Emberti Gialloreti Leonardo, Basa Faiq B, Moramarco Stefania, Salih Adil O, Alsilefanee Haveen H, Qadir Sivar A, Bezenchek Antonia, Incardona Francesca, Di Giovanni Daniele, Khorany Revan, Alhanabadi Luma H H, Salih Shahla O, Akhshirsh Gorgees S, Azeez Bayar S, Tofiq Berivan A, Palombi Leonardo
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Rizgary Teaching Hospital, Erbil, Iraq.
Front Public Health. 2020 Jan 30;8:7. doi: 10.3389/fpubh.2020.00007. eCollection 2020.
Iraq has endured several conflicts and socio-political tensions that have disrupted its public health system. Nowadays, because health data are not collected on a routine basis, the country still lacks proper statistics and, consequently, response plans to meet present and future health needs of its population. An international partnership is developing in the Iraqi Kurdistan a Health Monitoring System with the aim of supporting evidence-based health policy decisions. The pilot phase for assessing the feasibility of the programme was launched in 2015. In 2018 the implementation phase began. The first step was to choose the software platform and the coding system, as well as to identify the public hospitals (PH) and Public Health Centers (PHC) to be included in the e-health system. The technical infrastructure of each PHC or PH was updated. The staff of each center was trained in the use of the e-health system and in disease coding. Several seminars introduced regional and district health managers to the basic concepts of data-driven decision making. A local team of experts was trained to create a highly specialized staff with the objective of "training the trainers" and ensuring the future self-sufficiency of the system. By September 2019, 59 PHC and PH were entering data in the Health Monitoring System, while 258 health operators (medical doctors, administrative staff, nurses, statisticians, IT and public health specialists, pharmacists) have been already trained. Currently, more than 600,000 disease events have been collected. Additionally, further 734 medical doctors, statisticians, and health managers have been trained on the basics of public health practice. The goal during the next 3 years is to reach 120 operative centers within the region, envisaging a subsequent expansion of the system to all Iraq. The creation of a functioning health monitoring system is feasible also in regions characterized by socio-political tensions. However, multiple stakeholder partnerships are essential. The provision of an e-health information system, coupled with the establishment of a team of local experts, allows the routinely and timely collection of health information, facilitating prompt responses to present and emerging needs, while guiding the formulation and evaluation of health policies.
伊拉克经历了几次冲突和社会政治紧张局势，这些都扰乱了其公共卫生系统。如今，由于卫生数据并非定期收集，该国仍然缺乏适当的统计数据，因此也缺乏满足其民众当前和未来卫生需求的应对计划。在伊拉克库尔德斯坦，一个国际伙伴关系正在建立一个健康监测系统，旨在支持基于证据的卫生政策决策。评估该计划可行性的试点阶段于2015年启动。2018年开始实施阶段。第一步是选择软件平台和编码系统，以及确定要纳入电子卫生系统的公立医院（PH）和公共卫生中心（PHC）。每个初级卫生保健中心或公立医院的技术基础设施都得到了更新。每个中心的工作人员都接受了电子卫生系统使用和疾病编码方面的培训。举办了几次研讨会，向地区和区级卫生管理人员介绍数据驱动决策的基本概念。培训了一个当地专家团队，以打造一支高度专业化的工作人员队伍，目标是“培训培训人员”并确保该系统未来的自给自足。到2019年9月，59个初级卫生保健中心和公立医院正在健康监测系统中输入数据，同时已有258名卫生工作人员（医生、行政人员、护士、统计人员、信息技术和公共卫生专家、药剂师）接受了培训。目前，已经收集了超过60万例疾病事件。此外，又有734名医生、统计人员和卫生管理人员接受了公共卫生实践基础知识的培训。未来3年的目标是在该地区达到120个运营中心，并设想随后将该系统扩展到整个伊拉克。在社会政治紧张局势突出的地区，建立一个有效的健康监测系统也是可行的。然而，多方利益相关者的伙伴关系至关重要。提供一个电子卫生信息系统，再加上建立一个当地专家团队，能够定期及时收集卫生信息，便于对当前和新出现的需求迅速做出反应，同时指导卫生政策的制定和评估。
