This document discusses family medicine in the Arab world and whether it is a luxury. It argues that family medicine should be the foundation of healthcare systems as it provides comprehensive, continuous care at an affordable cost. However, there is currently a drastic shortage of family physicians in Arab countries. While some countries have begun family medicine training programs, production rates would need to drastically increase to meet population needs. Strengthening primary care through family medicine could help address health challenges in the region more efficiently.
Pan American Health Organization (PAHO) Strategic Plan 2014-2019. Learn more about PAHO's core functions, health initiatives, goals and challenges in finding solutions to health problems throughout the Americas.
Pan American Health Organization (PAHO) Strategic Plan 2014-2019. Learn more about PAHO's core functions, health initiatives, goals and challenges in finding solutions to health problems throughout the Americas.
The right to health of non-nationals and displaced persons in the sustainable...Lyla Latif
Under the Millennium Development Goals (MDGs), United Nations (UN) Member States reported
progress on the targets toward their general citizenry. This focus repeatedly excluded marginalized ethnic and
linguistic minorities, including people of refugee backgrounds and other vulnerable non-nationals that resided
within a States’ borders. The Sustainable Development Goals (SDGs) aim to be truly transformative by being made
operational in all countries, and applied to all, nationals and non-nationals alike. Global migration and its diffuse
impact has intensified due to escalating conflicts and the growing violence in war-torn Syria, as well as in many
countries in Africa and in Central America. This massive migration and the thousands of refugees crossing borders
in search for safety led to the creation of two-tiered, ad hoc, refugee health care systems that have added to the
sidelining of non-nationals in MDG-reporting frameworks.
How Africa turned AIDS around By Michel Sidibé Celebrating 50 Years of Africa...Dr Lendy Spires
Michel Sidibé Executive Director UNAIDS At the May 2013 African Union Summit celebrating the 50 years of African unity, a new commission will be launched to explore HIV and global health in the post-2015 debate. “The UNAIDS and Lancet commission: from AIDS to sustainable health” will be co-chaired by Malawi President Joyce Banda, African Union Commission Chairperson Nkosazana Dlamini Zuma and London School of Hygiene and Tropical Medicine Director Peter Piot.
The pace of progress is quickening in Africa. Nowhere have we seen this more clearly than in the AIDS response. Fewer people are dying from AIDS. The number of HIV infections is coming down, with young Africans leading the prevention revolution. There is true hope that in a matter of years, Africa will reach an AIDS-free generation. It has taken a massive shift in how we work together. It has required leaders to show immense courage, passion and action from all sectors. It has taken a united Africa. I am not saying it has been easy— but it has happened. We have a shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths.
And today there is an African Union endorsement of a new Roadmap to accelerate progress in HIV, Tuberculosis and Malaria—through shared responsibility and global solidarity. Given the extraordinary history of the AIDS response in Africa—in terms of both galvanizing political support and mobilizing resources and communities—the Roadmap sees AIDS as a pathfinder for tuberculosis, malaria and other diseases affecting the continent that require African-sourced solutions. Leadership, it turns out, was that elusive magic bullet. It is the “disruptive innovation” that has irrevocably changed the course of AIDS and now can do even more. As we look to our future goals, I am confident that African leadership can be UNAIDS | Special report with vision and action we can change the world
The right to health of non-nationals and displaced persons in the sustainable...Lyla Latif
Under the Millennium Development Goals (MDGs), United Nations (UN) Member States reported
progress on the targets toward their general citizenry. This focus repeatedly excluded marginalized ethnic and
linguistic minorities, including people of refugee backgrounds and other vulnerable non-nationals that resided
within a States’ borders. The Sustainable Development Goals (SDGs) aim to be truly transformative by being made
operational in all countries, and applied to all, nationals and non-nationals alike. Global migration and its diffuse
impact has intensified due to escalating conflicts and the growing violence in war-torn Syria, as well as in many
countries in Africa and in Central America. This massive migration and the thousands of refugees crossing borders
in search for safety led to the creation of two-tiered, ad hoc, refugee health care systems that have added to the
sidelining of non-nationals in MDG-reporting frameworks.
How Africa turned AIDS around By Michel Sidibé Celebrating 50 Years of Africa...Dr Lendy Spires
Michel Sidibé Executive Director UNAIDS At the May 2013 African Union Summit celebrating the 50 years of African unity, a new commission will be launched to explore HIV and global health in the post-2015 debate. “The UNAIDS and Lancet commission: from AIDS to sustainable health” will be co-chaired by Malawi President Joyce Banda, African Union Commission Chairperson Nkosazana Dlamini Zuma and London School of Hygiene and Tropical Medicine Director Peter Piot.
The pace of progress is quickening in Africa. Nowhere have we seen this more clearly than in the AIDS response. Fewer people are dying from AIDS. The number of HIV infections is coming down, with young Africans leading the prevention revolution. There is true hope that in a matter of years, Africa will reach an AIDS-free generation. It has taken a massive shift in how we work together. It has required leaders to show immense courage, passion and action from all sectors. It has taken a united Africa. I am not saying it has been easy— but it has happened. We have a shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths.
And today there is an African Union endorsement of a new Roadmap to accelerate progress in HIV, Tuberculosis and Malaria—through shared responsibility and global solidarity. Given the extraordinary history of the AIDS response in Africa—in terms of both galvanizing political support and mobilizing resources and communities—the Roadmap sees AIDS as a pathfinder for tuberculosis, malaria and other diseases affecting the continent that require African-sourced solutions. Leadership, it turns out, was that elusive magic bullet. It is the “disruptive innovation” that has irrevocably changed the course of AIDS and now can do even more. As we look to our future goals, I am confident that African leadership can be UNAIDS | Special report with vision and action we can change the world
Ivo Pezzuto - Making Healthcare Systems More Efficient and Sustainable in Eme...Dr. Ivo Pezzuto
This paper focuses on the potential opportunities that disruptive innovation may bring to the healthcare sector of emerging and developing economies, and in particular to the one of the leading Sub-Saharan Africa’s country, Nigeria. The author examines the possibility of using advancements in the innovation of Technology 4.0 to bridge the gap in access to what could be defined as “good enough” healthcare services for poorer regions of the world while also aiming to potentially reduce healthcare costs and making the local healthcare systems more sustainable, productive, and accessible. Nigerian health industry is used as an exploratory case study to examine the feasibility of implementing Mobile Health and Telehealth Systems, and more in general, to assess the potential benefits of disruptive innovations in the healthcare industry for the lower income patients of emerging and developing economies. This analysis on disruptive innovation, industry competitiveness, and sustainability of the healthcare models is inspired by Michael Porter’s Creating Shared Value (CSV) strategic framework (Porter et al., 2011; 2018) and by Clayton Christensen’s Disruptive Innovation Theory (Christensen et al., 1997; 2000; 2004; 2006; 2013; 2015, 2017). This study also aims to provide a compelling argument supporting the thesis that disruptive innovations in the healthcare system can help grant access to critical basic healthcare services in poor regions of the world while also achieving multiple goals such as, sustainability, efficiency, shared-value creation, and corporate profitability for forward-looking firms with scalable and disruptive business models. Ultimately, the paper aims to contribute to the body of knowledge in the field of disruptive innovation, sustainability, and creating shared-value strategies, assessing the feasibility of solutions that may drive to improved competitiveness, social progress, social inclusion, and sustainability of the healthcare industry in one of the developing economies. The results of this study aim to prove that, in the coming years, disruptive innovations are likely to redefine the competitive environment of the healthcare industry and improve the healthcare conditions of the poorer, underserved, and underreached population of developing and emerging economies like Nigeria, thus increasing their life expectancy rates.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Family medicine in the arab world2 1
1. Family Medicine in the Arab
World
Is it a Luxury ?
Professor Faisal Abdul Latif Alnasir FPC, FRCGP,
MICGP,FFPH, PhD
Chairman; Dept of Family & Community Medicine
Arabian Gulf University. Bahrain
President Scientific Council; Family & Com. Medicine
Arab Board for Health Specializations
1
2. Primary Health Care
Definition
Is
the first level of contact with the
health system to:
PCMP
-Prevent illness
-Care for common illnesses
-Manage ongoing health problems
-Promote health
2
3. Family Medicine (FM)
Is a medical specialty that provides
continuing and comprehensive health care
for the individual and the family with a total
health care responsibility from the first
contact and initial assessment to the
management of chronic problems. It
includes prevention and early recognition
of disease.
3
4. Since ancient times, doctors have been
using the holistic approach while
practicing medicine. Avicenna, Alrazi and
several other Muslim doctors were
implementing the concepts of family
medicine while caring for their patients.
4
5. Principles of Primary Health Care
Intersectoral/
Interdisciplinary
Appropriateness
Accessibility
Continuity P H C Affordable &
of Care Sustainable
Population Efficiency
Health Community
Participation
5
6. Primary Health Care extends beyond the traditional
health sector and includes all human services which play
part in addressing the inter-related determinants of health .
Social
Environments
Employment/
Income & Working
Social Status Conditions
P H C Physical
Culture Factors
Prenatal/Early Social
Childhood Support
Experiences Level of Networks
Education
6
7. Family Medicine Should Shape Reform, Not
Vice Versa
Family physicians have to be in the forefront of
health care reform. They have to marry the
reform of financial access with the reform of
services.
Barbara Starfield
7
8. Health Care Reform
(With PHC Concept)
Medical model Primary Health Care
Treatment Health promotion
Illness Health
Cure Prevention, care, cure
Episodic care Continuous care
Specific problems Comprehensive care
Individual practitioners Teams of practitioners
Health sector alone Intersectoral collaboration
Professional dominance Community participation
Passive reception Joint responsibility
8
Barbara Starfield, Johns Hopkins University
9. Arab World
No. of total population : 281 million
(410-459 million by
2020)
No. of Countries: 23
Area: More than 11 million
square kilometers
9
11. 65 million adults are
illiterate (19%) , two-thirds
women
10 million 6 - 15 year olds
are not in school (if current
trends persist, that number will
increase by 40% by 2015)
54 million lack access to
“The Arab region has
safe water
dramatically reduced 29 million lack access to
poverty and inequality in the health services
20th Century.” Maternal mortality rates are
Yet the backlog of double those in Latin
deprivation must be
cleared.
America and the Caribbean;
four times those in East Asia
UNDP
11
12. Total factor productivity has
steadily dropped by 0.2%
since 1960 - the largest
decline compared to other
regions
Growth is anemic; highly
vulnerable to changes in oil
Lower inflation and budget prices
deficits attained during the
1990’s. However: Oil wealth
For a decade, per capita
distorts the picture: income has stagnated at
“In 1999, the GDP (Gross 0.7% a year ( > 3.2%
domestic products) of all average for developing
Arab countries combined countries)
stood at just US$531.2 billion
– less than that of a single
Unemployment, at around
medium sized European 15%, is among the world’s
country, Spain (US$595.5 highest
billion).” UNDP
12
13. Arab universities and
schools beyond global
academic standards
and fail local job
markets
Only 0.6% of the
population uses the
The costs of improving internet
education systems may
be substantial, while
the costs of
perpetuating ignorance
The penetration rate of
are incalculably greater the PC is only 1.2%
AHDR 2002
Wealth depends on
natural resource, and
not knowledge based
UNDP 13
16. Country Total Population Total Number of Physician Ratio of Physician
(Latest) (Last updated October 2004, WHO) per individual
Bahrain 677,886 1,106 1:613
Djibouti 460,700 86 1:5,357
Egypt 74,718,797 143,555 1:521
Iraq 25,374,691 12,955 1:1,959
Jordan 5,153,378 10,623 1:485
Kuwait 2,041,961 3,589 1:569
Lebanon 3,826,018 11,505 1:333
Libyan Arab Jamahiriya 1,759,540 6,371 1:276
Morocco 29,891,708 14,293 1:2,091
Oman 2,622,198 3,478 1:754
Qatar 817,052 1,310 1:624
Saudi Arabia 26,417,599 31,896 1:828
Somalia 8,591,000 310 1:27,713
Sudan 35,079,814 4,973 1:7,054
Syrian Arab Republic 18,448,752 23,742 1:777
Tunisia 9,924,742 6,459 1:1,536
United Arab Emirates 3,480,000 5,825 1:597
Yemen 19,349,881 4,078 1:4,744
TOTAL 268,635,717 286,154
16
WHO, October 2004,
17. Number of physicians per 1,000 people
Year 1960 1970 1980 1990 2000
Egypt 0.39132783 0.527 1.0654 0.7595 2.117838
Saudi 0.06110429 0.134 1.4334
Arabia 4
Bahrain 0.44966444 0.4286 1.0868
4
World Bank (WHO) 17
22. Health System Funding:
This show clearly that the
richer (and General
more
developed) the country is
the more the government
spend money on health
with less private and OOP LIC MIC HIC
(out of pocket). This is very Private OOP
important slides which
indicate that countries like
the GCC Governments
should take the burden
Private Pooled
away from the citizen on
all health matters. Good
health system is the one in
which no one should face
bankruptcy or poverty
resulting from catastrophic
illness or injury, where no
one chooses to ignore a Government
medical condition because
he or she can't afford to
see a doctor, and where no
impoverished person dies
unnecessarily due to lack
of care.
22
WHO Centre, IC London S Rawaf 2009
27. Current Demand for
Family Physicians
“According to Merritt, Hawkins & Associates’ 2005 Survey of
Hospital Physician Recruiting Trends, more hospitals are
actively engaged in recruiting family physicians than any other
type of physician.”
Leslie Champlin – AAFP News Now (7/25/06)
27
28. Current Demand for
Family Physicians
“MOST WANTED
For the first time in six
years, general internists
and family physicians are at
the top of the ‘in demand’
list for hospitals and
medicals groups, according
to a review of 2,840
Merritt, Hawkins &
Associates’ listings. Here
by year are the number of
physician searches by
specialty starting in 2002-
03 and continuing through
2005-06.”
AMA News June, 2006
28
29. Health Line
PC Hosp Care
H
O
S
F P
P I
T
A
L
Healthy Living
Cost: 10% + 11% 50% Acute, 15% MH
Contacts: 80% - 90% 10-20%
30. Cost-Effectiveness (Intervention cost/case):
• Telephone Call £16
PHC
• Family Physician £15
• Walk-in-Centre £55
• FP with Special Interest £75
• Hospital Outpatient £150 2 Care
• Day Care £500
• One-Day Admission £1,000
• Inpatient (2ndary Care) £5,000
• Tertiary Care £20,000 3 Care
30
WHO Collaborating Centre, London Source: Rawaf, Dubois, 2007
31. Cost in Bahrain
Heath centre visit cost US$ 13-19
Hospital OPD visit cost US$ 132
Admission per night cost US$ 530-660
Admission intensive care US$
1320
MOH 2009
31
32. The Arab Health Ministers in Kuwait in
February 1978, decided to establish the
Arab Board for Medical Specializations
It aims to improve medical services in the
Arab world by:
raising the level for professional skills
to develop and institute guidelines for training
within the different medical disciplines
to maintain the level of control and periodic review
by keeping pace with the advances in medicine.
32
33. The number of the Arab Countries is: 18
The number of the doctors who have finished the
training program and passed the final oral and
clinical exam is: 7833
ABMS 2010
33
34. Arab Board in Family and Community Medicine
Started in 1986
13 ARAB Countries started or to start Family
Medicine Program
Bahrain Lebanon
Saudi Arabia Kuwait
UAE Qatar
Oman Egypt
Iraq Jordan
Syria Tunisia
Libya Yemen
34
35. Family Medicine programs in various countries
Turkey 1961
Bahrain 1978
Lebanon 1979
Jordan 1981
Kuwait 1983
KSA 1987
Arab Board 1986
Qatar, UAE 1994
Oman 1994
Egyptian Board 2003
Libya 2006
Iraq Recent
Yemen To start
35
36. Number and Percent Primary
Care Doctors by Country
120 112
100 96
87
80 78
68
60
56
51
53 Primary Care Doctors
40 41 per 100,000
36
22
20 19
% Primary Care
Doctors
0
Australia
Canada
New Zealand
Kingdom
United States
Saudi Arabia
United
36
37. Only around 2000 physicians (F & C)
have graduated since its foundation.
ABMS 2009
37
38. World-wide, the optimal Family
doctor/patient ratio is 2000 people.
With the realization that its population is
over three hundred and fifty million, the
Arab World now needs more than
175000 FD specialists.
38
39. Continuation at the current production rate
of Board qualified FD by the ABMS, (100
per year);
Arab countries would need 1750 years
to have optimum number of immediately
required FD!!!
39
40. Taking Bahrain as an example, with its
production of an average of 16 FD per
year, and with its immediate need for more
than 600 FD (around 250 currently
available);
It will require more than 20 years to reach
to that goal.
40
41. Fifty percent of the physicians work force
in any country should be constituted of
Family Physicians
Barbra Starfield
41
42. Again, to highlight the crucial importance of FM,
the Gulf Cooperation Council participants who
concluded three days of discussions on family
medicine and primary health care in June, 2007,
have recommended that
20 percent of all doctors in the six GCC member
countries should be trained as specialists in
family medicine over the next 10 years.
However, there is still a drastic shortage in the
training programs.
42
43. In this part of the world, the high
prevalence of non-communicable
diseases, communicable diseases and
hereditary and genetic disorders, beside
the cost burden of health services,
necessitate developing countries in
general and the Arab countries in
particular to implement Family Medicine.
FM should be the ultimate goal of health
provision.
43
44. A lot of (sub) specialty care is not necessary
if you have good primary care.
Barbara Starfield
44
45. The presence of narrow specialists at
PHC centers is a source of inefficiency
and a barrier to developing PHC as it
adversely impacts on first contact,
continuity and comprehensiveness
functions of PHC.
Review of Experience of Family Medicine in Europe
and Central Asia:
Moldova Case Study
World Bank 2005
45
46. Primary care everywhere in the world is
most of the care, for most of the people,
most of the time.
Barbara Starfield
46
48. In conclusion
The health of the population in the Arab world
will be affected dramatically and may be in
danger due to deficiencies in FD .
Therefore a brave and immediate decision ought
to be taken and efforts ought to be made in order
to establish more training programs or to
increase the capacity of the existing ones to
produce more skilled Family Physicians to serve
in maintaining and upgrading the health of the
nations of the Arab world.
48
51. More than 80% of Health Care Spending on Behalf of People with
Chronic Conditions
5+ Chronic O Chronic
Conditions, Conditions,
16% 17%
4 Chronic
Conditions,
12% 1 Chronic
Condition,
21%
3 Chronic
Conditions, 2 Chronic
16% Conditions,
18%
Thorpe, Kenneth E, PhD. What Accounts for the High and Rising Costs of Health Care? Slides presented at the State 51
Coverage Initiatives National Meeting, Washington, DC, February 23-24, 2006
52. FM as a discipline started re-emerging at
the beginning of the 20th century.
In 1923, Francis Peabody commented
that modern medicine had markedly
fragmented health care delivery. He also
stated “the essence of the practice of
medicine is that it is an intensely personal
matter. The treatment of a disease maybe
entirely impersonal; the care of a patient
must be completely personal”.
Therefore, he called for the return of the
generalist physician.
52
53. History of
Family Medicine
1946 AMA established a section on General Practice to give
voice to the mounting problems and decreasing numbers
of generalists. Section develops into American Academy
of General Practice.
1966 Three independent reports supporting the value of the
practice of family medicine were published: the Millis
Report, the Folsom Report, and the Willard Report
They called for a “a physician who focuses not upon individual organs and
systems but upon the whole man, who lives in a complex setting…”, and
whose “relationship with the patient must be a continuity one”
53
https://www.theabfm.org/about/history.aspx
54. History of
Family Medicine
(continued)
1969 The American Board of Family Practice was officially
recognized in February as the 20th primary medical
specialty with 15 pilot programs
The specialty was formed because of the dwindling number of medical school
graduates entering general practice and the difficulty of general practitioners
without board certification acquiring hospital privileges
1971 The American Academy of General Practice became
the American Academy of Family Physicians
1984 Family Practice became the third largest residency
with 380 programs
54
https://www.theabfm.org/about/history.aspx
55. Total No. of Physicians 354029
Estimated Primary Care 30%
Physicians of the total number of
physicians
No. of Medical School
Offering Family/Community Medicine 70
No. of Countries with
Family Medicine Program 13
55
57. Arab World
No. of total Physician : 354029
Estimated % of Primary Care : 5 -30 % of the total
Physicians number of physicians*
No. of Medical School : 70
(Offering Family/Community Medicine)
No. of EMRO Countries with : 17
Family Medicine Program
Barrier * 57
58. Percentage of Primary Care
Doctors in Arab Countries
Less than 20 % are working in Primary
Health Care
Resolutions of the Regional
Committee (WHO, EMRO, 2008)…
Health as a human right
Importance of intersectoral collaboration in
health development
Need to invest in health
Direct attention to social determinants of health
58
59. Family Doctor
A physician who is primarily responsible
for providing primary, continuing,
comprehensive, curative and preventive
medical care in a personalized manner to
patients and to their families, to all ages
and both sexes, regardless of the
presence of disease or the nature of the
presenting complaint be it biological,
behavioral, or social.
59
63. In Saudi, the Ministry of Health,
Realizing the importance of FM, is
seeking to recruit 13,000 FD to work at its
newly established 150 primary health
centers in various parts of the Kingdom.
Saudi MOH 2009
63