Evaluation of the phc system in Iraq

Abstract EN

Objective: Description of the availability and operation of infrastructure, workforce, equipment, and supplies at the primary health care level of the health system in Iraq, and suggesting a renovative plan for Iraqi health system reform.

Methods: A cross-sectional national survey conducted during the period from February 2004 to September 2005 that evaluates 30 primary health centers from 8 governorates.

Thirty primary health care centers were selected from 8 provinces by an adjusted sampling Eleven objective convenience criteria were selected for evaluating buildings structure and infrastructure; signs and label guides, state, look, and healthiness of the health care building, presence of a garden, waiting place convenience, adequate furniture, presence of AC generator, air-conditioners, examining rooms’ suitability, and overall convenience of the building.

Results: Health centers’ buildings are unsuitable; a prediction model of six variables is built for buildings’ suitability, using logistic regression.

The average catchments population is high (60977).

There is one doctor for each 10.429 citizens.

Professional workforce means are: 7.6 doctors, 6.6 dentists, and 0.8 pharmacists in each primary health care center.

Health centers’ paramedics are deficient with poor skill-mix, especially for medical assistants, nurses, sanitarians, and dental hygienists.

Conclusions: The infrastructure of the health centers in terms of buildings and furniture is poor, so as the manpower skill-mix especially for nurses and medical assistants.

The mean catchments population is high while there is an under-doctoring and mal-distribution of medical personnel.

Health information records system is primitive.