Awareness of Urgent Care Services Among Primary Healthcare Center Patients in Al-Ahsa, Saudi Arabia

Background Urgent care clinics (UCCs) provide services for patients without the need to book an appointment in advance to treat acute diseases and injuries that do not need ED service and provide care for chronic conditions. This study aimed to assess the patients's level of awareness regarding UCCs in the Al-Ahsa region and provide information contributing to decision-makers' support about the urgent care services and their patterns of use within primary healthcare. Methods A descriptive cross-sectional study was conducted in the Al-Ahsa region from August 2023 to December 2023. A validated questionnaire was used. Cluster sampling was used to select three primary healthcare centers from four health sectors (southern cluster, middle cluster, northern cluster, and eastern cluster), and then simple random sampling was used to select participants. sample size calculated by Cochran's sample size formula, which estimated 377 participants. However, to accommodate a non-response rate of 10.0% and stronger statistical power and effect size, the final sample size was 469 participants. Data were analyzed by SPSS Statistics version 28 (IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. Armonk, NY: IBM Corp.). Both descriptive and inferential statistics were used. A p-value ≤0.05 is considered statistically significant. Results Of the 469 participants in the study, more than half (54.8%) were aged between 18 and 38 years old, and more than half (54.8%) were male. More than half (67.4%) reported having no chronic diseases, whereas the most common chronic diseases reported were diabetes mellitus (11.9%) and hypertension (14.3%). Most of the participants (84.9%) weren't aware of UCCs. Among the participants who were aware of UCCs (n=71), 53.5% of them had visited a UCC in the last three months. The most common reasons for their visits were the common cold (40.8%), headaches (5.6%), and abdominal pain (5.6%). More than one-third of participants (38.6%) believed that UCCs provide services like those of the emergency center. According to patients' sex, there was a significant (0.031) difference in the awareness level; the highest was among females at 20.1% vs. 12.6%. Conclusion The study revealed that the majority of the participants were unaware of UCCs. Increasing patients' awareness of UCCs is necessary through different media to improve access to healthcare services and reduce overcrowding in the ED that is caused by non-urgent problems.

Make your choice: Angiography or periodical health examination?

Periodical health examination is one of the important factors influencing a healthy lifestyle. Patients undergoing routine physical examination in primary care are included in the scope of preventive medical services, which is the most basic principle of primary care. Identifying the risk factors enables individuals to adopt healthier lifestyle practices. In our study, we examined the correlation between patients undergoing coronary angiography for suspected coronary stenosis and the extent of primary care services they had received in their medical history, along with the severity of stenosis observed during the angiography. Patients were interviewed using a pre-structured questionnaire to gather information about their past utilization of primary healthcare services related to coronary matters and their cardiovascular (CV) risk profile as documented in their medical history. The necessary standard tests for angiography procedures were retrieved from patient records. The SYNTAX score, a tool that aids in the objective assessment of the severity of coronary artery disease (CAD), was computed and documented. This score was then compared with the history of primary care utilization. The patients' utilization of services from the Primary Healthcare Center (PHC) was evaluated using a scoring system, with an average score of 29.27 ± 11.27 out of 100 points (minimum: 20; maximum: 60). The average SCORE Türkiye indicating the 10-year risk of CV events for all patients was calculated as 14.31% ± 8.65% (high-very high risk), while the average SYNTAX score was 15.20 ± 9.97. There was a positive and significant correlation found between fasting blood glucose and creatinine values with both SYNTAX score and SCORE Türkiye (respectively; R = 0.238, P = .013; R = 0.289, P = .002). Factors such as smoking and metabolic syndrome were associated with CAD severity. It important to highlight that individual recommended for angiography had a notably lower utilization of healthcare services from the PHC based on their medical histories. This circumstance has resulted in individuals who do not undergo CV event screenings at PHCs having higher SYNTAX scores, indicating more severe CAD that necessitates angiography. Conducting regular periodical health examinations at PHCs can help mitigate these statistics.

Comparing Job Satisfaction Among Healthcare Workers at Emergency Departments and Primary Healthcare Units During the COVID-19 Pandemic

Background The primary healthcare professionals' work description changed during the COVID-19 pandemic, as was the case of all other healthcare departmental operation systems. Objectives This investigation compares job satisfaction between emergency department (ED) and primary healthcare professionals during the COVID-19 pandemic to ascertain the possible effect of the pandemic on healthcare providers. Methods A cross-sectional online self-assessment questionnaire consisting of 36 questions was distributed using available social media to target all frontline healthcare workers (HCWs) in emergency departments and primary healthcare centres in Riyadh. The inclusive criterion was that the respondents should have been frontline HCWs during the pandemic era. The questionnaire was validated by a pre-test of responses of 10 frontline HCWs. This was to ensure the comprehensibility and validity of the questions. Thereafter, necessary corrections were made to the final questionnaire. Responses were collected with an Excel sheet (Microsoft Corp., Redmond, WA), while data were analysed with SPSS version 23 (IBM Corp., Armonk, NY) and GraphPad Prism version 9.2.0 (GraphPad Software, San Diego, CA). Results The targeted sample size was 400; however, 159 HCWs responded to the questionnaire and were thus included in the investigation. There were more male (60.4%) than female (39.6%) respondents, the majority of whom were Saudi nationals (86.6%) while the remaining were non-Saudi nationals working in the Kingdom. Also, 67% of the respondents were emergency medical service professionals while the remaining (23%) were primary healthcare professionals. Significantly, 71.8% of the respondents (p < 0.05) disagreed with adequate enumeration, rewards, and chances of promotion compared to those who agreed (28.2%) during the COVID-19 pandemic. Job satisfaction was not significantly correlated to gender or the work departments (p > 0.05). Respondents significantly (p < 0.05) agreed to the competence of their supervisors, and liked their colleagues and work environment. Conclusion The study has shown that although supervision during the pandemic era was with competence; however, hours of work put in by these frontline emergency professionals were not adequately remunerated. Also, the services they provide seemed not to have been appreciated and hence did not lead to promotion either. Therefore, there was job satisfaction. As expected, the workload was huge while chances of promotion were lacking. These observations could lead to a substandard service should there be another pandemic. There is a need for all stakeholders to look into this more cautiously should there be another pandemic.

Chronic Low Back Pain: Prevalence, Impact on Quality of Life, and Predictors of Future Disability

BACKGROUND

In primary healthcare settings, chronic low back pain (cLBP) is a widespread health issue with a great global impact.

METHODS

A cross-sectional analytical study was performed on 918 adults attending primary healthcare settings in Makkah, Saudi Arabia, to estimate the cLBP prevalence, its effect on health-related quality of life (QOL), and predictors of subsequent disability. The visual analog scale of pain (VAS), World Health Organization Quality of Life Scale (WHO-QOL), and Oswestry low back pain disability index (ODI) were used to assess back pain severity, impact on QOL, and physical disability, respectively.

RESULTS

The prevalence of cLBP among adults attending primary care settings in Makkah City was 25.9%, and 88.6% of them had a limited range of motion of the spine. About 58.1% had abnormal radiological findings detected by MRI. Based on the VAS scale, most patients (83.8%) had mild pain. The median (IQR) QOL score was 70 (60-80). Minimal and moderate disability scores were prevalent among 16.2% and 65.7% of patients, respectively. Disability scores were independently predicted by a lower QOL score (beta = -0.39, 95%CI = -0.49 to -0.29, p < 0.001) and higher VAS scores (beta = 0.47, 95%CI = 0.38-0.56, p < 0.001). Furthermore, disability was independently associated with having post-void residual volume (PVRV) (beta = 5.84, 95%CI = 1.97-9.72, p = 0.004) and abnormal X-ray findings (beta = 7.10, 95%CI = 1.77-12.4, p = 0.010).

CONCLUSION

cLBP is common among adults attending primary care settings in Makkah City; it is associated with moderate disability and lower health-related QOL.

Association Between Maternal Literacy and Child Immunization According to the Expanded Program on Immunization Schedule in a Primary Health Care Center of a Squatter Settlement in Karachi

Background An increase in maternal education may influence vaccine administration to a significant extent, therefore reducing the childhood mortality rate. Hence, this survey aims to establish an association between maternal literacy and childhood immunization in children under five years of age. Methods A questionnaire-based cross-sectional study was conducted in a primary healthcare center of a squatter settlement in Karachi, Pakistan. Mothers of 250 children under the age of five years were interviewed. We used IBM SPSS Statistics for Windows, version 20 (released 2011; IBM Corp., Armonk, New York, United States) for data analysis to assess the relationship between maternal education and childhood immunization. Results The survey revealed that complete vaccination coverage among children under five years of age (n=250) was 71.7%, while 24.6% were partially vaccinated and 2% were unvaccinated. The most common reason for unvaccinated children was the parents' personal choice (80%), while incomplete vaccination was majorly due to a medical condition (30.2%).  Conclusion According to the survey, maternal educational qualification did not prove to be directly associated with vaccination coverage in children. However, a multi-centered study with larger sample size and multiple populations as targets would provide more accurate outcomes.

Primary Healthcare Center's Healthcare Providers' Perception and Practice Toward Pediatric Cow's Milk Allergy in Qassim Region, Saudi Arabia

BACKGROUND

Cow's milk allergy (CMA) typically first manifests in the first year of life, and it is the most challenging food allergy to detect since the clinical symptoms can vary significantly in both types and severity. This study is carried out to evaluate the level of knowledge and practice of healthcare providers (HCPs) in the Qassim Region regarding CMA.

RESEARCH METHODOLOGY

This is a cross-sectional study conducted among HCPs in the Qassim Region, Saudi Arabia. A self-administered questionnaire was distributed among HCPs using face-to-face interviews compromising four governorates of Qassim such as Buraydah, Unaizah, AlRass, and Albukairyah. The questionnaire includes socio-demographic characteristics and questions to assess the knowledge and practice of HCPs regarding CMA.

RESULTS

Among 124 HCPs, 29% were aged between 25 and 30 years, 50.8% were males and 49.2% were females. Over three-quarters (77.4%) were categorized as having poor knowledge levels, while poor practice was also prevalent (83.1%). Factors associated with increased knowledge and practice were being non-Saudi, being a consultant/specialist, and having more than 10 years of experience. There was a significant positive correlation between knowledge and practice scores (p<0.001).

CONCLUSION

The knowledge and practice of HCPs regarding CMA were insufficient. Non-Saudi consultants/specialists with more years of experience tend to be more knowledgeable and have better skills in managing the disease. Further longitudinal studies are required to establish the level of knowledge and practices toward CMA.

Distribution of Primary Healthcare Centers Between 2017 and 2021 Across Saudi Arabia

BACKGROUND AND AIM

Access to adequate healthcare systems is seen as a fundamental human right. Therefore, healthcare services must be distributed and accessible in the most efficient way possible to those who need them the most. Primary healthcare centers are the backbone of any healthcare system as they provide essential healthcare services to the general population. Inequalities in the distribution of primary healthcare centers can lead to disparities in healthcare access and outcomes. This study aimed to assess the equity of primary healthcare centers distribution, we analyzed and evaluated the allocation of primary healthcare centers in Saudi Arabia from 2017 to 2021.

METHOD

This cross-sectional study utilized data from the Health Statistical Yearbook published by the Ministry of Health, Saudi Arabia, during the period of 2017-2021. The number of primary healthcare centers per 10,000 population was calculated for the 20 health regions. We used the Gini index to measure inequality in the distribution of primary healthcare centers. The Pearson coefficient was calculated to assess the correlation between the number of primary healthcare centers and the population in each health region.

RESULT

 The overall ratio of primary healthcare centers to population decreased from 0.72 to 0.62 between 2017 and 2021. The Gini index showed relative equality in the distribution of primary healthcare centers from 2017 to 2021 with values between 0.2 and 0.3. There was a positive correlation between the population and the primary healthcare centers in Jeddah, Tabouk, and the Northern Region. However, in Riyadh, Makkah, Taif, Madinah, Qaseem, Eastern Region, Al-Ahsa, Aseer, Hail, Jazan, Najran, Al-Baha, and Al-Jouf, the correlation was found to be negative.

CONCLUSION

 From 2017 to 2021, primary healthcare facilities are distributed fairly throughout 20 health regions of Saudi Arabia. However, there are still some disparities between provinces, and efforts must be made to ensure that primary healthcare centers are distributed equitably across the country to improve healthcare access and outcomes for all.

The Effect of COVID-19 Vaccine on Women's Reproductive Health: A Cross-Sectional Study

INTRODUCTION

The coronavirus disease 2019 (COVID-19) vaccine was developed to stimulate acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms of reproductive health abnormalities have been reported following the administration of the adenovirus and mRNA-containing vaccine. Such complaints included irregular menstrual cycles, miscarriages, changes in sexual interest, vaginal bleeding, and decreased milk supply in breastfeeding mothers. This study aimed to explore the effect of the COVID-19 vaccine on the reproductive health of women attending five primary healthcare centers in the western region of Saudi Arabia.

METHODS

A cross-sectional study was conducted with 300 women between 15 and 50 years. Five primary healthcare centers were included from May to September 2022. Non-probability convenient sampling technique was used; data were collected via a self-administered questionnaire from women who received any number or type of COVID-19 vaccine. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22 (IBM SPSS Statistics, Armonk, NY, USA).

RESULTS

Of those who responded to the questionnaire (297 participants), 74% were married, and 52% had 1-3 children. Of the pregnant women, only 4% lost their pregnancy. In addition, of the breastfeeding mothers, 10% noticed a decrease in milk production after the vaccination. The effect of the vaccination status on decreased libido was 11%. A small proportion (18%) of the participants reported worsening dietary habits after the vaccine. Less than half of the participants (44%) reported a change in the length and amount of the menstrual cycle, and 29% worsened premenstrual syndrome (PMS). There was no significant association between the type and the number of doses on the rate of miscarriage (p=0.47), breastmilk production (p=0.47), libido (p=0.11), health diet habits (p=0.15), monthly cycle (p=0.570), heavy menses (p=0.999), and PMS symptoms in the study participants.

CONCLUSION

COVID-19 vaccination remains necessary to prevent severe infection and is safe for females of reproductive age, whether trying to get pregnant or lactating, and has no significant effect on the menstrual cycle. This research can be used as a basis when deciding on vaccines in case of future pandemics and remove misinformation and doubts regarding the vaccines that should be adequately addressed.

The leadership styles of primary healthcare center managers and center performance outcomes in Riyadh, Saudi Arabia: A correlational study

BACKGROUND

Leadership is a wide concept that is rapidly developing. Diverse theories suggest different styles of leadership, with strong relationships between the different styles and their outcomes. The transformational style emphasizes motivating employees and encouraging them to find new ways of dealing with issues. The transactional (TL) style promotes ideas of rewards and punishments. The Laissez-faire style is characterized by relaxation and the tendency to leave things to happen with minimal interference.

MATERIALS AND METHODS

This is a descriptive cross-sectional study design conducted in Primary Healthcare Centers in Riyadh, Saudi Arabia. The leadership styles were assessed using a Multi-Factor Leadership Questionnaire, which identifies the different styles of leadership. SPSS v 26.0 was used for data analysis. t-test employed to compare leadership style between raters and managers. Logistics regression model used to determine the influence of leadership styles of managers. Pearson correlation coefficient determined the linear relationship between leadership styles and its domains.

RESULTS

A total of 130 respondents (65 managers vs. 65 raters) took part. "Raters" refer to any persons other than the manager, such as a secretary, nurse, doctor. The "manager" is when the person rates himself. The global transformation mean score was 3.55, for TL it was 3.42 and for passive avoidant, the mean score was 0.93. The passive avoidant (t = 2.005; P = 0.047) and management by exception (passive) (MBEP) mean scores of raters were statistically significantly higher than managers. In the binary regression model, MBEP was the independent significant predictor of manager.

CONCLUSION

The perceived leadership style of Primary Healthcare Center managers was transformational but with TL. Transformational leadership was positively correlated with TL leadership but negatively correlated with passive avoidant (The Laissez-faire style). The outcome of this study demonstrated that intellectual stimulation, idealized attributes, and inspirational motivation are perhaps better than contingent reward, active management.

Diagnostic Performance of SARS-CoV-2 Rapid Antigen Test in a Large, German Cohort

We assessed the performance of a rapid antigen test (RAT) in everyday clinical practice. Between 1 November 2020 until 1 April 2021 all in-patients at the Helios University Hospital Wuppertal, Germany, as well as the accompanying relatives at the Children's Hospital received a SARS-CoV-2 RAT and a SARS-CoV-2 RT-PCR prior to admission. Out of 3686 patients, 22 (0.6%) subjects were tested positive by RT-PCR and RAT, and 3591 (97.4%) were negative by both methods, showing discordant results: RT-PCR+/RAT- in 58 (1.6%) and RT-PCR-/RAT+ in 15 patients (0.4%). Overall sensitivity and specificity of RAT was 27.5% (95%CI 18.1-38.6%) and 99.6% (95%CI 99.3-99.8%), respectively. The sensitivity was slightly higher in adults (30.4%, 95%CI 18.8-90.9%) than in pediatric subjects (20.8%, 95%CI 7.1-42.2%). False negative RAT had a statistically higher Ct-value (p < 0.001) compared to true positive values, and overall sensitivity increased to 80% [59.3-93.2%] with Ct value < 30. While the sensitivity of the RAT was poor compared with the RT-PCR, the specificity was excellent. However, the sensitivity increased with lower Ct value, and with the right anamnesis the RAT can be a quick and easy approach to distinguish people who are infectious with SARS-CoV-2 from noninfectious people, enabling appropriate triage in clinical practice while waiting for the RT-PCR result.

Reference intervals for routine biochemical markers and body mass index: A study based on healthcare center database in northeastern Iran

Age- and sex-specific reference intervals (RIs) for some biochemical tests may be useful for their interpretation, due to the variations in lifestyle and genetic, or ethnic factors. The aim of this study was to obtain RIs for some routine biochemical markers including a serum lipid profile, fasting blood glucose (FBG), aspartate and alanine aminotransferase (AST and ALT), uric acid, and body mass index (BMI) in subjects who attended primary healthcare centers. The large database of primary healthcare centers uses RIs to report results for children, adolescents, and young and old adults. RIs were obtained by using the indirect method, recommended by the CLSI Ep28-A3 guidelines. RIs for FBG, BMI, and serum lipid profile, including triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in people aged 18 to 120 years, were obtained without age/sex segmentation. RIs for serum AST, ALT, and uric acid were obtained without age segmentation, though these RIs were higher in males than females. The RIs for AST, ALT, and uric acid were higher in men, while the RIs for the other variables were similar in both sexes. This is the first study reporting the use of indirect RIs for BMI.

Measurement of the Quality of Life of Prolanis Hypertension Patients in Sixteen Primary Healthcare Centers in Pandeglang District, Banten Province, Indonesia, Using EQ-5D-5L Instrument

Introduction

The prevalence of hypertension in Indonesia is increasing, not least in some peripheral areas, including in Pandeglang District, Banten Province. The government of Indonesia, through the Social Health Insurance Administration Body (BPJS Kesehatan) has launched a chronic disease management program (Prolanis) to achieve more optimal results in treating patients with chronic diseases, including hypertension.

Objective

This study aimed to measure the quality of life of Prolanis hypertension patients at the primary healthcare centers (PHCs) using EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) instrument and taking pharmacists' counseling intervention into account. This study was conducted in 96 Prolanis patients, consisting of 48 patients from 8 PHCs who did not receive pharmacists' counseling intervention (control group) and 48 other patients from 8 different PHCs who received 4 times intervention (intervention group). This study was conducted in a period of 3 months (June–August 2019) in 16 sub-districts of Pandeglang District.

Methods

An experimental study design was applied by considering a purposive sampling method. Patients' quality of life were measured by using EQ-5D-5L instrument and its Indonesian value set. For data analysis, we applied the Kruskal–Wallis, Mann–Whitney, Wilcoxon, and Binomial tests to investigate the differences of patients' quality of life in both groups of control and intervention.

Results and Conclusions

The results showed that the average utility value of the intervention group experienced an improvement at each meeting (m1 = 51.25%; m2 = 66.25%; m3 = 84.17%; and m4 = 91.67%), while the control group experienced a lower and more fluctuative improvement than the intervention group (m1 = 65.42%; m2 = 70.42%; m3 = 80.42%; and m4 = 76.67%). The same results also occurred in the average value of visual analogue scale (VAS). There was a better improvement in the intervention group than in the control group.

Clinical Trial Registration Number

62/UN6.KEP/EC/2019.

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Study on drug use pattern in primary healthcare centers of Kathmandu valley

Background:

The basic health service is a fundamental right of every citizen. Appropriate use of medicine is an essential component for the quality of health. Drug use evaluation is a systematic and criteria-based drug evaluation, which ensures the appropriate use of the drug. The purpose of this study was to analyze the drug use situation in primary healthcare centers of Kathmandu valley.

Methodology:

A cross-sectional descriptive study was performed in all primary healthcare centers of Kathmandu valley. Six hundred prescriptions were analyzed retrospectively, choosing a simple random sampling method for prescribing indicators. One hundred twenty patients were interviewed for patient-care indicators, and health facility representatives were interviewed for health facility indicators. Drug use indicators developed by World Health Organization/International Network for Rational Use of Drugs were used with slight modification.

Result:

The average number of drugs per encounter was 2.6. The percentage of drugs prescribed by generic names and from the essential medicine list was 60% and 80.9%, respectively. The prescriptions encounters with antibiotics and injections were 58% and 4.2%, respectively. The average consultation and dispensing time were 3.6 min and 54.4 s, respectively. The percentage of drugs actually dispensed was 76.6%. Only half of the patients knew the correct dose of the dispensed drug and no adequate labeling at all. The majority of dispensers were intern nursing students (42%), and all prescribers were medical officers. Ten out of 12 primary healthcare centers had a copy of EML. The availability of key drugs in primary healthcare centers was incomplete (64.7%).

Conclusion:

The observed values for all World Health Organization indicators deviated from the optimal range. Patient care provided by health facilities was insufficient and thus an effective intervention program for the promotion of rational drug use practice is recommended.

Professional satisfaction of family physicians working in primary healthcare centers: A comparison of two Saudi regions

Introduction

As a new healthcare market force and first point of contact, family physicians (FPs) play a key role in healthcare delivery system. It is vital to understand issues that affect performance and satisfaction with their practices and working environment. The objectives of this study are to assess the level of professional satisfaction and to compare and identify the factors potentially associated with professional satisfaction/dissatisfaction among FPs of two regions.

Materials and Methods

A comparative cross-sectional study on FPs working in primary healthcare centers under Ministry of Health was conducted in two regions (Jeddah and Eastern region) to assess job satisfaction and dissatisfaction among them. Validated close-ended questionnaire was emailed. Overall satisfaction along with the associated factors was identified. Chi-square and multivariate regression analyses were performed to test the association between job satisfaction and predictors.

Results

A total of 237 FPs completed the survey and an overall 62% of them were satisfied. Male doctors were less in number yet more satisfied (71%). FPs of eastern region were slightly more satisfied (63.4%) when compared with 59.2% of Jeddah. Factors significantly associated with professional dissatisfaction included FPs having the opinion that they were not respected by community members [odds ratio (OR) 2.7, confidence interval (CI): 1.24-5.97, P = 0.012] and FPs' own perception of being inferior to other specialties (OR 13.59, CI: 4.98-37.07, P < 0.001).

Conclusion

More than half of the FPs were professionally satisfied; however, the majority had perception of being inferior to other specialties. Improving self-esteem, working environment, and addressing other identified factors for dissatisfaction can help FPs overcome their stresses, leading to better healthcare delivery.

Patients' satisfaction regarding family physician's consultation in primary healthcare centers of Ministry of Health, Jeddah

Introduction:

The current study aims to assess the level of patients’ satisfaction and the factors contributing to patients’ satisfaction toward family physicians (FPs) consultation, visiting primary healthcare centers (PHCCs) working under Ministry of Health, Jeddah.

Materials and Methods:

In this cross-sectional study conducted in Jeddah from November 1, 2016 to March 1, 2017, we used consultation satisfaction questionnaire and its four subscales with standard cutoffs. These subscales include general satisfaction, professional care, depth of relationship, and length of consultation. Mean scores along with standard deviation of these subscales were measured. Independent sample t-test, ANOVA, and multivariate regression analysis were performed to test the association between satisfaction level and predictors.

Results:

Overall, patients’ satisfaction was 60%. Around 74% of patients were satisfied with the professional care and 58% with the depth of the relationship. Around 60% of patients need more consultation time with the physicians. Knowledge about the presence of FP in the nearest PHCCs was around 70%. Multivariate regression analysis for the overall high satisfaction showed that the most important predictors of this high satisfaction level are regular visits to a particular FP (P < 0.001), distance from the PHCC (P = 0.044) and gender of the patient (P = 0.027).

Conclusion:

This study concluded that satisfaction with the FP's consultation is acceptable but needs improvement. Lower satisfaction was reported among males, patients living at a distance from PHCC and who had less knowledge about the presence of FP in their nearest PHCC. Such study data are vital for any corrective measures to boost satisfaction in patients attending PHCCs.

Gender-based Violence Among Pregnant Women of Syangja District, Nepal

Objectives

This study aims to determine prevalence of gender-based violence among pregnant women attending an antenatal care (ANC) clinic.

Methods

Between September 2014 and December 2014, a cross-sectional study was conducted among 202 pregnant women attending the antenatal ward of the Primary Healthcare Centre (PHC) of Syangja district, Nepal. The data were collected using semistructure questionnaires with face-to-face interviews. SPSS software (IBM Corp, Armonk, NY, USA) was used for analysis the data.

Results

The prevalence rate of gender-based violence was found to be 91.1% (184). Most of the respondents (87%) faced economic violence followed by psychological (53.8%), sexual (41.8%), and physical (4.3%) violence. Women experienced: (1) psychological violence with most complaining of angry looks followed by jealousy or anger while talking with other men, insults using abusive language and neglect; (2) economic violence with most complaining of financial hardship, denial of basic needs and an insistence on knowing where respondents were and restricting them to parents' home or friends/relatives' houses (jealousy); (3) physical violence by slapping, pushing, shaking, or throwing something at her, twisting arm or pulling hair, and punching and kicking; and (4) sexual violence by physically forcing her to have sexual intercourse without consent, and hurting or causing injury to private parts. Most (100%) of the perpetrators were found to be husbands and mothers-in-law (10.7%) who violated them rarely.

Conclusion

The prevalence of gender-based violence (GBV) among pregnant women attending the ANC clinic was greater in the Syangja district of Nepal. Women's empowerment, economic autonomy, sensitization, informal or formal training regarding GBV for men and women, and the need for large-scale population-based surveys are the major recommendations of this study.