This letter intends to clarify information and misconceptions found in the article &a... more This letter intends to clarify information and misconceptions found in the article "Syrian refugees in Lebanon: the search for universal health coverage" which was published June 1st, 2016, and to challenge the core notion of fragmentation as presented by the authors. It also highlights the fact that the article does not recognize the severe shortage in refugees health financing and unmet promises by the international community, and calls for immediate action and far greater support from that community to address the needs of refugees in Lebanon.
Hepatitis B and C are two potentially life threatening liver infections. Lebanon is ranked as a z... more Hepatitis B and C are two potentially life threatening liver infections. Lebanon is ranked as a zone of moderate endemicity. This study aimed to determine the prevalence of hepatitis B and C in Lebanon and their distribution according to age, region and sex. This national prospective cross-sectional study was conducted from January 2011 till December 2012 in the six Lebanese Governorates in collaboration with municipalities, the Ministry of Public Health, Health Centres and dispensaries. An upcoming screening for hepatitis B and C was announced? in different districts of each Governorate. All individuals presenting to local laboratory, not known to have chronic hepatitis, were asked for a blood sample and answered a questionnaire addressing sex, age, place of birth and residence. Screening tests were "Abbots" for hepatitis B and "Human Hexagon" for hepatitis C. PCR testing was used to confirm the positivity of the previous tests. Of 31147 individuals screened, 542 had a rapid test positive for HBV (prevalence 1.74%, 95% CI 1.6-1.89) with a male to female ratio of 1.08. This prevalence was higher in the South and Nabatieh (1.9%) compared to Beirut (0.73%). Of 31,147 individuals screened, 64 had a rapid test positive for HCV (prevalence 0.21%, 95% CI 0.16-0.27) with a male to female ratio of 0.85. This prevalence was higher in Nabatieh (0.61%) compared to Mount Lebanon (0.08%). The prevalence of HBV and HCV in Lebanon is 1.74% and 0.21%, respectively with a higher prevalence in South and Nabatieh districts. These data rank Lebanon amongst countries with low endemicity for both viruses. Decrease in the prevalence of HBV is due to awareness campaign as well as success of the MOPH National Hepatitis Program in vaccinating all new born since 1998 and in screening and vaccinating high risk groups.
To determine the incidence and the prevalence of hepatitis B and C viral infections in patients o... more To determine the incidence and the prevalence of hepatitis B and C viral infections in patients on hemodialysis (HD) across Lebanon. We reviewed the data registry at the Lebanese Ministry of Public Health where records of monthly hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) serology are reported from 60 affiliated HD centers across Lebanon. All patients who were on HD or who started HD between October 2010 and July 2012 were included in the study. Patients from seven HD centers were excluded due to inadequate and incomplete results reporting. During the selected period, HBsAg and HCV serology were available for 3769 patients from 53 HD centers distributed at all Lebanese governorates. The prevalence was calculated by dividing the number of patients with positive HBsAg or HCV serology to the total number of patients. The Incidence was calculated by dividing the number of newly acquired infection to number of patients-years (p-y). Incidence rates at different govern...
Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refug... more Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis. We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system. In studying the case of Lebanon we used input-process-output-outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them. Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved.
Structuring and implementing an endorsed neonatal resuscitation program results in decreased neon... more Structuring and implementing an endorsed neonatal resuscitation program results in decreased neonatal mortality. This paper aims to evaluate the implementation of formal training using the neonatal resuscitation program (NRP) in a private sector context of a middle income country. Between 2008 and 2011, the National Collaborative Perinatal Neonatal Network (NCPNN) supported by the Ministry of Health piloted the implementation of NRP training in member hospitals throughout the country. Training of trainers (TOT) then providers (TOP) took place over workshops where a lecture was given followed by hands on training using low fidelity manikins. Pre and post workshop knowledge assessment and hands-on-training evaluation were done. Statistical analysis using SPSS-20 was done with t-test and one way ANOVA to compare mean differences in pre and post scores and percent improvements across specialties and locations. Of 20 TOT participants, 9 (45%) conducted NRP in their hospitals. Ten TOP workshops included 256 professionals. Majority were doctors 128 (50%), 99 (39%) nurses and 20(8%) midwives. Overall pretest scores (67.25%, SD = 16.00) were significantly lower than posttest (87.48%, SD = 11.89) (p = 0.000); percent improvement among all participants was 37.12% (SD = 41.15) (p = 0.82). Nurses and Northern participants had highest mean difference in pre / post scores (21.56; SD = 12.32 and 23.29; SD = 6.62 respectively). Midwives showed the highest percent improvement (Mean = 40.44; SD + 47.28). All but 25 (9.8%) participants passed the "Megacode" from the first attempt. In our setting, implementing NRP training is essential to increase the knowledge and skills of health care professionals. It is sustainable with support from the ministry and other sources. Continuing education should be mandated at the ministry of health level.
Le Journal Medical Libanais the Lebanese Medical Journal, 2009
The accumulation of national epidemiological data since the late 1990s has led to the adoption of... more The accumulation of national epidemiological data since the late 1990s has led to the adoption of evidence-based guidelines for breast cancer screening in Lebanon (2006). Almost 50% of breast cancer patients in Lebanon are below the age of 50 years and the age-adjusted incidence rate is estimated at 69 new cases per 100,000 per year (2004). This official notification calls for breast self-examination (BSE) every month starting age 20, and a clinical breast examination (CBE) performed by a physician every three years between the ages of 20 and 40 years. Starting age 40, and for as long as a woman is in good health, an annual CBE and mammography are recommended. Women with known genetic family history of breast cancer should start screening 10 years earlier than the first young patient in the family, or earlier depending on medical advice. The Breast Cancer National Task Force (BCNTF) recommends certification of mammography centers and continued training of personnel to assure high quality mammograms, and to minimize unnecessary investigations and surgeries.It recommends that a national program should record call-backs of women for annual screening and follow-up data on abnormal mammograms. BCNTF encourages the adoption of these guidelines and monitoring of their results, as well as follow-up of breast cancer epidemiology and registry in Lebanon, and scientific progress in early breast cancer detection to determine needs for modifications in the future.
The accumulation of national epidemi- ological data since the late 1990s has led to the adop- tio... more The accumulation of national epidemi- ological data since the late 1990s has led to the adop- tion of evidence-based guidelines for breast cancer screening in Lebanon (2006). Almost 50% of breast cancer patients in Lebanon are below the age of 50 years and the age-adjusted incidence rate is esti- mated at 69 new cases per 100,000 per year (2004). This
Le Journal médical libanais. The Lebanese medical journal
Lebanon has a highly fragmented health care system. The Lebanese population receives its health c... more Lebanon has a highly fragmented health care system. The Lebanese population receives its health care services through a system dominated by the private sector that is dependent to a large extent on public sector financing. Lebanon spends about 83% of its Gross Domestic Product (GDP) on health. This study consists of observations on the utilization of the Ministry of Public Health (MOH) program of hospital care provision. The study population included all patients admitted for hospitalization in any of the 126 hospitals contracted with the MOH, between August 2008 and July 2009 (one full year). This review is limited to medical admissions only. The surgical admissions have been excluded since they are covered under a 'flat fee' reimbursement. Findings reveal that a significant proportion of the hospital admissions under this program are for conditions that may not need hospitalization. Moreover, most of these admissions receive care in relatively small and peripheral hospital...
Le Journal médical libanais. The Lebanese medical journal
The Ministry of Labor (MOL) has submitted to the Council of Ministers a social security reform pl... more The Ministry of Labor (MOL) has submitted to the Council of Ministers a social security reform plan. The Ministry of Public Health (MOPH) considers that health financing should be dealt with as part of a more comprehensive health reform plan that falls under its prerogatives. While a virulent political discussion is taking place, major stakeholders' inputs are very limited and civil society is totally put away from the whole policy making process. The role of the media is restricted to reproducing political disputes, without meaningful substantive debate. This paper discusses health insurance reform from labor market as well as public health perspectives, and aims at launching a serious public debate on this crucial issue that touches the life of every citizen.
Le Journal médical libanais. The Lebanese medical journal
From data collected in Lebanon by the 1999 National Household Health Expenditures and Utilization... more From data collected in Lebanon by the 1999 National Household Health Expenditures and Utilization Survey an analysis was made of reported medication use (n = 14,142). Seventy-two percent of the population aged 25-64 reported taking a medication in the month preceding the survey. Medications with high frequencies of reported use were analgesics, psychotropics, antibiotics and vitamins. Women were more than one and a half times more likely than men to report taking any medication (OR = 1.6), and significantly more likely to report taking eight of the 19 medication types analyzed. Analyses of the association of medication use with socio-economic variables show different effects for education and employment (inversely correlated with higher use), and higher socio-economic status (positively correlated with higher use). Multivariate analyses were carried out on two of the frequently used medications, antibiotic and prescription psychotropic use, to further explore the simultaneous effect...
International agencies have recently assigned Lebanon to the group H of countries with &a... more International agencies have recently assigned Lebanon to the group H of countries with "no national data on maternal mortality," and estimated a corresponding maternal mortality ratio (MMR) of 150 per 100,000 live births. The Ministry of Public Health addressed the discrepancy perceived between the reality of the maternal mortality ratio experience in Lebanon and the international report by facilitating a hospital-based reproductive age mortality study, sponsored by the World Health Organization Representative Office in Lebanon, aiming at providing an accurate estimate of a maternal mortality ratio for 2008. The survey allowed a detailed analysis of maternal causes of deaths. Reproductive age deaths (15-49 years) were initially identified through hospital records. A trained MD traveled to each hospital to ascertain whether recorded deaths were in fact maternal deaths or not. ICD10 codes were provided by the medical controller for each confirmed maternal deaths. There were 384 RA death cases, of which 13 were confirmed maternal deaths (339%) (numerator). In 2008, there were 84823 live births in Lebanon (denominator). The MMR in Lebanon in 2008 was thus officially estimated at 23/100,000 live births, with an "uncertainty range" from 153 to 30.6. Hemorrhage was the leading cause of death, with double the frequency of all other causes (pregnancy-induced hypertension, eclampsia, infection, and embolism). This specific enquiry responded to a punctual need to correct a clearly inadequate report, and it should be relayed by an on-going valid surveillance system. Results indicate that special attention has to be devoted to the management of peri-partum hemorrhage cases. Arab, postpartum hemorrhage, development, pregnancy management, verbal autopsy
In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascu... more In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population. A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension. Approximately 25% of the sample displayed metabolic impairments (11% for ...
Maternal behavior before and after conception affects maternal and child health. Limited awarenes... more Maternal behavior before and after conception affects maternal and child health. Limited awareness of adolescents in preconception health may be addressed through school education. The aim of this intervention is to assess preconception health awareness among adolescents in Lebanese high schools and to test the effectiveness of a one-time educational session in improving preconception knowledge. The intervention consisted of a 30-minute educational session about good practices in preconception health, developed by the National Collaborative Perinatal Neonatal Network's (NCPNN) research team. A convenience sample of high school Lebanese students in grades 10 to 12, aged 14 to 26 years old, from 70 private and public schools in all six Lebanese provinces, participated in the intervention in 2011 and 2012. A multiple-choice questionnaire administered prior to and 2 months after the session was used to assess knowledge improvement among the students. A total of 7,290 students were e...
This letter intends to clarify information and misconceptions found in the article &a... more This letter intends to clarify information and misconceptions found in the article "Syrian refugees in Lebanon: the search for universal health coverage" which was published June 1st, 2016, and to challenge the core notion of fragmentation as presented by the authors. It also highlights the fact that the article does not recognize the severe shortage in refugees health financing and unmet promises by the international community, and calls for immediate action and far greater support from that community to address the needs of refugees in Lebanon.
Hepatitis B and C are two potentially life threatening liver infections. Lebanon is ranked as a z... more Hepatitis B and C are two potentially life threatening liver infections. Lebanon is ranked as a zone of moderate endemicity. This study aimed to determine the prevalence of hepatitis B and C in Lebanon and their distribution according to age, region and sex. This national prospective cross-sectional study was conducted from January 2011 till December 2012 in the six Lebanese Governorates in collaboration with municipalities, the Ministry of Public Health, Health Centres and dispensaries. An upcoming screening for hepatitis B and C was announced? in different districts of each Governorate. All individuals presenting to local laboratory, not known to have chronic hepatitis, were asked for a blood sample and answered a questionnaire addressing sex, age, place of birth and residence. Screening tests were "Abbots" for hepatitis B and "Human Hexagon" for hepatitis C. PCR testing was used to confirm the positivity of the previous tests. Of 31147 individuals screened, 542 had a rapid test positive for HBV (prevalence 1.74%, 95% CI 1.6-1.89) with a male to female ratio of 1.08. This prevalence was higher in the South and Nabatieh (1.9%) compared to Beirut (0.73%). Of 31,147 individuals screened, 64 had a rapid test positive for HCV (prevalence 0.21%, 95% CI 0.16-0.27) with a male to female ratio of 0.85. This prevalence was higher in Nabatieh (0.61%) compared to Mount Lebanon (0.08%). The prevalence of HBV and HCV in Lebanon is 1.74% and 0.21%, respectively with a higher prevalence in South and Nabatieh districts. These data rank Lebanon amongst countries with low endemicity for both viruses. Decrease in the prevalence of HBV is due to awareness campaign as well as success of the MOPH National Hepatitis Program in vaccinating all new born since 1998 and in screening and vaccinating high risk groups.
To determine the incidence and the prevalence of hepatitis B and C viral infections in patients o... more To determine the incidence and the prevalence of hepatitis B and C viral infections in patients on hemodialysis (HD) across Lebanon. We reviewed the data registry at the Lebanese Ministry of Public Health where records of monthly hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) serology are reported from 60 affiliated HD centers across Lebanon. All patients who were on HD or who started HD between October 2010 and July 2012 were included in the study. Patients from seven HD centers were excluded due to inadequate and incomplete results reporting. During the selected period, HBsAg and HCV serology were available for 3769 patients from 53 HD centers distributed at all Lebanese governorates. The prevalence was calculated by dividing the number of patients with positive HBsAg or HCV serology to the total number of patients. The Incidence was calculated by dividing the number of newly acquired infection to number of patients-years (p-y). Incidence rates at different govern...
Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refug... more Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilizing governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis. We conceptualized resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements. We explored factors contributing to the resilience of the Lebanese health system, including networking with stakeholders, diversification of the health system, adequate infrastructure and health human resources, a comprehensive communicable disease response and the integration of the refugees within the health system. In studying the case of Lebanon we used input-process-output-outcome approach to assess the resilience of the Lebanese health system. This approach provided us with a holistic view of the health system, as it captured not only the sustained and improved outcomes, but also the inputs and processes leading to them. Our study indicates that the Lebanese health system was resilient as its institutions sustained their performance during the crisis and even improved.
Structuring and implementing an endorsed neonatal resuscitation program results in decreased neon... more Structuring and implementing an endorsed neonatal resuscitation program results in decreased neonatal mortality. This paper aims to evaluate the implementation of formal training using the neonatal resuscitation program (NRP) in a private sector context of a middle income country. Between 2008 and 2011, the National Collaborative Perinatal Neonatal Network (NCPNN) supported by the Ministry of Health piloted the implementation of NRP training in member hospitals throughout the country. Training of trainers (TOT) then providers (TOP) took place over workshops where a lecture was given followed by hands on training using low fidelity manikins. Pre and post workshop knowledge assessment and hands-on-training evaluation were done. Statistical analysis using SPSS-20 was done with t-test and one way ANOVA to compare mean differences in pre and post scores and percent improvements across specialties and locations. Of 20 TOT participants, 9 (45%) conducted NRP in their hospitals. Ten TOP workshops included 256 professionals. Majority were doctors 128 (50%), 99 (39%) nurses and 20(8%) midwives. Overall pretest scores (67.25%, SD = 16.00) were significantly lower than posttest (87.48%, SD = 11.89) (p = 0.000); percent improvement among all participants was 37.12% (SD = 41.15) (p = 0.82). Nurses and Northern participants had highest mean difference in pre / post scores (21.56; SD = 12.32 and 23.29; SD = 6.62 respectively). Midwives showed the highest percent improvement (Mean = 40.44; SD + 47.28). All but 25 (9.8%) participants passed the "Megacode" from the first attempt. In our setting, implementing NRP training is essential to increase the knowledge and skills of health care professionals. It is sustainable with support from the ministry and other sources. Continuing education should be mandated at the ministry of health level.
Le Journal Medical Libanais the Lebanese Medical Journal, 2009
The accumulation of national epidemiological data since the late 1990s has led to the adoption of... more The accumulation of national epidemiological data since the late 1990s has led to the adoption of evidence-based guidelines for breast cancer screening in Lebanon (2006). Almost 50% of breast cancer patients in Lebanon are below the age of 50 years and the age-adjusted incidence rate is estimated at 69 new cases per 100,000 per year (2004). This official notification calls for breast self-examination (BSE) every month starting age 20, and a clinical breast examination (CBE) performed by a physician every three years between the ages of 20 and 40 years. Starting age 40, and for as long as a woman is in good health, an annual CBE and mammography are recommended. Women with known genetic family history of breast cancer should start screening 10 years earlier than the first young patient in the family, or earlier depending on medical advice. The Breast Cancer National Task Force (BCNTF) recommends certification of mammography centers and continued training of personnel to assure high quality mammograms, and to minimize unnecessary investigations and surgeries.It recommends that a national program should record call-backs of women for annual screening and follow-up data on abnormal mammograms. BCNTF encourages the adoption of these guidelines and monitoring of their results, as well as follow-up of breast cancer epidemiology and registry in Lebanon, and scientific progress in early breast cancer detection to determine needs for modifications in the future.
The accumulation of national epidemi- ological data since the late 1990s has led to the adop- tio... more The accumulation of national epidemi- ological data since the late 1990s has led to the adop- tion of evidence-based guidelines for breast cancer screening in Lebanon (2006). Almost 50% of breast cancer patients in Lebanon are below the age of 50 years and the age-adjusted incidence rate is esti- mated at 69 new cases per 100,000 per year (2004). This
Le Journal médical libanais. The Lebanese medical journal
Lebanon has a highly fragmented health care system. The Lebanese population receives its health c... more Lebanon has a highly fragmented health care system. The Lebanese population receives its health care services through a system dominated by the private sector that is dependent to a large extent on public sector financing. Lebanon spends about 83% of its Gross Domestic Product (GDP) on health. This study consists of observations on the utilization of the Ministry of Public Health (MOH) program of hospital care provision. The study population included all patients admitted for hospitalization in any of the 126 hospitals contracted with the MOH, between August 2008 and July 2009 (one full year). This review is limited to medical admissions only. The surgical admissions have been excluded since they are covered under a 'flat fee' reimbursement. Findings reveal that a significant proportion of the hospital admissions under this program are for conditions that may not need hospitalization. Moreover, most of these admissions receive care in relatively small and peripheral hospital...
Le Journal médical libanais. The Lebanese medical journal
The Ministry of Labor (MOL) has submitted to the Council of Ministers a social security reform pl... more The Ministry of Labor (MOL) has submitted to the Council of Ministers a social security reform plan. The Ministry of Public Health (MOPH) considers that health financing should be dealt with as part of a more comprehensive health reform plan that falls under its prerogatives. While a virulent political discussion is taking place, major stakeholders' inputs are very limited and civil society is totally put away from the whole policy making process. The role of the media is restricted to reproducing political disputes, without meaningful substantive debate. This paper discusses health insurance reform from labor market as well as public health perspectives, and aims at launching a serious public debate on this crucial issue that touches the life of every citizen.
Le Journal médical libanais. The Lebanese medical journal
From data collected in Lebanon by the 1999 National Household Health Expenditures and Utilization... more From data collected in Lebanon by the 1999 National Household Health Expenditures and Utilization Survey an analysis was made of reported medication use (n = 14,142). Seventy-two percent of the population aged 25-64 reported taking a medication in the month preceding the survey. Medications with high frequencies of reported use were analgesics, psychotropics, antibiotics and vitamins. Women were more than one and a half times more likely than men to report taking any medication (OR = 1.6), and significantly more likely to report taking eight of the 19 medication types analyzed. Analyses of the association of medication use with socio-economic variables show different effects for education and employment (inversely correlated with higher use), and higher socio-economic status (positively correlated with higher use). Multivariate analyses were carried out on two of the frequently used medications, antibiotic and prescription psychotropic use, to further explore the simultaneous effect...
International agencies have recently assigned Lebanon to the group H of countries with &a... more International agencies have recently assigned Lebanon to the group H of countries with "no national data on maternal mortality," and estimated a corresponding maternal mortality ratio (MMR) of 150 per 100,000 live births. The Ministry of Public Health addressed the discrepancy perceived between the reality of the maternal mortality ratio experience in Lebanon and the international report by facilitating a hospital-based reproductive age mortality study, sponsored by the World Health Organization Representative Office in Lebanon, aiming at providing an accurate estimate of a maternal mortality ratio for 2008. The survey allowed a detailed analysis of maternal causes of deaths. Reproductive age deaths (15-49 years) were initially identified through hospital records. A trained MD traveled to each hospital to ascertain whether recorded deaths were in fact maternal deaths or not. ICD10 codes were provided by the medical controller for each confirmed maternal deaths. There were 384 RA death cases, of which 13 were confirmed maternal deaths (339%) (numerator). In 2008, there were 84823 live births in Lebanon (denominator). The MMR in Lebanon in 2008 was thus officially estimated at 23/100,000 live births, with an "uncertainty range" from 153 to 30.6. Hemorrhage was the leading cause of death, with double the frequency of all other causes (pregnancy-induced hypertension, eclampsia, infection, and embolism). This specific enquiry responded to a punctual need to correct a clearly inadequate report, and it should be relayed by an on-going valid surveillance system. Results indicate that special attention has to be devoted to the management of peri-partum hemorrhage cases. Arab, postpartum hemorrhage, development, pregnancy management, verbal autopsy
In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascu... more In 2012, the Ministry of Public Health in Lebanon piloted a service of multifactorial cardiovascular screening in the publicly subsidized Primary Health Care (PHC) Network. We present an epidemiological analysis of data produced during this pilot to justify the inclusion of this service in the package of essential services offered through PHC and to present a preliminary cardiovascular risk profile in an asymptomatic population. A total of 4,205 participants (two-thirds of which were women) aged at least 40 years and reportedly free from diabetes, hypertension, dyslipidemia, and cardiovascular disease (CVD) were screened. The screening protocol used a questionnaire and direct measurements to assess 5 modifiable cardiovascular risk factors; total cardiovascular risk score was calculated according to a paper-based algorithm developed by the World Health Organization and the International Society of Hypertension. Approximately 25% of the sample displayed metabolic impairments (11% for ...
Maternal behavior before and after conception affects maternal and child health. Limited awarenes... more Maternal behavior before and after conception affects maternal and child health. Limited awareness of adolescents in preconception health may be addressed through school education. The aim of this intervention is to assess preconception health awareness among adolescents in Lebanese high schools and to test the effectiveness of a one-time educational session in improving preconception knowledge. The intervention consisted of a 30-minute educational session about good practices in preconception health, developed by the National Collaborative Perinatal Neonatal Network's (NCPNN) research team. A convenience sample of high school Lebanese students in grades 10 to 12, aged 14 to 26 years old, from 70 private and public schools in all six Lebanese provinces, participated in the intervention in 2011 and 2012. A multiple-choice questionnaire administered prior to and 2 months after the session was used to assess knowledge improvement among the students. A total of 7,290 students were e...
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