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DOCTORS WORKFORCE IN ERBIL GOVERNORATE: A STUDY ON DISTRIBUTION AND TURNOVER By

DOCTORS WORKFORCE IN ERBIL GOVERNORATE: A STUDY ON DISTRIBUTION AND TURNOVER By MOAYAD ABDULLAH WAHAB M. B. Ch. B SUPERVISOR PROFESSOR TARIQ S. AL – HADITHI M.B.Ch.B, M.Sc., DTM & H, Ph.D. Outline. Introduction Subjects and Methods Results and Discussions Conclusions

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DOCTORS WORKFORCE IN ERBIL GOVERNORATE: A STUDY ON DISTRIBUTION AND TURNOVER By

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  1. DOCTORS WORKFORCE IN ERBIL GOVERNORATE: A STUDY ON DISTRIBUTION AND TURNOVER By MOAYAD ABDULLAH WAHAB M. B. Ch. B SUPERVISOR PROFESSOR TARIQ S. AL – HADITHI M.B.Ch.B, M.Sc., DTM & H, Ph.D.

  2. Outline • Introduction • Subjects and Methods • Results and Discussions • Conclusions • Recommendations

  3. Introduction • The first decade of the 21st century is considered to be the era of health workforce. • Many countries face workforce imbalances. The problems are rooted in political, economic, cultural, and health systems.

  4. After 2003, Erbil governorate faced tremendous health demand, due to rapid socio-demographic changes. • Many aspects of doctors workforce distribution in Erbil governorate are not disclosed. There is few published studies in this field in Kurdistan region and Iraq.

  5. Aim of the study The aim of this study was to tackle the problem of uneven distribution of doctors in Erbil governorate and rapid turnover of doctors in primary health care centers in Erbil city.

  6. Objectives • To find out current distribution of doctors relevant to age, gender, location, marital status. • To determine current ratio of doctors to population at the governorate and district levels. • To identify possible causes for uneven distribution of doctors in Erbil governorate and their rapid turnover at PHCs inside Erbil city. • To set up certain recommendations for health policy makers to ensure proper future distribution of doctors.

  7. Subjects and Methods • A cross-sectional study was done from 1st Sep., 2008 to 31st March, 2010 ( Data collection from the period 1st Feb., to 30th Sep., 2009. • The sample included 962 doctors from: DOH-Erbil health facilities and HMU affiliated to DOH-Erbil.

  8. Exclusion criteria: • Doctors not affiliated from HMU to DOH-Erbil. • Employers other than DOH-Erbil & retired doctors. • Postgraduate students (529 doctors). • Long leave for >72 days (23 doctors). • Koya and Makhmour districts.

  9. Mergasor 62,139 PHC=5, H=1 Soran 232,938 PHC=7, H=3 Choman 35,922 PHC=2, H=1 Shaqlawa 147,682 PHC=7, H=3 Khabat 63,566 PHC=20 Nawandi Hawler 1,192,459 PHC=21 ,H=8, SMC=7 DashtiHawler 128,287 Koisnjaq 112,864

  10. Results & Discussion

  11. Distribution of doctors by gender • Male: female ratio is1.59:1

  12. Distribution of doctors by age • Mean age ± SD is35.10 ± 9.79y ranging from23 – 68y

  13. Distribution of doctors by marital status and geographical distribution • In: Single= 80.2%, Married = 85.4%, T = 83.6%, P = 0.001

  14. P = 0.001 Distribution of doctors by No. of children

  15. Distribution of doctors by type of health facility

  16. Distribution of doctors by hospital per district

  17. Distribution of doctors by hospital per district

  18. Relationship between workplace and birthplace

  19. Relationship between workplace and birthplace

  20. Distribution of doctors by job title

  21. Distribution of doctors by type of health facility

  22. Distribution of doctors according to job title and employer

  23. Distribution of specialists by gender & specialty

  24. Distribution of doctors by job titles for those working for private clinic and / or hospitals

  25. Factors influence employment process in rural areas

  26. Density of doctors per 10,000 populations

  27. Density of doctors per 10,000 populations

  28. Doctors satisfaction with the current health system by socio-demographic characteristics and other variables

  29. Conclusions • Numerical imbalance : below the regional and international average. • Urban- rural imbalance: geographic maldistribution of specialists. • Institutional imbalance: hospitals versus PHCs.

  30. The largest category is specialists and the smallest is general practitioners. • The proportion of pediatricians is declining. • The most common specialties: Overall: General surgery, internal medicine, pediatrics, obstetrics. Female: Obstetrics , radiology, pediatrics, dermatology.

  31. Most influential factors to determine the workplace and satisfaction are: • Having private practice. • Opportunity to choose workplace. • More than half of the doctors are satisfied with their work.

  32. Recommendations • Increase no. of doctors: next 6 y by two fold = 10 / 10,000 populations ( Middle East region level). • Make rural jobs more attractive than urban jobs: financial and non-financial incentives.

  33. Strengthening liaison between DOH and HMU through emphasis on primary health care and family medicine: • ٍٍPostgraduate study. • Adopt family health care system. • Emphasis on appointment of properly trained health managers: regular supervision of health facilities.

  34. Make private sector synergize with the public sector. • Similar studies in this field are highly recommended in Erbil governorate to study in more details the findings of this study.

  35. THANK YOU

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