Background: Most primary Health Care Centers (PHCCs) in Iraq have a referral system records; however, this mechanism does not function well because of the lack of other requirements for an efficient referral system. Objective: To assess the practice & opinion of doctors in PHCs toward the referral system, and to determine the doctors in PHC's commitment to referral system instructions and guidelines. Subjects and methods: A cross-sectional study with analytic elements was conducted in nine health directorates in Iraq, from the 1st October 2018 – 30th June 2019.One PHC was selected randomly form each sector in every governorate, A questionnaire was used to collect the required information. SPSS version 24 analysis was used for the statistical analysis. Results:  sixty-three doctors were working in PHCs had participated in the current study, the mean age (40.03 ±10.24), 58.7%were female, 46% were general practitioner, 30.2% of the participated doctors had 300 and less patient/month; 31.7% of doctors had ≤10 Patients referred/month, emergencies was the main cause for referral (46.03%), and 37(58.37%) of doctors announced that the referred-form not retrained to the PHC, and ever retrained-forms had no feedback 29(46%), 28(44%)of the participated doctors agreed that the current referral-system was effective and seven of them strongly agreed, 59(93.7%) believe in the importance of hospital-feedback, with a significant relationship between their attitude about the effective-current-referral system & Refer cases Percentage, while no significant-relation with their Patients examined/month. Loaded crowded and hospital doctors shortage as possible causes and suggest to referral-system activation especially the hospital -part". Conclusions: there was inadequate knowledge of referral-policies and lack of coordination or/and clear feedback-expectations and PHCs-hospitals collaboration and lack of referral-system integrated within an electronic-health-record.

Background: Primary Health care (PHC) is unanimous to be the cornerstone of a person-centered health system. While the adoption of a well-function, two-way, and organized referral system is the mainstay in the development of an efficient healthcare delivery system.   Objective: To Assess the practice & opinion of doctors in the hospitals toward the referral system.  to determine the doctors in the hospital's commitment to referral system instructions and guidelines. Subjects and Methods: A cross-sectional study with analytic elements was conducted in nine Iraqi governorates. Eight doctors from each health directorate, resulting in a total of 72 doctors using a specially designed questionnaire. Statistical analysis was done by using SPSS, the P≤0.05 was considered statistically significant. Results: of the total 72 physicians, 31(43.1%) aged 40-49years, 48(66.7%) were males, and 58(80.6%) were specialists., 58 doctors (80.6%) had no coordination with the PHC-doctors, the same percentage considered the current referral system is ineffective. PHC patients-crowded, doctors-shortage were the causes of inadequately filling PHC-part of the referral form. And PHC-hospital doctors-coordination had a significant association with their age, gender, and their thinking about adequate filling. Conclusion: despite the importance of the referral system, half of the doctors disagreed about the current referral system’s effectiveness; & most of them had no coordination with the PHC-doctors. PHC crowded/doctors’ shortage the main causes of inadequate filling PHC part of referral-form.       الملخص: الخلفية: تعتبر الرعاية الصحية الأولية بالإجماع حجر الزاوية في نظام صحي يركز على المريض. في حين أن اعتماد نظام إحالة جيد ثنائي الاتجاه ومنظم هو الدعامة الأساسية في تطوير نظام فعال لتقديم الرعاية الصحية. الهدف: تقييم ممارسة ورأي الأطباء في المستشفيات تجاه نظام الإحالة. كذلك لتحديد مدى التزام الأطباء في المستشفى بتعليمات وإرشادات نظام الإحالة. طريقة البحث: أجريت دراسة مقطعية مع عناصر تحليلية في تسع محافظات عراقية. ثمانية أطباء من كل مديرية صحية ، مما أدى إلى ااشتراك 72 طبيبًا في استبيان مصمم خصيصًا للبحث. تم إجراء التحليل الإحصائي باستخدام SPSS ، واعتبر P≤0.05 ذو دلالة إحصائية. النتائج: من إجمالي 72 طبيبًا ، 31 (43.1٪) تتراوح أعمارهم بين 40-49 عامًا ، 48 (66.7٪) من الذكورو 58 (80.6٪) من المتخصصين. ، 58 (80.6٪) منهم ليس لديهم اي تنسيق مع أطباء الرعاية الصحية الأولية. و بنفس النسبة يعتبرون نظام الإحالة الحالي غير فعال. ازدحام المرضى في المراكز ونقص الأطباء هي اهم أسباب نقص ملأ نموذج الإحالة الخاص باطباءالمراكز الصحية بشكل مناسب. وكان لتنسيق أطباء مستشفى الرعاية الصحية الأولية علاقة كبيرة مع العمر والجنس وتفكيرهم في الملأ االنموذجي. الخلاصة: بالرغم من أهمية نظام الإحالة ، اختلف نصف الأطباء حول فعالية نظام الإحالة الحالي. ومعظمهم ليس لديهم اي تنسيق مع أطباء المراكز الصحية. ازدحام الرعاية الصحية الأولية / نقص الأطباء اهم الأسباب الرئيسية لضعف ملأ نموذج الإحالة.  

Background: Infections are common in the children attending daycare centers how act as predisposes to it. Hygienic interventions have a fundamental role in infection control and disease prevention in child care settings. Objective: - To evaluate the knowledge, attitude, and practice of nurseries workers in infection prevention and control among the children. Subjects and Methods: A cross-sectional study using the researcher-developed questionnaire validated by two experts and piloted and 100 nurseries-workers had participated in it. Result: the mean age of participants was 37.5 years±12.1, (37%) aged 18-30 yrs, 58% married, and 57% with higher education, 54% of nurseries the participant take care of 11-20 children. 67 (67%) had correct knowledge about infection control, (91%) had the corrected practice, but unfortunately, 47 (47%) had low-attitude. Education level has significantly associated with the knowledge, attitude, and practice of the child care workers. Conclusion: the majority of the nurseries workers had good knowledge and correct practice and less about their attitude in infection prevention.

Background: COVID-19 pandemic has influenced all life aspects; Dental staff, like other healthcare providers, may be exposed to COVID-19 as part of their work and its psychological impacts on healthcare workers should not be ignored Objectives: To assess the anxiety, and fear from COVID-19 pandemic in dentists working in specialist dental centers: sample the Al-Resafa health directorate, and its relation between the anxiety, and COVID-19 fear with some of their demographic variables Subjects and Methods: A cross-sectional study was conducted on 2nd Jan. to 14th Feb. 2021, by an electronic version of questionnaire through Google-form; the questionnaire was formed based on Mental-Health-American-Organization (MHAO) for anxiety test & the English-Version of the Fear of COVID-19 Scale. Analysis of data by using SPSS, Frequencies, percentages chi-square test had calculated; P-value considered significant if it's ≤0.05. Results: The response rate was 90.43%, most of them aged less than 30 years old, female 356(60.8%), married status 295(50.3%), Rotator 297(50.7%). The study revealed that moderate anxiety 115(19.6%), moderate and mild fear of COVID-19 in 275(46.9%), severe in 120(20.5%) of them. there is a significant relation between gender &anxiety, marital status & No. of children with COVID-19 Fear. Conclusion: One-fifth of dentists had moderate anxiety, and half of them had a mild fear of COVID-19 & one-fifth had a severe fear of COVID-19.