individual divided into 6rubriques (workload and unpredictability, control, rewards, recognition and fairness at work, social support, conflicts and perceived value valuri work and training) The data collected were anonymous and confidential. Data analysis was performed using SPSS (version17.0). Univariate analysis was performed (chi-square Pearson correlations and a multivariate analysis (logistic regression). Results:The response rate was 78.75%, average age 38.42 ± 8.26, sex ratio 1.1 with a female predominance. The state of burn-out was 23.6% after logistic regression the main social determinants of psychological distress in the overall sample one taking medication to relieve pain (p = 0.0002) remained significant. Regarding the determinants “professional” contact with the public and strong mode part of work were significant respectively (p = 0.0017 and 0.0042). Moderators of stress for the multivariate analysis recognized two subscales of bad training (p Conclusion: Mental suffering in the service sector is high. Preventive actions to reduce or eliminate risk factors directly affect the environment and source of work: training more relevant, better organization of work, especially the riding tasks and recognition of work done.

Nargilah Smoking Emerging Epidemic: The Case Among Palestinian School Children Khuloud Jamal AL Khayyat Al Dajani Palestine The twentieth witnessed a pandemic of tobacco smoking, which was transferred from the west to the east, now we are living an emerging nargilah epidemic transferring from the east to the west. We have conducted an assessment of tobacco smoking among Palestinian school children in order to try and explain when they start smoking tobacco, how they maintain this habit and why school students risk their health by adopting this harmful behavior. An ecological framework was chosen as the appropriate study theoretical framework because it incorporates the individual, the family, the school, and the community as determinants in children’s and adolescent’s lives. For the basis of study design two theories were used; (1) ‘the theory of socialization,’ which considers the school as a central component of socialization, and (2) ‘the problem behavior theory’ which suggests that humans develop clusters of dangerous behaviors which become part of their daily life. The assessment was done on a study population of 17,715, of which 9,444 are from the West Bank and 8,271 are from the Gaza strip. Epidemiological analysis of the character and distribution of the phenomenon of school children and adolescents’ tobacco smoking was done. Logistic regression analysis was used to predict the adoption of tobacco smoking by school students was run. The most significant statistical results were found by running the multiple step-wise logistic regression analysis. A unique feature of this study is its dual focus on individuals and schools in order to identify factors that contribute smoking as health endangering behaviors, and offer recommendations for preventative actions. The prevention of smoking should begin at home and school and should target children before they have experimented with smoking. Health policy programs and practices are a worthwhile socio-economic investment around the world.

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Poster Presentation Factors affecting the quality of type 2 diabetes care in a diabetes centre in Abu-Dhabi United Arab Emirates: A qualitative study Layla Alhyas UAE

Objective To identify and provide further understanding on the factors affecting the quality of type 2 diabetes care provided by healthcare professionals working at a diabetes centre in the United Arab Emirates. Design A qualitative research approach was employed using semi-structured interviews. Nine semi-structured interviews were conducted with healthcare professionals of various professional backgrounds. Setting The setting took place at a diabetes centre located in Abu-Dhabi, United Arab Emirates. Participants Healthcare professionals including specialist physicians, dieticians, podiatrists, health educators and nurses were recruited through purposive sampling. Results Nine health care professionals, five females (56%) and four males (44%), were interviewed in the study. Four main themes emerged from the analysis of the present study: 1) motivation of healthcare professionals, 2) teamwork, 3) training healthcare professionals and 4) Emirate’s cultural impact on health behaviours and beliefs. Within these themes, twenty three different barriers and facilitators/motivators to improve the quality of type 2 diabetes care at the diabetes centre were identified and further explored. Conclusion This qualitative study provides some unique insights about factors affecting healthcare professionals providing T2DM care. We found many players affecting healthcare professionals in this study including the patients, healthcare professionals themselves, organization and the Emirate culture. To improve the motivation of healthcare professionals in the management of diabetes and the quality of diabetes care, several steps should be taken. Importantly, the role of the primary care in the management of Type 2 DM should be reinforced and strengthened, privacy of consultations should be protected and regulated, and awareness on the Emirate culture and its impact on the health should be disseminated to healthcare professionals providing care to Emirates with diabetes. Also, greater emphasis should be placed on educating and involving Emirates with diabetes in the management of their disorders. Finally, non-adherence to treatment, particularly medications was found as a barrier for healthcare professionals’ motivation to provide high quality of diabetes care; hence identifying factors that influence Emirates with T2DM adherence to medications is essential.

Do Peer Led Education Interventions Work? Mayada Kanj Lebanon Objectives: to highlight the limitations of peer education led interventions and provide recommendations for its use as an intervention approach Methodologies: review of literature on evaluation of peer education interventions Target beneficiaries: professionals working health promotion interventions, youth program managers Peer education (PE) is used in health promotion and community health as a method that relies on the active participation of members of that same community for the delivery of health messages. It is based on the notion that peers, when equipped with the accurate scientific knowledge and proper communication skills would be more effective in transferring these messages to their peers. Peer-led education has been used to address issues that are regarded as by communities and in which horizontal learning practices are favored over vertical ones. Although peer-led interventions are being conducted in different countries of the Arab region, a thorough literature search using different search engines (JSTOR, Pub- Med, Academic Search Complete, Scopus and others) and key words such as : peer education, education, intervention, Peer-led, Arab world, developing countries, MENA region, youth and adolescents, revealed that there is very little documentation of evaluation results of such interventions, if at all, and that there are many limitations to their use. Findings of our search indicate that Peer Education works mostly when it aims at increasing knowledge level and changing attitudes that knowledge and recall decrease over time, that peer education is not efficient in achieving a change in behavior or intentions leading to a certain behavior. Peer Education interventions usually adopt quasi experimental design or a pre- post test assessment (for comparative reasons) thus leading to biased results. Recommendations: Peer Education interventions should not stand alone but should be anchored in more comprehensive programs, they require follow up on participants, they should adopt sound scientific design and evaluation and should have control group whenever possible. Better documentation of interventions is needed

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Poster Presentation Evaluation Of A Teaching Model of Public Healh in Egypt Mohamed Kamel Farag United States The attitude of medical students in Egypt towards the content and teaching of public health (PH) course, especially the practicum, during their undergraduate education is negative. This was the prime motivation to set our goal to improve the quality of education of the PH practicum in Mansoura University Faculty of Medicine started in the academic year 2009-2010. This experience was documented in a book “Tutor Guide: The Know How, Quality Assurance of the Course practicum”. The challenges included limited resources, exceptionally large class size (>300 per rotation, class size >1000), resistance to change, new experience and questioned outcome. The concept of our teaching model was based on continuous daily assessment method that included small group discussions, critical thinking, peer education, self learning and team-based problem solving, which constituted 90% of daily activities. The remaining 10% was 15-minute written question(s). The student grade was based on participation (50%) and final multiple-choice questions exams (50%). Oral exams were eliminated to reduce bias which is full-blown in our settings. Students were teamed to present their assigned work in a Power Point format, competing for financial awards. The structure, process and outcome of our new teaching model were evaluated at the end of the course by anonymous “Students Satisfaction Questionnaireâ€administered by the school’s Quality Assurance Unit. Analysis of the feedback (response rate 85%) revealed high students™ satisfaction in all aspects of the rotation, including faculty/staff performance (65-78%). This satisfaction was least for material resources and classroom appropriateness (5-56%). After the conclusion of the course, students were invited to a special event “Sports and Social Dayâ sponsored by the school. Its main purpose was to give the students an opportunity to vent their talents outside the classroom. Our experience proves that this teaching model

The tip of the iceberg: cholera outbreaks in Aldhalae, 2011 Mohammed Ali Abdullah Saleh Yemen Introduction: Yemen civil unrest since January 2011 has led to deteriorating health conditions. During July-August, cases of watery diarrhea and vomiting were reported to local health care facilities in multiple regions of the country including Aldhalae Governorate. We investigated these cases to determine the etiology of the outbreak. Methods: We used routine surveillance data in Aldhalae Governorate to compile the cases reported by health centers. Suspected cholera cases were defined as acute watery diarrhea with or without vomiting during the outbreak. A team from the Ministry of health and the local health departments initiated an investigation of reported cases. A case investigation form was used to collect clinical, demographic and potential sources of exposures information. Five stool samples were collected and sent to the central laboratory in Sana’a for testing using ELISA Results: A total of 3,172 suspected cholera cases were reported. Children less than 10 years old were more affected (45%). The outbreak started in Qataba district and spread to adjacent districts. Sanah, a central fruits and vegetables market place was the most affected and has 42% of cases. A total of 41 persons died, which gives a fatality rate of 1.3%. The mortality was higher among children less than 10 years old (49%).Three samples out of five tested positive to v.cholera Conclusion: This is the largest cholera outbreak reported in recent years in Dhalea. Our results call for strengthening surveillance and control measures including early detection and response, Continues community health education and water chlorination for sanitation. It is important for donors and public health officials in Yemen to have plans for dealing with the consequences of the conflict situation Keywords: Cholera outbreak, Aldhalae health office, MOPH&PYemen

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Poster Presentation Assessment of Motivating and Demotivating factors of Voluntary Blood Donation among the Students of Khartoum State Universities Mohammed ZAHRAN Sudan

Background: The National Program for Voluntary Blood Donation has been launched in June 2005. The program has been targeting university students and youth groups. One of its specific goals in Sudan for the coming few years is to increase the percentage of voluntary [healthy and low-risk] blood donors. Voluntary Blood donation concept is a remarkably safe medical procedure. However, attitudes, beliefs and level of knowledge associated with voluntary blood donation may affect such procedure. Objective: The aim of this study was to assess the motivating and demotivating factors in promotion of Voluntary Blood Donation concept among the students of Khartoum State universities. Methodology: The present descriptive cross- sectional facility based study conducted in eight clustery randomly selected facilities. A well-structured Arabic questionnaire was used to assess the motivating and demotivating factors in addition to reviewing the quarterly reports ...etc. Study data processed using SPSS version 13 and data reliability checked using Chi Squire Test (P < 0.05). Results: The convenience random sample consisted of 204 male (51%) and 196 female (49%); the majority of the sample (73%) were non-voluntary blood donors. The Association test was significant (P- Value<0.05) for governmental universities students who has more informations than students of private universities. Test of association was significant (P- value<0.05) for students of science faculties who were more knowledgeable about blood donation than students of literary faculties. Forty two percent of respondents required more trust in sterilization of the used instruments during blood donation. There was no direct relation between females and knowledge (P-Value<0.05). Forty five percent believed that post donation there will be a harmful effect by getting infectious disease. Sixty two percent of females have considered menstrual cycle as a not forbidding cause form blood donation. Ninety percent of respondents have accepted religious value as a motivational factor. Sixty five percent selected TV as most suitable enhancing methods to strengthen the spread of the voluntary blood donation awareness. Conclusion: Different fears, mistrust and lack of information may serve as demotivating factors but if they are well addressed they will defiantly turned to be motivating factors of useful use when we develop the standardized blood donation awareness package.

Evaluation of Health Communication Training Course for TB Health Workers AlGazira State 2012

Muaz Ibrahim Mohammed Ahmmed Hassan Sudan

Introduction:Tuberculosis is leading causes of death worldwide which is estimated to affect one-third of the world’s population. Its treatment requires six months of regimen combination of anti-tuberculosis drugs, improved means of relaying information, listening to needs, encouraging and motivating patients are essential for the direct observe treatment strategy (DOTs) to achieve treatment success. Hypothesis: Training TB health workers on local health communication model with TB patients is expected to change their behavior and attitude, Hence, improving the success of DOTs. By improving health workers communication skills that lead to increase patients understanding to the Tuberculosis as a disease this will consequently affect the treatment outcome. Settings:40 TB health workers were selected from AlGazira state, from 20 TB management units (TBMUs), to attend a health communication training course. The evaluation aims to measure the change in communication between health workers and TB patients, it is necessary to improve adherence and reduce the TB defaulters. Qualitative evaluation was conducted (pre and posts) the course to assess the knowledge, skills and attitudes of the TB workers and its impact on the TB patients. Specially designed evaluation method adopting Kirkpatrick Framework conducted three months post intervention was held to evaluate

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Poster Presentation the impact of the HC training, the evaluation includes four levels: reaction, learning, behavior and results. Conclusion: The health worker gained knowledge regarding the health communication skills but still no behavioral change occurs, although it needs more time and other methods to evaluate such kind of training

Unintentional Injuries: Magnitude And Feasibility of Collecting Data. Yemeni Hospital Nabiha Abdulrahman Al-Abhar Yemen Introduction: Unintentional injuries are a major public health problem,increasing in most developing countries, including Yemen.A large proportion of injuries are caused by road traffic accidents.In 2010,18,407 traffic accidents injuries were reported in Yemen,87.7% involved men, causing 2,735 deaths, 87.2% were men.The burden and pattern of injuries in Yemen are poorly known;therefore,we assessed the feasibility of collecting unintentional injury data to better understand its epidemiology and help plan prevention programs. Methods: We collected unintentional injuries data using the WHO case definition and a modified WHO questionnaire.From April-July, 2012,trained volunteers collected data from individuals who met the case definition and presented at/or admitted to Al-thowra hospital.Epi info was used for analysis. Result: A total 887unintentional injuries were collected,248cases (27.96%) ages 20-29 years with mean age 25.7.The Male: Female ratio was 5:1.1.The most common cause of unintentional injuries was traffic accidents with374 (42.1%); odds ratio for traffic accidents in age group20-29 compared to all age groups1.55 CI (1.1-2.1) p value< 0.0024.Injuries due to falling down,55.9%, resulting in fracture and joint dislocation, 26.9 %,( 23.7% male, 40% female),cuts and open wounds,26.3 %, ( 27.6% male, 21.1% female).Most injuries,42.1%,occurred outside home and 33.3% at home.Most injured were students,35.4%.Most deaths, 90.0%,occurred due to traffic accidents with odds ratio of20.5 compared to other causes of death CI (2.6-161) P value < 0.00006. Conclusions: Surveillance for unintentional injuries is feasible in major hospitals.Young adult males are at high risk for road traffic accidents and students are at high risk for falls .We recommend instituting hospital based surveillance using a standardized instrument to generate data to provide planners and policy makers with information needed for prevention and control measures. Keyword: unintentional injuries-feasibility- data collection- Yemen.

Factors Associated With Medical Students Career Choices Regarding Public Health Nawal Tariq Al-Daqqaq Bahrain In a world where public health manifests the primary and most important step in disease prevention and health promotion, it is essential that numerous individuals are recruited into this career pathway. A previous study has shown that most students chose their specialisations during their undergraduate study1. The goal of our research was to discover and determine the factors that affect medical students in selecting Public Health as their career choice. We used an online survey which was constructed using “survey monkey”. The survey comprised of 3 sections, the first section contained eight background questions used to collect demographic information whilst the other two sections contained career option related questions. Data was analysed using SPSS and allowed us to rank the five most and the least influential job factors which contributed to their selection of career. This analysis also allowed us to discover the medical students’ specific perceptions towards Public Health as a career itself. The target beneficiary of this research will be Public Health management system as they can implement the appropriate findings to make Public Health a more popular choice amongst undergraduates.

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Poster Presentation A Cross-Sectional Survey of Knowledge and Attitude among Out-patient Clinic Attendees of King Fahad National Guard Hospital, Riyadh Noura abdullah almoither Saudi Arabia

Introduction: Diabetes is a chronic disease affecting every organ in the body and can negatively affect oneââ&#x201A;Źâ&#x201E;˘s quality of life. It can cause serious complications such as loss of vision and renal failure if not properly treated and monitored. In addition, diabetes emotional and financial costs are huge and cannot be ignored. The prevalence of diabetes worldwide is estimated to be 4.6%. However its burden of Saudi population is even larger. Reported worldwide estimates ranked Saudi Arabia as third in terms of highest prevalence of diabetes (reaching up to 28%). Several health education programs have been implemented in the kingdom; however effectiveness appears to be questionable due to improper needs assessments and evaluation. Needs assessment and collecting information regarding the population knowledge and attitudes towards diabetes is critical for developing potentially effective population-based preventive interventions. Aim of the study: A pilot study has been conducted to collect preliminary data following statistical analysis and to check the face validity of the questionnaire. Measuring the adults knowledge and attitudes toward diabetes, its associated risk factors, methods for preventions diabetes and steps to be taken to achieve optimal control of the disease. Design and Methods: A cross-sectional survey took place in the national guard main hospital in Riyadh, the outpatient clinics attendees is the target group. Data is being collected through a Self-administrated questionnaire. Conclusion and recommendations: 63.33% of the participants were female and 36.67% were male, Preliminary results showed an alarming lack of knowledge and misconception about this chronic disease that is highly prevalent in KSA, with almost two third of the surveyed population (65%) believing that the disease only affects elderly people. Confirmation of these results will be achieved following the conduct of the actual study, which we believe would be of importance to understand the needs of the Saudi population in terms of knowledge and attitudes and upon which future health education and promotion programs can be planned.

Is Chagas Disease Still a Formidable Challenge for Latin America and Africa Pierrette Cazeau & Nancy Martelly Sajous Lewis United States Background: Chagas disease (CD) or American trypanosomiasis is a major endemic disease representing a serious public health problem for countries in Central and South America, Brazil and South Africa. CD is caused by a parasitic protozoan passed on to humans by the contaminated feces of blood-feeding bugs from the Triatominae sub-family. It may also be transmitted by blood transfusion, organ transplant or accidental ingestion of contaminated food such as acai juice, sugar cane or drinking water. Symptoms of acute Chagas can include fever, lymph node enlargement, muscle pain and a high mortality rate from heart failure as a result of cardiac fiber lesions. Methods: Current therapy centers on the compounds benznidazole and nifurtimox with a long history in treating CD but with significant side effects. Diagnosis of CD is confirmed by testing blood samples using two different diagnostic tests. T. cruzi positive patients are immediately treated with benznidazole as a first-defence treatment, and follow-up with counseling and active participation from parents or family members. Novel anti- Tc compounds are being developed that rely on the demonstrated ability of nitric oxide to kill the parasite. Most treatment plans in developing countries focus on patients < 18 years of age. Results: Current treatment is limited to benznidazole and nifurtimox, but these drugs are limited to children (< 12 years old) with acute infection and early chronic disease with growing support for treatment in indeterminate disease. Both drugs require a 30-60 day treatment period which often leads to a high rate of patient non-compliance. With target organ involvement in the chronic phase, a lack of studies supports their use as parasitological therapy. Differences in drug susceptibility among different T. cruzi isolates have led to wide-ranging parasitological cure rates based on the geographical region. Since the poverty

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Poster Presentation and remoteness of the primary target population represents a major obstacle, guaranteeing access to diagnosis and treatment is a challenge. Conclusion: Chagas disease continues to be neglected with the current drug research and development pipeline being very limited. CD will continue to be an important health issue not only in Latin America but also increasingly around the world. Implementing Chagas disease diagnosis and treatment programs point to resource-limited settings in remote rural areas and demonstrates the limitations of current treatment and measures of efficacy. New treatments are urgently needed that include pediatric formulations of existing and new drugs plus a faster and more reliable test of cure.

Caregiver Burden From Caring For Impaired Elderly: A Cross-Sectional Study In Rural Lower Egypt Rasha Aziz Attia Salama UAE

Background: increased life expectancy and an aging population have made home care for the elderly a major responsibility for families. Caring for a chronically ill or physically disabled person has been referred to as physically or emotionally stressful, placing the caregiver at a heightened risk of burden. This study aimed to identify factors related to caregiving burden among caregivers who care for their disabled older family members. Methods: a cross sectional descriptive study was conducted from October 2008 to January 2009 in two randomly selected villages of Shebin El-Kom Menoufiya, Egypt. In an interview setting, questionnaires were used to collect the required data from 288 primary caregivers. Independent variables included the demographic characteristics of caregivers and care recipients, the severity of care recipients’ functional abilities, financial adequacy and caregivers’ degree of social support. Hierarchical regression was used to predict the levels of caregiver burden. The objective of the study was adequately explained to participants and their consent was obtained with assured confidentiality. Results: caregivers who had little informal social support, inadequate financial resources and more caregiving hours were more likely to experience intense caregiving burden. Burden was also positively associated to the functional disabilities of care recipients and the degree of caregiver burnout. The results of this study indicated that the female spouse was the most common caregiver within the sample, which indicates that cultural norms in Egypt still affect caregiving burden. Conclusions: identifying predictors of caregiver burden promotes a more comprehensive understanding of burden experiences when caring for older adults, and this may help prevent their deterioration to burn out syndrome Key words: Home Care; Elderly; Caregiver burden; Burnout

Uptake of Cervical Cancer Screening among South Asian Women in Hong Kong 2010-2011 Sharmila Gurung, Asma Batool, Joyce S. F. Tang Hong Kong Introduction: The United Christian Nethersole Community Health Service started a health promotion programme Named South Asian Health Support Programme in 2007 , the first of its type targeting particulary the South Asian community to meet the health gap amongst this community. 1,2 Many overseas studies have identified a health gap between the South Asian Community and the general population 1-4 ; in addition, there is research evidence that cervical cancer is more prevalent among the South Asian women.3,5 However despite a growing South Asian community, there is paucity of health information about this community in Hong Kong. Method: From 2009 to 2011, over 1000 women were screened for Cervical Cancer through pap smear test. From 2009 -2011 we observed that all case abnormality rate was higher among the South Asian women (13% -19.4% ) compared to the local Hong Kong Chinese women (7-%-7.7%). Results: In 2011, we screened 355 cases, and of those, 69 cases were found to have ASC-US (Atypical squamous cells of undetermined significance), 3 cases of LSIL (Low-grade squamous intraepithelial lesion). All cases received medical follow up and management .

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Poster Presentation Discussion: We observed that health education improved uptake of screening services. In addion this health promotion programme provided culturally appropriate setting to attract women from South Asian community to come for preventive action. Hence reponse for uptake of preventive health care was indeed positive. Language is a main barrier in the healthcare facilities in Hong Kong for South Asians, due to lack of interpretation services. Many patients cannot tell their problems properly to the doctors, thus many tend to defer going to these facilities. This service has facilitated uptake of preventive health care for these South Asian group. Healthier women mean stronger societies. An investment in women’s health is an investment in the social and economic development of our societies 4. References: 1. Bolanle et al. Ethnic minorities ill served by health service The Lancet, Volume 356, Issue 9238 2. A Szczepura .Access to health care for ethnic minority populations. Postgrad Med J 2005;81:141-147 3.Allison Worth, Tasneen Irshad et al .Vulnerability and access to care for South Asian Sikh and Muslim patients with life limiting illness in Scotland prospective longitudinal qualitative study BMJ 2009;338:b183 4. Frank J. A Women and Health Agenda: It’s Time. Harvard Public Health Review. Summer 2010. 5. Mark Dignan, Robert Michielutter et al. Effectiveness of Health Education to Increase Screening for Cervical Cancer Among Eastern-Band Cherokee Indian Women in North Carolina. 6. Gupta A. Kumar A et al .. Cervical cancer screening among South Asian women in Canada: the role of education and acculturation. Health Care Women Int 2002 Feb;23(2):123-34.

Self-Reported Oral Health, Oral Hygiene Habits, And Dental Attendence Of Prignent Women In Tulkarem City Suad Samara, Amira A.Shaheen Niveen Abu-Rmeileh Palestine Background: During pregnancy, women become more susceptible to periodontal disease and gingivitis (1). Further, some studies reported association between poor maternal oral health , preeclampsia and preterm labor at maternal level . Poor maternal oral health was reported to affect babies negatively. Such effect includes low birth weight and increased risk of early childhood caries through the direct transmission of bacteria from infected saliva (2,3,4,5) Because of the absence of information about the oral health habits and practices among pregnant women in Palestine, we decided to conduct this study. That aim is to describe self-reported oral health, oral hygiene habits, dental practices among pregnant women in maternal health clinic in Tulkarem city, in the north of West Bank . Methods: This is a cross-sectional study, where a self-administered questionnaire was distributed on a convenient sample of pregnant women visiting Maternal and Child Care unit of Ministry of Health in Tulkarem. Results: are expressed as number and percentages of respondents for each question, And analyzed with SPSS; the chi-square test was used to evaluate the differences between several variables and the level of significant set to P < 0.05. Results: One hundred participants answered self-reported questionnaire about oral health, 68% reported having dental caries and 31% reported to have gingival problem. 43% of pregnant women visited dentist during pregnancy , 41% believes that dental treatment during pregnancy have an adverse effect on Fetus while 49% believe in the statement “ a tooth for a baby “ Regarding oral health practices 97% brush their teeth mostly twice or more a day but only 22% use an additional means for teeth cleaning. Conclusion and Recommendation: This study shows that the Palestinian women need a health education program before and during pregnancy, as our study shows that most women didnt visit dentist during pregnancy . Key words: pregnancy, oral health, oral hygiene habits, periodontal disease, dental attendance.

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Poster Presentation The Impact Of Health Education Trends To The Smoking Rates Among The High School Students In Japan Suketaka Iwanaga Japan

Background and Objectives: The smoking rates among the high school students have been investigated from 1996 to 2010 on study base. And the successive school curriculum guidelines by the government have revised around these years. We considered the impact of possible factors especially the trends of health education through materials. Materials and Methods: The investigation reports on smoking of the minors by the Ministry of Health, Labour and Welfare and the Cabinet Office are analyzed and the successive school curriculum guidelines of health education were referred. Results: The smoking rates of junior and senior high school students (male/female) have rapidly dropped after 2000. From 1996 to 2000, the rates of daily smokers increased among both schools and all sexes in spite of price hike of tobacco two times during these years. In the curriculum guidelines were revised and enforced in 1992, 2002 and 2011. The smoking issues were included for the first time in 1992. It is reported that the 74.6% students pointed school instructionâ and 54.5% of them pointed “home teaching as effective way of education and enlightenment for smoking prevention. (n=2,000) In 1987, the customs duties for foreign tobacco products were abolished and until the self-regulation by the Japanese and American Tobacco Companies in 1998, they advertise their products in many ways. This might has increased the smoking rate of the students. And from 2000 to 2010, the government set a goal of minor smoking rate as 0% in the Healthy Japan 21policy and developed programs for smoking prevention including Smoke Free Schools Conclusions: It is important that smoking issues got included in the curriculum guidelines of Health Education. But as the subject is not provided many hours for teaching, other events and factors seem to have helped the goal.

Unintentional Injuries: A Public Health Challenge In United Arab Emirates Susan M. Smith, Amina Sandal United States Unintentional injury deaths are reported by the World Health Organization as a major public health problem throughout the Arabian Gulf Region. However, very few research studies have been conducted to assess whether the cause of unintentional injury deaths are significantly different for unintentional injury deaths reported for male citizen and immigrants (non-citizens). This presentation will describe the results of an analysis of unintentional injury deaths of male citizens and immigrants ages 20-65 reported to six selected medical districts of the United Arab Emirates (UAE) for the years 2006-2008. Fatality data was provided by six UAE medical districts and coded by the researchers. Nonparametric statistical procedures were employed to analyze data using rates of death for each group. One question addressed by the study was whether the death rate of immigrant males differed significantly from citizen males for each reported category by cause of death. The categories of Accidental Falls, Accidental Poisonings, Motor Vehicles & Traffic Accidents and Accidents & Adverse Effects were included. In the years 2006-2008, 73.8 % of the unintentional male deaths were immigrants (non-citizens) and the rate of unintentional injury death reported for male immigrants and citizens ages 20-65 differed significantly by the specific cause of the death. The observed rate of death for UAE male citizens from traffic deaths was found to be significantly higher than expected when compared to the rate of traffic death for immigrants (non-citizens); and the observed rate of death of UAE male immigrants (non-citizens) from accidental falls was found to be significantly higher than the expected rate for male citizens. Participants will be able to describe how unintentional injury fatalities significantly differ by frequency and rate for male immigrants living in the UAE and citizens by cause and outline three recommended unintentional injury prevention program

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Poster Presentation Health Seeking Behavior of A Sample of The General Population Of Erbil City, Iraq: A Community-Based Study

Tariq Al-Hadithi, Wali Omer , Samim Al-Dabbagh, Iraq

Background and Objectives:Like many transitional communities in the developing countries, a wide range of therapeutic choices coexist in Kurdistan region. Everyday thousands of people become ill and make use of the health care services but little is known about their health seeking behavior. The aim of this study was to answer the basic questions of what people do and where do they go when they become ill in a representative sample from Erbil city. Methods: A community-based house to house study was conducted with a sample size of 1328 individuals. Satellite images and geographical information system were used to identify residential pattern that helped design a more representative sample. Data collection was done during the six months between January and June 2011. Principal Component Analysis was used to assign weight and develop an evidence-based socioeconomic scale. Results: A minority did not seek external help but the majority (90.7%) did so: 44.8% of them consulted a private doctor clinic as their initial response to the illness. Consulting other providers included: 21.8%, 17.4%, 9.4% and 6.5% for nurse clinic, emergency department, primary health care centers and public health centers respectively. No one from the sample consulted a traditional healer in the initial step but a minority (2.4%) did so when they did not get benefit from the first attempt. A similar proportion chose to travel abroad as their next choice of service provider. Conclusion: The findings of this study can help public health policy-makers in better understanding of the way people behave when becoming ill and help them plan for higher quality health services.

Problem Drug use in Lithuania Valerij Dobrovolskij, AudronÄ— Astrauskiene, Rimantas Stukas Lithuania Aim of the study is to estimate and assess the prevalence of problem drug users in Lithuania. Problem drugs users mean persons “ injecting drug users or regular users of heroin and other opioids (including illicit methadone and buprenorphine), cocaine and/or amphetamine (including use of methamphetamines, excluding ecstasy). To estimate the prevalence of problem drug users the capture-recapture method was used. For the study, the data concerning problem drug users were selected from the databases of the health care and law enforcement institutions , Were identified 431 monitored problem drug users in 2005 in Lithuania, i.e. in 2006 “ 482, and in 2007 - 447. The ratio of males and females among the monitored problem drug users was as follows: in 2006 “ 6:1, in 2005 and 2007 - 4:1. The average age of the monitored problem drug users in 2005 was 26.8 years, in 2006 “ 27.6, and in 2007 “ 28.0 years. In 2005, 2006 and 2007 “ the youngest problem drug user was 15 years old, the oldest in 2005 “ 47 years of age, in 2006 “ 57 years, and in 2007 “ 61 years. In most cases the age of monitored problem drug users was 26 years throughout the period of the study. Biggest share of the monitored problem drug users belonged to the age group of 25 “ 34 years. In 2005, in Lithuania 5699 problem drug users were identified (95 % Confidence Interval (hereinafter - C.I.) 5552 - 5849), in 2006 - 5800 (95 % C.I. 5652 - 5951) and in 2007 - 5458 (95 % C.I. 5314 - 5605). Using the received data the prevalence of problem drug users was calculated as follows: in 2005, 2.3 problem drug users per 1000 Lithuanian population aged 15-64, in 2006 “ 2.5, and in 2007, 2.4. The study showed that in Lithuania one of the lowest prevalence levels of problem drug users was observed, as in Germany, the Netherlands, Greece and Cyprus. In 2005 “ 2007, in Lithuania problem drug users mainly were young men.

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Poster Presentation Rapid Assessment Of The National Egyptian Disease Surveillance System (Nedss), December 2012

Wessam Abdelazeem, Maisa Omara, Mohamed Abdelwahab, Marwa Amin, Yasser Kandeel, Ahmed Etman, Mohamed Hafezl, Sameer Elrefaay, Amr Kandeel Egypt

Introduction: Egypt MOHP started implementation of the National Egyptian Disease Surveillance System (NEDSS) -an electronic communicable disease reporting system- in 2001 in collaboration with CDC and NAMRU-3. NEDSS was designed to promote e collection, exchange and analysis of accurate notifiable disease data. A rapid assessment was conducted to identify whether NEDSS is serving a useful public health function and is meeting its objectives. Methods: Assessment was conducted in Luxor governorate according to CDC guidelines. Using a pre-designed questionnaire; interview was conducted with the surveillance teams at 4 levels: Central, Governorate, Districts and fever hospital. Logbooks and data collection tools were reviewed and compared to NEDSS electronic database to assess completeness and data quality. Surveillance data for year 2012 was analyzed to calculate sensitivity and positive predictive value (PPV). Results: System is simple in terms of data collection tools and case definitions; however system is multiple levels and requires laboratory confirmation. It is flexible and acceptable from surveillance teams; however treating physicians are mostly using their clinical sense for diagnosis. System is highly stable with electronic data backup system and proper infrastructure. It is representative of patients admitted to fever hospitals; however patients visiting other health facilities for care are not represented. Completeness is moderate (60%), timeliness is good as the system is web-based. Sensitivity is 94% if compared to hospital-based and 11% if compared to population-based survey incidence and its PVP is 89%. NEDSS operational costs are reasonable for national system. Conclusions: National electronic surveillance was successfully implemented in Egypt. NEDSS is highly flexible, simple and cost effective and is achieving most of its objectives. Completeness and quality of data are good. System represents only patients admitted to fever hospitals. A standard surveillance evaluation of the system in other governorates is essential to better describe NEDSS strengths and weaknesses

Incidence of Rubella IgM Antibody in Yemen from 2008 to 2011 Yaser ALeryani, Nahed , Shibani Khalid , Sharon, A.Jumman Yemen Introduction: Vaccination decreased rubella cases reported worldwide from 670,894 in 2000 to 121,344 in 2009 globally, 112000 cases of congenital rubella syndrome (CRS) occur each year. In Yemen, during 2003,a study showed that 6.6% of pregnant women and 5.1% of females at childbearing age were at risk for rubella, yet Rubella vaccine isnâ&#x20AC;&#x2122;t included in Yemen EPI. We aimed to determine the incidence of Rubella virus in Yemen to consider the introduction of Rubella vaccine. Method: All records of patients with fever and rash available at National Central of Public Health Laboratory (NCPHL) between January 2008 and December 2011 were reviewed. Demographic data and results of Rubella specific IgM, that were tested as a part of Measles investigations and sent to NCPHL according to WHO standards, were retrieved and analyzed. Results: Of 3621 samples, 1002 (27.08%) were rubella IgM positive. The incidence rate was 0.86 in 2008, 1.02 in 2009, 0.84 in 2010 and 1.66 in 2011 per 100,000. The incidence is highest in late winter and early spring.. Rubella antibodies IgM were detected in 56 of 158 (36%) of females aged (15 - 49 years). The most affected governorates were Say on with 102 /100,000, and the lowest were Raymah with 1/100,000. The most affected age group was (5 to 15) with 42%. Conclusion: An increasing rubella incidence was noted that might be attributed to the improvement of the reporting system and availability of rubella reagents. The majority of patients were from the southern governorates which could be attributed to the active reporting. Groups at risk were children aged 5 to 15 years of age, and women of reproductive age. Rubella immunization and educational campaigns are recommended. Key words: rubella, incidence, immunization

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Poster Presentation Herams: Towards Better Consolidated Health System During Emregencies Yousif Fadol Goma Sudan This project is to shed lights on successes of implementing HeRAMS (Health Resources Availability Mapping System) to provide timely, relevant and reliable information about the available health resources to the decision makers in order to support them: monitoring Who is doing What Where, and when, measuring gaps and resources planning, ensuring evidence-based actions, enhancing coordination & accountability and Helps health sector in developing exit scenario. HeRAMS is initiated and developed in Sudan considering Darfur as a model and using its data as the first dataset being tested on the system, since 2008 many studies and field assessments were carried out and yielded in adoption of the tool by Global Health Cluster in achieving its comment to provide leadership in emergency and crisis preparedness, HeRAMS as facility-based tool was developed to allow data collection at a centralized level. Specific data collection forms were designed using excel which integrated certain features in order to facilitate the data collection process as much as possible and ensure data quality and consistency during the collection process and analysis. The issue is; Emergencies and crisis are likely and common in some countries in the region where the need for early start will help put in place a strategic framework in advance which will facilitate a more coherent and therefore more efficient recovery of the health Information system. This is important, as during the protracted crisis numerous international partners will act with little coordination and structure. The danger during early recovery is to have a combination of isolated and uncoordinated interventions by numerous agencies which often lead to duplication and waste of resources. HeRAMS will therefore be important to bring together the broad range of organizations to support national actors in a coordinated and cohesive way of information system.

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Experience Dubai

About Dubai Dubai - the exotic jewel of the United Arab Emirates. Bordered by deserts and beaches, Dubai provides stark contrasts, from intriguing Islamic culture to the ultra-modern, high-tech metropolis of the 21st century. The city is a magnificent expression of an incredible vision and an uncompromising statement of success and opportunity. Dubai has something for everyone, from vacationers seeking a relaxing break away from the pressures of work, to business travelers looking for a new exciting experience. The emirate is an international conference, exhibition and leisure destination..

Climate Dubai has a sub-tropical, arid climate. Sunny, blue skies can be expected most of the year. Rainfall is infrequent and irregular, falling mainly in winter. Temperatures range from a low of about 10.5°C /50 °F to a high of 48°C/118.4°F. The mean daily maximum is 24 °C/75.2 °F in January rising to 41°C/105.8 °F in July.

Clothing Lightweight summer clothing is suitable for most of the year, but sweaters or jackets may be needed for the winter months, especially in the evenings. Compared with certain parts of the Middle East, Dubai has a very relaxed dress code. However, care should be taken not to give offence by wearing clothing which may be considered revealing, for example low-cut dresses, very short skirts, or tight shirt or top in public. At the pool or on the beaches, trunks, swimsuits and bikinis are quite acceptable. Good quality sunglasses are advised, and photo chromatic lenses for those who wear spectacles. Hats, or some protection for the head, are advisable when in direct sunlight.

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Experience Dubai

Culture & Lifestyle Dubaiâ&#x20AC;&#x2122;s culture is firmly rooted in the Islamic traditions of Arabia. Courtesy and hospitality are among the most highly prized of virtues, and the visitor is sure to be charmed by the genuine warmth and friendliness of the people. Dubai society is marked by a high degree of tolerance for different lifestyles. Foreigners are free to practice their own religion, alcohol is served in hotels and, provided reasonable discretion is shown, the dress code is liberal. Women face no discrimination and may drive and walk around unescorted. Despite rapid economic development in recent years, Dubai remains close to its heritage. Local citi zens dress in traditional robes and headdress. Arab culture and folklore find expression in poetry, dancing, songs and traditional art. Weddings and other celebrations are colorful occasions of feasting and music. Traditional sports such as falconry, camel racing and dhow racing at sea continue to thrive.

Language & Religion The official language is Arabic but English is widely spoken and understood. Both languages are commonly used in business and commerce. Islam is the official religion of the UAE and there are a large number of mosques throughout the city. Other religions are respected and Dubai has two Christian churches, St Maryâ&#x20AC;&#x2122;s (Roman Catholic) and Holy Trinity (inter-denominational).

Photography Normal tourist photography is allowed, however it is considered offensive to photograph Muslim women. It is also courteous to request permission before photographing men.

Currency The monetary unit is the dirham which is divided into 100 fills. The dirham is linked to the Special Drawing Right of the International Monetary Fund. It has been held constant against the US dollar since the end of 1980 at a mid-rate of approximately US$1= Dh3.67 100

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Notes

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2 Arab World Conference on Public Health nd

26-28 April, 2014 Dubai - UAE

Save the Dates!

www.publichealthdubai.com Conference Secretariat: Public Health and Safety Department of DHA, Email: publichealthdubai@mci-group.com

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Public Health