Journal of Local and Global Health Perspectives - Volume 2015, Issue 1

In Switzerland, the direct and indirect medical costs from non-communicable diseases are estimated at 51.7 billion Swiss francs per year. This essay describes the challenges faced by the Confederation in its efforts to control diet-related chronic diseases, and discusses the various factors affecting the nutrition of the population. It highlights the need to, not only, build stronger political support for prevention and health promotion, but also to ensure coherence across policies in the health, the agricultural and the trade sectors.

Background: From 2004 to 2010, the population of Qatar increased by 128%, from 744,029 to 1,699,435 inhabitants. This sharp rise in population led to declines in per-capita health care personnel and hospital bed capacity. Aims and objectives: To examine patient and provider characteristics associated with health system performance measures, the variation in these measures between Qataris and non-Qataris, and whether these measures have changed over time. Methods: We examine access, utilization, health system responsiveness and satisfaction measures, using multivariate regression analysis based on health surveys from 2006 and 2010. For purposes of representativeness, 2006 analysis applied population weights, and 2010 analysis applied weights constructed by using age, gender, nationality and occupation, based on the 2010 Census. Results: For access, we find no differences between Qataris and non-Qataris in the probability of having a usual source of care (USC). For utilization, Qatari women are 67% more likely than non-Qatari women to have an inpatient stay; both Qatari men and women are more likely to have any outpatient visits (48% and 35%) compared to non-Qataris. For health system responsiveness, for outpatient care, those who go to private clinics report higher ratings than those who go to Primary Health Care Corporation (PHCC) centers in 2006. Those who go to private clinics, private hospitals and other/employer clinics report higher ratings than those who go to PHCC centers in 2010. For satisfaction with the health care system, non-Qataris are twice as likely as Qataris to report high satisfaction in 2006. Conclusions: We find that satisfaction with outpatient services for public providers is lower than ratings for private providers, most significantly for waiting times (odd ratio of 1.20 [0.15] vs. 0.77 [0.08]). For satisfaction with the health care system, non-Qataris are twice as likely as Qataris to report high satisfaction; although for access, we find no difference between Qataris and non-Qataris in the probability of having a USC.

Policy implications include improving public services, increasing provider capacity and improving access to private providers. In addition, a major policy action was the launch of a mandatory social health insurance scheme in 2013, which enabled choice of provider and access to public and private providers. As such, increased provider capacity, public private partnerships, and competition between public and private providers are likely to improve services among public providers, including waiting times.

Objective: The study aimed to assess cold chain management status among health care professionals at primary health care centers (PHCCs) in Qatar. Methods: A cross-sectional design with pre-post intervention study was conducted in 21 PHCCs. A structured cold chain checklist was used to collect data regarding the status of cold chain management system in the centers before and after educational intervention. Results: Prior to the intervention, six key criteria for cold chain management were present in all 21 PHCCs (100%), eight were present in >80%, another eight were present in 60–80%, while 13 were present in < 60%. Post intervention, these figures improved to 8, 13, 4, and 10 respectively. Conclusion: In Qatar, cold chain management system practices among primary health care workers were generally positive. These practices significantly improved following an educational intervention within the targeted primary health care centers. Therefore, it is recommended that all health care professionals working in PHCCs should receive mandatory cold chain management training prior to their initiation of clinical practice to ensure delivery of safe and effective vaccines in Qatar.