Department of Family Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44124, USA.
KinderBerg International, e.V., Stuttgart, Germany.
Public Health. 2011 Jan;125(1):55-59. doi: 10.1016/j.puhe.2010.08.021. Epub 2010 Dec 8.
Little is known regarding the nature of primary care in post-conflict communities for several reasons, including: data collection is often given a lower priority than the immediate medical care needs in emergencies; and dynamic changes in a patient population and their needs make it difficult to collect data over the long term. Kinderberg International, e.V. is a German humanitarian organization that has been providing primary care in northern Afghanistan for the past 3 years. The aim of this article is to provide demographic data, pattern of clinic visits and descriptive epidemiology of the large data set from the primary care units.
Observational study.
Patient data gathered using the standardized government tally sheet were reviewed for 1 January to 31 December 2008. The data contained information from 12 primary care clinics and mobile clinics in three northern provinces in Afghanistan.
In 2008, the 12 primary care clinics had more than 250,000 clinical encounters. There were significantly more visits due to diarrhoea and dehydration during the summer months. Overall, the number of primary care clinic visits showed clear seasonal variation, while the number of visits to mobile clinics remained stable throughout the year. Forty-three percent of all clinic visits were due to acute respiratory tract infection and diarrhoeal diseases, and 43% were due to uncategorized diagnoses.
Based on the data from three provinces in northern Afghanistan, mobile clinics can be an effective method to provide medical care in remote areas. A substantial proportion of diagnoses in patients at the clinics was not classified into pre-defined disease categories; these patients presented with numerous symptoms needing treatment. The high volume of ill-defined visits with various complaints to primary care clinics in emergencies may support the claim that primary care clinics are providing more than medical solutions, but also provide care for various complaints and an indispensable safety net to communities under stress. From this standpoint, primary care clinics in post-conflict communities should be considered as a vital element of peace building.
由于多种原因，包括数据收集通常优先于紧急情况下的直接医疗需求，以及患者人群及其需求的动态变化使得长期收集数据变得困难，因此对于冲突后社区的初级保健的性质知之甚少。Kinderberg International，e.V. 是一家德国人道主义组织，过去 3 年来一直在阿富汗北部提供初级保健。本文的目的是提供来自初级保健单位的大量数据集的人口统计学数据、就诊模式和描述性流行病学。
观察性研究。
使用标准化政府计数表收集的患者数据在 2008 年 1 月 1 日至 12 月 31 日进行了审查。该数据包含来自阿富汗北部三个省份的 12 个初级保健诊所和流动诊所的信息。
2008 年，12 个初级保健诊所的就诊次数超过 25 万次。夏季腹泻和脱水就诊次数明显增多。总体而言，初级保健诊所就诊次数呈明显季节性变化，而流动诊所就诊次数全年保持稳定。所有诊所就诊的 43%是由于急性呼吸道感染和腹泻病，43%是由于未分类的诊断。
基于阿富汗北部三个省份的数据，流动诊所可以成为向偏远地区提供医疗服务的有效方法。诊所患者的大部分诊断未归入预先确定的疾病类别；这些患者出现了许多需要治疗的症状。大量未明确诊断的就诊者带着各种不适到紧急情况下的初级保健诊所就诊，这可能支持以下说法，即初级保健诊所不仅提供医疗解决方案，还为各种不适提供护理，并为处于压力下的社区提供不可或缺的安全网。从这个角度来看，冲突后社区的初级保健诊所应被视为建设和平的重要组成部分。
