SCOPH NEWSLETTER Health Systems 2021
Feb - May 2021
Health Systems THEME:
A well-functioning health system responds in a balanced way to a population's needs and expectations.
Health
systems
have
hugely
contributed to better health and influenced the lives and well-being of billions of people, thus their role has become increasingly important. This why we chose 'Health Systems' as the theme for this edition of SCOPH Newsletter!
Newsletter Team
Nada Moustafa (NPO DA ME) Coordinator
Nermeen Yousef Scientific team
Rafik Fouad Proofreader
Menna Ayman Scientific team
Dana Tarek Proofreader
Ahmed Alameen Scientific team
Samira Yasser Designer
Marawan Alaa Scientific team
SCOPH Newsletter
TABLE OF CONTENTS
NATIONAL UPDATES 4
NPO - Mr. Hamdy Shaheen
5
NPO GA - Ms. Menna Tarek
6
NPO DA ME - Ms. Nada Moustafa
7
NPO DA CB - Ms. Mai Elhenidy
8
AMR NC - Mr. Abdelrahman Al-Gaafary
ACHIEVEMENTS 13
National Achievements
ARTICLES 19
Lessons from the past paving the way to the future
21
Global health and Social Health Determinants
22
Primary Healthcare & Family Physicians
9
NCDs NC - Mr. Omar Hesham
23
9
MH NC - Ms. Sarah Dawood
Health Workforce
25
One Health Approach
11
Climate Change NIC - Ms. Rania Harhira
26
Digital Health
12
BGH NIC - Ms. Salma Moatamad
27
Preeclampsia
29
Asthma
SCOPH Newsletter
NATIONAL UPDATES NPO Mr. Hamdy Shaheen Attended OGA March Meeting 2021 MEETINGS
Attended EMR17 Represented IFMSA-Egypt in the UN Focus meeting.
Follow up the work with WHO in Mental Health & psychosocial support “MHPSS” collaboration.
Attended an evaluation meeting with IOM Represented IFMSA-Egypt in IOM End project Celebration Initiated Bridging Gaps in Health National initiative Followed up on Greenish collaboration in Climate Change & Health
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
NPO GA Ms. Menna Tarek Attended EMR17 Attended all LPO’s and national team Monthly meetings & took minutes Attended World Asthma Day Celebration Attended Mental Health TOT Conducted 2 sessions in Winter Camp XI Conducted a session in AMR TOT Conducted 2 sessions in LPOs & 2nd man competency modules National team representation at the local level through conducting local SCOPH sessions in “AMSA-Aswan, MSSA-Menofia, ZMSSA-Zagazig”. Updated reporting and scoring system Monthly reporting and evaluation form for National team Monthly reporting for LPOs Monthly Scoring for LCs Updating SCOPH database Situation analysis of SCOPH strategic plan Open a MWG for SCOPH resource center “SCOPHub” as the coordinator of the mega working group
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
NPO DA ME Ms. Nada Moustafa Click to see
Work with COVID-19 Response Team (CAT)
Participation in World Immunization Week online campaign Conducting the third wave of the CAT online campaign
Introduction Video
World Immunisation Week
Vaccine Myths & Facts
Astrazeneca Vaccine
Sinopharm Vaccine
Moderna Vaccine
Pfizer Vaccine
Animals & COVID-19
COVID-19 Misconceptions
What Are Mutations?
SWGs & Courses Finalized the advanced level of SCOPH course Opened the call for Newsletter SWG
3000 MEMBERS On SCOPH Facebook group
104 TRAINERS Created SCOPH Trainers/Facilitators database and a Telegram channel with 16 old, 88 new, 44 graduated trainers
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
75 APPLICANTS FOR INTERNATIONAL OPPORTUNITIES Forwarded 12 international opportunities on the SCOPH server
World Days Celebration
World
World
Kidney Day
Hygiene Day
March 11
May 5
NPO DA CB Ms. Mai Elhenidy Attended March Meeting 21 Trainer in AMR TOT and Climate Change Workshop Conducted SCOPH 101 session during the 2nd man competency module Coordination of LPOs competency module through April and May Coordination of 2nd man competency module in May Finalizing the SCOPH Manual draft updates with the coordinator Follow up with LPOs manual coordinator to finalize the design edits
2O HOURS of Capacity Building sessions (SCOPH sessions, soft skills, and project management)
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
AMR National Coordinator Mr. Abdelrahman Al-Gaafary TOT Building the capacity of 27 IFMSA-Egypt members providing them with the knowledge needed about AMR, one health approach, infection control bringing the spot on the correlation with Sustainability development goals and global health. Moreover, providing them with the soft skills needed to graduate AMR qualified advocates.
Held over 4 days (8th-11th of April) AGENDA
Online Campaign Video Competition
SMSA - Sohag 16th of April Outreach = 3,834
BMSA - Beni Suef 17th of April Outreach = 3,126
Winners
AUSSS - Ain Shams 18th of April Outreach = 2,025
Click to watch
ZMSA - Zagazig 19th of April Outreach = 2,243
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
NCDs National Coordinator Mr. Omar Hesham Online Campaigns Click to see
World Hypertension Day 17th of May
Cancer Awareness Campaign 20, 21 & 22nd of May
World No tobacco Day 31st of May
Regional Representation Representing IFMSA-Egypt with active participation during SCOPH sessions in the EMR general assembly.
at
Mental Health National Coordinator Ms. Sarah Dawood Meetings Local Coordinators OLM for follow up & discussing the new opportunity/targets. Second Phase OLM meeting for Local Coordinators.
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
TOT A new partnership was adopted with WHO regarding our conjoint goal to promote mental health status between students & health care workers in Egypt, especially after the pandemic. MHPSS Training for 2 days for 36 members from IFMSA-Egypt & ENNSA that took place in Intercontinental Cairo Semiramis. Follow up with our graduates regarding their graduation sessions & needs.
Updates Finalize MHPSS Training Package to be published (see achievements). IEC Materials preparations & edits. Obtaining a study survey about the effect of COVID-19 on mental health of medical students in Egypt and using it to advocate to decision-makers [with the help of RSDD]. Preparing for our national online campaign.
The Effect of COVID-19 on
Mental Health of Egyptian Medical Students
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
Climate Change National Initiative Coordinator Ms. Rania Harhira National Certified Workshop The workshop which graduated the firstever batch in IFMSA-Egypt specialized in climate change “The Planeteers”. They are 29 passionate activists gathered for 6 days
AGENDA
of active learning, group interaction, and discussions. Click to see photos from the workshop!
World Days Celebration Global Recycling Day
International Day of Forests
March 18
March 21
International Participation Participated in MM21 SCOPH Fair & our project was one of the top 5 activities in the fair, February 27.
top 5
SWGs An SWG for recommendations for climate-friendly meetings and physical events has been formed. The final edition of the recommendations will be published soon.
External Collaborations
with Greenish
2 batches of medical students graduated from 2 camps we have conducted through the 1st and 2nd terms. These graduates or as we say “co-founders” are aware of all aspects of climate change and how we can solve this global problem.
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
BGH National Initiative Coordinator Ms. Salma Moatamad
12 SESSIONS
352
conducted nationally & locally with a total reach of
Discussing various topics in the Bridging Gaps In Health initiative, such as: Basics of Public Health
ATTENDEES
Health literacy Health literacy definition, importance, levels, red flags, and consequences of low quality health literacy. Strategies to improve and develop health literacy quality.
Health system and UHC
Difference between public health and
Universal Health Coverage and Health
community medicine.
system Definition.
Community medicine domains and their
Health system Framework { Blocks -
definitions.
Levels - models - goals - function }
Public Health Definition
UHC from SDGs point of view.
Who is responsible for public health,
Myths around UHC.
public health stakeholders and partners
UHC principles.
Introduction to global health.
Strategies to achieve UHC and How to
How to define the health state of a
measure progress { UHC Cube}
community
Primary Health Care and Universal Health Insurance Levels of Healthcare. PHC definition and Health For All concept.
Social Determinants of Health
PHC elements and Principles.
SDOH definition, elements and categories.
Challenges to implement PHC.
Public Health and Global Health.
New Health system in Egypt.
Health Indicators and determinants.
Role of PHC and Family medicine
SDoH effect on health.
Physicians.
World Day Celebrations
Sessions
World Health Day March 7
BGH Intersectionality session for LPOs competency module.
SCOPH Newsletter
ACHIEVEMENTS Won as one of the 5 finalists of the most impactful and innovative activities in the March Meeting SCOPH Activities Fair 2021.
top 5
Click to like/ comment on the activity and see other finalists!
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
IFMSA-Egypt collaboration with WHO EMRO & ENSSA in the Mental Health & Psycho-Social Support (MHPSS) Project
Conduct a rapid assessment on the role of the covid-19 pandemic on the mental health of medical and paramedical students Develop a training package based on the results of the assessment to enhance mental health coping techniques and psychological first aid Conduct TOT for medical and paramedical students on MHPSS training package Develop/adapt IEC materials to be disseminated in a number of medical and paramedical schools Conduct physical awareness campaigns in a number of medical and paramedical schools on MHPSS Conduct a baseline assessment of existing MH support units in 2 universities to identify opportunities and gaps of its services
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
Click to see the MHPSS Training Package!
Our proposal was successfully chosen by WHO EMRO from between multiple projects from the EMR region to receive a generous fund to support our efforts in the MHPSS project. Over the next 2 months we created surveys, held workshops, campaigns, advocacy efforts and more, and we showcased our members' efforts to the WHO and stakeholders across the region!
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
SWGS We reached a number of 49 members representing 20 LCs having national exposure throughout 8 different SWGs.
SWG
SCOPHu
b
Gr ou p
SCOPHHub Mega Working Group
rk in g Me ga Wo
Members General Team
Yara Elsawy Mohamed Karem Yara Hamdy Menna Ragab Esraa Amr
NCDs Team
Salma Kandel Abdalla Magdy Mahmoud Fahim Mahmoud Abd Elslam Nada Hamada
AMR Team
Doha Agwa Mahmoud Ahmed Mohab El-Nabawy Rovan Emad Rania Sokkar
MH Team
Saif Ali Aya ElRawi Fatma Ahmed Rana Mohamed Ibrahim Farag
Climate Team
Rania Harhera Omar Elmowafi Moaaz Rafat Mohammed Osama Ahmed Hafez
MH Team
Saif Ali Aya ElRawi Fatma Ahmed Rana Mohamed Ibrahim Farag
BGH Team
Salma Moatamed Ahmed Sedky Kamal ElFadwa Elbaz Qalamawy
SCOPH Newsletter SWG Climate Friendly Meetings Recommendations
Ahmed Alameen Marwan Alaa
Nermeen Yousef Menna Ayman Dana Tarek
Rafik Fouad Sameera Yasser
Rania Harhera Menna Jamal Moaz Raafat Tasneem Abdelrahman
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
Creation of SCOPH Trainers Database
NEW OLD
16
88
GRADUATED
104
Trainers SCOPH
44
Created SCOPH Trainers/Facilitators database Created a Telegram channel
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
HEALTH SYSTEMS THEME
SCOPH Newsletter
ARTICLES
01
Lessons from the past paving the way to the future
02
Global health and Social Health Determinants: Are we different?
03
Primary Healthcare & Family Physicians
04
Health Workforce
05
One Health Approach: Integrating to Eradicate!
06
Digital Health: Integrating Technology and Healthcare!
07
Preeclampsia
08
Asthma
IFMSA EGYPT | SCOPH NEWSLETTER FEB-MAY 2021
ARTICLES
HEALTH SYSTEMS THEME
ARTICLES
LESSONS FROM THE PAST PAVING THE WAY TO THE FUTURE SDGs & Health for All (UHC)
Sustainable Development Goals (SDGs) is a convoluted long term for some, with an interesting history for others. It all dates back to September 2000 when the historic Millennium Declaration was signed by the leaders of 189 countries gathered at the United Nations headquarters to achieve a set of eight measurable goals which are: (1) Eradicate extreme poverty and hunger; (2) Achieve universal primary education; (3) Promote gender equality and empower women; (4) Reduce child mortality; (5) Improve maternal health; (6) Combat HIV/AIDS, malaria, and other diseases; (7) Ensure environmental sustainability; and (8) Develop a Global Partnership for Development by 2015. These goals were made to be accomplished by the year 2015. Indeed, applying the Millennium Development Goals (MDGs) resulted in impressive progress, but there was another side to the coin. Not all goals were met due to various
limitations,
causing
uneven
achievements.
Firstly, MDGs were developed exclusively by certain actors
with
little
contribution
from
developing
countries. Secondly, while the goals were not challenging enough for the developed countries, they were too difficult to achieve for the developing ones. Thirdly, they missed important issues: reducing inequality between nations, providing political and human rights, ending gender inequality secondary
instead and
environmental
of
decreasing
post-secondary issues,
and
it,
neglecting
education,
improving
fighting
health
reducing poverty from all important aspects.
and
HEALTH SYSTEMS THEME
ARTICLES
Thus, the clock ticked, and time for
advancing
health
change arrived. The Rio +20 conference
workforce
status,
promoted the development of a new set
and increasing the
of goals that will continue the progress
capacity
made by MDGs, marking the birth of
countries
SDGs in history. SDGs are a people-
fighting
centered development agenda composed
health risks.
of 17 goals with 169 targets that should ultimately spread prosperity across all countries. Those goals, should be met by 2030, are: no poverty, zero hunger, good
health
and
well-being,
quality
education, gender equality, clean water and sanitation, affordability and clean energy,
decent
work
growth,
industry
infrastructure, sustainable
and
cities
economic
innovation
reduced
responsible
and
underwater,
climate life
and
on
communities, and
action, land,
strong
and
inequalities,
consumption
production, justice
and
life
peace
and
institutions,
and
partnership for the goals.
good health and well-being. Diving into targets
of
this
goal,
we
find
it
tackling a wide scope of issues. Those targets aim for lowering the rates of maternal mortality, neonatal mortality, premature mortality, and deaths as well as
injuries
accidents
caused
into
by
half.
road
Also,
traffic
they
are
concerned with ending epidemics such as AIDS, tuberculosis, neglected tropical diseases,
water-borne
Furthermore and
they
treatment
increasing
of
diseases,
include to
etc.
prevention
substance
access
reproductive
abuse,
sexual
health-care
and
services,
achieving universal health coverage, and combatting illnesses from pollution and contamination
hazards.
Other
targets
include implementing WHO convention for tobacco control, supporting research and
production
medication,
of
all for
global
Of vital importance to us is the eighth target, universal health coverage (UHC) which means providing essential health service to individuals and communities without Those
imposing health
promotion
financial
services
to
hardship.
include
prevention,
health
treatment,
rehabilitation, and palliative care across the life course. UHC seeks to strengthen the health system and ensure that the system’s
performance
accepted
levels
efficiency,
of
achieves quality,
accountability,
the
equity,
resilience,
and sustainability. Moreover, progress towards UHC will be essential to other SDGs: ending poverty in all its forms
Our main focus will be the third goal, the
of
vaccines
and
everywhere, education
inclusive and
equitable
lifelong
opportunities, providing
and
learning
gender
access
to
equality,
justice
,
and
are
the
building accountable institutions. In
summary,
SDGs,
descendants
of
which
MDGs,
are
the
continuation of the progress on the path of a bright future. The SDGs cover a large number of development aspects to achieve
sustainable
advancement
for
both countries and individuals. Meeting the
targets
of
the
third
SDG,
good
health and well-being, is vital because a health community is a well functioning productive
community,
and
presents
a
golden
promote
a
comprehensive
approach to health.
UHC
opportunity
to
coherent
HEALTH SYSTEMS THEME
ARTICLES
Global health and Social Health Determinants
ARE WE DIFFERENT? Perhaps you are wondering why some
For example: Lack of education will be
areas
an obstacle in employment which will
have
high
rates
of
certain
diseases and others do not? What is
lead
the reason for this difference? Maybe
reduces access to health services and
to
low
income
which
in
turn
it’s that not all areas are the same, we
nutrition.
don’t live in the same environment or community and therefore do not have
N o w th a t w e k n o w S D H i s a m a j o r
the same health issues. "Social Health
factor in determining health outcomes
Determinants" are factors that affect
we have to ask: What can we do to
the
reduce its negative impact on us?
health
status
of
a
community
which differs from one community to
Organizations
another.
working hard to improve health and reduce
across
health
the
globe
are
disparities
addressing
The
physical, and economic environments
World
Health
Organization
SDH
create
that
factors that affect our health.
potential for health and well-being for
include
income
and
social
attaining
social,
(WHO) defines it as the non-medical They
promote
to
by
What are Social Health Determinants?
the
full
all.
protection, education, unemployment
Following the World Conference on
and
Social Determinants of Health, 19-21
work
life
conditions,
housing,
access to affordable health services of
October
decent quality.
Brazil, ILO, UNAIDS, UNDP, UNFPA,
2011,
de
UNICEF
work together on social determinants
power,
and
resources among a society.
have
Janeiro,
distribution
money,
WHO
Rio
These circumstances are shaped by the of
and
in
agreed
to
of health to reduce health inequities and
promote
development,
they
Just to help us imagine the impact of
agreed to work on the four themes,
SDH on us, various studies stated that
which
SDH account for between 30-55% of
Capacity
health
and, Country work.
outcomes
underlying societal
cause
health
heart
&
is
of
a
today’s
concerns
disease,
significant as
diabetes,
loops
among
determinants of health.
and the
strengthening;
Advocacy; Monitoring;
major And also in the US every decade, the
and
“Healthy People” initiative develops a new
interactions
exist
interlinked:
obesity,
depression. Complex
are
set
of
science-based
10-year
feedback
national objectives with the goal of
social
improving the health of all Americans.
HEALTH SYSTEMS THEME
ARTICLES
PRIMARY HEALTHCARE & FAMILY PHYSICIANS In line with the 2030 Agenda, the Egyptian
Primary
care
Government has launched a working plan
doctors,
nurse
called Egypt’s Vision 2030 to implement
assistants.
sustainable
specialties
development
goals
(SDGs),
providers
(PCP)
practitioners,
There as
are
some
well.
or
may
be
physician
primary
care
Geriatricians,
and
setting universal health coverage (UHC) as
pediatricians are all primary care doctors;
a priority goal. But what is UHC? UHC
they just specialize in caring for a particular
simply
group of people.
means
communities they
that
all
receive
need
the
without
hardship,
individuals health
suffering
including:
health
and
services financial
promotion,
An essential part of primary health care is family
medicine.
speciality
in
Family
which
the
Medicine
physician
is
a
provide
curative, and preventive services. In short,
comprehensive care for the individual and
UHC equals prosperity of people’s health.
family
One of the most important approaches that
affected
can help us reach our goal is the “Primary
integrating
healthcare
as
a
unit
organ,
regardless
and
type
biological,
of
of
age,
sex,
disease
by
clinical,
and
on
behavioral sciences. It should be noted that
health
the difference between family medicine and
systems so that people can access services
general practice is that a family physician
for their health and well-being based on
receives extensive training in comprehensive
their needs and preferences, as quickly as
and continuous outpatient medicine.
possible,
everyday
The broad education and wide spectrum of
environments. Simply, Primary healthcare
medical knowledge family physicians have
(PHC)
on
allow them to provide a wide range of health
scientifically sound and socially acceptable
services in the primary health care setting.
methods
Beside diagnosing and treating illnesses, they
approach”
organizing
is
and
and
that
focuses
strengthening
existing
essential making
in
their
healthcare universal
based
healthcare
accessible to all individuals and families in
give
a community.
check-ups,
Most people are very familiar with primary
Also,
care. It is their first contact with the health
manage chronic diseases, such as diabetes,
sector.
cancer,
For
instance,
you
may
see
your
preventive
care
through
screening,
and
cooperate
with
they
stroke,
asthma,
etc.
assessment,
immunization. specialists
to
Furthermore,
primary care doctor when you notice a new
they adapt to meet the needs of their specific
symptom
community through understanding the social
or
are
concerned
that
you
contracted a cold, the flu, or some other
determinants
bacterial or viral disease or even muscle
Family
physicians
sore or skin rash. Also, primary care is
contact
and
typically responsible for coordinating your
case of the need for referral.
care among specialists and other levels of
A family physician's duties are influenced by
care for example, when you need referral
t h e n a t u r e o f h i s / h e r s o c i e t y. T h o s e w o r k i n g
to a more specialized institution.
with other specialists need to provide only
Studies helped us estimate the importance
comprehensive care while those working as
of Primary health care, it has shown that
the only speciality locally available, like in
primary
rural areas, have also to perform surgeries
care
providers
benefit
the
healthcare system as a whole by delivering about 80% of essential health services.
of
health act
coordinate
of
their
as
people’s
with
society. first
specialists
and take care of patients in critical status.
in
HEALTH SYSTEMS THEME
ARTICLES
HEALTH WORKFORCE We all need good health and well-being, and one the most important pillars of this goal is a competent healthcare system, so let’s talk briefly about the personnel responsible for providing the healthcare. Who are exactly the health workers? They are all people engaged in actions whose primary intent is to enhance health,
as
doctors
and
nurses,
helpers,
laboratory
technicians, or even medical waste handlers. Some are clinical jobs, such as physicians who diagnose and treat,
nurse
practitioners
(NPs)
who
are
authorized
to
diagnose illnesses, treat conditions, and provide evidencebased health education to their patients. NPs assess their patients physical
by
examining
evaluations;
medical and
histories;
ordering
(or
performing performing)
diagnostic tests. In many countries, nurses make up half of all health care professionals and have a vital role in how health actions are organized and applied, both at the frontline and managerial levels. They are often the first and sometimes only health professional a patient will see and the quality of their initial assessment and subsequent care is vital to strong health outcomes. Also, one of the important people in the healthcare process is physician assistants (PAs) who work interdependently with physicians, PAs provide diagnostic and therapeutic patient care in virtually all medical specialties and settings. They take patient histories, perform physical examinations, order
laboratory
and
diagnostic
studies,
prescribe
medications, and develop patient treatment plans. Their job descriptions are as diverse as those of their supervising physicians, and include clinical practice, patient education, team leadership, medical education, health administration, and research. Dentists diagnose oral diseases and create treatment plans to maintain or restore the oral health. Pharmacists, who are involved in all aspects of medicine delivery to patients, prepare
and
package
medication
that
a
doctor
prescribed and also sell medication over the counter.
has
HEALTH SYSTEMS THEME
ARTICLES
Other healthcare workers include physical
ional
therapists,
pressure,
occupational
therapists,
stressors, a
which
high
include
workload
low,
time social
physical and behavior therapists, as well
support at work, uncertainty about patient
as
treatment,
applied
health
professionals
phlebotomists,
medical
scientists,
dieticians,
therapists,
speech-language
such
as
laboratory respiratory
and
pstrong
emotional
responses due to encountering suffering and dying patients.
pathologists,
and social workers.
Thus, health care workers are at a high risk
of
experiencing
severe
distress,
Yet those heroes face several economic,
burnout, and both mental and physical
occupational, and social issues on a global
illness.
scale
reported
including
low
wages,
workforce
In
Egypt,
higher
different
prevalence
studies
of
burnout
shortage, work overload, limited resources
among HCWs, which ranged from 66.0% t
or low expenditure on the health system,
in Tanta, a moderate level, to 63.1% in
and violence, all of which is present in
Suez canal. Consequently, work pressure
Egypt too.
affects the quality of care provided by healthcare institutions.
As
for
wages,
reports
pointed
out
an
enormous gap in wages for health workers
Next
between rich and poor countries. Thus,
generation of resources is an important
many health workers migrate to countries
challenge
with better wages, causing challenges for
efficient utilization of available resources.
the
The
reforms
healthcare
and
improvements
systems
of
poor
in
countries.
is
limited to
overcome,
healthcare
advancements
too
system
since
is
as the
has
made
President
Abdel
Fattah
since 2016 as many as 10,000 Egyptians
health insurance (UHI) law in 2018. Yet,
work
overall spendings on health care remains
due
to
low
wages.
Low
In
Sisi
so
Just
According to Egyptian Medical Syndicate, abroad
El
resources.
fact,
introduced
a
government
universal
income also drives many to have a second
low.
job in the private sector.
decreased from 5.4% of the total budget in
expenditure
WHO estimates a projected shortfall of 18
FY 2014/15 to 4.7% in FY 2019/20.
million health workers by 2030, mostly in low- and lower-middle income countries.
Lastly is a widespread phenomenon in the
There
this
healthcare sector: violence. Personnel at
shortage which are present in all countries
Emergency Departments (EDs) are known
to
to
are
various
various
causes
degrees,
behind
such
as
under-
be
at
higher
risk
of
exposure
to
investment in education and training, the
violence from patients and their relatives
mismatch
or
between
education
and
friends
compared
with
other
population needs, difficulties in deploying
departments. Violence caused healthcare
health workers to rural, and under-served
professionals
areas,
and
helplessness,
health
workers
international
experience
absence of rights and justice, all of which
according to World Bank figures, in 2018
may lead to increased errors, decreased
Egypt had an estimated 0.45 physicians
quality
per 1000 people. According to WHO there
productivity and performance.
for
of
dissatisfaction,
anger,
depression,
stress,
As
job
to
humiliation,
health
shortages
exacerbates
of
Egypt,
workforce
that
migration
care,
and
feeling
an
decreased
were 74,923 doctors in 2019 and the total number
was
While the government is working hard to
approximately 207,000. The ministry of
of
nurses
in
Egypt
tackle the various issues of the healthcare
health estimates that Egypt suffers from a
system, you too can contribute to this
shortage of 44.000 nurses at all levels.
effort!
Increase
awareness
about
the
importance of our heroes and advocate for Several
studies
have
shown
that
health
care professionals suffer several occupat-
more respect and less violence directed toward them.
HEALTH SYSTEMS THEME
ARTICLES
One Health Approach
INTEGRATING TO ERADICATE! and
Even chronic diseases, mental health, injury,
microorganisms are all intertwined in a one
occupational health, and noncommunicable
big network called mother nature; our lives
diseases
and fates are interconnected. Humans have
programs.
reached this realization, and are now acting
One
upon it.
communication
Humans,
Indeed,
animals,
a
simple
plants,
reflection
of
how
the
are
included
Health
collaborations
in
the
approach between between
One
Health
needs
strong
various
sectors;
professionals
in
environment functions grants us the proof.
human, animal, environmental health, and
For example, the majority of the emergent
other relevant disciplines; controlling public
zoonotic infectious diseases originating in
health
animals, especially wildlife, are associated
diseases
with
cause
enforcement and policymakers. In summary,
Some
One Health is not achieved by stand-alone
human
disturbances
activities in
the
that
ecosystem.
diseases, such as rabies, can effectively be prevented
only
by
targeting
the
threats
and
spread;
learning and
about
effective
how law
actions but rather by collective work.
animal
source. Vaccines are developed based on Information
on
the
selection
of
viruses.
One Health Approach aims to Strengthening monitoring, surveillance, and reporting systems to detect and prevent animal and zoonotic disease emergence and control disease spread Understanding risk factors for disease spread from wildlife to domestic animals and humans to prevent and manage disease outbreaks Reinforcing veterinary and plant health infrastructure Promoting for safe food and animal production practices Controlling environmental threats and disturbances that give rise to health emergencies and disease outbreak Expanding the capacities of the food and agriculture sectors to combat and minimize the risks of AMR Developing capacities at all levels for better coordination and knowledge exchange among institutions and stakeholders Forming effective policies and providing education on One Health and its goals
Drug-resistant microbes can be transmitted from
animals
contact
or
to
humans
indirect
through
contact
direct
such
as
contaminated food. Thus,
it
is
crucial
to
develop
an
interdisciplinary approach of health that recognizes the interconnectivity of all life systems
on
planet
earth:
One
Health
approach. Its main goal is planning and implementing
programmes,
policies,
legislation, and research in which different sectors work together to achieve optimal health
outcomes.
The
World
Health
Organization (WHO) collaborates with the Food and
and the
Agriculture
World
Organization(FAO)
Organisation
for
Animal
Health (OIE) to create and support multisectoral operate
One at
the
Health
programmes
that
human-animal-ecosystem
interface. One food
Health
approach
safety,
antimicrobial
is
concerned
zoonotic resistance,
with
diseases, vector-borne
In short, to save our beautiful mother nature, it
is
of
vital
importance
to
adopt
an
diseases, contamination, and other health
interdisciplinary approach that tackles health
threats shared by people, animals, and the
from all its aspects.
environment.
HEALTH SYSTEMS THEME
ARTICLES
Digital Health
INTEGRATING TECHNOLOGY AND HEALTHCARE! Nowadays,
technology
is
What is Digital Health?
taking a role in almost every
While digital health is a simple concept — using technology to
field in our daily lives. This
help improve individuals' health and wellness — it's a broad
can also be seen clearly in
and growing sector. It can cover everything from wearable
the
and
gadgets to ingestible sensors, from mobile health apps to
and
artificial
scope
of
healthcare. scale
up
health
The
of
use
digital
health
intelligence,
from
robotic
solutions can revolutionize
digital
how
change, to the healthcare sector.
people
worldwide
carers
to
electronic
records. In a nutn, early diagnosshell, it is about applying transformation,
through
technologies
and
cultural
achieve higher standards of
What Are the Benefits of Digital Health Technologies?
health, and access services
Digital tools are giving healthcare providers a more broad and
to promote and protect their
interconnected view of patient health through easier access to
health and well-being.
data and giving patients more control over their health. Digital health offers real opportunities to improve medical outcomes and enhance efficiency. These technologies can empower consumers to make better-
Where can Digital health be found? Digital health implementations can be spotted almost everywhere including our homes. Some the current examples are: Telemedicine: it is about digitization of medical records, remote care, appointment booking, self-symptom checkers, patient outcome reporting. Wearable technology: it promotes self-monitoring and typically associated with fitness and sleep tracking. Augmented and virtual reality: which are used to build smart devices for healthcare professionals.
informed decisions about their own health and provide new options for facilitating preventiois of life-threatening diseases, and management of chronic conditions outside of traditional health care settings. Providers and other stakeholders are using digital
health
technologies
in
their
efforts
to
reduce
inefficiencies, improve access, reduce costs, increase quality, and make medicine more personalized for patients. Patients and consumers can use digital health technologies to better manage and track their health and wellness-related activities. The use of technologies, such as smartphones, social networks, and internet applications, is not only changing the way we communicate, but also providing innovative ways for us to monitor our health and well-being and giving us greater access to information. Together, these advancements are leading to an
integration
of
people,
information,
technology,
and
connectivity to improve health care and health outcomes. Long Term Aims with Digital Health Implementation By implementing digital health, organisations are aiming to improve health for everyone, everywhere by accelerating the development affordable,
and
scalable
adoption and
of
appropriate,
sustainable
person
accessible,
centric
digital
health solutions to prevent, detect and respond to epidemics and pandemics, developing infrastructure and applications that enable countries to use health data to promote health and wellbeing, and to achieve the health-related SDGs.
HEALTH SYSTEMS THEME
ARTICLES
May
PREECLAMPSIA Preeclampsia death
is
and
one
severe
of
the
leading
maternal
causes
morbidity.
of It's
prevalence is still underestimated in some places due to underreporting.
Preeclampsia Awareness Month
T h er e a r e a l s o s o m e o t h e r r i s k f a c t o r s t h a t w e c a r e to display which are 1. A p e r s o n a l o r f a m i l y h i s t o r y o f p r e e c l a m p s i a significantly raises risk of preeclampsia. 2. C h r o n i c h y p e r t e n s i o n . 3. T h e r i s k o f d e v e l o p i n g p r e e c l a m p s i a i s h i g h e s t
So what about the Symptoms & diagnosis? T o d i a g n o s e pr e e c l a m p s i a , p a t i e n t h a s t o h a v e
d u r i n g t h e f i r s t p r e g n a n c y. 4. N e w
paternity.
Each
pregnancy
with
a
new
high blood pressure and one or more of the
partner increases the risk of preeclampsia more
following complications after the 20th week of
than does a second or third pregnancy with the same partner.
pregnancy: Preeclampsia comes with high blood pressure and complications
following
the
20th
week
of
pregnancy in women whose blood pressure had been normal. Such as
women
as
well
as
pregnant
6. R a c e .
Black
women
have
a
higher
risk
of
7. O b e s i t y . T h e r i s k o f p r e e c l a m p s i a i s h i g h e r i f
Low platelet count
you're obese.
Impaired liver function Pulmonary edema; fluid in the lungs resulting in shortness of breath disturbances
pregnant
women older than 35.
races.
Decreased urine output
of
young
developing preeclampsia than women of other
Proteinuria; Protein in urine.
New-onset
5. A g e . T h e r i s k o f p r e e c l a m p s i a i s h i g h e r f o r v e r y
severe
headaches
including
or
temporary
visual
loss
of
vision, blurred vision or light sensitivity.
8. M u l t i p l e
pregnancies.
common
in
women
Preeclampsia
who
are
is
more
carrying
twins,
Having
babies
triplets or other multiples. 9. I n t e r v a l
between
pregnancies.
less than two years or more than 10 years apart leads to a higher risk of preeclampsia. 1 0. H i s t o r y o f c e r t a i n c o n d i t i o n s . H a v i n g c e r t a i n conditions before you become pregnant — such
So what causes Preeclampsia? It
is
a
result
of
several
as chronic high blood pressure, migraines, type
factors.
Researchers
1 or type 2 diabetes, kidney disease, a tendency
believe it begins in the Placenta; that nourishes
to develop blood clots, or lupus — increases
the fetus during pregnancy. Early in pregnancy, new
blood
vessels
evolve
to
efficiently
your risk of preeclampsia.
send
1 1. I n v i t r o f e r t i l i z a t i o n . Y o u r r i s k o f p r e e c l a m p s i a
blood containing oxygen and nutrients to the
is increased if your baby was conceived with in
placenta.
vitro fertilization.
In women with preeclampsia, these blood vessels are narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them. Causes
of
this
abnormal
development
may
include:
Tendency of preeclampsia occurrence is around the
first
trimester,
third
A problem with the immune system
been
trimester.
This
proportion
of
pregnant
women may develop preeclampsia after 32 weeks
Certain genes
of gestation . However, there is an undeniable concentration
magnitude
of
the
social
and
economic impact of preeclampsia, and evident clinical
have
need to be reassessed in a late-second or early-
Damage to the blood vessels
the
models
fact that a huge proportion of pregnant women
Insufficient blood flow to the uterus
Considering
some
proposed in later gestational ages, based on the
consequences,
there
is
a
need
anticipate this condition before occurring.
to
Over
the
markers
of
years, were
effort
in
the
biophysical identified
as
first
and
trimester.
biochemical
possible
early
indicators of failures in the complex placentation process, which would lead to preeclampsia.
HEALTH SYSTEMS THEME
ARTICLES
Pathogenesis
Treatment
T h e p a t h o g e n e s i s o f pr e e c l a m p s i a i s c o m p l e x a n d
The most effective treatment for preeclampsia is
not fully understood, however, it is known to
delivery.
involve
You're
at
increased
risk
of
seizures,
systemic
placental abruption, stroke and possibly severe
inflammation, and oxidative stress as has been
bleeding until your blood pressure decreases. Of
described
course,
dysfunctional
placentation,
elsewhere.
Abnormal
placentation
occurs due to failure of appropriate remodelling of
the
spiral
resistance
arteries,
to
resulting
placental
in
blood
if
it's
too
early
in
your
pregnancy,
delivery may not be the best thing for the baby.
higher
flow
and
If a patient is diagnosed with preeclampsia, the doctor
will
chronic placental ischemia and reduced blood
visits,
more
flow to the developing fetus. These maladaptive
recommended for pregnancy. Along with more
processes
and
frequent blood tests, ultrasounds and nonstress
adverse outcomes including IUGR, preterm birth,
tests than would be expected in an uncomplicated
oligohydramnios,
pregnancy.
hypoperfusion
can
of
the
placenta.
precipitate
fetal
placental
This
causes
hypoxia
abruption,
fetal
increase
the
frequently
number than
of
what's
prenatal typically
distress, and fetal death in utero. The frequency of fetal complications differs depending on the
Possible treatment for preeclampsia may include
onset
Medications
of
preeclampsia.
preeclampsia
has
Early
been
onset
associated
of with
to
lower
blood
pressure,
Corticosteroids and Anticonvulsant medications.
significantly higher rates of adverse outcomes for
Bed rest used to be routinely recommended for
the fetus, including IUGR, oligohydramnios, and
women with preeclampsia. But research hasn't
fetal death.
shown a benefit from this practice, and it can increase
your
risk
of
blood
clots,
as
well
as
impact your economic and social lives. For most women, bed rest is no longer recommended.
Prevention
Severe preeclampsia may require that you be
So is there a way to prevent Preeclampsia? Researchers continue to explore ways to prevent preeclampsia,but emerged.However,
no
clear
lowering
strategies the
risk
have of
Preeclampsia could be done by 1. L o s i n g w e i g h t i f y o u a r e o v e r w e i g h t . 2. S t o p p i n g s m o k i n g d u r i n g p r e g n a n c y 3. G e t t i n g b l o o d p r e s s u r e u n d e r c o n t r o l , i n c a s e s of chronic hypertension. 4. M a i n t a i n i n g a r e g u l a r e x e r c i s e r o u t i n e . 5. T a k i n g a b a b y a s p i r i n ( 8 1 m g ) d a i l y a f t e r 1 2 weeks gestation in high-risk pregnancies. It is important to note that any supplements or medication should be prescribed by a doctor. The best way to keep both mother and baby healthy throughout pregnancy is via scheduled prenatal visits for continuous checks on blood pressure and any other signs and symptoms of preeclampsia.
hospitalized. In the hospital, your doctor may perform regular nonstress tests or biophysical profiles to monitor your baby's well-being and measure the volume of amniotic fluid. A lack of amniotic fluid is a sign of poor blood supply to the baby. If you're diagnosed with preeclampsia near the end
of
your
recommend
pregnancy,
inducing
your
labor
right
doctor
may
away.
The
readiness of your cervix, whether it's beginning to open, thin and soften also may be a factor in determining induced.
whether
or
when
labor
will
be
HEALTH SYSTEMS THEME
ARTICLES
Asthma is a common pathology, Leading to multiple
ASTHMA
hospital admissions and increased healthcare costs. Thus
we
deaths
can
conclude
occur
countries,
in
low-
where
that and
most
asthma-related
lower-middle
under-diagnosis
and
income under-
treatment is a challenge. Asthma affects around 15% to 20% of people in developed countries and around 2% to 4% in less Asthma is a major NCD, affecting both children and
developed
adults. It is a common disease that varies in severity,
common in children.
from a very mild, occasional wheeze to acute, life-
Of all the asthma cases, about 66% are diagnosed
threatening airway closure. It usually presents in
before the age of 18 years. Almost 50% of children
childhood and is associated with other features of
with
atopy (refers to the genetic tendency to develop
disappearance of symptoms during early adulthood.
allergic diseases) such as eczema and hayfever.
Of all the asthma cases, about 66% are diagnosed
countries.
asthma
have
It
a
is
significantly
decrease
in
more
severity
or
before the age of 18 years. Almost 50% of children The
key
which
feature
can
be
is
airway
triggered
by
hyper-responsiveness,
with
many
disappearance of symptoms during early adulthood.
factors
(called
asthma
have
a
decrease
in
severity
or
triggers). If not treated promptly, asthma has a high mortality. According to the WHO asthma affected an estimated 262 million people in 2019 and caused
Management
461000 deaths.
So how does a patient manage Asthma? There Asthma comprises a range of diseases and has a variety
of
heterogeneous
phenotypes.
The
recognized factors that are associated with asthma are a genetic predisposition, specifically a personal or family history of atopy. It's also associated with exposure to triggers such as
that
are
Inhaled corticosteroids are considered the most effective
long
managing
term
asthma.
As
usage they
medication decrease
for
airway
inflammation and prevent asthma flare-ups. Eg: Fluticasone beta-agonist
(LABA).
that
are
LABAs
are
helpful
in
only in combination with a corticosteroid to
Grass and tree pollen
treat asthma. (Inhaled form)
Animal fur & feathers
Anticholinergics:
Strong soaps & perfume is
lines
opening airways. N.B: LABAs should be taken
Changes in the weather
cause
treatment
symptom-controllers
Dust, smoke & fumes
overall
some
long-acting
Viral infections (colds)
The
are
recommended by doctors such as
complex
and
not
fully
understood, but it is agreed that asthma is influenced by both genetics and environmental exposure.
they
are
also
known
as
antimuscarinic agents, they target the junction between nerves and muscle cells in the airway to maintain bronchodilation and reduce mucus production. They are taken by using an inhaler. Eg: tiotropium Leukotriene modifiers; leukotriene antagonists. Oppose the effects of leukotrienes. N.B: Where
Asthma could be classified into types according to its onset and triggers: Exercise-induced
asthma
(EIA)
or
exercise-
induced bronchoconstriction (EIB), where people develop
asthma
exercise,especially
symptoms high
intensity
during (strenuous)
exercise. Allergic Asthma. People with a family history of allergies or asthma are more prone to developing asthma. Nonallergic
Asthma.
Commonly
triggered
by
illnesses, environmental factors and medications. Occupational asthma is caused by inhaling fumes, gases,
dust
or
other
potentially
harmful
substances while on the job. Childhood asthma
asthma;
before
the
where age
of
children five.
This
millions of children and their families.
develop impacts
leukotrienes
are
inflammatory
chemicals
released when the body's immune system senses an allergen causing the tightening of airways as well as excess mucus and fluid production. Another way to manage asthma is via Exercise. Exercise is important for overall health as well as lung
health,
and
there
are
many
benefits
of
physical activity for people living with asthma. Daily exercise helps to improve lung capacity; the maximum amount of oxygen your body can use. Exercise also increases blood flow to our lungs, promoting blood flow to the heart which pumps oxygen throughout your body. Ie;people who exercise have more ability to pull oxygen from the lungs and into the blood that feeds the muscles that keep us going.
"Our health care system has failed when a doctor fails to treat an illness that is treatable.”
FEB-MAY 2021 SCOPH NEWSLETTER IFMSA EGYPT