Health in Dubai

Situational Analysis and Future Prospects

By

Ali Abdel Halim Hasab

Consultant Epidemiologist

Department of Planning and Statistics

DOHMS

Dubai, UAE

2007

Professor of Epidemiology, HIPH, Alexandria University

 ‫اﻟﺼﺤﺔ ﺑﺪﺑﻲ‬
‫اﻟﻮﺿﻊ اﻟﺤﺎﻟﻲ واﻟﺘﻮﻗﻌﺎت اﻟﻤﺴﺘﻘﺒﻠﻴﺔ‬

‫إﻋﺪاد‬

‫اﻷﺳﺘﺎذ اﻟﺪآﺘﻮر‪ :‬ﻋﻠﻰ ﻋﺒﺪ ا ﻟﺤﻠﻴﻢ ﺣﺴﺐ‬

‫اﺳﺘﺸﺎري اﻟﻮﺑﺎﺋﻴﺎت‬

‫إدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء‬

‫داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬

‫‪2007‬‬

‫أﺳﺘﺎذ اﻟﻮﺑﺎﺋﻴﺎت ﺑﺎﻟﻤﻌﻬﺪ اﻟﻌﺎﻟﻲ ﻟﻠﺼﺤﺔ اﻟﻌﺎﻣﺔ ﺟﺎﻣﻌﺔ اﻹﺳﻜﻨﺪرﻳﺔ‬

 ‫ﺒﺴﻡ ﺍﷲ ﺍﻟﺭﺤﻤﻥ ﺍﻟﺭﺤﻴﻡ‬

‫ﺃﻓﻤﻥ ﻴﻤﺸﻰ ﻤﻜﺒﺎ ﻋﻠﻰ ﻭﺠﻬﻪ ﺃﻫﺩﻯ ﺃﻤﻥ ﻴﻤﺸﻰ ﺴﻭﻴﺎ ﻋﻠﻰ ﺼﺭﺍﻁ ﻤﺴﺘﻘﻴﻡ‬
‫)ﺻﺪق اﷲ اﻟﻌﻈﻴﻢ (‬

‫ﺳﻮرة اﻟﻤﻠﻚ اﻵﻳﺔ )‪(22‬‬

‫‪IS ONE WHO WALKS GROVELING ON HIS FACE BETTER GUIDED‬‬

‫‪OR ONE WHO WALKS ON A STRAIGHT LINE‬‬

‫‪SURA AL MULK‬‬

‫‪VERSUS 22‬‬
 ACKNOWLEDGMENTS

The writer wishes to thank all who helped in the preparation of this work. Gratitude
and thanks are due to Mrs. Laila alJassmi, Director of Planning and Statistics,
DOHMS, Mrs. Mona Buhannad, Head Statistical Analysis Section for their
continuous support and follow up during all stages of preparation. Special
gratitude and thanks to Ms. Wafa Yousef Al-Ali, Administrative Officer and all
members of the Department of Planning and Statistics for their help.
 Preface
Health development is an essential component of the socioeconomic development. There is an
internationally observable trend towards more systematic planning and management of health care
systems. The H.H. Rulers Decree No. (17) of the year 2007, Article (5) stated that Dubai Health
Authority shall resume the responsibility of improving the health status in the Emirate of Dubai
through developing a comprehensive strategic plans relating to the health sector, developing a unified
health information system and setting priorities for health researches in Dubai. Reliable and timely
information, obtained from a wide range of sources is increasingly required to support the more
quantitative approaches being adopted. A high level of interest among senior decision makers in
DOHMS and among services staff in improving the use and managing of existing health data is
appreciated .

With the rapidly increasing number of data basis available in the electronic network in DOHMS and
private health sector, researchers should use these data even more in the future. Nevertheless,
surprisingly little has been written on how to go about this. The main advantage of these data is speed
and economy. A research question that might otherwise require much time and money to investigate
can sometimes be answered rapidly and inexpensively by analyzing existing data.

The aim of the first issue of Dubai Health Profile 2004 submitted by the writer to the Department of
Planning and Statistics has been to give a description of the data collected by the various health care
services of DOHMS & Private Sector in Dubai, studying the nature of the main health problems and
suggesting preventive and control measures. As the health status in Dubai is not changing in very short
time, The new approach followed in the " Health in Dubai: Situational Analysis and Future
Prospects" will be trend analysis of the secondary data in the electronic data base in DOHMS (2000-
2006) & private health sector (2004-2006), emphasizing the epidemiologic transition in Dubai in recent
years and future prospects of health in Dubai in the 21st century together with studying the most
common diseases in Dubai and its risk factors. The installation of SAS software that did a big jump in
extracting and analysis of data in DOHMS has facilitated that job and proved that electronic data base
if used efficiently can save time and effort and be used as a main mode of research in DOHMS .

We hope the "Health in Dubai: Situational Analysis and Future Prospects" will provide decision
makers, health planners and researchers with the necessary information for finding potential problems,
preparing plans, monitoring and evaluating health status, service performance and source availability

AA Hasab
 ‫ﻣﻘﺪﻣﺔ‬
‫ﺗﻌﺘﺒﺮ اﻟﺘﻨﻤﻴﺔ اﻟﺼﺤﻴﺔ ﺟﺰءا أﺳﺎﺳﻴﺎ ﻣﻦ اﻟﺘﻨﻤﻴﺔ اﻻﻗﺘﺼﺎدﻳﺔ واﻻﺟﺘﻤﺎﻋﻴـﺔ اﻟـﺸﺎﻣﻠﺔ‪ .‬وﻟﻤـﺎ آـﺎن هﻨـﺎك اﺗﺠـﺎﻩ‬
‫ﻋﺎﻟﻤﻲ ﻣﻠﺤﻮظ ﻟﺘﺨﻄﻴﻂ وإدارة ﻧﻈﻢ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﺑﻄﺮﻳﻘﺔ ﻣﻨﻬﺠﻴﺔ ﻓﻘﺪ ﺗﻀﻤﻦ ﻗﺎﻧﻮن إﻧﺸﺎء هﻴﺌـﺔ اﻟـﺼﺤﺔ‬
‫ﺑﺪﺑﻲ ﻓﻲ اﻟﻤﺎدة اﻟﺨﺎﻣﺴﺔ ﻣﻨﻪ أن ﺗﺘﻮﻟﻰ اﻟﻬﻴﺌﺔ ﻣـﺴﺆوﻟﻴﺔ ﺗﻄـﻮﻳﺮ اﻟﻮاﻗـﻊ اﻟـﺼﺤﻲ ﻓـﻲ اﻹﻣـﺎرة ﻣـﻦ ﺧـﻼل‬
‫إﻋﺪاد اﻟﺨﻄﻂ اﻹﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺸﺎﻣﻠﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﻘﻄـﺎع اﻟـﺼﺤﻲ ووﺿـﻊ اﻷﺳـﺲ واﻟﻤﻌـﺎﻳﻴﺮ اﻟﻼزﻣـﺔ ﻟﺘﻨﻔﻴـﺬ‬
‫إدارة ﻧﻈﺎم اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ ﺑﺎﻹﻣﺎرة ووﺿﻊ أوﻟﻮﻳﺎت اﻟﺪراﺳﺎت واﻟﺒﺤـﻮث اﻟـﺼﺤﻴﺔ اﻟﻼزﻣـﺔ وﺗﺤﻔﻴـﺰ اﻟﺘﻄـﻮﻳﺮ‬
‫واﻟﺪراﺳﺎت ﻓﻲ ﻣﺠﺎل اﻟﺼﺤﺔ اﻟﻮﻗﺎﺋﻴﺔ واﻟﻌﻼﺟﻴﺔ‪ .‬وﻟﻤـﺎ آـﺎن ﺗـﻮﻓﺮ اﻟﺒﻴﺎﻧـﺎت اﻟـﺼﺤﻴﺤﺔ واﻟﺤﺪﻳﺜـﺔ ﻣـﻦ ﻣـﺼﺎدر‬
‫ﻣﺘﻌﺪدة ﺿﺮوري ﻟﺪﻋﻢ اﻟﺴﺒﻞ اﻟﻼزﻣﺔ ﻟﻬﺬا اﻻﺗﺠﺎﻩ‪ .‬ﻓﻘﺪ آﺎن هﻨﺎك رﻏﺒﺔ آﺒﻴﺮة ﻣـﻦ اﻹدارة اﻟﻌﻠﻴـﺎ واﻟﻌـﺎﻣﻠﻴﻦ‬
‫ﺑﺎﻟﺪاﺋﺮة ﻓﻲ ﺗﺤﺴﻴﻦ اﺳـﺘﺨﺪام اﻟﺒﻴﺎﻧـﺎت اﻟـﺼﺤﻴﺔ اﻟﻤﺘـﻮﻓﺮة وﺳـﺒﻞ ﺟﻤﻌﻬـﺎ وﺗﺤﻠﻴﻠﻬـﺎ وﻋﺮﺿـﻬﺎ ﻋﻠـﻰ آﺎﻓـﺔ‬
‫ﻣﺴﺘﻮﻳﺎت اﻟﺨﺪﻣﺔ‪ .‬وﻧﻈﺮاً ﻟﻠﺘﺰاﻳﺪ اﻟﺴﺮﻳﻊ ﻓﻲ ﻗﺎﻋﺪة اﻟﺒﻴﺎﻧﺎت اﻟﻤﺘﻮﻓﺮة ﺑﺎﻟﺸﺒﻜﺔ اﻹﻟﻜﺘﺮوﻧﻴﺔ ﺑﺎﻟﺪاﺋﺮة واﻟﻘﻄﺎع‬
‫اﻟﺼﺤﻲ اﻟﺨﺎص ﻓﺎﻧﻪ ﻳﻤﻜﻦ ﻟﻤﺤﻠﻠﻲ اﻟﺒﻴﺎﻧﺎت واﻹﺣﺼﺎﺋﻴﻴﻦ ﻣـﻦ اﺳـﺘﺨﺪام هـﺬﻩ اﻟﺒﻴﺎﻧـﺎت وﺑﺪرﺟـﺔ أآﺒـﺮ ﻓـﻲ‬
‫اﻟﻤﺴﺘﻘﺒﻞ ‪ .‬ﻓﺎﻟﺴﺆال اﻟﺒﺤﺜﻲ اﻟﺬي ﻳﺤﺘﺎج اﺳﺘﻘﺼﺎؤﻩ إﻟﻰ اﻟﻜﺜﻴﺮ ﻣـﻦ اﻟﻮﻗـﺖ واﻟﻤـﺎل ﻳﻤﻜـﻦ أﺣﻴﺎﻧـﺎً اﻹﺟﺎﺑـﺔ‬
‫ﻋﻠﻴﻪ ﺑﺴﺮﻋﺔ ﺑﺘﺤﻠﻴﻞ اﻟﺒﻴﺎﻧﺎت اﻟﻤﺘﺎﺣﺔ وﺑﺘﻜﻠﻔﺔ أﻗﻞ‪ .‬آﻤـﺎ ﻳﻤﻜـﻦ ﻗﻴـﺎس اﻻرﺗﺒﺎﻃـﺎت ﺑـﻴﻦ ﺧـﺼﺎﺋﺺ اﻟﻤـﺮض‬
‫واﻟﻌﻮاﻣﻞ ذات اﻟﻌﻼﻗﺔ وآﻤﺎ ﻟـﻮ آـﺎن اﻟﺒﺎﺣـﺚ ﻳﺠﻤـﻊ ﺗﻠـﻚ اﻟﺒﻴﺎﻧـﺎت ﻣـﻦ اﻟﺪراﺳـﺎت اﻟﺒﺤﺜﻴـﺔ‪ .‬وﺗﻮﺟـﺪ اﻟﺒﻴﺎﻧـﺎت‬
‫اﻟﺨﺎﺻﺔ ﺑﺎﻷﻓﺮاد ﺑﺎﻟﺪاﺋﺮة ﺑﺎﻟﺴﺠﻼت اﻟﻄﺒﻴﺔ ﻟﻠﻤﺮﺿﻰ وﺷﻬﺎدات اﻟﻮﻓﺎة وﺑﻴﺎﻧـﺎت ﺧـﺮوج اﻟﻤﺴﺘـﺸﻔﻴﺎت وﺑﻌـﺾ‬
‫اﻟﻤﺼﺎدر اﻷﺧﺮى آﻤﺎ أﻧﻪ ﻳﻤﻜﻦ اﻻﺳﺘﻔﺎدة ﻣﻦ اﻟﺒﻴﺎﻧﺎت اﻟﻤﺠﻤﻌﺔ ﺑﺪﺑﻲ‪.‬‬

‫وﻧﻈﺮا ﻻن اﻟﻮﺿﻊ اﻟﺼﺤﻲ ﺑﺪﺑﻲ ﻻ ﻳﺘﻐﻴﺮ ﻓﻲ وﻗﺖ ﻗﺼﻴﺮ ﻓﻘﺪ روﻋﻲ ﻓﻲ إﺻﺪار ﺗﺤﻠﻴﻞ اﻟﻮﺿﻊ اﻟـﺼﺤﻲ ﻟـﺪﺑﻲ‬
‫واﻟﺘﻮﻗﻌﺎت اﻟﻤﺴﺘﻘﺒﻠﻴﺔ أن ﻳﻜﻮن اﻟﻤﺪﺧﻞ اﻟﺠﺪﻳﺪ هـﻮ ﺗﺤﻠﻴـﻞ اﻻﺗﺠـﺎﻩ ﻟﻠﺒﻴﺎﻧـﺎت اﻟﺜﺎﻧﻮﻳـﺔ ﻟﻠﻘﺎﻋـﺪة اﻻﻟﻜﺘﺮوﻧﻴـﺔ‬
‫ﺑﺎﻟﺪاﺋﺮة )‪ (2006 - 2000‬واﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص )‪ (2006 - 2004‬وﺗﺄآﻴـﺪ اﻟﺘﺤـﻮل اﻟﻮﺑـﺎﺋﻲ ﻟﻸﻣـﺮاض ﺑـﺪﺑﻲ‬
‫واﻟﺘﻮﻗﻌﺎت اﻟﻤﺴﺘﻘﺒﻠﻴﺔ ﻓﻲ اﻟﻘﺮن اﻟﻮاﺣﺪ واﻟﻌﺸﺮﻳﻦ ﻣﻊ دراﺳﺔ أهﻢ اﻷﻣﺮاض ﺑﺪﺑﻲ‪.‬‬
‫و ﻗﺪ آﺎن ﻹدﺧﺎل ﺑﺮﻧﺎﻣﺞ ﺳﺎس اﻹﺣﺼﺎﺋﻲ ﺑﻘﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣـﺼﺎﺋﻲ اﻷﺛـﺮ اﻟﺒـﺎﻟﻎ ﻓـﻲ اﺳـﺘﺨﺮاج اﻟﺒﻴﺎﻧـﺎت‬
‫وﺗﺤﻠﻴﻠﻬﺎ وإﺛﺒﺎت أن ﻗﺎﻋﺪة اﻟﺒﻴﺎﻧﺎت ﺑﺎﻟﺪاﺋﺮة إذا أﺣـﺴﻦ اﺳـﺘﺨﺪاﻣﻬﺎ ﺑﻜﻔـﺎءة ﺗـﻮﻓﺮ اﻟﻮﻗـﺖ واﻟﺠﻬـﺪ وﻗـﺪ ﺗﻜـﻮن‬
‫أﺳﻠﻮﺑﺎ هﺎﻣﺎ ﻟﻠﺒﺤﻮث ﺑﺎﻟﺪاﺋﺮة‪.‬‬

‫ﺁﻣﻠﻴﻦ أن ﻳﻘﺪم آﺘﺎب اﻟﻮﺿﻊ اﻟﺼﺤﻲ ﺑﺪﺑﻲ واﻟﺘﻮﻗﻌﺎت اﻟﻤـﺴﺘﻘﺒﻠﻴﺔ ﻟﻤﺘﺨـﺬي اﻟﻘـﺮار واﻟﻤﺨﻄﻄـﻴﻦ اﻟـﺼﺤﻴﻴﻦ‬
‫واﻟﺒﺎﺣﺜﻴﻦ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻼزﻣﺔ ﻟﺘﺤﺪﻳﺪ اﻟﻤﺸﺎآﻞ اﻟﺼﺤﻴﺔ وإﻋﺪاد اﻟﺨﻄﻂ وﻣﺘﺎﺑﻌﺔ وﺗﻘﻴﻴﻢ اﻟﺤﺎﻟﺔ اﻟـﺼﺤﻴﺔ وأداء‬
‫اﻟﺨﺪﻣﺎت وﺗﻮﻓﺮ اﻹﻣﻜﺎﻧﻴﺎت ﺑﺎﻟﺪاﺋﺮة‪.‬‬

‫ﻋﻠﻲ ﺣﺴﺐ‬
 CONTENTS

PAGE • TOPIC
I. HEALTH SITUATION IN DUBAI
1 • Non communicable diseases in Dubai: Situational Analysis
and Challenges
29 • Hypertensive Diseases in Dubai
36 • Hypertension Mortality among Emirate Inpatients in Dubai
42 • Hypertensive Diseases in Pregnancy
47 • Cardiovascular Diseases in Gulf Countries
56 • Diabetes Mellitus among Emirate Females in Dubai
71 ••• Diabetes Mellitus among School Age Children in Dubai
82 • Diabetes Mellitus in Dubai 2004 – 2006
89 • Malignant Neoplasm of Breast in DOHMS – Dubai
96 • Cancer in Dubai 2001 – 2006
103 • Cancer in Gulf countries
111 • Obesity in Dubai
121 • Health Profile of Elderly Emirate Inpatients in Dubai
130 • Heat effects in Dubai
134 • Comparative Study of Heat Effects in Dubai
140 • Effect of Traffic Campaign on Road Traffic Injuries
148 • Eye Diseases in Dubai
153 • Surgical Operations in DOHMS
167 • Surgical Mortality in DOHMS as an Indicates of Hospital
Quality
172 • Hospital Mortality in DOHMS
179 • Comparative Study of Hospital Mortality in DOHMS, Dubai
2000- 2006.
184 • Outpatient Attendances in DOHMS 2000 -2006
197 • Inpatient Services in DOHMS 2000 -2006
206 • Infectious Diseases among Inpatients in DOHMS 2000 -
2006
214 • Private Health Sector Statistics in Dubai
226 • Infectious Diseases in Private Health Sector in Dubai 2006
232 • Mortality Statistics in Dubai
II. SITUATION OF STATISTICAL ANALYSIS IN DOHMS
250 • Situational Analysis
253 • Project Plans of Design and Implementation of Statistical
Analysis System in DOHMS
265 • Coordination and integration of Health information system
in Dubai
268 • DOHMS Statistical Committee
III. EPIDEMIOLOGIC TASKS IN DOHMS
273 • Building Future Epidemiologic Capacity in DOHMS
275 • Epidemiologic Tasks in Department of Planning and
Statistics
280 • Infection Control in DOHMS
280 o Infection Control Program
282 o Formulating Infection Control Plan in DOHMS
291 • Health Research in DOHMS
293 o Proposed Health Research Section in Planning and
Statistics Department in DOHMS
307 • Health Indicators in DOHMS
309 • Demography Situational Analysis in Dubai
 Noonn C
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Coom muunniiccaabbllee D Duubbaaii:: SSiittuuaattiioonnaall A
Diisseeaasseess iinn D Chhaalllleennggeess
Annaallyyssiiss aanndd C

The global epidemic of chronic non communicable diseases continues to grow. In

2005, they caused an estimated 35 million deaths: 60% of all deaths globally, with
80% in low and middle income countries. One quarter of these deaths-almost 9
million in 2005-are in men and women aged <60 years and about 16 million in people
under 70 years of age. Cardiovascular disease is the leading cause of death among
both men and women, accounting for more than 17 million deaths in 2005. The major
causes of NCD-attributable mortality are cardiovascular disease (30% of total global
mortality), cancers (13%), chronic respiratory disease (7%) and diabetes (2%). Total
deaths from chronic disease are projected to increase by a further 17% over the next
10 years, while deaths from infectious diseases, maternal and perinatal conditions and
nutritional deficiencies combined are expected to decline. NCDs place a substantial
burden on already inadequate health services and are an impoverishing drain on
families and communities. With further urbanization and globalization driving
changes in behavior, this burden is likely to increase, hindering economic and social
development. Despite this, less than 0.1 % of all health funding from the international
assistance community is directed towards chronic NCDs(1).

The common major risk factors for chronic diseases are the same for men and women
in all regions: unhealthy diet, physical inactivity, and tobacco and alcohol use. These
risks, which are expressed through raised blood pressure, raised glucose
concentrations in blood, abnormal concentrations of lipids in blood, overweight,
obesity and consequences of harmful use of alcohol, are driven by underlying social,
economic and environmental determinants of health. About 80% of premature heart
disease and stroke, 80% of type 2 diabetes and 40% of cancers are preventable. A
broad range exists of public-health interventions that are cost-effective, many are also
inexpensive to implement. Reductions in the incidences of many NCD and their
complications are, however, already possible (2-5).

1
During the past three decades, many Arab countries have generally made
considerable progress in the control of the communicable diseases of childhood.
These changes are perhaps more apparent in the member countries of the Gulf
Cooperation Council where infant mortality has fallen significantly and where fertility
rates remain comparatively high. In Dubai, for example, the infant mortality rate has
dropped to 8.5 per 1000 live births in 2005 (2) .

Socio-economic development in UAE accompanied by the characteristics cultural

changes observed in developed societies elsewhere, improved sanitation and
consequent reduction in the occurrence of communicable diseases has led to
increasing life expectancy, changing nutritional habits, decreasing habitual physical
activity and the emergency of non-communicable diseases as the dominant feature of
ill health in the community (6) .

It is apparent from Table (1) that non communicable diseases amounted for three
fourths of all deaths in Dubai (74.9%) in 2006 with an age standardized mortality rate
of 478.0 per 100,000 populations. The rate was 195.87 for cardiovascular diseases
and 113.36 per 100,000 populations in Dubai for cancer. Figure (1) shows that that
diseases of the circulatory system amounted to 41% of all non communicable diseases
deaths in Dubai, neoplasms (21%), injury, poisoning and external cases of morbidity
and mortality (11%), genitourinary 9%, endocrine and nutritional diseases (7%),
diseases of the digestive system (5%), diseases of the respiratory system (4%), mental,
behavioral and diseases of the nervous system (2%) of the cases.

Table (2) shows the top 5 leading non communicable diseases deaths in Dubai in
2006. ischemic heart disease accounts for more than one fifth (21.92%) of all deaths,
cerebrovascular diseases 8.45%, diabetes mellitus 6.59%, injuries of the head 6.59%
and cancer breast 2.7%.

2
Non communicable diseases accounted for 34.15% of all admitted cases in DHA.
Males amounted to 66.48% of cases and expatriates more than two thirds (67.38%) of
cases. The percentage of males was more among expatriates (73.53%), Table (3).
Table (4) shows that diseases of the circulatory system amounted to 21.84% of all non
communicable diseases cases admitted in DOHMS, injury, poisoning and external
cases of morbidity and mortality (20.54%), diseases of the respiratory system
(7.96%), diseases of the digestive system (15.76%), endocrine and nutritional diseases
(7.08%), neoplasm's (4.81%) mental and behavioral diseases (4.17%) and diseases of
the nervous system (3.19%) of the attended cases.
Among cases attending specialist clinics in DOHMS, non communicable diseases
amounted to 60.29% of the cases. Emirates accounted for about three fourths of
attended non communicable diseases and Emirate females 44.98%, Table (5).
Endocrine, nutritional and metabolic diseases amounted to 43.74% of attended cases
to specialist clinics in DHA and cardiovascular diseases 29.33%, Table (6).

Table (7) shows that out of the 799510 non communicable diseases cases reported in
the private health sector in Dubai 2004-2006, 11.84% were Emirates and more than
two thirds (68.4%) of cases were males. Studying the age distribution of non
communicable diseases attending outpatient private health sector clinics, Table (7)
shows that 15.33% were below 15 years, 9.98% in the age group 15-24 years, 43.86%
in the age group 25-44 years, 27.09% in the age group 45-64 years and only 3.76% of
cases attending outpatient private health sector clinics with non communicable
diseases were 65 years and above.

Table (9) shows that injury, poisoning and external cases of morbidity and mortality
amounted to about one fourth (25.16%) of all non communicable diseases cases
attended private health sector outpatient clinics in Dubai, diseases of the digestive
system (18.67%), diseases of the respiratory system (18.64%), diseases of the

3
circulatory system (14.09%), mental and behavioral diseases (6.09%) and diseases of
the nervous system (5.44%) of the attended cases.
Non communicable diseases constituted 46.34% of all admitted cases in private health
sector hospitals in Dubai, Emirates amounted to 20.8% of admitted cases. The
percentage of males among admitted cases was 54.7%. There is increase in the
number of non communicable reported by year of admission, Table (10). Table (11)
shows that 11.6% admitted cases of non communicable diseases in private health
sector in Dubai were below 15 years, 8.88% in the age group 15-24 years, 44.03% in
the age group 25-44 years, 27.8% in the age group 45-64 years and 7.69% of the
admitted cases were 65 years and above. The distribution was nearly the same by sex
and nationality. Table (12) shows that neoplasm amounted to 6.51% of all admitted
non communicable diseases in private health sector institution, Endocrine diseases
7.2%, CVD 13.38% mental and nervous diseases 4%, respiratory diseases 8.94%,
digestive system diseases 23.03%, musculoskeletal system diseases 9.47%,
genitourinary diseases 14.9% and injury 11.94% of all admitted non communicable
diseases in private health sector institutions in Dubai.

C Noonn C
Chhaalllleennggeess ooff N mm
Coom muunniiccaabbllee D Duubbaaii
Diisseeaasseess iinn D

Although some activities has been made for the prevention and control of no
communicable diseases, but much more needs to be done – and urgently, the major
challenges, for strategic plan are: (1)

• To increase awareness of the magnitude of the burden of chronic no

communicable diseases and the potential that exists for their prevention and
control.

4
• To increase political, financial and technical commitments to prevention and
control to respond to the double burden of infectious and chronic no
communicable diseases.

• To contribute to the strengthening of health systems, especially primary health-

care systems, through the integration of chronic disease prevention and control
activities therein.

• To initiate appropriate multicultural collaboration in order to generate and sustain

prioritized actions that will modify the behavioral, social, economic and
environmental determinants of health within a set time frame and with defined
indicators.

• To generate more information about the socioeconomic consequences of chronic

diseases. Specific information would support the argument for the need to place
chronic disease prevention and control on health and development agendas.

• To identify the core interventions needed for chronic disease prevention and
control, estimate the cost of implementing them and calculate their impact in
terms of lives saved, disability averted and macroeconomic benefit to countries.

• To further encourage dialogue with the private sector, with a view to improving
public health and managing the conditions of people at high risk for chronic
diseases.

• To sustain media interest in functioning as advocates for healthy behaviors and as

supporters of policies and action plans to counter chronic diseases and reduce their
risk factors and determinants.

5
• To explore and capitalize on new financial measures and funding mechanisms,
including partnerships, for chronic disease prevention and control.

Accttiioonn ffoorr tthhee PPrreevveennttiioonn aanndd C

PPllaann ooff A mm
Noo ccoom
Coonnttrrooll ooff N muunniiccaabbllee
((11))
Diisseeaasseess iinn D
D Duubbaaii (1)

Vision The plan of action is intended to guide DOHMS work on the prevention and
control of no communicable diseases .It focuses on cardiovascular diseases, cancer,
chronic respiratory diseases and diabetes, which are responsible for half the deaths
worldwide. Many of these deaths could be prevented through known and cost-
effective interventions that focus on no communicable diseases and their shared risk
factors.

The long-term goal of the action plan is to direct comprehensive and coordinated
action in order to meet the target of reducing death rates from no communicable
diseases by two per cent annually over and above existing trends.

DOHMS priorities for achieving this long-term goal include:

• Place growing burden of no communicable diseases on the development agenda.

• Strengthening capacity of health-systems to prevent and control such diseases.
• strengthen prevention and control of no communicable diseases.
• Building partnerships for prevention and control.
• Measuring and improving performance at all levels in order to assure
accountability and transparency.

Actions DHA will strengthen efforts aimed at preventing and controlling no

communicable diseases by:

6
• Strengthening advocacy.
• Generating and disseminating evidence-based information.
• Fostering implementation on Tobacco Control, and strategies, plans, programs and
charters that strengthen prevention and control of no communicable diseases.
• Building partnerships for prevention and control.
• Measuring and improving performance at all levels in order to assure
accountability and transparency.

Time frame The action plan would be implemented within the framework of the
strategic plan, 2008 – 2013 and other existing schedules at all levels of the
Organization of DHA.

Indicators and evaluation

1. Prevalence of risk factors for no communicable diseases.

2. Mortality and burden of disease.
3. Implementation of the Framework Convention on Tobacco Control, strategies,
plans, programs and charters for prevention and control of no communicable
diseases.

Editor Comments

The H.H. Rulers Decree No.17 of the year 2007, Article (5) stated that Dubai Health
Authority shall resume the responsibility of improving the health status in the Emirate
of Dubai through developing a comprehensive strategic plans relating to the health
sector. DOHMS should strive for development, implementation and evaluation of
programs for the prevention and control of non communicable diseases. There should
be a policy for chronic disease prevention and control with a chronic non
communicable disease unit in DOMHS.

7
The impact of chronic diseases shackles the macroeconomic development in Dubai.
Heart disease, stoke and diabetes alone are estimated to reduce the growth domestic
product by between 1% and 5% in countries experiencing rapid economic growth as
UAE. The full response to the double burden of infectious and chronic non
communicable diseases still facing Dubai requires a strong primary health care system
as part of an integrated health system. Promoting the use of standardized methods and
tools and enable Dubai to strengthen its capacity to collect the core data required for
policy and program development, implementation and evaluation is required. Training
in all aspects of data collection and management, analysis and reporting is needed.
The data will be used to support the introduction and strengthening of priority actions
against chronic diseases and their risk factors. Improving access by public health
professionals to data on chronic diseases and risk factors in Dubai is a must.
DOHMS’s prevention efforts should focus on the risk factors for chronic diseases
(Tobacco use, diet, physical activity). DOHMS’s work in promoting health diet and
physical activity should continue including improvement of the quality of food and
drink products, information available to consumers and the way in which products are
marked especially to children.

Priority should be given to the integrated step by step approach to the surveillance,
prevention and control of non communicable diseases responding to the increasing
burden of chronic non communicable diseases, with a target of reducing death rates
from all chronic diseases by 2% per year over the next 10 years. Achieving this target
would avert premature deaths from these diseases. Tools for managing high-risk
population should be produced including frameworks and guidelines for integrated
management of CVD, integrated guidelines of the prevention and management of
upper and lower respiratory diseases. Cancer control programs and framework for
prevention of haemoglobinopathies and care of patients (1-3, 4, 5).

8
References:
Prevention and Control of non communicable Diseases: Implementation of the
Global Strategy
www.who.int/gb/ebwha/pdf_files/EB120/b120_22en.pdf
• Statistical Year Book. DOHMS, 2005
• Prevention of non communicable diseases in Pakistan: an integrated partnership
bases model
www.pubmedcentral.nih.gov/articlerender.fcgi?artid=520824
• Issues and Challenges in the Prevention and Control of Noncommunicable
Diseases in the South-East Asia Region
www.wpro.who.int/NR/rdonlyres/3D29EF66-8E34-4813-92CF-
E3D22F6197DE/0/NCD.pdf
• Chronic Non Communicable Diseases, a Challenge for the African Region.
www.afro.who.int/dnc/index.html
• Dubai Health Profile, DOHMS, 2004
• http://www.prb.org/pdf06/06WorldDataSheet.pdf

9
 ‫اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﺪﺑﻲ ‪ -‬اﻟﻮﺿﻊ واﻟﺘﺤﺪﻳﺎت‬

‫ﻣﺎزال اﻟﻮﺑﺎء اﻟﻌ ﺎﻟﻤﻲ ﻟﻸﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ اﻟﻤﺰﻣﻨ ﺔ ﻣ ﺴﺘﻤﺮًا ﻓ ﻲ اﻟﻨﻤ ﻮ ﻓﻔ ﻲ ﻋ ﺎم ‪ 2005‬ﺗ ﺴﺒﺐ ﻓ ﻲ ﺣ ﺪوث ‪35‬‬
‫ﻣﻠﻴﻮن ﺣﺎﻟ ﺔ وﻓ ﺎة وﺣ ﻮاﻟﻲ ‪ %60‬ﻣ ﻦ ﻣﺠﻤ ﻞ اﻟﻮﻓﻴ ﺎت اﻟﻌﺎﻟﻤﻴ ﺔ‪ -‬وآ ﺎن ‪ %80‬ﻣ ﻦ ﺗﻠ ﻚ اﻟﻮﻓﻴ ﺎت ﺑﺎﻟ ﺪول ذات اﻟ ﺪﺧﻞ‬
‫اﻟﻤﺘﻮﺳﻂ واﻟﻤﻨﺨﻔﺾ آﻤﺎ آﺎن رﺑ ﻊ ﺗﻠ ﻚ اﻟﻮﻓﻴ ﺎت‪ 9 -‬ﻣﻠﻴ ﻮن ﺣﺎﻟ ﺔ‪ -‬ﻓ ﻲ اﻟﺮﺟ ﺎل واﻟﻨ ﺴﺎء ﺗﺤ ﺖ ‪ 60‬ﻋﺎﻣ ًﺎ ﻣ ﻦ اﻟﻌﻤ ﺮ‬
‫وﺣﻮاﻟﻲ ‪ 16‬ﻣﻠﻴﻮن ﺣﺎﻟﺔ ﺗﺤﺖ ‪ 70‬ﻋﺎﻣًﺎ ﻣ ﻦ اﻟﻌﻤ ﺮ وآﺎﻧ ﺖ أﻣ ﺮاض اﻟﻘﻠ ﺐ ه ﻲ اﻟ ﺴﺒﺐ اﻟﻤ ﺆدي ﻟﻠﻮﻓ ﺎة ﺑ ﻴﻦ اﻟﺮﺟ ﺎل‬
‫واﻟﻨﺴﺎء ﻷآﺜﺮ ﻣﻦ ‪ 17‬ﻣﻠﻴﻮن ﻓﻲ ﻋﺎم ‪ 2005‬وﺣﻮاﻟﻲ ‪ %30‬ﻣﻦ اﻟﻮﻓﻴﺎت ﺑﺎﻟﻌ ﺎﻟﻢ ‪ ,‬واﻟ ﺴﺮﻃﺎﻧﺎت ‪ %13‬واﻷﻣ ﺮاض‬
‫اﻟﺘﻨﻔﺴﻴﺔ اﻟﻤﺰﻣﻨﺔ ‪ %7‬واﻟﺴﻜﺮي ‪ ,%2‬آﻤﺎ ﻳﺘﻮﻗﻊ أن ﺗﺰﻳﺪ اﻟﻮﻓﻴﺎت ﻣﻦ اﻷﻣﺮاض اﻟﻤﺰﻣﻨ ﺔ ﺣ ﻮاﻟﻲ ‪ %17‬ﻓ ﻲ اﻟﻌ ﺸﺮ‬
‫ﺳ ﻨﻮات اﻟﻤﻘﺒﻠ ﺔ ﺑﻴﻨﻤ ﺎ ﺗ ﻨﺨﻔﺾ اﻟﻮﻓﻴ ﺎت ﻣ ﻦ اﻷﻣ ﺮاض اﻟﻤﻌﺪﻳ ﺔ وﺣ ﺎﻻت اﻷﻣﻮﻣ ﺔ وﺣ ﻮل اﻟ ﻮﻻدة واﻟ ﻨﻘﺺ اﻟﻐ ﺬاﺋﻲ‬
‫ﻣﺠﺘﻤﻌ ﺔ‪ .‬آﻤ ﺎ ﺗ ﻀﻊ اﻷﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ ﻋﺒﺌ ًﺎ ﺣﻘﻴﻘﻴ ًﺎ ﻋﻠ ﻰ اﻟﺨ ﺪﻣﺎت اﻟ ﺼﺤﻴﺔ وﺗ ﺴﺘﻨﺰف ﻣ ﻮارد اﻷﺳ ﺮ‬
‫واﻟﻤﺠﺘﻤﻌ ﺎت‪ .‬وﺑﺎﻟﺘﻤ ﺪن اﻟﻤﺘﺰاﻳ ﺪ وﺗﻐﻴ ﺮات اﻟﻌﻮﻟﻤ ﺔ اﻟﻨ ﺸﻄﺔ ﻓ ﺈن ه ﺬا اﻟﻌ ﺐء ﺳ ﻮف ﻳﺘﺰاﻳ ﺪ ﺑﻤ ﺎ ﻳﻌ ﻮق اﻟﺘﻨﻤﻴ ﺔ‬
‫اﻻﺟﺘﻤﺎﻋﻴﺔ واﻻﻗﺘﺼﺎدﻳﺔ‪ .‬وﺑﺎﻟﺮﻏﻢ ﻣﻦ هﺬا ﻓﺈن أﻗﻞ ﻣﻦ‪ %.10‬ﻣﻦ اﻋﺘﻤﺎدات اﻟﺼﺤﺔ ﻣﻦ ﻣﺴﺎﻋﺪات اﻟﻤﺠﺘﻤ ﻊ اﻟ ﺪوﻟﻲ‬
‫ﺗﻮﺟﻪ إﻟﻰ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ )‪. ( 1‬‬

‫وﻋﻮاﻣﻞ اﻟﺨﻄﻮرة اﻷﺳﺎﺳﻴﺔ ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ واﺣ ﺪة ﻓ ﻲ اﻟﺮﺟ ﺎل واﻟﻨ ﺴﺎء ﺑﻜ ﻞ اﻟﻌ ﺎﻟﻢ آﺎﻟﻐ ﺬاء ﻏﻴ ﺮ اﻟ ﺼﺤﻲ‬
‫وﻗﻠﺔ اﻟﻨﺸﺎط اﻟﺒﺪﻧﻲ واﻟﺘﺪﺧﻴﻦ واﻟﻜﺤﻮﻟﻴﺎت ﻣﻤﺎ ﻳﻨﻌﻜﺲ ﻓﻲ ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم وارﺗﻔﺎع ﻧﺴﺒﺔ اﻟﺠﻠﻮآﻮز واﻟﻨ ﺴﺐ ﻏﻴ ﺮ‬
‫اﻟﻄﺒﻴﻌﻴﺔ ﻟﻠﺪهﻮن ﺑﺎﻟﺪم وزﻳﺎدة اﻟ ﻮزن واﻟ ﺴﻤﻨﺔ واﻟﺘ ﻲ ﺗ ﺴﺎق ﺑﺎﻟﻤﺤ ﺪدات اﻻﺟﺘﻤﺎﻋﻴ ﺔ واﻻﻗﺘ ﺼﺎدﻳﺔ واﻟﺒﻴﺌﻴ ﺔ ﻟﻠ ﺼﺤﺔ‪،‬‬
‫ﻓﺤﻮاﻟﻲ ‪ %80‬ﻣﻦ وﻓﻴﺎت اﻟﻘﻠﺐ اﻟﻤﺒﻜﺮ وﺟﻠﻄﺎت اﻟﻤ ﺦ ‪ %.80‬ﻣ ﻦ اﻟﻨ ﻮع اﻟﺜ ﺎﻧﻲ ﻣ ﻦ اﻟ ﺴﻜﺮي و ‪ %40‬ﻣ ﻦ ﺣ ﺎﻻت‬
‫اﻟﺴﺮﻃﺎن ﻳﻤﻜﻦ اﻟﻮﻗﺎﻳﺔ ﻣﻨﻬﺎ آﻤﺎ ﻳﻮﺟﺪ ﻣﺪى واﺳ ﻊ ﻣ ﻦ ﺗ ﺪﺧﻼت اﻟ ﺼﺤﺔ اﻟﻌﺎﻣ ﺔ ذات اﻷﺛ ﺮ اﻟﻔﻌ ﺎل وأن اﻟﻜﺜﻴ ﺮ ﻣﻨﻬ ﺎ‬
‫ﻏﻴﺮ ﻣﻜﻠﻒ ﻟﺘﻄﺒﻴﻘﻪ آﻤﺎ أن ﺗﻘﻠﻴﻞ ﺣﺪوث اﻟﻜﺜﻴﺮﻳﻦ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ وﻣﻀﺎﻋﻔﺎﺗﻬﺎ ﻣﻤﻜﻨًﺎ إﻻ أن ذﻟﻚ ﻳﺤﺘﺎج إﻟ ﻰ‬
‫)‪(5-2‬‬
‫‪.‬‬ ‫اﻟﺘﺪﺧﻼت اﻟﻤﺪﻣﺠﺔ واﻟﻤﺒﻨﻴﺔ ﻋﻠﻰ اﻟﺴﻜﺎن واﻟﺴﺒﻞ اﻟﻤﺮآﺰة ﻋﻠﻰ اﻷﺷﺨﺎص ذو اﻟﺨﻄﻮرة اﻟﻌﺎﻟﻴﺔ‬

‫وﺧﻼل اﻟﺜﻼﺛﺔ ﻋﻘﻮد اﻟﻤﺎﺿﻴﺔ ﻓﻘﺪ ﺷﻬﺪت اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﺪول اﻟﻌﺮﺑﻴﺔ ﺗﻘﺪﻣًﺎ ﻣﻠﺤﻮﻇًﺎ ﻓﻲ ﻣﻜﺎﻓﺤﺔ اﻷﻣ ﺮاض اﻟﻤﻌﺪﻳ ﺔ ﻓ ﻲ‬
‫اﻷﻃﻔﺎل وآﺎﻧﺖ هﺬﻩ اﻟﺘﻐﻴﺮات أآﺜﺮ وﺿ ﻮﺣًﺎ ﺑ ﺪول ﻣﺠﻠ ﺲ اﻟﺘﻌ ﺎون اﻟﺨﻠﻴﺠ ﻲ ﺣﻴ ﺚ اﻧﺨﻔ ﺾ ﻣﻌ ﺪل وﻓﻴ ﺎت اﻷﻃﻔ ﺎل‬
‫ﻼ اﻧﺨﻔ ﺾ ﻣﻌ ﺪل وﻓﻴ ﺎت اﻷﻃﻔ ﺎل اﻟﺮﺿ ﻊ إﻟ ﻰ ‪ 8.5‬ﻟﻜ ﻞ ‪1000‬‬
‫ﺑﻴﻨﻤﺎ ﻇﻠﺖ ﻣﻌﺪﻻت اﻟﺨﺼﻮﺑﺔ ﻋﺎﻟﻴﺔ‪ ،‬ﻓﻔ ﻲ دﺑ ﻲ ﻣ ﺜ ً‬
‫ﻣﻮﻟﻮد ﺣﻲ ﻓﻲ ﻋﺎم ‪. (2) 2005‬‬

‫‪10‬‬
‫وآ ﺎن ﻟﻠﺘﻘ ﺪم اﻻﻗﺘ ﺼﺎدي واﻻﺟﺘﻤ ﺎﻋﻲ ﺑﺪوﻟ ﺔ اﻹﻣ ﺎرات اﻟﻌﺮﺑﻴ ﺔ اﻟﻤﺘﺤ ﺪة وﻣ ﺎ ﺻ ﺎﺣﺒﻪ ﻣ ﻦ اﻟﺘﻐﻴ ﺮ ﻓ ﻲ اﻟﺨ ﺼﺎﺋﺺ‬
‫اﻟﺜﻘﺎﻓﻴ ﺔ واﻟﺘﺤ ﺴﻦ اﻟﺒﻴﺌ ﻲ و اﻻﻧﺨﻔ ﺎض ﻓ ﻲ ﺣ ﺪوث اﻷﻣ ﺮاض اﻟﻤﻌﺪﻳ ﺔ وزﻳ ﺎدة ﻋﻤ ﺮ اﻟ ﺴﻜﺎن واﻟﺘﻐﻴ ﺮ ﻓ ﻲ اﻟﻌ ﺎدات‬
‫) ‪(6‬‬
‫‪.‬‬ ‫اﻟﻐﺬاﺋﻴﺔ وﻗﻠﺔ اﻟﻨﺸﺎط اﻟﺒﺪﻧﻲ إﻟﻰ ﻇﻬﻮر اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ آﻈﺎهﺮة ﻏﺎﻟﺒﺔ ﻟﺘﺪهﻮر اﻟﺼﺤﺔ ﺑﺎﻟﻤﺠﺘﻤﻊ‬

‫وﻳﻈﻬﺮ ﻣﻦ ﺟ ﺪول )‪ (1‬أن اﻟﻮﻓﻴ ﺎت ﻣ ﻦ اﻷﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ ﻗ ﺪ ﺗ ﺴﺒﺒﺖ ﻓ ﻲ ﺣ ﻮاﻟﻲ ﺛﻼﺛ ﺔ أرﺑ ﺎع ﺣ ﺎﻻت اﻟﻮﻓ ﺎة‬
‫)‪ (%74.6‬ﺑ ﺪﺑﻲ ﻓ ﻲ ﻋ ﺎم ‪ 2006‬وﺑﻤﻌ ﺪل وﻓ ﺎة ﻣﻌﻴ ﺎري ﺑ ﺎﻟﻌﻤﺮ ‪ 478‬ﻟﻜ ﻞ ‪ 100.000‬ﻣ ﻦ اﻟ ﺴﻜﺎن وآ ﺎن اﻟﻤﻌ ﺪل‬
‫‪ 222.3‬ﻷﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ و ‪ 128.64‬ﻟﻜﻞ ‪ 100.000‬ﻣﻦ اﻟﺴﻜﺎن ﻟﻠﺴﺮﻃﺎﻧﺎت‪.‬‬

‫هﺬا وﻗﺪ اﻋﺘﻤﺪ ﺣﺴﺎب ﻣﻌﺪل اﻟﻮﻓﺎة اﻟﻤﻌﻴﺎري ﺑﺎﻟﻌﻤﺮ ﻋﻠﻰ ﺑﻴﺎﻧ ﺎت ﺳ ﻜﺎن اﻟﻌ ﺎﻟﻢ ‪ (7) 2006‬وﻳﻈﻬ ﺮ اﻟ ﺸﻜﻞ رﻗ ﻢ )‪(1‬‬
‫أن أﻣﺮاض اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ ﺗ ﺸﻜﻞ ‪ %41‬ﻣ ﻦ وﻓﻴ ﺎت اﻷﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ ﺑ ﺪﺑﻲ واﻟ ﺴﺮﻃﺎﻧﺎت ‪%21‬‬
‫واﻷذى واﻟﺴﻤﻮم ‪ %11‬وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺒﻮﻟﻲ واﻟﺘﻨﺎﺳﻠﻲ ‪ %9‬وأﻣ ﺮاض اﻟﻐ ﺪد اﻟ ﺼﻤﺎء واﻟﺘﻐﺬﻳ ﺔ ‪ %7‬وأﻣ ﺮاض‬
‫اﻟﺠﻬﺎز اﻟﻬﻀﻤﻲ ‪ %5‬وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ ‪ %4‬واﻷﻣ ﺮاض اﻟﻌﻘﻠﻴ ﺔ واﻟ ﺴﻠﻮك واﻷﻣ ﺮاض اﻟﻌ ﺼﺒﻴﺔ ‪ %2‬ﻣ ﻦ‬
‫وﻓﻴﺎت اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬

‫وﻳﻈﻬﺮ اﻟﺠﺪول رﻗ ﻢ )‪ (2‬اﻟﺨﻤ ﺴﺔ وﻓﻴ ﺎت اﻷﻋﻠ ﻰ ﻣ ﻦ اﻷﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ ﺑ ﺪﺑﻲ ﻓ ﻲ ﻋ ﺎم ‪ 2006‬وه ﻲ ﻗ ﺼﻮر‬
‫اﻟ ﺸﺮﻳﺎن اﻟﺘ ﺎﺟﻲ ﻟﻠﻘﻠ ﺐ )‪ , (%21.92‬أﻣ ﺮاض ﺷ ﺮاﻳﻴﻦ اﻟﻤ ﺦ )‪ ،(%8.45‬داء اﻟ ﺴﻜﺮي ‪ ،%6.59‬أذى اﻟ ﺮأس‬
‫)‪ (%6.59‬وﺳﺮﻃﺎن اﻟﺜﺪي )‪ (%2.7‬هﺬا وﻗﺪ ﺷﻜﻠﺖ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ‪ %34.15‬ﻣﻦ ﺣ ﺎﻻت اﻟ ﺪﺧﻮل ﺑ ﺪاﺋﺮة‬
‫اﻟﺼﺤﺔ ﺑﺪﺑﻲ وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﺬآﻮر ‪ %66.48‬آﻤﺎ ﺷﻜﻞ ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ ‪ %67.34‬ﻣﻦ اﻟﺤﺎﻻت وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﺬآﻮر‬
‫أﻋﻠﻰ ﺑﻴﻦ ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ )‪ ،(%73.53‬ﺟﺪول رﻗﻢ )‪.(3‬‬

‫وﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (4‬أن أﻣﺮاض اﻟﺠﻬﺎز اﻟﺪوري ﺗﺸﻜﻞ ‪ %21.84‬ﻣﻦ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳ ﺔ اﻟﺘ ﻲ ﺗ ﻢ إدﺧﺎﻟﻬ ﺎ‬
‫ﺑﺪاﺋﺮة اﻟﺼﺤﺔ ﻓﻲ دﺑﻲ واﻷذى واﻟﺴﻤﻮم ‪ %20.54‬وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ ‪ %7.96‬وأﻣﺮاض اﻟﺠﻬ ﺎز اﻟﻬ ﻀﻤﻲ‬
‫‪ %15.76‬وأﻣﺮاض اﻟﻐﺪد اﻟﺼﻤﺎء واﻟﺘﻐﺬﻳ ﺔ ‪ %7.08‬واﻟ ﺴﺮﻃﺎﻧﺎت ‪ %4.81‬واﻷﻣ ﺮاض اﻟﻌﻘﻠﻴ ﺔ واﻟ ﺴﻠﻮآﻴﺔ ‪4.17‬‬
‫واﻷﻣﺮاض اﻟﻌﺼﺒﻴﺔ ‪ %3.19‬ﻣﻦ ﺣﺎﻻت اﻟﺪﺧﻮل‪.‬‬

‫وآ ﺎن ﺑ ﻴﻦ اﻟﺤ ﺎﻻت اﻟﺘ ﻲ راﺟﻌ ﺖ ﻋﻴ ﺎدات اﻷﺧ ﺼﺎﺋﻴﻴﻦ ﺑ ﺪﺑﻲ ‪ 2006-2000‬ﺣ ﻮاﻟﻲ ﺛﻠﺜ ﻲ اﻟﺤ ﺎﻻت )‪(%60.29‬‬
‫أﻣﺮاض ﻏﻴﺮ ﻣﻌﺪﻳﺔ وﻗﺪ ﺷﻜﻞ اﻟﻤﻮاﻃﻨﻮن ﺣﻮاﻟﻲ ﺛﻼﺛ ﺔ أرﺑ ﺎع اﻟﺤ ﺎﻻت واﻹﻧ ﺎث اﻟﻤﻮاﻃﻨ ﺎت ‪ %44.98‬ﺟ ﺪول رﻗ ﻢ‬
‫)‪ .(5‬وأن أﻣ ﺮاض اﻟﺘﻐﺬﻳ ﺔ واﻟﻐ ﺪد اﻟ ﺼﻤﺎء آﺎﻧ ﺖ ‪ %43.74‬ﻣ ﻦ اﻟﺤ ﺎﻻت اﻟﻤﺮاﺟﻌ ﺔ وأﻣ ﺮاض اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ‬
‫اﻟﺪﻣﻮﻳ ﺔ ‪) %29.33‬ﺟ ﺪول رﻗ ﻢ ‪ .(6‬وﻳﻈﻬ ﺮ اﻟﺠ ﺪول رﻗ ﻢ )‪ (7‬أن ﺑ ﻴﻦ ‪ 799510‬ﺣﺎﻟ ﺔ أﻣ ﺮاض ﻏﻴ ﺮ ﻣﻌﺪﻳ ﺔ ﺗ ﻢ‬

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‫ﺗﺴﺠﻴﻠﻬﺎ ﺑﺎﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ‪ %11.84 ،2006-2004‬ﻣﻮاﻃﻨﻴﻦ وأآﺜ ﺮ ﻣ ﻦ ﺛﻠﺜ ﻲ اﻟﺤ ﺎﻻت ) ‪(%68.4‬‬
‫ذآﻮر‪.‬‬

‫وﺑﺪراﺳﺔ اﻟﺘﻮزﻳﻊ اﻟﻌﻤﺮي ﻟﻸﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ واﻟﻤﺮاﺟﻌ ﺔ ﻟﻠﻌﻴ ﺎدات اﻟﺨﺎرﺟﻴ ﺔ ﻟﻠﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص ﺑ ﺪﺑﻲ‬
‫ﻳﻈﻬﺮ اﻟﺠﺪول رﻗ ﻢ )‪ (8‬أن ‪ %15.33‬آ ﺎﻧﻮا ﺗﺤ ﺖ ‪ 15‬ﻋﺎﻣ ًﺎ ﻣ ﻦ اﻟﻌﻤ ﺮ‪ %9.98 ،‬ﻓ ﻲ اﻟﻤﺠﻤﻮﻋ ﺔ اﻟﻌﻤﺮﻳ ﺔ ‪24-15‬‬
‫ﻋﺎﻣﺎً‪ %43.86 ،‬ﺑﻴﻦ ‪ 44-25‬ﻋﺎﻣ ًﺎ و ‪ %27.09‬ﻣﻦ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 64-45‬ﻋﺎﻣًﺎ وأن ‪ %3.76‬ﻓﻘﻂ آ ﺎﻧﻮا ‪65‬‬
‫ﻋﺎﻣًﺎ وأآﺜﺮ ﻣﻦ اﻟﻌﻤﺮ‪ .‬وﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (9‬أن ﺣﺎﻻت اﻷذى واﻟﺴﻤﻮم ﺗﺸﻜﻞ أآﺜ ﺮ ﻣ ﻦ رﺑ ﻊ ﺣ ﺎﻻت اﻷﻣ ﺮاض‬
‫ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ )‪ (%25.16‬اﻟﺘ ﻲ راﺟﻌ ﺖ اﻟﻌﻴ ﺎدات اﻟﺨﺎرﺟﻴ ﺔ ﻟﻠﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص ﺑ ﺪﺑﻲ وأﻣ ﺮاض اﻟﺠﻬ ﺎز‬
‫اﻟﻬﻀﻤﻲ ‪ %18.67‬وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ ‪ %18.64‬وأﻣﺮاض اﻟﺠﻬﺎز اﻟ ﺪوري ‪ %14.09‬واﻷﻣ ﺮاض اﻟﻌﻘﻠﻴ ﺔ‬
‫واﻟﺴﻠﻮآﻴﺔ ‪ %6.09‬واﻷﻣﺮاض اﻟﻌﺼﺒﻴﺔ ‪.%5.44‬‬

‫هﺬا وﺷﻜﻠﺖ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ‪ %46.34‬ﻣﻦ ﻣﺠﻤﻮع اﻹدﺧﺎل ﺑﺎﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ وﻗﺪ آﺎﻧ ﺖ ﻧ ﺴﺒﺔ‬
‫اﻟﻤﻮاﻃﻨﻴﻦ ‪ %20.8‬واﻟﺬآﻮر ‪ %54.7‬وآﺎن هﻨﺎك زﻳﺎدة ﻓﻲ ﻋﺪد ﺣﺎﻻت اﻷﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ ﻟ ﺴﻨﻮات اﻹدﺧ ﺎل‬
‫)ﺟﺪول رﻗﻢ ‪ .(10‬وﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (11‬أن ‪ %11.6‬ﻣﻦ ﺣﺎﻻت إدﺧﺎل ﺣﺎﻻت اﻷﻣﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ آﺎﻧ ﺖ‬
‫ﺗﺤﺖ ‪ 15‬ﻋﺎﻣ ًﺎ ﻣﻦ اﻟﻌﻤﺮ‪ %8.88 ،‬ﻣﻦ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 24-15‬ﻋﺎﻣًﺎ ﻣﻦ اﻟﻌﻤﺮ و ‪ %44.03‬ﺑﻴﻦ ‪ 44-25‬ﻋﺎﻣ ًﺎ‬
‫ﻣﻦ اﻟﻌﻤﺮ و ‪ %27.8‬ﻣﻦ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳ ﺔ ‪ 64-45‬ﻣ ﻦ اﻟﻌﻤ ﺮ و ‪ %7.69‬ﻣ ﻦ ﺣ ﺎﻻت اﻹدﺧ ﺎل ‪ 65‬ﻋﺎﻣ ًﺎ وأآﺜ ﺮ‬
‫وآﺎن اﻟﺘﻮزﻳﻊ ﺗﻘﺮﻳﺒ ًﺎ ﻣﺘﺴﺎوﻳًﺎ ﺑﻴﻦ اﻟﺬآﻮر واﻹﻧﺎث واﻟﻤﻮاﻃﻨﻴﻦ وﻏﻴﺮ اﻟﻤ ﻮاﻃﻨﻴﻦ‪ .‬آﻤ ﺎ ﻳﻈﻬ ﺮ اﻟﺠ ﺪول رﻗ ﻢ )‪ (12‬أن‬
‫ﺣ ﺎﻻت اﻟ ﺴﺮﻃﺎﻧﺎت ﻗ ﺪ ﺷ ﻜﻠﺖ ‪ %6.51‬ﻣ ﻦ ﺣ ﺎﻻت اﻹدﺧ ﺎل ﺑﻤﺆﺳ ﺴﺎت اﻟﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص واﻟﻐ ﺪد اﻟ ﺼﻤﺎء‬
‫واﻟﺘﻐﺬﻳ ﺔ ‪ %7.2‬وأﻣ ﺮاض اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ ‪ %13.38‬واﻟﺠﻬ ﺎز اﻟﺘﻨﻔ ﺴﻲ ‪ %8.94‬وأﻣ ﺮاض اﻟﺠﻬ ﺎز‬
‫اﻟﻬ ﻀﻤﻲ ‪ %23.03‬وأﻣ ﺮاض اﻟﺠﻬ ﺎز اﻟﻌ ﻀﻠﻲ واﻟﻬﻴﻜﻠ ﻲ ‪ %9.47‬وأﻣ ﺮاض اﻟﺠﻬ ﺎز اﻟﺒ ﻮﻟﻲ واﻟﺘﻨﺎﺳ ﻠﻲ ‪%14.9‬‬
‫واﻷذى ‪ %11.94‬ﻣﻦ ﺣﺎﻻت اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ اﻟﺘﻲ ﺗﻢ إدﺧﺎﻟﻬﺎ ﻣﺆﺳﺴﺎت اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ‪.‬‬

‫ﺗﺤﺪﻳﺎت اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﺪﺑﻲ‬

‫ﺑﺎﻟﺮﻏﻢ ﻣﻦ أن هﻨﺎك ﺑﻌﺾ اﻷﻧ ﺸﻄﺔ اﻟﺘ ﻲ ﺗ ﻢ ﺗﻨﻔﻴ ﺬهﺎ ﻟﻤﻘﺎوﻣ ﺔ وﻣﻜﺎﻓﺤ ﺔ اﻷﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ ﺑ ﺪﺑﻲ إﻻ أن هﻨ ﺎك‬
‫اﻟﻤﺰﻳﺪ اﻟﺬي ﻳﺤﺘﺎج إﻟﻰ ﺗﻨﻔﻴﺬﻩ وﺑﺴﺮﻋﺔ وﺗﻌﺘﺒﺮ اﻟﺘﺤﺪﻳﺎت اﻷﺳﺎﺳﻴﺔ ﻟﻠﺨﻄﺔ اﻹﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻤﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض‬
‫ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ هﻲ‪:‬‬

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 ‫‪ .1‬زﻳﺎدة اﻟﻮﻋﻲ ﻋﻦ ﺣﺠﻢ ﻋﺒﺊ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ واﻹﻣﻜﺎﻧﺎت اﻟﻤﺤﺘﻤﻠﺔ ﻟﻤﻘﺎوﻣﺘﻬﺎ وﻣﻜﺎﻓﺤﺘﻬﺎ‪.‬‬
‫‪ .2‬زﻳ ﺎدة اﻻﻟﺘ ﺰام اﻟ ﺴﻴﺎﺳﻲ واﻟﻤ ﺎﻟﻲ واﻟﺘﻘﻨ ﻲ ﻟﻠﻤﻘﺎوﻣ ﺔ واﻟﻤﻜﺎﻓﺤ ﺔ وﻟﻼﺳ ﺘﺠﺎﺑﺔ ﻟﻠﻌ ﺐء اﻟﻤ ﻀﺎﻋﻒ ﻣ ﻦ اﻷﻣ ﺮاض‬
‫اﻟﻤﻌﺪﻳﺔ ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬
‫‪ .3‬اﻟﻤﺴﺎهﻤﺔ ﻓﻲ ﺗﻘﻮﻳﺔ اﻟﻨﻈﻢ اﻟﺼﺤﻴﺔ ﺧﺎﺻ ﺔ اﻟﺮﻋﺎﻳ ﺔ اﻟ ﺼﺤﻴﺔ اﻷوﻟﻴ ﺔ ﻣ ﻦ ﺧ ﻼل دﻣ ﺞ أﻧ ﺸﻄﺔ ﻣﻘﺎوﻣ ﺔ وﻣﻜﺎﻓﺤ ﺔ‬
‫اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﻬﺎ‪.‬‬
‫‪ .4‬اﻟﺒﺪء ﻓﻲ اﻻﺷﺘﺮاك ﻣﺘﻌﺪد اﻟﺜﻘﺎﻓﺎت ﻟﺨﻠﻖ واﺳﺘﻤﺮار أﻧﺸﻄﺔ ذات أوﻟﻴﺔ ﻟﺘﻄﻮﻳﺮ اﻟﻤﺤﺪدات اﻟﺴﻠﻮآﻴﺔ واﻻﺟﺘﻤﺎﻋﻴ ﺔ‬
‫واﻻﻗﺘﺼﺎدﻳﺔ واﻟﺒﻴﺌﻴﺔ ﻟﻠﺼﺤﺔ ﻣﻦ ﺧﻼل إﻃﺎر زﻣﻨﻲ وﻣﺆﺷﺮات ﻣﺤﺪدة‪.‬‬
‫‪ .5‬اﺳﺘﺤﺪاث ﻣﻌﻠﻮﻣﺎت أآﺜﺮ ﻋﻦ اﻟﻌﻮاﻗﺐ اﻻﺟﺘﻤﺎﻋﻴﺔ واﻻﻗﺘﺼﺎدﻳﺔ ﻟﻸﻣ ﺮاض اﻟﻤﺰﻣﻨ ﺔ ﺗ ﺴﺎﻋﺪ ﻋﻠ ﻰ دﻋ ﻢ اﻟﺨ ﻼف‬
‫ﺣﻮل اﻟﺤﺎﺟﺔ إﻟﻰ وﺿﻊ ﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض اﻟﻤﺰﻣﻨﺔ وﻣﻜﺎﻓﺤﺘﻬﺎ ﻋﻠﻰ أﺟﻨﺪة اﻟﺼﺤﺔ واﻟﺘﻨﻤﻴﺔ‪.‬‬
‫‪ .6‬اﻟﺘﻌﺮف ﻋﻠﻰ اﻟﺘﺪﺧﻼت اﻟﺠﻮهﺮﻳﺔ اﻟﺘﻲ ﻳﺤﺘﺎج إﻟﻴﻬﺎ ﻟﻤﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ ﻣ ﻊ ﺗﻘ ﺪﻳﺮ ﺗﻜﻠﻔ ﺔ‬
‫ﺗﻨﻔﻴﺬ ﺗﻠﻚ اﻟﺘﺪﺧﻼت وﺗﻘﺪﻳﺮ أﺛﺮهﺎ ﻓﻲ إﻧﻘﺎذ اﻟﺤﻴﺎة وﺗﺠﻨﺐ اﻟﻌﺠﺰ واﻟﻔﻮاﺋﺪ اﻻﻗﺘﺼﺎدﻳﺔ ﻟﻠﻤﺠﺘﻤﻌﺎت‪.‬‬
‫‪ .7‬ﺗﻘﻮﻳ ﺔ اﻟﻤ ﺸﺎرآﺔ ﻣ ﻊ اﻟﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص ﻣ ﻦ ﻣﻨﻈ ﻮر ﺗﺤ ﺴﻴﻦ اﻟ ﺼﺤﺔ اﻟﻌﺎﻣ ﺔ وﻣﻌﺎﻟﺠ ﺔ اﻷﺷ ﺨﺎص ذو‬
‫اﻟﺨﻄﻮرة اﻟﻌﺎﻟﻴﺔ ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬
‫) ‪(5 - 1‬‬
‫‪.‬‬ ‫‪ .8‬اﻟﺘﺤﺮي ﻋﻦ اﻟﻄﺮق اﻟﻤﺎﻟﻴﺔ وﺳﺒﻞ اﻟﺘﻤﻮﻳﻞ ﻣﺘﻀﻤﻨﺎ اﻟﻤﺸﺎرآﺔ ﻟﻤﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‬

‫)‪(1-5‬‬
‫ﺧﻄﺔ ﻋﻤﻞ ﻣﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض اﻟﻐﻴﺮ ﻣﻌﺪﻳﺔ ﺑﺪﺑﻲ‬

‫اﻟﺮؤﻳﺎ‬

‫ﺗﻘﺼﺪ ﺧﻄﺔ اﻟﻌﻤﻞ إﻟﻰ ﺗﻮﺟﻴﻪ أﻧﺸﻄﺔ داﺋﺮة اﻟ ﺼﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ ﻓ ﻲ ﻣﺠ ﺎل ﻣﻘﺎوﻣ ﺔ وﻣﻜﺎﻓﺤ ﺔ اﻷﻣ ﺮاض ﻏﻴ ﺮ‬
‫اﻟﻤﻌﺪﻳ ﺔ‪ .‬وﺗﺮآ ﺰ ﻋﻠ ﻰ أﻣ ﺮاض اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ واﻟ ﺴﺮﻃﺎﻧﺎت واﻷﻣ ﺮاض اﻟﺘﻨﻔ ﺴﻴﺔ اﻟﻤﺰﻣﻨ ﺔ واﻟ ﺴﻜﺮي‬
‫اﻟﻤﺴﺌﻮﻟﺔ ﻋﻦ ﻏﺎﻟﺒﻴﺔ اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ وأن آﺜﻴﺮا ﻣﻦ ﺗﻠﻚ اﻟﻮﻓﻴﺎت ﻳﻤﻜﻦ اﻟﻮﻗﺎﻳﺔ ﻣﻨﻬﺎ ﻣﻦ ﺧ ﻼل ﺗ ﺪﺧﻼت ﻣﻌﺮوﻓ ﺔ وذات‬
‫ﻓﺎﻋﻠﻴﺔ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻜﻠﻔﺘﻬﺎ واﻟﺘﻲ ﺗﺮآﺰ ﻋﻠﻰ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ وﻋﻮاﻣﻞ ﺧﻄﻮرﺗﻬﺎ اﻟﻤﺸﺘﺮآﺔ‪.‬‬

‫واﻟﻐﺎﺑﺔ ﻃﻮﻳﻠﺔ اﻷﺟﻞ ﻟﺨﻄﺔ اﻟﻌﻤ ﻞ ه ﻲ ﺗﻮﺟﻴ ﻪ أﻧ ﺸﻄﺔ ﻣﺘﻜﺎﻣﻠ ﺔ وﻣﺘﻨﺎﺳ ﻘﺔ ﻟﻠﻮﺻ ﻮل إﻟ ﻰ ﺧﻔ ﺾ ﻣﻌ ﺪﻻت اﻟﻮﻓ ﺎة ﻣ ﻦ‬
‫اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﻨﺴﺒﺔ ‪ %2‬ﺳﻨﻮﻳﺎ‪.‬‬

‫‪13‬‬
 ‫أوﻟﻮﻳﺎت هﻴﺌﺔ اﻟﺼﺤﺔ ﺑﺪﺑﻲ‬

‫وﺿﻊ اﻟﻌﺐء اﻟﻤﺘﻨﺎﻣﻲ ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻋﻠﻰ أﺟﻨﺪة اﻟﺘﻨﻤﻴﺔ‪.‬‬ ‫•‬
‫ﺗﻘﻮﻳﺔ ﻗﺪرة اﻟﻨﻈﺎم اﻟﺼﺤﻲ ﻋﻠﻰ ﻣﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬ ‫•‬

‫هﺬا وﺳﻮف ﺗﺤﺪد ﺧﻄﺔ اﻟﻌﻤﻞ اﻷوﻟﻮﻳﺎت واﻷﻧﺸﻄﺔ واﻹﻃﺎر اﻟﺰﻣﻨﻲ وﻣﺆﺷﺮات اﻷداء ﻟﻤﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤ ﺔ اﻷﻣ ﺮاض‬
‫ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻣﺎ ﺑﻴﻦ ‪ 2013 – 2008‬وﻋﻠﻰ أن ﻳﻘﺎس أﺛﺮ ﺗﻠﻚ اﻷﻧﺸﻄﺔ ﺑﻨﻬﺎﻳﺔ ‪.2013‬‬

‫اﻷﻧﺸﻄﺔ‬

‫ﺳﺘﻘﻮي هﻴﺌﺔ اﻟﺼﺤﺔ اﻷﻧﺸﻄﺔ اﻟﺮاﻣﻴﺔ إﻟﻰ ﻣﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻣﻦ ﺧﻼل‪:‬‬

‫‪ .1‬ﺗﻘﻮﻳﺔ اﻟﻮﻋﻲ ﺑﺄهﻤﻴﺔ ﻣﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ودﻋﻤﻬﺎ‪.‬‬

‫‪ .2‬إﻧﺸﺎء وﻧﺸﺮ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺮﺗﻜﺰة ﻋﻠﻰ اﻟﺪﻟﻴﻞ‪.‬‬
‫‪ .3‬ﺗﻌﺰﻳﺰ ﺗﻨﻔﻴﺬ ﺑﺮاﻣﺞ ﻣﻜﺎﻓﺤﺔ اﻟﺘﺪﺧﻴﻦ واﻻﺳ ﺘﺮاﺗﻴﺠﻴﺎت واﻟﺨﻄ ﻂ واﻟﺒ ﺮاﻣﺞ واﻟﺘ ﺸﺮﻳﻌﺎت ﺗ ﺪﻋﻢ ﻣﻘﺎوﻣ ﺔ وﻣﻜﺎﻓﺤ ﺔ‬
‫اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬
‫‪ .4‬ﻗﻴﺎس وﺗﺤﺴﻴﻦ اﻷداء ﻋﻠﻰ آﺎﻓﺔ اﻟﻤﺴﺘﻮﻳﺎت ﻟﺘﺄآﻴﺪ اﻟﻤﺴﺆوﻟﻴﺎت واﻟﺸﻔﺎﻓﻴﺔ‪.‬‬

‫اﻟﻤﺆﺷﺮات واﻟﺘﻘﻴﻴﻢ‬

‫‪ .1‬اﻧﺘﺸﺎر ﻋﻮاﻣﻞ اﻟﺨﻄﻮرة ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬

‫‪ .2‬اﻟﻮﻓﻴﺎت وﻋﺒﺊ اﻟﻤﺮض‪.‬‬
‫‪ .3‬ﺗﻨﻔﻴﺬ أﻣﺮ وﻣﻮاﺛﻴﻖ اﺳﺘﺮاﺗﻴﺠﻴﺎت ﻣﻜﺎﻓﺤﺔ اﻟﺘﺪﺧﻴﻦ واﻟﺨﻄ ﻂ واﻟﺒ ﺮاﻣﺞ واﻟﺘ ﺸﺮﻳﻌﺎت اﻟﺨﺎﺻ ﺔ ﺑﻤﻘﺎوﻣ ﺔ وﻣﻜﺎﻓﺤ ﺔ‬
‫اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬

‫اﻹﻃﺎر اﻟﺰﻣﻨﻲ‬

‫ﺳﻮف ﺗﻨﻔﺬ اﻟﺨﻄﺔ ﻣﻦ ‪ 2013 – 2008‬ﻋﻠﻰ آﻞ اﻟﻤﺴﺘﻮﻳﺎت اﻹدارﻳﺔ ﻟﻬﻴﺌﺔ اﻟﺼﺤﺔ ﺑﺪﺑﻲ‪.‬‬

‫‪14‬‬
 ‫اﻟﺘﻌﻠﻴﻖ‬

‫ﻟﻘﺪ ﻧﺺ ﻗ ﺮار ﺻ ﺎﺣﺐ اﻟ ﺴﻤﻮ ﺣ ﺎآﻢ دﺑ ﻲ رﻗ ﻢ )‪ (17‬ﻟﻌ ﺎم ‪ 2007‬اﻟﻤ ﺎدة اﻟﺨﺎﻣ ﺴﺔ أن ﺗﻜ ﻮن هﻴﺌ ﺔ اﻟ ﺼﺤﺔ ﻓ ﻲ دﺑ ﻲ‬
‫ﻣﺴﺌﻮﻟﺔ ﻋﻦ ﺗﺤ ﺴﻴﻦ اﻟﻮﺿ ﻊ اﻟ ﺼﺤﻲ ﻟﻺﻣ ﺎرة ﻣ ﻦ ﺧ ﻼل وﺿ ﻊ اﻟﺨﻄ ﻂ اﻹﺳ ﺘﺮاﺗﻴﺠﻴﺔ اﻟﻤﺮﺗﺒﻄ ﺔ ﺑﺎﻟﻮﺿ ﻊ اﻟ ﺼﺤﻲ‬
‫وإﻧﺸﺎء ﻧﻈﺎم ﻣﻌﻠﻮﻣﺎت ﺻﺤﻴﺔ ﻣﻮﺣﺪ ووﺿﻊ اﻷوﻟﻮﻳﺎت ﻟﻠﺒﺤﻮث اﻟﺼﺤﻴﺔ ﺑﺎﻹﻣﺎرة ﻟﺬا ﻓﺈن اﻟﻬﻴﺌﺔ ﻳﺠﺐ أن ﺗﺠﺎهﺪ ﻣﻦ‬
‫أﺟﻞ ﺗﺨﻄﻴﻂ وﺗﻨﻔﻴﺬ وﺗﻨﻈﻴﻢ ﺑ ﺮاﻣﺞ ﻟﻤﻘﺎوﻣ ﺔ وﻣﻜﺎﻓﺤ ﺔ اﻷﻣ ﺮاض ﻏﻴ ﺮ اﻟﻤﻌﺪﻳ ﺔ‪ ،‬ه ﺬا وﻳﺠ ﺐ أن ﺗﻜ ﻮن هﻨ ﺎك ﺳﻴﺎﺳ ﺔ‬
‫ﻟﻤﻘﺎوﻣﺔ وﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻣﻊ إﻧﺸﺎء وﺣﺪة ﻟﻤﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﺎﻟﻬﻴﺌﺔ‪.‬‬

‫ﺗﺮاﺟﻊ اﻟﻨﺴﺨﺔ اﻹﻧﺠﻠﻴﺰﻳﺔ‬ ‫اﻟﻤﺮاﺟﻊ‬

‫‪15‬‬
Table (1) Distribution of Crude and Age Standardized Mortality Rate in Dubai,
2006

Rate Crude Age Standardized

( Per 100, 000 Population) ( Per 100, 000 Population)
Mortality Rate 1869(144) 7087(537.9)

NCD 1400 (105.98) 6299 (478.0)

CVD 616 (46.6) 2937 (222.3)

Cancer 258 (19.58) 1699(128.64)

* Calculation of age standardized mortality rate was based on the World Population
Data Sheet 2006

16
 Figure ( 1 ) Distribution of Non Communicable Diseases Mortality in
Dubai 2006

9%
4%
2%
5%
41%
7%

11%

21%

CVD Cancer Injury Endocrine Digest ive Ment al & Nervous Respirat ory Genit ourinary

17
 Table (2) Top 5 Non communicable Diseases Deaths in Dubai 2006

Causes No. %
Ischaemic Heart Disease 130 21.92
Cerebrovascular Diseases 50 8.45
Diabetes Mellitus 39 6.59
Injuries of the head 39 6.59
Cancer Breast 16 2.7
Total No. of Coded Non communicable
592
Diseases Deaths in Dubai

18
Table ( 3 ) Distribution of Non communicable Diseases among Inpatients in
DOHMS, Dubai 2000 -2006

Nationality
Sex Total

Emirate Expatriate
19831 22536 42367
Female 15.69 17.83 33.52
48.10 26.47
21400 62617 84017
Male 16.93 49.55 66.48
51.90 73.53
41231 85153 126384
Total 32.62 67.38 100.00

19
Table ( 4 ) Distribution of Non communicable Diseases among Inpatients by
Sex and Diagnosis in DOHMS, Dubai 2000 -2006

Diagnosis Sex Total

Female Male
Neoplasm 3322 2760 6082
2.63 2.18 4.81
7.84 3.29
Blood 1813 2206 4019
1.43 1.75 3.18
4.28 2.63
Endocrine 4123 4821 8944
3.26 3.81 7.08
9.73 5.74
Mental 1985 3283 5268
1.57 2.60 4.17
4.69 3.91
Nervous 1638 2394 4032
1.30 1.89 3.19
3.87 2.85
CVD 6090 21516 27606
4.82 17.02 21.84
14.37 25.61
Respiratory 3990 6076 10066
3.16 4.81 7.96
9.42 7.23
Digestive 5959 13955 19914
4.71 11.04 15.76
14.07 16.61
Genitourinary 8407 6084 14491
6.65 4.81 11.47
19.84 7.42
Injury 5040 20922 25962
3.99 16.55 20.54
11.90 24.90
Total 42367 84017 126384
33.52 66.48 100.00

20
 Table ( 5 ) Distribution of Coded Non communicable Diseases among
Outpatients Attending Specialist Clinics by Nationality and Sex in DHA, Dubai
2000 -2006

Sex Nationality Total

Emirate Expatriate
Female 95185 24381 119566
44.98 11.52 56.50
61.51 42.87
Male 59561 32495 92056
28.14 15.36 43.50
38.49 57.13
Total 154746 56876 211622
73.12 26.88 100.00

21
 Table ( 6 ) Distribution of Coded Non communicable Diseases among
Outpatients Attending Specialist Clinics by Nationality and Sex in DOHMS,
Dubai 2000 -2006

Diagnosis Sex Total

Female Male
Neoplasm 2128 723 2851
1.01 0.34 1.35
1.78 0.79
Blood 3864 2052 5916
1.83 0.97 2.80
3.23 2.23
Endocrine 54318 38256 92574
25.67 18.08 43.74
45.43 41.56
Mental 1810 2304 4114
0.86 1.09 1.94
1.51 2.50
Nervous 3399 2889 6288
1.61 1.37 2.97
2.84 3.14
CVD 31828 30232 62060
15.04 14.29 29.33
26.62 32.84
Respiratory 5298 4787 10085
2.50 2.26 4.77
4.43 5.20
Digestive 8501 7455 15956
4.02 3.52 7.54
7.11 8.10
Injury 1191 1676 2867
0.56 0.79 1.35
1.00 1.82
genitourinary 7229 1682 8911
3.41 0.79 4.21
6.05 1.82
Total 119566 92056 211622
56.50 43.50 100.00

22
Table (7) Distribution of Non Communicable Diseases among Private Health
Sector Outpatient Clinics by Sex in Dubai 2004 -2006

Nationality Sex Total

Female Male
Expatriate Sum 208710.00 496140.00 704850.00
% 82.50 90.78 88.16

Emirate Sum 44265.00 50395.00 94660.00

% 17.50 9.22 11.84
All Sum 252975.00 546535.00 799510.00

23
 Table ( 8 ) Distribution of Non Communicable Diseases among Private
Health Sector Outpatient Clinics by Age Group , Nationality and Sex in Dubai
2004 -2006

Nationality Total
Age Group
Expatriate Emirate

Female Male Female Male

Sum 7275.00 10222.00 2390.00 2406.00 22293.00
<1
% 3.52 2.09 5.48 4.86 2.83
1- Sum 16879.00 20443.00 4748.00 5119.00 47189.00
% 8.17 4.18 10.88 10.34 5.99
5- Sum 18007.00 23206.00 4753.00 5360.00 51326.00
% 8.72 4.75 10.89 10.83 6.51
15- Sum 24009.00 42512.00 5967.00 6164.00 78652.00
% 11.63 8.70 13.67 12.45 9.98
25- Sum 85897.00 228649.00 14926.00 16325.00 345797.00
% 41.60 46.78 34.20 32.97 43.86
45- Sum 46834.00 147576.00 8676.00 10478.00 213564.00
% 22.68 30.19 19.88 21.16 27.09
65- Sum 7588.00 16186.00 2186.00 3658.00 29618.00
% 3.67 3.31 5.01 7.39 3.76
Total Sum 206489.00 488794.00 43646.00 49510.00 788439.00
% 100.00 100.00 100.00 100.00 100.00

24
 Table ( 9 ) Distribution of Non Communicable Diseases among Private
Health Sector Outpatient Clinics by Sex in Dubai 2004 -2006

Non Communicable Disease Sex All

Female Male
Sum 3296.00 3062.00 6358.00
Neoplasm (C00- D48)
% 1.30 0.56 0.80
Diseases of the Blood & Blood Forming Sum 2580.00 1731.00 4311.00
Organs (D50 - D89) % 1.02 0.32 0.54
Endocrine, Nutritional & Metabolic Sum 28333.00 55628.00 83961.00
Discuses (E00 – E90) % 11.20 10.18 10.50
Mental & Behavioral disorders Sum 19196.00 29532.00 48728.00
(F00 – F99) % 7.59 5.40 6.09
Diseases of the Nervous System Sum 14536.00 28940.00 43476.00
(G00 – G99) % 5.75 5.30 5.44
Diseases of the Circulatory System Sum 30002.00 82684.00 112686.00
(I00 – I99) % 11.86 15.13 14.09
Diseases of the Respiratory System Sum 50219.00 98777.00 148996.00
(J00 – J99) % 19.85 18.07 18.64
Diseases of the Digestive System Sum 44114.00 105129.00 149243.00
(K00 – K93) % 17.44 19.24 18.67
Diseases of the Genitourinary System Sum 202.00 388.00 590.00
(N00 – N99) % 0.08 0.07 0.07
Sum 60497.00 140664.00 201161.00
Injury & Poisoning and External causes of % 23.91 25.74 25.16
Morbidity & Mortality (S00 – Y98)

25
 Table ( 10 ) Distribution of Non Communicable Diseases among Inpatients of Private Health Sector by ICD Code,
Sex and Nationality in Dubai 2004 – 2006

Year Emirates Expatriate Total

Female Male Total Female Male Total Female Male Total
No. No. No. No. (%) No. (%) No. (%) No. (%) No. (%) No. (%)
(%) (%) (%)
2004 904.00 967.00 1871.00 2378.00 3279.00 5657.00 3282.00 4246.00 7528.00
22.83 26.21 24.46 18.71 19.91 19.39 19.69 21.07 20.44
2005 1603.00 1385.00 2988.00 5090.00 6430.00 11520.00 6693.00 7815.00 14508.00
40.48 37.54 39.06 40.05 39.05 39.49 40.15 38.78 39.40
2006 1453.00 1337.00 2790.00 5242.00 6756.00 11998.00 6695.00 8093.00 14788.00
36.69 36.24 36.48 41.24 41.03 41.12 40.16 40.16 40.16
Total 3960.00 3689.00 7649.00 12710.00 16465.00 29175.00 16670.00 20154.00 36824.00
100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00

26
 Table ( 11 ) Distribution of Non Communicable Diseases among Inpatients of
Private Health Sector by ICD Code, Sex and Nationality in Dubai 2004 – 2006

Age Nationality Total

Emirates Expatriates
Total Female Male No. Total Female Male Female Male Total
No. (%) No. (%) (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%
<15 1010.00 395.00 615.00 3260.00 1289.00 1971.00 1684.00 2586.00 4270.00
13.20 9.97 16.67 11.17 10.14 11.97 10.10 12.83 11.60
15- 971.00 506.00 465.00 2299.00 1171.00 1128.00 1677.00 1593.00 3270.00
12.69 12.78 12.61 7.88 9.21 6.85 10.06 7.90 8.88
25- 3039.00 1699.00 1340.00 13175.00 6377.00 6798.00 8076.00 8138.00 16214.0
39.73 42.90 36.32 45.16 50.17 41.29 48.45 40.38 44.03
45- 1588.00 852.00 736.00 8649.00 3086.00 5563.00 3938.00 6299.00 10237.0
20.76 21.52 19.95 29.65 24.28 33.79 23.62 31.25 27.80
65+ 1041.00 508.00 533.00 1792.00 787.00 1005.00 1295.00 1538.00 2833.00
13.61 12.83 14.45 6.14 6.19 6.10 7.77 7.63 7.69
All 7649.00 3960.00 3689.00 29175.00 12710.00 16465.00 16670.00 20154.00 36824.0
100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00

27
Table ( 12 ) Distribution of Non Communicable Diseases among Inpatients of Private Health
Sector by ICD Code, Sex and Nationality in Dubai 2004 - 2006

ICD Classification Nationality Total

(ICD 10 CODE) Emirates Expatriate
Female Male Female Male
No. (%) No. (%) No. (%) No. (%) No. (%)
227.00 124.00 1255.00 791.00 2397.00
Neoplasm (C00- D48)
5.73 3.36 9.87 4.80 6.51
Diseases of the Blood & Blood 34.00 20.00 96.00 84.00 234.00
Forming Organs (D50 - D89)
0.86 0.54 0.76 0.51 0.64
Endocrine, Nutritional & 578.00 245.00 1160.00 669.00 2652.00
Metabolic Discuses (E00 – E90) 14.60 6.64 9.13 4.06 7.20
Mental & Behavioral disorders 59.00 88.00 136.00 176.00 459.00
(F00 – F99) 1.49 2.39 1.07 1.07 1.25
Diseases of the Nervous System (G00 – 127.00 137.00 352.00 395.00 1011.00
G99)
3.21 3.71 2.77 2.40 2.75
Diseases of the Circulatory System 331.00 467.00 978.00 3151.00 4927.00
(I00 – I99) 8.36 12.66 7.69 19.14 13.38
Diseases of the Respiratory System 436.00 462.00 963.00 1431.00 3292.00
(J00 – J99) 11.01 12.52 7.58 8.69 8.94
Diseases of the Digestive System (K00 753.00 835.00 2725.00 4168.00 8481.00
– K93) 19.02 22.63 21.44 25.31 23.03
Diseases of the Musculoskeletal 438.00 388.00 1184.00 1477.00 3487.00
System (M00 – M99) 11.06 10.52 9.32 8.97 9.47
Diseases of the Genitourinary 698.00 413.00 2666.00 1711.00 5488.00
System (N00 – N99) 17.63 11.20 20.98 10.39 14.90
279.00 510.00 1195.00 2412.00 4396.00
Injury & Poisoning and External 7.05 13.82 9.40 14.65 11.94
causes of Morbidity & Mortality
(S00 – Y98)
Total 3960.00 3689.00 12710.00 16465.00 36824.00
100.00 100.00 100.00 100.00 100.00

28
 Hypertensive Diseases in Dubai

Raised blood pressure is a massive health problem in almost every country. It is one
of the most important underlying risk factors for morbidity and mortality in the world
today, ranking alongside tobacco in estimates of the worldwide attributable burden of
mortality. Population studies suggest that blood pressure in excess of 140/90 mmHg is
found in nearly 30% of adults. In addition, Hypertension is already a highly prevalent
cardiovascular risk factor worldwide because of increasing longevity and prevalence
of contributing factors such as obesity. Whereas the treatment of hypertension has
been shown to prevent cardiovascular diseases and to extend and enhance life,
(1-5).
hypertension remains inadequately managed everywhere

Cardiovascular diseases (CVD) amounted to 28% of all deaths in UAE in 2003. In

Dubai, it amounted to 31.4% of all deaths in 2005. Inpatient cardiovascular diseases
amounted to 3919 (8.49%) of all admitted cases in DOHMS in 2005. Hypertensive
diseases constituted 9.8% of all the admitted cases of CVD in DOHMS and were
more frequent among females (17.0%). It is one of the ten leading causes of death
among Emirates in 2005.

There were 386 cases admitted in DOHMS, 147 (38.1%) were Emirates and 61.9%
were Expatriates, (Figure 1). Among the Emirate population, 72 (49.0%) were males
and 51.0% were females. The frequency distribution of hypertension increased with
increase in age, but hypertension was more prevalent among females in the age group
45-64 years and males in the age group 65 years and above.

Out of 237055 outpatient cases diagnosed by specialist in DOHMS in 2005, there

were 13497 cases of CVD with a rate of 5.7%. Hypertensive diseases amounted for
more than two fifths of the cases (43.46%). Studying hypertensive heart diseases
among persons diagnosed by specialist, there were 1132 (45.24%) males and 1371

29
(54.77%) females. The frequency distribution of the diseases increased with increase
in age. There was a significant difference between males and females regarding
distribution of hypertensive heart diseases by age, (P=0.02).

The mean age for Emirates population was 61.21 ± 13.08. It was 62.62 ± 13.01 years
for males and 60.44 ± 13.07 for females. This difference is significant. The mean
number of visit was 2.44 ± 1.67 visits with no significant difference between males
and females. Studying the distribution of hypertensive diseases by type, essential
hypertension amounted to 93.0%, hypertensive heart disease, renal heart disease
(3.7%) and secondary hypertension 3.3%, (Figure 2). There was a significant
difference between males and females in the distribution of hypertensive heart disease
by type.

Out of the 2556 (CVD) cases admitted in Private health sector facilities in Dubai in
2005, 214 (8.4%) were hypertensive diseases. As for outpatient cases, there were
64299 outpatient attendances of cardiovascular diseases. Hypertension diseases
amounted for about two thirds (62.4%) of the attended cases.

Recommendation:
- Carrying out an integrated survey to determine the prevalence of
hypertension in Dubai and study the important risk factors of the disease.
- Developing a program for management and control of hypertension within
non-communicable diseases control program and integration of its
activities through primary health care.

References:
1. Wiist WL and Flack .Epidemiology of hypertension and hypertensive
target-organ damage in the United States. J Assoc Acad Minor Phys. 1991;
2(4):143-50. in

30
 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed
&list_uids=1839824&dopt=Abstract
2. American Journal of Epidemiology Vol. 153, No. 7 : 715-716 in
http://aje.oxfordjournals.org/cgi/content/full/153/7/715
3. 3. Elliott P. High blood pressure in the community. In: Bulpitt CJ, ed.
Handbook of hypertension. Vol. 20. Epidemiology of hypertension.
Amsterdam, the Netherlands: Elsevier Scientific B.V., 2000:1–18.
4. 4. Ezzati M, Lopez AD, Rodgers A, et al. Selected major risk factors and
global and regional burden of disease. Lancet. 2002; 360:1347-1360.
5. 5. Paul K. Whelton, Epidemiology and the Prevention of Hypertension in
http://www.medscape.com/vi ewarticle/494336

31
 ‫ﺑﺪﺑــﻲ‬
‫اﻟـﺪم ﺑﺪﺑــﻲ‬
‫ﺿﻐـﻂ اﻟـﺪم‬
‫ارﺗﻔــﺎع ﺿﻐـﻂ‬
‫أﻣــﺮاض ارﺗﻔــﺎع‬
‫أﻣــﺮاض‬

‫ﻳﺸﻜﻞ ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﻣﺸﻜﻠﺔ ﺻﺤﻴﺔ آﺒﻴﺮة ﻓﻲ ﻣﻌﻈﻢ ﺑﻠ ﺪان اﻟﻌ ﺎﻟﻢ آﻤ ﺎ اﻧ ﻪ اﺣ ﺪ أآﺜ ﺮ ﻋﻮاﻣ ﻞ اﻟﺨﻄ ﻮرة ﻟﻠﻤ ﺮض‬
‫وزﻳﺎدة أﻋﺒﺎء اﻟﻮﻓﺎة ﺑﺎﻟﻌﺎﻟﻢ ﺟﻨﺒًﺎ إﻟﻰ ﺟﻨﺐ ﻣﻊ اﻟﺘﺪﺧﻴﻦ‪ ،‬هﺬا وﻗﺪ أﻇﻬﺮت اﻟﺪراﺳ ﺎت اﻟ ﺴﻜﺎﻧﻴﺔ أن ارﺗﻔ ﺎع ﺿ ﻐﻂ اﻟ ﺪم‬
‫ﻳﻮﺟﺪ ﻓﻲ ﺣﻮاﻟﻲ ‪ %30‬ﻣﻦ اﻟﺒﺎﻟﻐﻴﻦ آﻤﺎ أﻧﻪ ﻋﺎﻣﻞ ﺧﻄﻮرة ﻷﻣ ﺮاض اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ آﻨﺘﻴﺠ ﺔ ﻟﺰﻳ ﺎدة ﻋﻤ ﺮ‬
‫اﻟﺴﻜﺎن ووﺟﻮد اﻟﻌﻮاﻣﻞ اﻟﻤﺴﺎﻋﺪة اﻷﺧﺮى آﺰﻳﺎدة وزن اﻟﺠﺴﻢ‪ ،‬وﺑﻴﻨﻤﺎ أﻇﻬﺮت اﻟﺪارﺳ ﺎت أن ﻋ ﻼج ارﺗﻔ ﺎع ﺿ ﻐﻂ‬
‫اﻟﺪم ﻗﺪ ﻳﻤﻨﻊ أﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ وﻳﻌﺰز اﻟﺤﻴﺎة ﻓﺎن ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﻣﺎزال ﻻ ﻳﻌﺎﻟﺞ ﺑﺪرﺟﺔ آﺎﻓﻴﺔ‪.‬‬

‫ه ﺬا وﻗ ﺪ ﺷ ﻜﻠﺖ أﻣ ﺮاض اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ ‪ %28‬ﻣ ﻦ اﻟﻮﻓﻴ ﺎت ﺑﺪوﻟ ﺔ اﻹﻣ ﺎرات اﻟﻌﺮﺑﻴ ﺔ اﻟﻤﺘﺤ ﺪة ﻓ ﻲ ﻋ ﺎم‬
‫‪ ،2003‬وﻓﻲ دﺑﻲ ﺷﻜﻠﺖ أﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳ ﺔ ‪ %31.4‬ﻣ ﻦ ﻣﺠﻤ ﻮع اﻟﻮﻓﻴ ﺎت ﻓ ﻲ ﻋ ﺎم ‪ 2005‬و‪%8.5‬‬
‫ﻣﻦ ﺣﺎﻻت اﻟﺪﺧﻮل ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ‪ ،‬وآﺎﻧﺖ ﻧﺴﺒﺔ أﻣ ﺮاض ارﺗﻔ ﺎع ﺿ ﻐﻂ اﻟ ﺪم ‪ %9.8‬ﻣ ﻦ ﺣ ﺎﻻت‬
‫دﺧﻮل أﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ ﺑﺎﻟﺪاﺋﺮة وآﺎﻧﺖ اﻟﻨﺴﺒﺔ أﻋﻠﻰ ﺑﻴﻦ اﻟ ﺴﻴﺪات )‪ (%17‬آﻤ ﺎ أن أﻣ ﺮاض ارﺗﻔ ﺎع‬
‫ﺿﻐﻂ اﻟﺪم آﺎﻧﺖ اﺣﺪ اﻟﻌﺸﺮة أﺳﺒﺎب اﻷوﻟﻴﺔ اﻟﻤﺆدﻳﺔ ﻟﻠﻮﻓﺎة ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ ﻓ ﻲ ﻋ ﺎم ‪ .2005‬ه ﺬا وآﺎﻧ ﺖ هﻨ ﺎك ‪386‬‬
‫ﺣﺎﻟﺔ ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﺗ ﻢ إدﺧﺎﻟﻬ ﺎ ﺑﺎﻟ ﺪاﺋﺮة ﻓ ﻲ ﻋ ﺎم ‪ (%38.1) 147 ،2005‬ﻣ ﻮاﻃﻨﻴﻦ و‪ %61.9‬ﻏﻴ ﺮ ﻣ ﻮاﻃﻨﻴﻦ‬
‫)ﺷﻜﻞ رﻗﻢ ‪ ،(1‬وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﺬآﻮر ‪ %49‬واﻹﻧ ﺎث ‪ %51‬ﺑ ﻴﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ وآ ﺎن هﻨ ﺎك زﻳ ﺎدة ﻓ ﻲ ﺗﻮزﻳ ﻊ اﻟﺤ ﺎﻻت‬
‫ﺑﺰﻳﺎدة اﻟﻌﻤﺮ‪ .‬وآﺎﻧﺖ أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟ ﺪم أآﺜ ﺮ اﻧﺘ ﺸﺎر ﺑ ﻴﻦ اﻟ ﺴﻴﺪات ﻓ ﻲ اﻟﻤﺠﻤﻮﻋ ﺔ اﻟﻌﻤﺮﻳ ﺔ ‪ 64-45‬ﻋﺎﻣ ًﺎ‬
‫وﻓﻲ اﻟﺬآﻮر اﻟﺒﺎﻟﻐﻴﻦ ‪ 65‬ﻋﺎﻣًﺎ وأآﺜﺮ‪.‬‬

‫وآ ﺎن ﺑ ﻴﻦ ‪ 237055‬ﺣﺎﻟ ﺔ ﻣﺮاﺟﻌ ﺔ ﻟﻌﻴ ﺎدات اﻷﺧ ﺼﺎﺋﻴﻴﻦ ﺑﺎﻟ ﺪاﺋﺮة ‪ 13497‬ﺣﺎﻟ ﺔ أﻣ ﺮاض ﻗﻠ ﺐ وأوﻋﻴ ﺔ دﻣﻮﻳ ﺔ‬
‫)‪ ،(%5.7‬وﺷ ﻜﻠﺖ أﻣ ﺮاض ارﺗﻔ ﺎع ﺿ ﻐﻂ اﻟ ﺪم ‪ %43.5‬ﻣ ﻦ اﻟﺤ ﺎﻻت وﺑﺪارﺳ ﺔ ﺗﻮزﻳ ﻊ ﺣ ﺎﻻت أﻣ ﺮاض ارﺗﻔ ﺎع‬
‫ﺿ ﻐﻂ اﻟ ﺪم ﻓﻘ ﺪ ﺷ ﻜﻞ اﻟ ﺬآﻮر ‪ %45.2‬واﻹﻧ ﺎث ‪ %54.8‬وآﺎﻧ ﺖ هﻨ ﺎك ﻓ ﺮوق ﺟﻮهﺮﻳ ﺔ ﺑ ﻴﻦ اﻟ ﺬآﻮر واﻹﻧ ﺎث ﻓ ﻲ‬
‫ﺗﻮزﻳﻊ اﻟﺤﺎﻻت ﺗﺒﻌ ًﺎ ﻟﻠﻌﻤﺮ‪ .‬وآﺎن ﻣﺘﻮﺳﻂ اﻟﻌﻤﺮ ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ ‪ 61.2‬ﻋﺎﻣًﺎ وﻣﻊ وﺟ ﻮد ﻓ ﺮوق ﺟﻮهﺮﻳ ﺔ ﻓ ﻲ ﺗﻮزﻳ ﻊ‬
‫اﻟﻌﻤﺮ ﺑﻴﻦ اﻟﺬآﻮر واﻹﻧﺎث وآﺎن ﻣﺘﻮﺳﻂ ﻋ ﺪد اﻟﺰﻳ ﺎرات ‪ 2.4‬زﻳ ﺎدة وﺑ ﺪون ﻓ ﺮوق ﺟﻮهﺮﻳ ﺔ ﺑ ﻴﻦ اﻟ ﺬآﻮر واﻹﻧ ﺎث‪.‬‬
‫وﺷﻜﻞ ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم اﻷﺳﺎﺳ ﻲ ‪ %93‬ﻣ ﻦ اﻟﺤ ﺎﻻت و‪ 3.7‬ﻟﻤﺮﺿ ﻰ اﻟﻘﻠ ﺐ واﻟﻜﻠ ﻰ أو آﻼهﻤ ﺎ و ‪ %3.3‬ارﺗﻔ ﺎع‬
‫ﺿﻐﻂ اﻟﺪم اﻟﺜﺎﻧﻮي )ﺷﻜﻞ رﻗﻢ ‪ ،(2‬آﻤﺎ آﺎﻧﺖ هﻨﺎك ﻓﺮوق ﺟﻮهﺮﻳﺔ ﺑﻴﻦ اﻟﺬآﻮر واﻹﻧ ﺎث ﻓ ﻲ ﺗﻮزﻳ ﻊ ﺣ ﺎﻻت ارﺗﻔ ﺎع‬
‫ﺿﻐﻂ اﻟﺪم ﺗﺒﻌًﺎ ﻟﻠﻨﻮع‪.‬‬

‫‪32‬‬
‫وﻗﺪ ﺑﻠﻐﺖ ﺣﺎﻻت أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم اﻟﺘﻲ ﺗ ﻢ إدﺧﺎﻟﻬ ﺎ ﻣﺆﺳ ﺴﺎت اﻟﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص ﺑ ﺪﺑﻲ ‪ 214‬ﺣﺎﻟ ﺔ‬
‫)‪ %8.4‬ﻣ ﻦ ﺣ ﺎﻻت أﻣ ﺮاض اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ( ﻓ ﻲ ﻋ ﺎم ‪ 2005‬وآﺎﻧ ﺖ هﻨ ﺎك ‪ 64299‬ﺣﺎﻟ ﺔ ﻣﺮاﺟﻌ ﺔ‬
‫ﻷﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ‪ ،‬ﺷﻜﻠﺖ أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﺣﻮاﻟﻲ ﺛﻠﺜﻲ اﻟﺤﺎﻻت )‪.(%62.4‬‬

‫اﻟﺘﻮﺻﻴﺎت‬

‫إﺟ ﺮاء ﻣ ﺴﺢ وﻃﻨ ﻲ ﻻرﺗﻔ ﺎع ﺿ ﻐﻂ اﻟ ﺪم ﺑﺈﻣ ﺎرة دﺑ ﻲ ﻟﺘﺤﺪﻳ ﺪ ﻣﻌ ﺪل اﻧﺘ ﺸﺎر اﻟﻤ ﺮض ودراﺳ ﺔ اﻟﻌﻮاﻣ ﻞ ذات‬ ‫•‬
‫اﻟﺨﻄﻮرة‪.‬‬
‫إﻧﺸﺎء ﺑﺮﻧﺎﻣﺞ ﻟﻤﻌﺎﻟﺠﺔ وﻣﻜﺎﻓﺤﺔ ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﺑﺎﻹﻣﺎرة ﺿﻤﻦ ﺑﺮﻧﺎﻣﺞ ﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳ ﺔ ﻣ ﻊ‬ ‫•‬
‫دﻣﺞ أﻧﺸﻄﺔ اﻟﺒﺮﻧﺎﻣﺞ ﺧﻼل أﻧﺸﻄﺔ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ‪.‬‬

‫‪33‬‬
 Figure (1) Distribution of Hypertensive Heart Diseases
among Inpatients in DOHMS by Nationality in 2005
‫ﺗﻮزﻳﻊ أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﺑﻴﻦ ﺣﺎﻻت اﻟﺪﺧﻮل ﺑ ﺪاﺋﺮة اﻟﺼ ﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ‬
2005 ‫ﺑﺪﺑﻲ ﺑﺎﻟﺠﻨﺴ ﻴﺔ ﻓ ﻲ ﻋ ﺎم‬

38%
Em irate
Expatriate
62%

34
Figure (2) Distribution of Hype rte nsive He art Dise ase s in DO HMS among
Emirate O utpatie nts to Spe cialist C linics, Dubai 2005
‫ﺗﻮزﻳﻊ أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﺑﻴﻦ ﺣﺎﻻت ﻣﺮاﺟﻌﺔ اﻟﻤﻮاﻃﻨﻴﻦ ﻟﻌﻴﺎدات اﻻﺧﺼﺎﺋﻴﻴﻦ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت‬
2005 ‫اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﺑﺎﻟﻨﻮع ﻓﻲ ﻋﺎم‬

4% 3%

Esse ntial
He art & Re nal
Se condary

93%

35
 Hypertensive Diseases Mortality among Emirate Inpatients in Dubai.

Background and objectives. Hypertension is a major risk factor for cardiovascular

diseases (CVD) which are still the leading causes of death. The World Health
Organization has estimated that high blood pressure causes one in every eight deaths,
making hypertension the third leading killer in the world... CVD amounted to 31.4 of
all deaths in Dubai; 2005.The study was carried out with the aim of studying the
nature of hypertensive diseases hospital mortality in the Department of Health and
Medical Services (DOHMS), Dubai, UAE.

Methods. The study was basically a retrospective case series. The information was
collected from the electronic network of health information system in DOHMS using
SAS server. Retrospective case series of cardiovascular diseases discharged during the
period 1999- 2006 were reviewed. Basic data were age, sex, nationality, diagnosis,
outcome at discharge and month of admission. The whole group of records was firstly
described within the categories of the different variables. Crude adds ratio was
calculated. Logistic regression model was applied for assessing the independent
influence of each variable on mortality.

Results. Out of the 2807 persons of hypertensive diseases admitted in DOHMS, there
were 180 deaths with a case fatality rate (CFR) of 6.4%. Comparing the CFR in the
different years, it was nearly the same. The rate was almost equal in Rashid and Dubai
hospitals, Table 1. Dubai population cases had more than three times increased risk
of hypertensive deaths (OR= 3.1, CI = 1.99, 4.77; P=0.0001) than other Emirates
population in .Those aged 55 years and above had higher risk of mortality than
inpatient cases below 55 years, (OR= 3.38, CI = 2.06, 5.55; P=0.0001), Table 2.
Applying logistic regression analysis to assess the independent influence of each
variable on deaths from hypertensive diseases, adjusted risks associated with those

36
aged 55 years and above and Dubai population cases were significantly increased
compared to the relevant different categories, Table 3.

Conclusion The results of the study show that Dubai inpatient those and those aged ≥
55 years were at an increased risk of death from hypertensive diseases. There is a
need to develop and implement a plan for the management and control of
hypertension in Dubai.

References
Clinical guidelines for the management of hypertension http://www.emro

37
 ‫ﺑﺪﺑﻲ‬
‫اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬
‫واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ‬
‫اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت‬
‫ﺑﺪاﺋﺮة اﻟﺼﺤﺔ‬
‫اﻹرﻗﺎد ﺑﺪاﺋﺮة‬
‫ﻣﺮﺿﻰ اﻹرﻗﺎد‬
‫ﺑﻴﻦ ﻣﺮﺿﻰ‬
‫اﻟﺪم ﺑﻴﻦ‬
‫ﺿﻐﻂ اﻟﺪم‬
‫ارﺗﻔﺎع ﺿﻐﻂ‬
‫ﺮاض ارﺗﻔﺎع‬
‫وﻓﻴﺎت أﻣأﻣﺮاض‬
‫دراﺳﺔ وﻓﻴﺎت‬
‫دراﺳﺔ‬

‫اﻟﺨﻠﻔﻴﺔ واﻟﻬﺪف‬

‫ﻳﺸﻜﻞ ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم اﺣﺪ ﻋﻮاﻣﻞ اﻟﺨﻄﻮرة اﻟﺮﺋﻴﺴﻴﺔ ﻷﻣﺮاض اﻟﻘﻠ ﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ وﻣ ﺎ زال اﺣ ﺪ اﻷﺳ ﺒﺎب‬
‫اﻟﺮﺋﻴﺴﻴﺔ ﻟﻠﻮﻓ ﺎة‪ ،‬ه ﺬا وﻗ ﺪ ﻗ ﺪرت ﻣﻨﻈﻤ ﺔ اﻟ ﺼﺤﺔ اﻟﻌﺎﻟﻤﻴ ﺔ أن ارﺗﻔ ﺎع ﺿ ﻐﻂ اﻟ ﺪم ﻳ ﺴﺒﺐ ﺣﺎﻟ ﺔ وﻓ ﺎة ﺑ ﻴﻦ آ ﻞ ﺛﻤ ﺎﻧﻲ‬
‫ﺣﺎﻻت وﻓﺎة واﻧﻪ اﻟﺴﺒﺐ اﻟﺜﺎﻟﺚ ﻟﻠﻮﻓﺎة ﺑﺎﻟﻌﺎﻟﻢ‪ ،‬هﺬا وﻗﺪ ﺷﻜﻠﺖ أﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳ ﺔ ‪ %31.4‬ﻣ ﻦ ﺣ ﺎﻻت‬
‫اﻟﻮﻓﺎة ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم ‪.2005‬‬

‫ﻃﺮﻳﻘﺔ اﻟﺒﺤﺚ‬

‫أﺟﺮﻳﺖ اﻟﺪراﺳﺔ ﺑﻬﺪف دراﺳﺔ ﻃﺒﻴﻌﺔ وﻓﻴﺎت أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﻓ ﻲ اﻟﻔﺘ ﺮة‬
‫ﻣﺎ ﺑﻴﻦ ‪ 2006-1999‬ﺑﺪﺑﻲ ﺑﺪوﻟﺔ اﻹﻣﺎرات واﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة وآﺎﻧ ﺖ اﻟﺪارﺳ ﺔ أﺳﺎﺳ ﺎ اﺳ ﺘﺮﺟﺎﻋﻴﺔ ﻟﺤ ﺎﻻت أﻣ ﺮاض‬
‫اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ وﻗ ﺪ ﺗ ﻢ ﺟﻤ ﻊ اﻟﺒﻴﺎﻧ ﺎت ﻣ ﻦ ﺷ ﺒﻜﺔ اﻟﻤﻌﻠﻮﻣ ﺎت اﻻﻟﻜﺘﺮوﻧﻴ ﺔ ﺑﺎﻟ ﺪاﺋﺮة آﻤ ﺎ ﺗ ﻢ ﻣﺮاﺟﻌ ﺔ ﺣ ﺎﻻت‬
‫ﺧﺮوج اﻟﺤﺎﻻت وآﺎﻧﺖ اﻟﺒﻴﺎﻧﺎت اﻟﻤﺠﻤﻌﺔ هﻲ اﻟ ﺴﻦ و اﻟﻨ ﻮع و اﻟﺠﻨ ﺴﻴﺔ واﻟﺘ ﺸﺨﻴﺺ وﺗ ﺎرﻳﺦ اﻟ ﺪﺧﻮل و اﻟﺨ ﺮوج ‪،‬‬
‫هﺬا وﻗ ﺪ ﺗ ﻢ وﺻ ﻒ اﻟﺤ ﺎﻻت ﺿ ﻤﻦ اﻟﻔﺌ ﺎت اﻟﻤﺨﺘﻠﻔ ﺔ ﻟﻠﻤﺘﻐﻴ ﺮات آﻤ ﺎ ﺗ ﻢ ﺣ ﺴﺎب ﻣﻌ ﺪل اﻟﻔ ﺮق اﻟﺨ ﺎم وﺗﻄﺒﻴ ﻖ إﻃ ﺎر‬
‫اﻧﺤﺪار اﻟﻤﻨﻄﻖ اﻟﺮﻣﺰي ﻟﺘﺤﺪﻳﺪ اﻷﺛﺮ اﻟﻤﺴﺘﻘﻞ ﻟﻜﻞ ﻣﺘﻐﻴﺮ ﻋﻠﻰ اﻟﻮﻓﻴﺎت‪.‬‬

‫اﻟﻨﺘﺎﺋﺞ‬

‫آﺎن ﺑﻴﻦ ‪ 2807‬ﺣﺎﻟﺔ إرﻗﺎد ﻷﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ‪ 180‬ﺣﺎﻟ ﺔ وﻓ ﺎة وﺑﻤﻌ ﺪل ه ﻼك ‪ %6.4‬وﺑﻤﻘﺎرﻧ ﺔ ﻣﻌ ﺪﻻت‬
‫اﻟﻮﻓﺎة ﻓﻲ اﻟﺴﻨﻮات اﻟﻤﺨﺘﻠﻔﺔ آﺎﻧﺖ ﻣﺘﺴﺎوﻳﺔ ﺗﻘﺮﻳﺒ ًﺎ آﻤﺎ آﺎن اﻟﻤﻌﺪل ﻣﺘﺴﺎوﻳًﺎ ﺗﻘﺮﻳﺒًﺎ ﺑﻤﺴﺘﺸﻔﻰ راﺷﺪ ودﺑﻲ )ﺟﺪول رﻗﻢ‬
‫‪ ،(1‬آﺎن ﻣﻌﺪل ﺧﻄﻮرة اﻟﻮﻓﻴﺎت ﻣﻦ أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم أآﺜﺮ ﻣﻦ ﺛﻼﺛﺔ ﻣﺮات ﺑ ﻴﻦ اﻟﺤ ﺎﻻت ﻣ ﻦ ﺳ ﻜﺎن دﺑ ﻲ‬
‫ﻋﻦ اﻹﻣﺎرات اﻷﺧﺮى آﻤﺎ آﺎن اﻟﻤﻌﺪل ﻋﺎﻟﻴ ًﺎ ﺑ ﻴﻦ اﻟﺒ ﺎﻟﻐﻴﻦ ﻣ ﻦ اﻟﻌﻤ ﺮ ‪ 55‬ﻋﺎﻣ ًﺎ وأآﺜ ﺮ ﻋ ﻦ اﻟﻤﺮﺿ ﻰ اﻗ ﻞ ﻣ ﻦ ‪55‬‬
‫ﻋﺎﻣًﺎ )ﺟﺪول رﻗﻢ ‪ ،(2‬وﺑﺘﻄﺒﻴﻖ ﺗﺤﻠﻴﻞ اﻧﺤﺪار اﻟﻤﻨﻄﻖ اﻟﺰﻣﻨﻲ ﻓﻘﺪ وﺟﺪ أن اﻟﺨﻄﻮرة اﻟﻤﻌﺪﻟﺔ اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺒ ﺎﻟﻐﻴﻦ ‪55‬‬
‫ﻋﺎﻣًﺎ ﻣﻦ اﻟﻌﻤﺮ وﺣﺎﻻت دﺑﻲ آﺎﻧﺖ زاﺋﺪة ﺑﺪرﺟﺔ ﺟﻮهﺮﻳﺔ ﻣﻘﺎرﻧﺔ ﺑﺎﻟﻤﺠﻤﻮﻋﺎت اﻟﻤﺨﺘﻠﻔﺔ )ﺟﺪول رﻗﻢ ‪.(3‬‬

‫‪38‬‬
 ‫اﻟﺨﻼﺻﺔ‬
‫ﺗﻈﻬﺮ اﻟﺪراﺳﺔ أن ﺧﻄﻮرة اﻟﻮﻓﺎة ﻣﻦ أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم آﺎﻧﺖ أﻋﻠ ﻰ ﺑ ﻴﻦ ﺣ ﺎﻻت إﻣ ﺎرة دﺑ ﻲ واﻟﺒ ﺎﻟﻐﻴﻦ ‪55‬‬
‫ﻋﺎﻣًﺎ وأآﺜﺮ ﻣﻦ اﻟﻌﻤﺮ وﺗﻮﺻﻰ اﻟﺪراﺳﺔ ﺑﺈﻧﺸﺎء ﺑﺮﻧﺎﻣﺞ ﻟﻤﻌﺎﻟﺠﺔ وﻣﻜﺎﻓﺤﺔ أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﺑﺪﺑﻲ‪.‬‬

‫‪39‬‬
 Table (1) Summary Characteristics of Hospital Hypertensive Diseases Mortality
in DOHMS According to Some Epidemiological Characteristics, Dubai 1999 –
2006
‫ﻤﻠﺨﺹ ﻭﻓﻴﺎﺕ ﺃﻤﺭﺍﺽ ﺍﺭﺘﻔﺎﻉ ﻀﻐﻁ ﺍﻟﺩﻡ ﺘﺒﻌ ﹰﺎ ﻟﺒﻌﺽ ﺍﻟﺨﺼﺎﺌﺹ ﺍﻟﻭﺒﺎﺌﻴﺔ ﺒﻤﺴﺘﺸﻔﻴﺎﺕ ﺩﺍﺌﺭﺓ ﺍﻟﺼﺤﺔ‬
1999-2006 ‫ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻁﺒﻴﺔ ﺒﺩﺒﻲ ﻟﻸﻋﻭﺍﻡ‬

Viable Value Significance

Age (Mean ± SD)

Discharged 62.11 ± 14.51 F = 61.76
Dead 60.32 ± 14.657 P = 0.0001
Dubai Population (CFR %)
Dubai 8.05 x2 = 27.95
Other Emirates 2.76 P = 0.001
Sex (CFR %)
Males 5.95 x2 = 0.944
Females 6.87 P = 0.331
Hospital (CFR %)
Dubai
6.19 0.267
P = 0.604
Rashid 6.67

Year (CFR %)
2004 6.70
x2 = 0.477
2005 7.51
P = 0.0.788
2006 6.94

40
 Table (2) Crude Odds Ratio of Hypertensive Diseases Mortality in DOHMS
Hospitals in Dubai 1999- 2006 by Certain Epidemiological Variables
‫ﻤﻌﺩل ﺍﻟﻔﺭﻕ ﺍﻟﺨﺎﻡ ﺃﻤﺭﺍﺽ ﺍﺭﺘﻔﺎﻉ ﻀﻐﻁ ﺍﻟﺩﻡ ﺘﺒﻌ ﹰﺎ ﻟﺒﻌﺽ ﺍﻟﺨﺼﺎﺌﺹ ﺍﻟﻭﺒﺎﺌﻴﺔ ﺒﻤﺴﺘﺸﻔﻴﺎﺕ ﺩﺍﺌﺭﺓ ﺍﻟﺼﺤﺔ‬
1999-2006 ‫ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻁﺒﻴﺔ ﺒﺩﺒﻲ‬

Variable Crude Odds Ratio x2 P

Dubai Population
Dubai vs. Other Emirates 3.08 (1.99, 4.77) 27.94 0.0001

Sex
Females vs. Males 1.16 (0.858, 1.57) 0.94 0331
Age
≥ 55 years v. < 55 years 3.38(2.063, 5.55 26.11 0.0001
Hospital
Dubai vs. Rashid 0.922 (0.677, 1.25) 0.27 0.604

Table (3) Logistic Regression Analysis of Hypertensive Diseases Mortality in

DOHMS in Dubai 1999 -2006 by Certain Epidemiological Variables.
‫ﺗﺤﻠﻴﻞ اﻻﻧﺤﺪار اﻟﻠﻮﺟﺴﺘﻰ ﻟﻮﻓﻴﺎت أﻣﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم ﺗﺒﻌ ًﺎ ﻟﺒﻌﺾ اﻟﺨﺼﺎﺋﺺ اﻟﻮﺑﺎﺋﻴﺔ‬

Variable Estimate P

Dubai vs. Other Emirates 0.5646 0.0001

(≥55 years v. < 55 years) 0.6141 0.0001

41
 Hypertensive Disorders in Pregnancy

It amounts to 7 per thousand of all admitted cases in 2005 in DOHMS. The mean age
of the studied cases was 30.85 ± 5.7 years. Pre-existing hypertension amounted to
3.2% of the cases, 24.2% were gestational hypertension, 0.9% eclampsia and 70.24%
were unspecified material hypertension. Emirates amounted for 54.46% of the cases.
Table (1) shows that hypertensive disorders in pregnancy amounted for 1.98% of all
cases admitted in pregnancy, childbirth and puerperium period among those below 35
and 3.27% in the age group 35 years and above. This difference is significant.
Expatriates had higher percentage (2.52%) of hypertension diseases in pregnancy than
nationals (1.99%) with a significant difference (P=0.02).

Table (2) shows that pregnant women aged 35 years and above had more than one and
half times increased risk of hypertension than those below 35 years (cOR=1.677
(1.32, 2.14), P=0.0001). Expatriates had more increased risk than Emirates
(cOR=1.27 (1.02, 1.58), P=0.02). By applying logistic regression model, adjusted
risks associated with those aged 35 years and above and Expatriates were significantly
increased compared to the different relevant categories, Table (3).

42
 ‫اﻟﺤﻤﻞ‬
‫أﺛﻨﺎء اﻟﺤﻤﻞ‬
‫اﻟﺪم أﺛﻨﺎء‬
‫ﺿﻐﻂ اﻟﺪم‬
‫ارﺗﻔﺎع ﺿﻐﻂ‬
‫أﻣﺮاض ارﺗﻔﺎع‬
‫أﻣﺮاض‬

‫ﺗﺸﻜﻞ أﻋﺮاض ارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم أﺛﻨﺎء اﻟﺤﻤﻞ ‪ 7‬ﻓ ﻲ اﻷﻟ ﻒ ﻣ ﻦ ﺣ ﺎﻻت اﻟ ﺪﺧﻮل ﺑ ﺪاﺋﺮة اﻟ ﺼﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ‬
‫ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم ‪ ،2005‬وﻗﺪ ﺷﻜﻞ ارﺗﻔﺎع ﺿﻐﻂ اﻟ ﺪم ﻗﺒ ﻞ اﻟﺤﻤ ﻞ ‪ %3.2‬ﻣ ﻦ اﻟﺤ ﺎﻻت وﺿ ﻐﻂ اﻟ ﺪم ﺑﺎﻟﺤﻤ ﻞ ‪%24.2‬‬
‫واﻟﺘﺸﻨﺞ أﺛﻨﺎء اﻟﺤﻤﻞ ‪ %.9‬وارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم اﻷﻣﻮﻣﻲ ﻏﻴﺮ اﻟﻤﺤﺪد ‪.%70.4‬‬

‫ه ﺬا وﻗ ﺪ ﺷ ﻜﻞ اﻟﻤﻮاﻃﻨ ﻮن ‪ %54.46‬ﻣ ﻦ اﻟﺤ ﺎﻻت ووﺟ ﺪ أن اﺿ ﻄﺮاﺑﺎت ارﺗﻔ ﺎع ﺿ ﻐﻂ اﻟ ﺪم أﺛﻨ ﺎء اﻟﺤﻤ ﻞ آﺎﻧ ﺖ‬
‫‪ %1.98‬ﻣﻦ ﻣﺠﻤﻮع ﺣﺎﻻت اﻟﺤﻤﻞ واﻟﻮﻻدة واﻟﻨﻔ ﺎس ﺗﺤ ﺖ ‪ 35‬ﻋﺎﻣ ًﺎ ﻣ ﻦ اﻟﻌﻤ ﺮ و‪ %3.27‬ﺑ ﻴﻦ اﻟ ﺴﻴﺪات اﻟﺒﺎﻟﻐ ﺎت‬
‫‪ 35‬ﻋﺎﻣ ًﺎ وأآﺜ ﺮ‪ ،‬وﻳﻌﺘﺒ ﺮ ه ﺬا اﻟﻔ ﺮق ﺟﻮهﺮﻳ ﺎً‪ ،‬آﻤ ﺎ آﺎﻧ ﺖ ﻧ ﺴﺒﺔ ارﺗﻔ ﺎع ﺿ ﻐﻂ اﻟ ﺪم أﺛﻨ ﺎء اﻟﺤﻤ ﻞ ﻋﺎﻟﻴ ﻪ ﺑ ﻴﻦ ﻏﻴ ﺮ‬
‫اﻟﻤ ﻮاﻃﻨﻴﻦ ﻋ ﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ‪)،‬ﺟ ﺪاول رﻗ ﻢ ‪ (1. 2‬وﺑﺘﻄﺒﻴ ﻖ إﻃ ﺎر اﻧﺤ ﺪار اﻟﻤﻨﻄ ﻖ اﻟﺮﻣ ﺰي وﺟ ﺪ أن هﻨ ﺎك زﻳ ﺎدة‬
‫ﺟﻮهﺮﻳﺔ ﻓﻲ اﻟﺨﻄﻮرة اﻟﻤﻌﺪﻟﺔ اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺒﺎﻟﻐﻴﻦ ‪ 35‬ﻋﺎﻣ ًﺎ وأآﺜ ﺮ وﻏﻴ ﺮ اﻟﻤ ﻮاﻃﻨﻴﻦ ﻣﻘﺎرﻧ ﺔ ﺑﺎﻟﻔﺌ ﺎت اﻟﻤﺨﺘﻠﻔ ﺔ ذات‬
‫اﻟﻌﻼﻗﺔ)ﺟﺪول رﻗﻢ ‪.(3‬‬

‫‪43‬‬
 Table (1) Summary characteristics of Hypertensive disorders in Pregnancy in
DOHMS according to Some Epidemiological characteristics, Dubai 2005

Viable Value Significance

Age (% of hypertension)
1.98
< 35 years x2= 17.72

≥ 35 years 3.27 P = 0.000

Nationality (% of hypertension)

Emirates 1.99 4.78

Expatriates 2.52 0.0288

44
 Table (2) Crude Odds Ratio of Hypertensive disorders in Pregnancy in DOHMS
hospital by certain Epidemiological variables, Dubai 2005

Variable Crude Odds Ratio x2 P

Age
≥ 35 years v. < 35 years 1.677 (1.32, 2.14) 17.22 0.0001
Nationality
Expatriates v. Emirates 1.27(1.02, 1.58) 4.78 0.029

45
 Table (3) Point Estimate of Hypertensive disorders in Pregnancy in DOHMS by
Certain Epidemiological Variables, Dubai 2005

Variable Point Estimate P

Age
≥ 35 years v. < 35 years 1.656 (1.29,2.11) 0.001

Nationality 0.796 (0.64, 0.99) 0.003

Emirates v. Expatriates

46
 Cardiovascular Diseases in Gulf countries

Cardiovascular diseases (CVD) have been identified as the primary non-

communicable health problem throughout the world. It represents the major health
burden in the industrialized countries and a rapidly growing health problem in
developing countries. The contribution of CVD to the burden of disease is increasing,
all socioeconomic groups are vulnerable, and CVD inflicts major economic and
human costs. They affect people in their peak mid-life years, disrupting the future of
the families dependent on them and undermining the development of nations by
depriving them of workers in their most productive years.

According to WHO estimates 16.7 million people around the globe die of CVD each
year, While CVD became the responsible for every third death globally, Coronary
Heart Disease (CHD) is already the number one killer in the world, which accounts
for 7.22 million deaths. Previously CVD were considered an existing and threatening
health problem in developed world as a result of industrialization and technology
development. Later on, change in quality of life, strengthening of surveillance systems
and analytical studies of CVD risk factors exposed the growing incidence of that
problem in developing countries as well. Adopting inactive life style and unhealthy
habits by populations in addition to hereditary traits all made most communities more
likely to be affected by CVD. Today, men, women and children are at risk.

Epidemiological projections suggest that for CHD, the mortality for all developing
countries will increase by 120% for women and 137% for men. Predictions for the
next two decades include tripling of CHD and stroke mortality in the Middle East, a
rate of increase, which exceeds that for any other region, except for Asian and Pacific
Islands countries. By contrast, the increase in more-developed nations as Gulf
countries, largely attributable to an expansion of the population of older people at risk,
will range between 30% and 60%. In Gulf countries, which economically stepped

47
ahead to be considered as developed countries, CVD deaths appear to be high and
increasing in a threatening manner. The highest annual number of deaths is the
Kingdom of Saudi Arabia (16438), while the lowest is in the state of Qatar (238).
Taking in consideration the population pyramids of each Gulf country, certainly these
figures pose a big health and economic burden, which needs urgent response and
intervention.

Cardiovascular diseases amounted to 28% of all deaths in UAE in 2003. In Dubai, it

amounted to 35.3% of all deaths in 2004. Inpatient Cardiovascular Diseases amounted
to 3919 (8.49%) of all admitted cases in DOHMS, Dubai in 2005. The mean age of
CVD was 52.74 ± 14.86years. The average admission was 1.07 times and ranged from
one to six admissions. Emirates population accounted for 26.6% of all admitted cases
of CVD in DOHMS.

Studying the distribution of CVD among Emirate cases admitted in DOHMS, males
constituted 559 (62.8%) and females 402 (37.2%) of cases. Cardiovascular diseases
increased with increase in age in both males and females among Emirate cases. More
than two thirds (71.0%) of the admitted cases were 55 years and above.

Ischaemic Heart Disease (IHD) constituted 51.0% of all cases of CVD, hypertension
9.8%, cerebrovascular disease 12.0% and other forms of cardiovascular diseases
27.1%. The same pattern was observed in both males and females, but ischaemic heart
disease was more prevalent (56.3%) in males and hypertension in females (17.0%),

The CVD case fatality rate among Emirates was 4.5%. It was 4.7% among males and
4.3% among females with insignificant difference Out of the 47 deaths of CVD,
Emirate inpatients in DOHMS, 17 (36.1%) were IHD, 24 (51.1%) Cerebrovascular
diseases and 6 cases (12.8%) from other forms of cardiovascular diseases.

48
Studying the nature of IHD among Emirate population, there were 428 inpatient cases
in DOHMS, 304 (71.0%) cases among males and 124 (29.0%) among females.
Studying the age distribution of the studied cases of IHD inpatient in DOHMS, 6.5%
of cases were below 45 years, 15.0% in the age group 45-54 years, 28.4% were 55-64
years and more than half the cases (50.4%) were 65 years and above. Males were
more prevalent in the younger age groups (< 55 years) and females in the older age
groups (55 years and above).

There were 60 Deaths from IHD disease with a case fatality rate of 2.8%. It was 2.7%
among males and 3.8% among females. Females had about one and half times
increased risk of fatality from IHD than males (cOR= 1.44 (0.68, 2.98), P=0.298).

As for hypertension, there were 386 cases admitted in DOHMS, 147 (38.1%) were
Emirates and 61.9% were Expatriates. Among the Emirate population, 72 (49.0%)
were males and 51.0% were females. The frequency distribution of hypertension
increased with increase in age, but hypertension was more prevalent among females in
the age group 45-64 years and males in the age group 65 years and above.

Regarding Cerebrovascular diseases, there were 472 inpatient cases, 130 (27.5%)
Emirates and 342 (72.5%) Expatriates. Out of the 130 Emirate cases, 57.7% were
males and 42.3% were females. There was an increase in the percentage of
cerebrovascular diseases with increase in age in both males and female Emirates.
There were 19 deaths from cerebrovascular diseases in DOHMS inpatient Emirates.
The case fatality rate was 14.3%. It was 15.8% among males and 12.3% among
females.

As for Rheumatic fever there are only 6 cases among Expatriates with only one case
of Rheumatic fever among Emirates population. There were 56 cases of Rheumatic

49
Heart Disease (RHD) admitted in DOHMS; only 4 cases were Emirates, all were
females.

Out of 109835 outpatient cases diagnosed by specialist in DOHMS, there were 5953
cases of CVD with a rate of 5.4%. Emirates amounted for 64.4% of cases and
expatriates 35.6%. As for Emirate CVD cases, males accounted for 48.4% of cases
and females 51.6%. There is an increase in the frequency distribution of CVD with
increase in age to reach 39.9% in the age group 65 years and above. The same pattern
was observed in both males and females.

Studying the distribution of cases diagnosed by specialist by type, hypertensive

diseases amounted for more than half of the cases (52.3%), IHD 22.1%, RHD 2.2%,
cerebrovascular diseases 4.0%, diseases of the arteries and veins 13.3% and other
cardiovascular diseases 5.8%. Studying the distribution in both males and females
separately, males had a higher percentage of IHD (32.6%) and females more
hypertension (59.5%) and RHD 3.5%.

There were 101 cases of congenital malformation of the circulatory system, 54.5%
Emirate and 45.5% expatriate. Among Emirates, 52.7% were males and 47.3%
females.

Data of the National Blood Pressure and Coronary Heart Disease Survey showed that
out of the 4732 people screened, 1278 (27.01%) had high blood pressure. There was
an increased risk of hypertension among males; people aged ³ 45 years and those of
sedentary occupational and leisure physical activity. Higher risks were also observed
among widows and divorced women and those with less than preparatory education.
When the epidemiological variables related to hypertension were assessed
simultaneously in a logistic regression model, adjusted risks associated with obesity
and those aged ³ 45 years were significantly increased compared with the other

50
relevant categories. Adjusted risks were also greater among males, widows and
divorced women, those with less than preparatory education and people with a
sedentary lifestyle.

Screening of 9904 Omani schoolchildren from different regions in Oman gave a

prevalence rate of rheumatic heart disease of 8 per 10 000 with no significant
difference by sex or level of education. Follow-up of the sample for three months
gave an estimated annual incidence of rheumatic fever of 4 per 10 000. The positive
predictive value of definite murmurs for diagnosis of cardiovascular disease was
35.21% for school health physicians and 86.67% for regional physicians. The results
show that rheumatic fever and rheumatic heart disease are not major public health
problems in Oman. The study recommends integration of the management and control
of the diseases within the primary health care system.

Out of a cross-sectional survey to study the prevalence and the characteristics of

current and former smoking among Omani adults. Crude prevalence of current
smoking was 7.0% (males 13.4%, females 0.5%); 2.3% were former smokers. The
overall highest prevalence of current smoking (11.1%) was observed in those 40–49
years (18.7% of males, 0.9% of females). Older age (40 years), higher educational
level and larger family size were protective against smoking. Mean age for starting
smoking was 18.7 years for males and 24.3 years for females.

In Kuwait cross-sectional study was conducted among 740 healthy Kuwaiti males
between the ages of 45 to 80 years, who underwent a mandatory job related physical
examination or who sought to obtain retirement benefits. In all, 37% of the men were
obese, 26% had elevated glucose values and 52% had elevated or high cholesterol
levels. Some had multiple risk factors for CHD, including age 45 y, obesity, male
gender, hyperglycemia and hypercholesterolemia. Blood glucose values increased
consistently from younger (45-54 years) to older age groups (55-64 and 65 years).
Blood glucose values varied inversely with education level. The study concluded that

51
in societies with relatively uniform income levels, educational level may be a better
indicator of chronic disease risk than income per se. These results, showing a high
percentage of men with several risk factors and high mean values, suggesting more
severe risk, suggest that immediate action should be taken to develop a public health
intervention strategy to educate Kuwaiti men to become aware of the causes and
correlates of CHD and how to decrease their risk for CHD and heart attack, the
leading cause of death in Kuwait

A retrospective cohort study was carried out in Hamad General Hospital in Qatar. All
Qatari and Non Qatari patients who were hospitalized with AMI with or without
hypertension from 1991 to 2002 were included in the study. The Diagnostic
classification of definite AMI was made in accordance with criteria based on the
International Classification of Disease tenth revision (ICD-10). The obtained. Of the
total 22,440 patients, 8976 (40%) were Qatari’s and 13,464 (60%) were non-Qatari’s.
Out of total sample, 5390 (24%) patients admitted with AMI. Qatari’s with AMI were
1598 and 601 among them were hypertensive and Non Qataris with AMI were 3792
and 826 among them were hypertensive. Also, the incidence of hypertension was
slightly higher in females than in males both among the Qataris 41.1% vs. 20.5%
p<0.001 and among the Non Qataris 13.0% vs. 3.2%. Hypertension cases were rising
sharply with increasing age (p<0.001) among the Qataris. The results of stepwise
logistics regression analysis showed that there was a statistically significant
association between AMI and gender, diabetes, hypercholesterolemia, shortness of
breath and smoking. The present study revealed that there is a strong association
between AMI, hypertension, DM and other CVD risk factors, indicating the
importance of the need for more effective prevention programs and control of
hypertension and AMI.

Circulatory diseases were the leading cause of death among Bahraini females,
accounting for one-third of the deaths in 1995. About 12.1% had cardiovascular
disorders. Hypertension was a major health problem for older Bahraini women .Over

52
one-half of Bahraini women 50-69 years of age were diagnosed with hypertension
(systolic pressure 140 mmHg, diastolic pressure 90 mmHg) and 27% of those aged 50
years reported having hypertension

An eleven-year study of the incidence and consequences of acute rheumatic fever was
carried out in Qatar. Study subjects were 86 children, aged four to fourteen years, and
satisfying criteria for acute rheumatic fever. Study methods included clinical
evaluation, standard laboratory studies, and echocardiography. A declining incidence
of rheumatic episodes, ranging from 1.06 to 18.6/100,000 population (average
11.2/100,000), was identified. The course of the episode was generally mild. Arthritic
findings predominated (92%), followed by carditis identified clinically in 43% and,
with the addition of echocardiography, in 71%. Residual valvular regurgitation, as a
longer term consequence, persisted in 46% of those with auscultatory confirmation of
valvulitis. No recurrences were identified. Comparison with countries of similar
socioeconomic status revealed relatively unimportant differences. Comparison with
nearby disadvantaged countries identified striking contrast. It may be concluded that
among the contributing factors, for the improvement in the incidence and sequelae of
a rheumatic episode, are an advantaged socioeconomic environment and accessibility
to unlimited medical care.

A total of 14,660 adult Saudi males and females (>14 years of age) in 35 areas were
screened and information on height (m) and weight (kg) was recorded during a
National Project to study various aspects of diabetes mellitus in Saudi Arabia. The
Body Mass Index (BMI) was calculated and the data was used to group the males and
females as overweight (BMI=25-29.9) and obese (BMI>30). In the total Saudi
population the prevalence of overweight was 27.23% and 25.20% in the males and
females respectively, while the prevalence of obesity was 13.05% and 20.26% in the
males and females respectively. When separated on the basis of each region, the
prevalence of obesity was highest in the females in Central Province and in the males

53
in the Western Province, while overweight was more prevalent in both the male and
female population of the Central Province. The data was further analyzed depending
on each area within each province and significant differences were encountered. In
general, overweight was more common in the males and obesity in the females. This
high prevalence of obesity is a cause for concern, since obesity is associated with
several complications which increase both morbidity and mortality. Awareness
programs must be initiated and nationwide control and prevention programs need to
be adopted to decrease the prevalence of obesity in the Saudi population.

In all countries of the Gulf Region, there are more awareness about cardiovascular
diseases as a main cause of mortality and morbidity. This awareness on cardiovascular
diseases was addressed by national intercountry workshops (Bahrain, Oman, Saudi
Arabia and United Arab Emirates). Oman and Saudi Arabia made significant progress
in national plans on hypertension prevention, as well as understanding of risk factors
in order to improve skills and knowledge of cardiovascular disease epidemiology.
Technical reports on guidelines for management of hypertension with emphasis on
primary care were established in Kuwait and Saudi Arabia. Promotion of healthy
lifestyles was advocated and strengthened through workshops and country
publications (Bahrain, Oman and Saudi Arabia) The Regional Office continues to
support the and development of comprehensive, integrated policies for prevention and
control of cardiovascular diseases, such as the Nizwa project in Oman.

Since the etiology of CVD is multifactorial, the approach to prevention should be also
multifactorial, aimed to preventing the emergence and spread, controlling or
modifying as many risk factors as possible in the Gulf Region. The aim should be to
change the community as a whole, not the individual subjects living in it. A
population approach to CVD prevention has been formally outlined by the WHO. It
embraces both the systematic practice of screening and education for high risk, where
national priorities can afford such practice, and broad public health policy and

54
programs in health promotion of communities. Strategies for CVD preventive practice
are now widely available. Some constraints are still faced by countries of the Gulf
Region, however, and should be carefully targeted for better planning:

• Financial constraints are limiting the development of more national programmes on

prevention and control of cardiovascular diseases

• Research on cardiovascular diseases, risk factors and community-based prevention

programmes are still lacking in several countries.

55
 Diabetes Mellitus among Emirate Females

Diabetes mellitus is a chronic disease caused by inherited and or acquired deficiency

in production of insulin by the pancreas or by the ineffectiveness of the insulin
produced. Its frequency is dramatically rising all over the world. The prevalence of
diabetes for all age groups worldwide was estimated to be 2.8% in 2000 and 4.4% in
2030. Much of this increase will occur in developing countries and will be due to
population ageing, unhealthy diets, obesity and a sedentary life style. The total
number of people with diabetes is projected to rise from 171 million in 2000 to 366
million in 2030. This is double the current number. Equally alarming and less well
known is the fact that, of these people, only around one half is known to have the
condition. This has been shown repeatedly in epidemiological surveys.

An added concern is that half of those who do present with type 2 diabetes clinically
already have signs of the complications of the disorder. In 2000, 3.2 million people
died from complications associated with diabetes. By 2025, while most people with
diabetes in developed countries will be aged 65 years or more, in developing countries
most will be in the 45-64 year age range and affected in their most productive years.
Because of its chronic nature, the severity of its complications and the means required
to control them, diabetes is a costly disease. The costs of diabetes to the individual
and the family are not only financial, the intangible costs of pain; anxiety and reduced
quality of life have a tremendous impact but are difficult to measure.

The epidemiological transition phenomenon has been well recognized in recent years.
Socioeconomic development in UAE accompanied by the characteristics cultural
changes observed in developed societies elsewhere, improved sanitation and
consequent reduction in the occurrence of communicable diseases has led to
increasing life expectancy, changing nutritional habits, decreasing habitual physical
activity and the emergency of noncommunicable diseases as the dominant feature of

56
ill health in the community. Noncommunicable diseases amounted for the majority
(86.8%) of deaths and for more than half of admissions (56.0%) in DOHMS hospitals
in 2004. Infectious and parasitic diseases constituted only 5% of all deaths among
Emirate population in Dubai in 2004. Of the various components of non-
communicable diseases, that of diabetes mellitus is becoming of increasing
importance and major concern.

Out of the 46,166 persons admitted in DOHMS in 2005, there were 1,297 (2.8%)
cases of diabetes mellitus. Emirates amounted for 57.9% of cases and Expatriates
42.1%. Emirate females amounted for 41.4% of all admitted diabetes mellitus in
DOHMS. Studying the distribution of admitted cases of diabetes mellitus among
Emirates in DOHMS by type, Type 1 amounted for 19.7% of the cases, Type 2
diabetes 38.2%, gestational diabetes 21.1% and unspecified diabetes mellitus 20.9%of
the cases. Among females, Type 1 Diabetes constituted 14.6% of the cases, Type 2
diabetes 31%, gestational diabetes 29.5% and unspecified diabetes mellitus 23.9% of
the cases, Figure (1). Males amounted for (28.6%) and females (71.4%) of cases,
Figure (2).

There is an increase in the number of cases of diabetes mellitus with increases in age
in both males and females. Studying the distribution of diabetes mellitus in male and
female Emirates by age, diabetes mellitus was more frequent among males in younger
age groups and in elder age groups in females, Figure (3). As for the distribution of
diabetes mellitus in pregnancy among Emirate inpatients by age, the percentage was
7.5% among those aged 15-24 years, 51.7% in the age group 25-34 years, 38.4% in
the age group 35-44 years and only 2.4% in the age group 45 years and above (Figure
4).

As for complications among Emirate females, 82% of cases of Type 2 diabetes

mellitus were complicated. About two thirds (66%) of the cases had multiple

57
complications (Figure 5). As for Type 1 diabetes, ketoacidosis amounted for 34% of
complications, 20% other and multiple complications and 46% had no complications
(Figure 6).

Out of the 109,835 Emirate persons attended specialist clinics in DOHMS in 2005,
there were 6,261 (5.7%), persons with a diabetes mellitus, Figure (7). Emirate females
amounted to about half (50.2%) of the cases. Type 1 Diabetes amounted for 20.1% of
cases and Type 2 Diabetes 75.2%, unspecific diabetes mellitus 1.8% and gestational
diabetes mellitus 2.7% of the cases (Figure 8).

Out of the 23,416 cases of diabetes mellitus attended outpatient clinics of private
health sector in Dubai, Emirate females amounted to 9% only of the attended cases.
Type 1 amounted to 32% of the cases, Type 2 diabetes 54% and other Types 14% of
the cases (Figure 9).

Recommendation

There is a lack of baseline data on the prevalence, distribution complications,

prevention and control of diabetes mellitus in the United Arab Emirates. Recent
studies produced alarming prevalence rates. Abdul Ghaffor A. reported that the
prevalence of DM has doubled over the last years, with an estimated 15.0% among
people aged 20 years and above, and that diabetes among children has increased from
4.0/10000 in 1986 to 18/10000 in 2000. El Mugamer IT et al. in 1996 reported that the
overall prevalence of diabetes in urban and rural people of Bedouin origin in UAE
was 6%; it was 11% and 7% respectively in males and females aged 30–64 years.
More studies are needed to determine the magnitude and risk factors of DM especially
among Emirate females in UAE with the aim of determining the prevalence of
diabetes mellitus amongst Emirate population 18 years and above in Dubai, studying
the risk factors most related to diabetes mellitus.

58
There is a need for developing and implementing a plan of action for management and
control of diabetes mellitus in Dubai. The plan should be a component of the health
care system designed for health protection and promotion of the general population.
The plan should be prepared with the objective and targets set and detailed activities
planned with a time frame. Process and outcome measures should be formatted.
However certain essential requirements should be addressed before the plan can be
established. These include public awareness about the increasing problem of diabetes
and the need for intervention, commitment and availability of resources. The Diabetes
Mellitus committee should be charged with the planning, implementation and
evaluation of the plan. Activities should be planned in co-ordination with similar
integrated efforts directed against other non-communicable diseases. Implementation
of the program is achieved through strengthening the human resources development
and full integration into the existing health care system. The activities of the health
services infrastructure at primary, secondary and tertiary level should be specified.
The Primary Health Care (PHC) should take the major load of providing health care
of diabetes. PHC personnel should be trained in the health care and special needs of
this vulnerable segment of the population. Guidelines for prevention, identification of
risk factors and high-risk groups, early detection of cases and clinical management
should be prepared.

59
 ‫داء اﻟﺴﻜــﺮي ﺑﻴﻦ اﻟﻤﻮاﻃﻨﺎت ﺑﺈﻣـﺎرة دﺑـــــــﻲ‬

‫ﻳﺮﺟﻊ داء اﻟﺴﻜﺮي إﻣﺎ إﻟﻰ ﻧﻘﺺ وراﺛﻲ أو ﻣﻜﺘﺴﺐ ﻹﻓﺮاز هﺮﻣﻮن اﻷﻧﺴﻮﻟﻴﻦ ﺑﺎﻟﺒﻨﻜﺮﻳﺎس أو ﻋﺪم ﻓﺎﻋﻠﻴﺔ اﻟﻬﺮﻣﻮن‬
‫اﻟﻤﻔﺮوز‪ ،‬هﺬا وﻗﺪ ارﺗﻔﻊ ﺗﻮاﺗﺮ اﻟﻤﺮض ﺑﺪرﺟﺔ آﺒﻴﺮة ﻓﻲ ﺟﻤﻴﻊ أﻧﺤﺎء اﻟﻌﺎﻟﻢ‪ ،‬وﺗﻢ ﺗﻘﺪﻳﺮ ﻣﻌﺪل اﻧﺘﺸﺎر اﻟﻤﺮض ﻟﻜﻞ‬
‫ﻓﺌﺎت اﻟﻌﻤﺮ ﺑﺎﻟﻌﺎﻟﻢ ‪ %2.8‬ﻓﻲ ﻋﺎم ‪ 2000‬و ‪ %4.4‬ﺑﻌﺎم ‪ 2030‬وأن ﻣﻌﻈﻢ هﺬﻩ اﻟﺰﻳﺎدة ﺳﻮف ﺗﻜﻮن ﺑﺎﻟﺪول اﻟﻨﺎﻣﻴﺔ‬
‫ﻧﻈﺮًا ﻟﺰﻳﺎدة ﻋﻤﺮ اﻟﺴﻜﺎن واﻟﺘﻐﺬﻳﺔ ﻏﻴﺮ اﻟﺼﺤﻴﺔ واﻟﺴﻤﻨﺔ وﻧﻤﻂ اﻟﺤﻴﺎة وﻗﻠﺔ اﻟﺤﺮآﺔ‪ ،‬هﺬا وﻳﺘﻨﺒﺄ ﺑﺎرﺗﻔﺎع ﻋﺪد‬
‫اﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﺴﻜﺮي ﻣﻦ ‪ 171‬ﻣﻠﻴﻮن ﺷﺨﺺ ﻓﻲ ﻋﺎم ‪ 2000‬إﻟﻰ ‪ 366‬ﻣﻠﻴﻮن ﺑﻌﺎم ‪ 2030‬أي ﺿﻌﻒ اﻟﺮﻗﻢ اﻟﺤﺎﻟﻲ‪،‬‬
‫واﻷآﺜﺮ ﺗﺤﺴﺒﺎ أن ﻧﺼﻒ اﻟﺤﺎﻻت ﻟﻢ ﻳﺘﻢ اآﺘﺸﺎﻓﻬﺎ ﺑﻌﺪ وهﺬا ﻣﺎ ﺗﺆآﺪﻩ آﻞ اﻟﻤﺴﻮﺣﺎت اﻟﻮﺑﺎﺋﻴﺔ اﻟﻤﺘﻜﺮرة‪ ،‬وﻣﻦ زاوﻳﺔ‬
‫أﺧﺮى ﻓﺈن ﻧﺼﻒ ﻣﺮﺿﻰ اﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻟﺪاء اﻟﺴﻜﺮي ﻳﻌﺎﻧﻮن ﻣﻦ ﻣﻀﺎﻋﻔﺎت اﻟﻤﺮض‪ ،‬ﻓﻔﻲ ﻋﺎم ‪ 2000‬ﺗﻮﻓﻲ ‪3.2‬‬
‫ﻣﻠﻴﻮن ﺷﺨﺺ ﻣﻦ ﻣﻀﺎﻋﻔﺎت داء اﻟﺴﻜﺮي‪ ،‬آﻤﺎ ﻳﺘﻮﻗﻊ أن ﺗﻜﻮن ﺣﺎﻻت اﻟﺴﻜﺮي ﺑﺎﻟﺪول اﻟﻨﺎﻣﻴﺔ ﺑﺎﻟﻤﺠﻤﻮﻋﺔ اﻷآﺜﺮ‬
‫إﻧﺘﺎﺟﻴﺔ ﻟﻠﻔﺌﺔ اﻟﻌﻤﺮﻳﺔ )‪ (64-45‬ﻋﺎﻣًﺎ ﺑﻌﻜﺲ اﻟﺪول اﻟﻤﺘﻘﺪﻣﺔ اﻟﺘﻲ ﺳﻮف ﻳﺘﺮآﺰ اﻟﻤﺮض ﻓﻲ اﻟﺒﺎﻟﻐﻴﻦ ‪ 65‬ﻋﺎﻣﺎ‬
‫وأآﺜﺮ‪ ،‬هﺬا وﻳﻌﺘﺒﺮ داء اﻟﺴﻜﺮي ﻣﻜﻠﻔﺎ ﻧﻈﺮًا ﻟﻄﺒﻴﻌﺔ اﻟﻤﺮض اﻟﻤﺰﻣﻨﺔ وﺧﻄﻮرة ﻣﻀﺎﻋﻔﺎﺗﻪ وﺳﺒﻞ ﻣﻜﺎﻓﺤﺘﻪ‪ ،‬وﻻ‬
‫ﻳﻘﺘﺼﺮ آﻠﻔﺔ اﻟﻤﺮض ﻟﻸﻓﺮاد واﻟﻤﺠﺘﻤﻌﺎت ﻋﻠﻰ اﻟﻤﺎدﻳﺎت ﻓﻘﻂ ﺑﻞ ﺗﺘﻌﺪاهﺎ إﻟﻰ اﻟﺘﻜﻠﻔﺔ ﻏﻴﺮ اﻟﻤﻠﻤﻮﺳﺔ ذات اﻷﺛﺮ‬
‫اﻟﻜﺒﻴﺮ واﻟﺘﻲ ﻻ ﻳﻤﻜﻦ ﻗﻴﺎﺳﻬﺎ آﺎﻷﻟﻢ واﻟﻘﻠﻖ واﻧﺨﻔﺎض ﺟﻮدة اﻟﺤﻴﺎة‪.‬‬

‫هﺬا وﻗﺪ ﻣﺮت اﻟﻜﺜﻴﺮ ﻣﻦ دول اﻟﻌﺎﻟﻢ ﺑﻤﺮﺣﻠﺔ اﻻﻧﺘﻘﺎل اﻟﻮﺑﺎﺋﻲ ﻓﻲ اﻟﺴﻨﻮات اﻷﺧﻴﺮة وآﺎن ﻟﻠﺘﻘﺪم اﻻﻗﺘﺼﺎدي‬
‫واﻻﺟﺘﻤﺎﻋﻲ ﺑﺪوﻟﺔ اﻹﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة وﻣﺎ ﺻﺎﺣﺒﻪ ﻣﻦ اﻟﺘﻐﻴﺮ ﻓﻲ اﻟﺨﺼﺎﺋﺺ اﻟﺜﻘﺎﻓﻴﺔ واﻟﺘﺤﺴﻦ اﻟﺒﻴﺌﻲ ﻣﻘﺎرﻧﺔ‬
‫ﺑﺎﻟﺪول اﻟﻤﺘﻘﺪﻣﺔ ﻣﻤﺎ أدى إﻟﻰ اﻻﻧﺨﻔﺎض ﻓﻲ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ وزﻳﺎدة ﻋﻤﺮ اﻟﺴﻜﺎن واﻟﺘﻐﻴﺮ ﻓﻲ اﻟﻌﺎدات اﻟﻐﺬاﺋﻴﺔ‬
‫وﻗﻠﺔ اﻟﻨﺸﺎط اﻟﺒﺪﻧﻲ أدى إﻟﻰ ﻇﻬﻮر اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ آﻈﺎهﺮة ﻏﺎﻟﺒﺔ ﻟﺘﺪهﻮر اﻟﺼﺤﺔ ﺑﺎﻟﻤﺠﺘﻤﻊ‪ ،‬هﺬا و ﻗﺪ‬
‫ﺳﺒﺒﺖ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻏﺎﻟﺒﻴﺔ اﻟﻮﻓﻴﺎت )‪ (%86.8‬وأآﺜﺮ ﻣﻦ ﻧﺼﻒ ﺣﺎﻻت اﻹدﺧﺎل )‪ (56%‬ﺑﻤﺴﺘﺸﻔﻴﺎت‬
‫اﻟﺪاﺋﺮة‪ ،‬وﺷﻜﻠﺖ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ واﻟﻄﻔﻴﻠﻴﺔ ‪ %5‬ﻣﻦ اﻟﻮﻓﻴﺎت ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم ‪.2004‬‬

‫وﻳﺤﺘﻞ ﻣﺮض اﻟﺴﻜﺮي أهﻤﻴﺔ آﺒﻴﺮة ﺑﻴﻦ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﺪﺑﻲ ﻓﺒﻴﻦ ‪ 46166‬ﺷﺨﺼًﺎ ﺗﻢ إدﺧﺎﻟﻬﻢ ﻣﺴﺘﺸﻔﻴﺎت‬
‫اﻟﺪاﺋﺮة ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم ‪ 2005‬آﺎن هﻨﺎك ‪ 1297‬ﺣﺎﻟﺔ ﺳﻜﺮي )‪ (%2.8‬وﻗﺪ ﺷﻜﻞ اﻟﻤﻮاﻃﻨﻮن ‪ %57.9‬ﻣﻦ اﻟﺤﺎﻻت‬
‫وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ ‪ %42.1‬آﻤﺎ ﺷﻜﻠﺖ اﻟﻤﻮاﻃﻨﺎت ‪ %41.4‬ﻣﻦ ﻣﺠﻤﻮع ﺣﺎﻻت اﻹدﺧﺎل ﺑﺎﻟﺪاﺋﺮة‪ ،‬وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ‬
‫اﻟﺴﻜﺮي ﺗﺒﻌًﺎ ﻟﻠﻨﻮع ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ ﻓﻘﺪ ﺷﻜﻞ اﻟﻨﻮع اﻷول )اﻟﻤﻌﺘﻤﺪ ﻋﻠﻰ اﻷﻧﺴﻮﻟﻴﻦ( ‪ %19.7‬ﻣﻦ اﻟﺤﺎﻻت واﻟﻨﻮع‬
‫اﻟﺜﺎﻧﻲ )ﻏﻴﺮ اﻟﻤﻌﺘﻤﺪ ﻋﻠﻰ اﻷﻧﺴﻮﻟﻴﻦ( ‪ %38.2‬وﺳﻜﺮي اﻟﺤﻤﻞ ‪ %21.1‬واﻟﺴﻜﺮي ﻏﻴﺮ اﻟﻤﻌﻴﻦ ‪ .%20.9‬هﺬا‬
‫وآﺎﻧﺖ اﻟﻨﺴﺒﺔ ﺑﻴﻦ اﻟﻤﻮاﻃﻨﺎت ‪ %14.6‬ﻟﻠﻨﻮع اﻷول و ‪ %31‬ﻟﻠﻨﻮع اﻟﺜﺎﻧﻲ و ‪ %29.5‬ﻟﺴﻜﺮ اﻟﺤﻤﻞ و ‪%23.9‬‬
‫ﻟﻠﺴﻜﺮي ﻏﻴﺮ اﻟﻤﻌﻴﻦ)ﺷﻜﻞ ‪ .(1‬وﻗﺪ ﺷﻜﻞ اﻟﺬآﻮر ‪ %28.6‬ﻣﻦ اﻟﺤﺎﻻت واﻹﻧﺎث ‪) %71.4‬ﺷﻜﻞ ‪ .(2‬وهﻨﺎك زﻳﺎدة‬

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‫ﻓﻲ ﻋﺪد ﺣﺎﻻت اﻟﺴﻜﺮي ﺑﺰﻳﺎدة اﻟﻌﻤﺮ ﻓﻲ اﻟﺬآﻮر واﻹﻧﺎث )ﺷﻜﻞ ‪ ،(3‬وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ ﺣﺎﻻت اﻟﺴﻜﺮي ﻓﻲ اﻟﺬآﻮر‬
‫واﻹﻧﺎث اﻟﻤﻮاﻃﻨﻴﻦ ﺑﺎﻟﻌﻤﺮ آﺎن هﻨﺎك زﻳﺎدة ﻓﻲ ﻋﺪد اﻟﺤﺎﻻت ﻓﻲ اﻷﻋﻤﺎر اﻟﺼﻐﻴﺮة ﻟﻠﺬآﻮر وﺑﺘﻘﺪم اﻟﻌﻤﺮ ﻟﻺﻧﺎث‪،‬‬
‫وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ ﺣﺎﻻت اﻟﺴﻜﺮي أﺛﻨﺎء اﻟﺤﻤﻞ ﺑﻴﻦ اﻹﻧﺎث اﻟﻤﻮاﻃﻨﺎت ﺑﺎﻟﻌﻤﺮ آﺎﻧﺖ اﻟﻨﺴﺒﺔ ‪ %7.5‬ﻟﻠﺤﻮاﻣﻞ أﻗﻞ ﻣﻦ‬
‫‪ 25‬ﻋﺎﻣﺎً‪ %51.7 ،‬ﻟﻠﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 34-25‬ﻋﺎﻣﺎ‪ %38.4 ،‬ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 44-35‬ﻋﺎﻣًﺎ و ‪%2.4‬‬
‫ﻓﻘﻂ ﻟﻠﺤﻮاﻣﻞ اﻟﺒﺎﻟﻐﻴﻦ ‪ 45‬ﻋﺎﻣًﺎ وأآﺜﺮ ﻣﻦ اﻟﻌﻤﺮ )ﺷﻜﻞ ‪ ،(4‬هﺬا وﻗﺪ ﺑﻠﻎ ﻣﺘﻮﺳﻂ ﻋﻤﺮ ﺣﺎﻻت ﻣﺮﺿﻰ اﻟﺴﻜﺮي‬
‫ﻟﻠﻤﻮاﻃﻨﺎت ‪ 40.4‬ﻋﺎﻣﺎ وآﺎن ﻣﺘﻮﺳﻂ اﻟﻌﻤﺮ ﻟﻠﻨﻮع اﻷول ‪22.3‬ﻋﺎﻣ ًﺎ و ‪ 57.8‬ﻋﺎﻣًﺎ ﻟﻠﻨﻮع اﻟﺜﺎﻧﻲ و ‪ 32.5‬ﻋﺎﻣُﺎ‬
‫ﻟﺴﻜﺮي اﻟﺤﻤﻞ‪ .‬أﻣﺎ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﻤﻀﺎﻋﻔﺎت ﻓﻘﺪ أﻇﻬﺮت ﺣﺎﻻت دﺧﻮل اﻟﺴﻜﺮي ﻟﻠﻤﻮاﻃﻨﺎت ﺑﻤﺴﺘﺸﻔﻴﺎت اﻟﺪاﺋﺮة أن‬
‫‪ %82‬ﻣﻦ ﺳﻜﺮي اﻟﻨﻮع اﻟﺜﺎﻧﻲ آﺎﻧﺖ ﺗﻌﺎﻧﻲ ﻣﻦ ﻣﻀﺎﻋﻔﺎت اﻟﺴﻜﺮي وان ﺣﻮاﻟﻲ ﺛﻠﺜﻲ اﻟﺤﺎﻻت )‪ (%66‬آﺎﻧﺖ ﺑﻬﺎ‬
‫ﻣﻀﺎﻋﻔﺎت ﻣﺘﻌﺪدة )ﺷﻜﻞ ‪ ،(5‬أﻣﺎ اﻟﻨﻮع اﻷول ﻓﻘﺪ ﺷﻜﻞ ارﺗﻔﺎع اﻷﺣﻤﺎض اﻟﻜﻴﺘﻮﻧﻴﺔ أآﺜﺮ ﻣﻦ ﺛﻠﺚ)‪(%34‬‬
‫اﻟﻤﻀﺎﻋﻔﺎت‪ % 20،‬ﻟﻠﻤﻀﺎﻋﻔﺎت اﻷﺧﺮى و ‪ %46‬ﻻ ﻳﻮﺟﺪ ﺑﻬﻢ ﻣﻀﺎﻋﻔﺎت ﻟﻤﺮض اﻟﺴﻜﺮي )ﺷﻜﻞ ‪.(6‬‬

‫وﺑﺪراﺳﺔ ﺣﺎﻻت اﻟﺴﻜﺮي ﺑﻴﻦ ‪ 109835‬ﻣﻮاﻃﻨﺎ راﺟﻌﻮا ﻋﻴﺎدات اﻷﺧﺼﺎﺋﻴﻴﻦ ﺑﺎﻟﺪاﺋﺮة ﻓﻲ ﻋﺎم ‪ ،2005‬آﺎن هﻨﺎك‬
‫‪ (%5.7) 6261‬ﻣﺮﻳﻀًﺎ ﺑﺪاء اﻟﺴﻜﺮي )ﺷﻜﻞ ‪ (7‬آﻤﺎ ﺷﻜﻠﺖ اﻟﻤﻮاﻃﻨﺎت ‪ %50.2‬ﻣﻦ ﻣﺠﻤﻮع اﻟﺤﺎﻻت ﺑﺎﻟﺪاﺋﺮة ‪،‬‬
‫وﻗﺪ ﺷﻜﻞ اﻟﻨﻮع اﻷول ‪ %20.1‬ﻣﻦ اﻟﺤﺎﻻت واﻟﻨﻮع اﻟﺜﺎﻧﻲ ‪ %75.2‬وﺳﻜﺮي اﻟﺤﻤﻞ ‪ %2.7‬واﻟﺴﻜﺮى ﻏﻴﺮ‬
‫اﻟﻤﻌﻴﻦ‪ %1.8‬ﺷﻜﻞ )‪.(8‬‬

‫وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ ﺣﺎﻻت اﻟﺴﻜﺮي ﺑﻴﻦ ﻣﺮاﺟﻌﻲ اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﺑﺎﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم ‪2005‬‬
‫ﻓﻘﺪ ﺷﻜﻞ اﻟﻨﻮع اﻷول ‪ %32‬ﻣﻦ اﻟﺤﺎﻻت واﻟﻨﻮع اﻟﺜﺎﻧﻲ ‪ %54‬واﻷﻧﻮاع اﻷﺧﺮى ‪ %14‬ﻣﻦ اﻟﺤﺎﻻت‬
‫ﺷﻜﻞ )‪.(9‬‬

‫اﻟﺘــﻮﺻـﻴـــــﺎت‪:‬‬
‫هﻨﺎك ﺣﺎﺟﺔ إﻟﻰ وﺟﻮد دراﺳﺎت ﻟﺘﺤﺪﻳﺪ ﺣﺠﻢ وﻋﻮاﻣﻞ اﻟﺨﻄﻮرة وأﺳﺒﺎب ﺣﺪوث اﻟﻤﺮض ﻟﺪاء اﻟﺴﻜﺮي ﺧﺎﺻﺔ ﺑﻴﻦ‬
‫اﻟﻤﻮاﻃﻨﺎت ﺑﻬﺪف ﺗﺤﺪﻳﺪ ﻣﻌﺪل اﻧﺘﺸﺎر داء اﻟﺴﻜﺮي ﻓﻲ دﺑﻲ ﺑﺪءا ﻣﻦ اﻟﻔﺌﺔ اﻟﻌﻤﺮﻳﺔ ﻣﻦ ‪ 18‬ﻋﺎﻣًﺎ ﻓﺄآﺜﺮ‪ .‬آﻤﺎ أن هﻨﺎك‬
‫ﺣﺎﺟﺔ إﻟﻰ إﻧﺸﺎء وﺗﻨﻔﻴﺬ ﺧﻄﺔ ﻋﻤﻞ ﻟﻤﻌﺎﻟﺠﺔ وﻣﻜﺎﻓﺤﺔ ﻣﺮض اﻟﺴﻜﺮي ﺑﺪﺑﻲ‪ ،‬ﻋﻠﻰ أن ﺗﻜﻮن اﻟﺨﻄﺔ ﺟﺰءًا ﻣﻦ ﻧﻈﺎم‬
‫اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﻤﺼﻤﻢ ﻟﺘﺤﺴﻴﻦ اﻟﺼﺤﺔ وﻣﻘﺎوﻣﺔ اﻟﻤﺮض ﻟﻠﺴﻜﺎن ﺑﺪﺑﻲ‪ ،‬وأن ﻳﺘﻢ إﻋﺪاد ﺧﻄﺔ زﻣﻨﻴﺔ ﻣﺘﻀﻤﻨﺔ‬
‫اﻷهﺪاف واﻟﻤﺮاﻣﻲ واﻷﻧﺸﻄﺔ اﻟﺘﻔﺼﻴﻠﻴﺔ آﻤﺎ ﻳﺠﺐ إﻋﺪاد ﻣﻌﺎﻳﻴﺮ ﺗﻘﻴﻴﻢ اﻟﺘﻘﺪم واﻷﺛﺮ‪ ،‬هﺬا وهﻨﺎك ﺑﻌﺾ اﻻﺣﺘﻴﺎﺟﺎت‬
‫اﻟﺮﺋﻴﺴﻴﺔ اﻟﺘﻲ ﻳﺠﺐ إرﺳﺎؤهﺎ ﻗﺒﻞ إﻧﺸﺎء اﻟﺨﻄﺔ وهﻲ وﺟﻮد وﻋﻲ ﺟﻤﺎهﻴﺮي ﻋﻦ زﻳﺎدة ﻣﺸﻜﻠﺔ داء اﻟﺴﻜﺮي ﻣﻊ‬
‫اﻻﻟﺘﺰام وﺗﻮﻓﻴﺮ اﻟﻤﻮارد اﻟﻼزﻣﺔ ﻟﺬﻟﻚ‪ ،‬هﺬا وﻳﺠﺐ أن ﺗﻘﻮم ﻟﺠﻨﺔ داء اﻟﺴﻜﺮي ﺑﺎﻟﺪاﺋﺮة ﺑﺈﻋﺪاد وﺗﻨﻔﻴﺬ وﺗﻘﻴﻴﻢ ﺧﻄﺔ‬

‫‪61‬‬
‫ﻣﻜﺎﻓﺤﺔ اﻟﺴﻜﺮي ﺑﺪﺑﻲ ﻋﻠﻰ أن ﺗﻜﻮن أﻧﺸﻄﺔ اﻟﻤﻜﺎﻓﺤﺔ ﻣﺮﺗﺒﻄﺔ ﺑﻤﺠﻬﻮدات اﻟﺪﻣﺞ اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‬
‫اﻷﺧﺮى‪ ،‬آﻤﺎ ﻳﺠﺐ أن ﺗﺤﺪد اﻷﻧﺸﻄﺔ ﺑﻤﺴﺘﻮﻳﺎت اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ واﻟﺘﺨﺼﺼﻴﺔ وأن ﻳﺪرب أﻃﺒﺎء اﻟﺮﻋﺎﻳﺔ‬
‫اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ ﻋﻠﻰ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ واﻻﺣﺘﻴﺎﺟﺎت اﻟﺨﺎﺻﺔ ﻟﻬﺬﻩ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻤﻌﺮﺿﺔ ﻣﻦ اﻟﺴﻜﺎن‪ ،‬آﻤﺎ ﻳﺠﺐ‬
‫إﻋﺪاد دﻻﺋﻞ اﻟﻌﻤﻞ ﻟﺘﺤﺪﻳﺪ ﻋﻮاﻣﻞ اﻟﺨﻄﻮرة واﻟﻤﺠﻤﻮﻋﺎت ذات اﻟﺨﻄﻮرة اﻟﻌﺎﻟﻴﺔ واﻻآﺘﺸﺎف اﻟﻤﺒﻜﺮ واﻟﻌﻼج اﻟﻄﺒﻲ‬
‫وﺳﺒﻞ اﻟﻤﻜﺎﻓﺤﺔ‪.‬‬

‫‪62‬‬
Figure (1) Distribution of Diabetes Mellitus Mellitus am ong
Em irate Fem ales adm itted in DOHMS , Dubai 2005
2005 ‫ﺗﻮزﻳﻊ ﻣﺮض اﻟﺴﻜﺮي ﺑﻴﻦ اﻟﻤﻮاﻃﻨﺎت ﺑﺎﻟﻘﺴﻢ اﻟﺪاﺧﻠﻰ ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم‬

24% 15%

31%
30%

Type 1 Type 2 GDM Unspe cific

63
Figure (2) Distribution of Inpatient Diabetic Emirate Cases by Sex in
DOHMS, Dubai 2005
‫ﺗﻮزﻳﻊ ﺣﺎﻻت دﺧﻮل ﻣﺮﺿﻰ اﻟﺴﻜﺮي ﻟﻠﻤﻮاﻃﻨﻴﻦ ﺑ ﺪاﺋﺮة اﻟﺼ ﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ ﺑ ﺪﺑﻲ ﺑ ﺎﻟﻨﻮع‬

29%

71%

Male s Fe male s

64
 Figure (3) Distribution of Inpatient Diabetic Emirate Cases in
DOHMS by Type and Age, Dubai 2005
‫ﺗﻮزﻳﻊ ﺣﺎﻻت دﺧﻮل ﻣﺮﺿﻰ اﻟﺴﻜﺮي اﻟﻤﻮاﻃﻨﻴﻦ ﺑ ﺪاﺋﺮة اﻟﺼ ﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ ﺑ ﺪﺑﻲ ﺑ ﺎﻟﻨﻮع‬
2005 ‫واﻟﺴﻦ ﻓﻲ ﻋﺎم‬

200

150
Males
100
Fem ales
50

0
<5 5- 15- 25- 35- 45- 55- 65+
Age Group

65
 Figure (4) Distribution of Diabe te s Me llitus in Pre gnancy among
Emirate Inpatie nts in DO HMS by Age , Dubai 2005
‫ﺗﻮزﻳﻊ ﻣﺮض اﻟﺴﻜﺮي ﻓﻲ اﻟﺤﻤﻞ ﺑﻴﻦ ﺣﺎﻻت دﺧﻮل اﻟﻤﻮاﻃﻨﻴﻦ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬
2005 ‫ﺑﺎﻟﻌﻤﺮ ﻓﻲ ﻋﺎم‬

2% 8%

38%

52%

15- 25- 35- 45-54

66
 Figure (5) Distribution of Com plications of Type 2 Diabetes Mellitus am ong
Fem ale Em irate Inpatients in DOHMS,Dubai 2005
‫ﺗﻮزﻳﻊ ﻣﻀﺎﻋﻔﺎت اﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻟﻤﺮض اﻟﺴﻜﺮي ﺑﻴﻦ ﺣﺎﻻت دﺧﻮل اﻟﻤﻮاﻃﻨﺎت ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم‬
2005

18% 3% 6% 3%
4%

66%

Ketoacidosis Renal Neurological Opthalmic Other & Multiple No Complication

67
Figure (6) Distribution of Type 1 Diabe te s Me llitus C omplications among
Emirate Fe male Inpatie nts in DO HMS, Dubai 2005
‫ﺗﻮزﻳﻊ ﻣﻀﺎﻋﻔﺎت اﻟﻨﻮع اﻷول ﻟﻤﺮض اﻟﺴﻜﺮي ﺑﻴﻦ ﺣﺎﻻت دﺧﻮل اﻟﻤﻮاﻃﻨﺎت ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ‬
2005 ‫ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم‬

34%
46%

20%

Ketoacidosis Other & Multiple Com plications No Com plication

68
 Figure (7) Distribution of Diabe te s Me llitus among Patie nts
Atte nding Spe cialist C linics in DO HMS, Dubai 2005
‫ﺗﻮزﻳﻊ ﻣﺮض اﻟﺴﻜﺮي ﺑﻴﻦ ﻣﺮاﺟﻌﻲ ﻋﻴﺎدات اﻷﺧﺼﺎﺋﻴﻴﻦ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬

6%

DM
O the r Dise ase s

94%

69
Figure (8) Distribution of Diabetes Mellitus am ong Em irate Fem ales Attended
Specialist Clinics in DOHMS by Type, Dubai, 2005

2% 3% 20%

75%

Type 1 Type 2 GDM Unspecific

70
 Diiaabbeetteess M
D moonngg SScchhooooll A
Meelllliittuuss aam Aggee C Duubbaaii
Chhiillddrreenn iinn D

Diabetes is one of the most common Non -communicable disease in children and
adolescents. When diabetes strikes during childhood, it is routinely assumed to be type
1, or juvenile-onset diabetes. However, the end of the 20th century witnessed a
dramatic rise in the incidence of type 2 diabetes in children. Although considered
uncommon a few decades ago, type 2 diabetes in adolescents now represents one of
the most rapidly growing forms of diabetes worldwide .Not surprisingly, the incidence
of type 2 diabetes in adolescents has paralleled the epidemic of childhood obesity now
occurring in Westernized societies. It is believed that the genetic and lifestyle factors
that increase the risk of developing type 2 diabetes in adolescents and adults are
similar. Children and adolescents diagnosed with type 2 diabetes are generally
between 10 and 19 years old, obese, have a strong family history for type 2 diabetes,
and have insulin resistance. Generally, children and adolescents with type 2 diabetes
have poor glycemic control. It is hard to detect type 2 diabetes in children because it
can go undiagnosed for a long time; children may have no symptoms or mild
symptoms; and because blood tests are needed for diagnosis. It is difficult to be sure it
is type 2, because criteria for differentiating between types of diabetes in children are
confusing; that is, children with type 2 can develop ketoacidosis; children with type 1
can be overweight; and because the overall prevalence of the disease may still be
low(1). Diabetes mellitus is a significant cause of morbidity and mortality in UAE.
Deaths attributed to DM accounted for 2.1-3.1% of all deaths in the last ten years(2).

There was 304 persons with diabetes mellitus among the school age group (4-19
years) diagnosed by specialist clinics in DOHMS in 2005, 229 (75.3%) Emirates and
24.7% Expatriates. Among Emirate children, females amounted to 46.7% of the cases,
(Figure 1). Type1 diabetes mellitus constituted 91.2% of Emirates diabetic cases,
(Figure 2). Studying the distribution by level of education, the percentage in
kindergarten was 7.4%, 41.0% were among primary, 21.0% among preparatory and 70

71
cases (30.6%) were among secondary school children. Studying the distribution of
type1 diabetes mellitus by age, there was a peak at 11 years old.

In Dubai, Diabetes mellitus amounted for 1.9 % of all admissions in DOHMS in 2005.
It constituted 2.6% of all admitted cases in the school age group 4-19 years in
DOHMS in 2005. There were 18 cases, 86 (72.9%) Emirates and 27.1% expatriates.
Studying the distribution of diabetes mellitus among Emirates, there were 51 (59.3%)
males and 35 (40.7%) females. Type 1 diabetes amounted to 93.02% of the cases.
Studying the distribution of type 1, diabetes by age, there is a peak at 11-12 years. As
for complications of type 1 diabetes, keloacidosis constituted 38.8%; other
complications 16.2% and 45% of the diabetic children were not complicated, (Figure
3). The distribution was nearly the same in both males and females, but ketoacidosis
was more in males (41.3%).

There were 597 diabetic persons below 25 years reported by the private health sector
in Dubai in 2005, 55.9% were males and 44.1% females. Only 27 cases (4.5%) were
below 15 years. Type 1 diabetes amounted to 43.6% of the cases and Type2 diabetes
56.4%. Emirates amounted to 14.1% of the cases.

Comments and Recommendation:

Type 2 diabetes mellitus is a new morbidity in children and adolescents. For pediatric
patients, it heralds earlier onset of cardiovascular disease, retinopathy, nephropathy,
and neuropathy, with risk of impaired quality of life and premature death. The
emergence of type 2 diabetes mellitus in young people is believed to be associated
with changes in physical activity and nutrition that are ubiquitous in modern society(3).

Prevention must take highest priority and should focus on decreasing the risk,
incidence, and consequences of type 2 diabetes mellitus among children. Primary

72
prevention efforts by primary health care professionals are recommended in two
arenas: general community health promotion and health education and clinically based
activities. Clinically based health promotion activities should not duplicate
community-wide health promotion but instead should offer additive benefits. The
principles of managing children with type 2 diabetes include diabetes self-management
education, nutrition management, exercise prescription, pharmacological management
and psychosocial considerations(4.5.6).

As in adults with type 2 diabetes, adolescents may be able to effectively manage this
condition with lifestyle adjustments focused on choice and amount of foods ingested
combined with increased physical activity. One major therapeutic goal should be
maintenance of a desirable body weight. As in adults, minor reductions in weight can
have dramatic results on glucose tolerance. This underscores the value of frequent
access to a diabetes team that can assess, prescribe, and assist in the implementation
of these children's care plans. Smoking cessation is essential since tobacco use
magnifies the risk for long-term micro- and macro vascular complications and
aggravates co-morbid problems (e.g., hypertension)(6.7).

Adolescence is well known to be characterized by diminished adherence to medical

regimens and increases in risk-taking behaviors. This problem is compounded by the
focus on short-term rather than long-term goals typical of many adolescents. Parents
may be reluctant to comply with insulin therapy. Proper education of the family is
essential to maximizing adherence to the medical regimen(4.6) .

Most overweight children with type 2 diabetes have diminished exercise tolerance. A
contributing factor is the lack of physical education in schools. Getting adolescents to
engage in physical activity takes an understanding of what each child considers
"acceptable." An overly ambitious exercise prescription can result in poor adherence
and frustrate teens and their families(4.8). For most inactive teens, walking is a good

73
start. If there is an activity a child enjoys, such as team sport, this can also be used.
Exercise must be started slowly (3 times a week) and for short periods of time (15–20
minutes) to build tolerance. The goal is to develop a healthy pattern of regular
physical activity, not a competitive athlete. Parents or other family members should
be encouraged to participate. This will help the entire family adopt a healthier lifestyle
and improve adherence in most cases. The key to a successful exercise program for
children, as for adults, is to engage in an enjoyable activity. As children develop
greater exercise tolerance, encourage increasing the duration and intensity of their
physician activity(8).

Nutritional education is a cornerstone of therapy for children with type 2 diabetes.

Often, these children come from a home environment with a poor understanding of
healthy eating habits. Adolescents and their families must be encouraged to
consistently make better food choices. This begins by teaching parents what foods to
bring home and how to plan meals and snacks(9).

Recommendation:

1. More elaborate data and precise indicators are required to assess the magnitude of
the problem of diabetes mellitus in Dubai in preparation for the development of a
plan for the prevention and management of the disease in Dubai.
2. A Task Force Group should be developed from DOHMS and Ministry of
Education for studying the nature of diabetes mellitus among school children in
Dubai and developing a program for managing and controlling the disease. The
Department of Planning and Statistics should be engaged in that activity. A
proposed protocol for studying diabetes mellitus among school children in Dubai
was prepared by the Department.

74
3. The Research and Diabetes committees in DOHMS and in collaboration of the
Department of Planning & Statistics and Department of Primary Health Care
should design and implant a study for studying diabetes mellitus among Emirate
Population 18 years and above in Dubai. A suggested protocol is prepared by the
Department.

References
1. Epidemiology of type1 and type2 diabetes mellitus among North American
children & adolescents available from CDC (home page on the internet).
http://www.cdc.gov/diabetes/projects/cda2.htm
2. Annual report 2004. Preventive Medicine Section, Ministry of Health - U.A.E.
3. Internal diabetes federal (homepage on the internet) type2 diabetes in the young,
available form http://www.eatlas.idf.org/Prevalence/Type_2_in_the_young
4. Guidelines for school health programs to promote life long healthy eating MMWR
June 14, 1996 145 (RR-9), 34-41. available form.
5. Medicine net com. (obesity double kid’s diabetes risk), available form
http://www.medicinenet.com/script/main/art.asp?articlekey=57727
6. Risk reduction for type 2 diabetes in Aboriginal children in Canada, Pediatrics &
Child Health 2005; 10(1): 49-52, available from
http://www.cps.ca/English/statements/II/FNIH05-01.htm
7. Obesity Doubles Kids' Diabetes Risk Available from
http://www.medicinenet.com/script/main/art.asp?articlekey=5772
8. Diabetes Spectrum. Type2 Diabetes Mellitus in Teens Volume 13 Number2, 2000,
Page95, available http://journal.diabetes.org/diabetesspectrum/00v13n2/pg95.htm
9. Simple Steps to Preventing Diabetes Available from
http://journal.diabetes.org/diabetesspectrum/00v13n2/pg95.htm

75
 ‫ﻣﺮض اﻟﺴﻜﺮي ﺑﻴﻦ أﻃﻔﺎل اﻟﺴﻦ اﻟﻤﺪرﺳﻲ ﺑﺪﺑﻲ‬

‫ﻳﻌﺘﺒﺮ ﻣﺮض اﻟﺴﻜﺮي أآﺜﺮ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ اﻧﺘﺸﺎرًا ﺑﻴﻦ اﻷﻃﻔﺎل واﻟﻴﺎﻓﻌﻴﻦ وﻏﺎﻟﺒًﺎ ﻣﺎ ﻳﻜﻮن ﻋﺎدة ﻣﻦ اﻟﻨﻮع‬
‫اﻷول ﻋﻨﺪﻣﺎ ﻳﺤﺪث اﻟﻤﺮض ﻓﻲ اﻷﻃﻔﺎل‪ ،‬ﻟﻜﻦ ﺑﻨﻬﺎﻳﺔ اﻟﻘﺮن اﻟﻌﺸﺮﻳﻦ ﺣﺪث ارﺗﻔﺎع آﺒﻴﺮ ﻓﻲ ﺣﺪوث اﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ‬
‫داء اﻟﺴﻜﺮي‪ ،‬وﺑﺎﻟﺮﻏﻢ ﻣﻦ آﻮن اﻟﻤﺮض ﻏﻴﺮ ﻣﻌﺘﺎد ﺣﺘﻰ ﺳﻨﻮات ﻗﺮﻳﺒﺔ إﻻ اﻧﻪ ﻟﻴﺲ ﻋﺠﻴﺒًﺎ أن ﻳﺘﺰاﻣﻦ ﺣﺪوث اﻟﻨﻮع‬
‫اﻟﺜﺎﻧﻲ ﻣﻦ اﻟﺴﻜﺮي ﻣﻊ وﺑﺎء اﻟﺴﻤﻨﺔ ﺑﻴﻦ اﻷﻃﻔﺎل ﺑﺎﻟﻤﺠﺘﻤﻌﺎت اﻟﺼﻨﺎﻋﻴﺔ‪ ,‬هﺬا وﻳﻌﺘﻘﺪ أن اﻟﻌﻮاﻣﻞ اﻟﻮراﺛﻴﺔ وﻧﻤﻂ اﻟﺤﻴﺎة‬
‫اﻟﺬي ﻳﺰﻳﺪ ﺧﻄﻮرة ﺣﺪوث اﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ داء اﻟﺴﻜﺮي ﺑﻴﻦ اﻷﻃﻔﺎل واﻟﺒﺎﻟﻐﻴﻦ ﻣﺘﺸﺎﺑﻬﺔ‪ ,‬وﻏﺎﻟﺒًﺎ ﻣﺎ ﻳﺤﺪث اﻟﻨﻮع اﻟﺜﺎﻧﻲ‬
‫ﻣﺎ ﺑﻴﻦ ‪ 19-10‬ﻋﺎﻣًﺎ ﺑﺎﻷﻃﻔﺎل واﻟﻴﺎﻓﻌﻴﻦ ﻷﻃﻔﺎل ﺑﺪﻧﺎء وذو ﺗﺎرﻳﺦ اﺳﺮي ﻟﻠﻨﻮع اﻟﺜﺎﻧﻲ وﻟﺪﻳﻬﻢ ﻣﻘﺎوﻣﺔ ﻟﻬﺮﻣﻮن‬
‫اﻷﻧﺴﻮﻟﻴﻦ‪ ،‬آﻤﺎ أن ﺗﺤﻜﻤﻬﻢ ﻓﻲ ﻣﺴﺘﻮى اﻟﺴﻜﺮ ﻳﻜﻮن ﺿﻌﻴﻔًﺎ‪ ,‬هﺬا وهﻨﺎك ﺻﻌﻮﺑﺔ ﻻآﺘﺸﺎف اﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ اﻟﺴﻜﺮي‬
‫ﺑﺎﻷﻃﻔﺎل ﺣﻴﺚ اﻧﻪ ﻣﻦ اﻟﻤﻤﻜﻦ أن ﺗﻤﺮ ﻓﺘﺮة ﻃﻮﻳﻠﺔ ﻗﺒﻞ اآﺘﺸﺎﻓﻪ آﻤﺎ اﻧﻪ ﻗﺪ ﻻ ﺗﻮﺟﺪ أﻋﺮاض ﻟﻠﻤﺮض أو أﻋﺮاض‬
‫ﻃﻔﻴﻔﺔ وﻗﺪ ﻳﺤﺘﺎج إﻟﻰ اﺧﺘﻴﺎرات اﻟﺪم ﻻآﺘﺸﺎﻓﻪ‪ ،‬وهﻨﺎك ﺻﻌﻮﺑﺔ ﻟﻠﺘﻔﺮﻳﻖ ﺑﻴﻦ اﻟﻨﻮﻋﻴﻦ ﻓﻲ اﻷﻃﻔﺎل ﺣﻴﺚ أن اﻷﻃﻔﺎل‬
‫اﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻗﺪ ﻳﻌﺎﻧﻮن ﻣﻦ ﻣﻀﺎﻋﻔﺎت اﻷﺣﻤﺎض اﻟﻜﻴﺘﻮﻧﻴﺔ وان اﻷﻃﻔﺎل اﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﻨﻮع اﻷول ﻗﺪ ﻳﻜﻮﻧﻮا‬
‫ﺑﺪﻧﺎء آﻤﺎ أن ﻣﻌﺪل اﻻﻧﺘﺸﺎر اﻟﻜﻠﻲ ﻟﻠﻤﺮض ﻣﺎ زال ﺿﻌﻴﻔًﺎ‪.‬‬

‫هﺬا وﻳﻌﺘﺒﺮ داء اﻟﺴﻜﺮي ﺳﺒﺒًﺎ ﺟﻮهﺮﻳ ًﺎ ﻟﻠﻮﻓﻴﺎت واﻷﻣﺮاﺿﻴﺔ ﺑﺪوﻟﺔ اﻹﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة آﻤﺎ أن اﻟﻮﻓﻴﺎت اﻟﺘﻲ‬
‫ﻳﻤﻜﻦ إرﺟﺎﻋﻬﺎ إﻟﻰ داء اﻟﺴﻜﺮي ﺗﺒﻠﻎ ‪ %3.1 – 2.1‬ﻣﻦ ﻣﺠﻤﻞ اﻟﻮﻓﻴﺎت ﻓﻲ اﻟﻌﺸﺮ اﻟﺴﻨﻮات اﻷﺧﻴﺮة‪.‬‬
‫ﻣﺠﻤﻮﻋﺔ اﻟﻌﻤﺮ اﻟﻤﺪرﺳﻲ ‪ 19-4‬ﻋﺎﻣُﺎ ﺑﻌﻴﺎدات اﻷﺧﺼﺎﺋﻴﻴﻦ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم ‪،2005‬‬
‫‪ (%75.3) 229‬ﻣﻮاﻃﻦ و‪ 24.7‬ﻏﻴﺮ ﻣﻮاﻃﻦ‪ ،‬آﻤﺎ ﺷﻜﻠﺖ اﻹﻧﺎث ‪ %46.7‬ﻣﻦ اﻟﺤﺎﻻت )ﺷﻜﻞ رﻗﻢ ‪ (1‬آﻤﺎ ﺑﻠﻎ اﻟﻨﻮع‬
‫اﻷول ‪ %91.2‬ﻣﻦ اﻟﺤﺎﻻت ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ )ﺷﻜﻞ رﻗﻢ ‪ ,(2‬وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ اﻟﺤﺎﻻت ﺑﻤﺴﺘﻮى اﻟﺘﻌﻠﻴﻢ‪ ,‬آﺎﻧﺖ اﻟﻨﺴﺒﺔ‬
‫‪ %7.4‬ﺑﻴﻦ رﻳﺎض اﻷﻃﻔﺎل‪ %41 ,‬ﺑﻴﻦ اﻟﻤﺮﺣﻠﺔ اﻻﺑﺘﺪاﺋﻴﺔ و‪ %21‬ﺑﺎﻹﻋﺪادﻳﺔ و‪ %30.6‬ﺑﻴﻦ ﺗﻼﻣﻴﺬ اﻟﻤﺪارس اﻟﺜﺎﻧﻮﻳﺔ‪,‬‬
‫وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ ﺣﺎﻻت اﻟﻨﻮع اﻷول ﺑﺎﻟﺴﻦ آﺎﻧﺖ هﻨﺎك ذروة ﻋﻨﺪ ‪ 11‬ﻋﺎﻣﺎ ﻣﻦ اﻟﻌﻤﺮ‪.‬‬

‫وﻗﺪ ﺷﻜﻞ داء اﻟﺴﻜﺮي ‪ %1.9‬ﻣﻦ ﺣﺎﻻت اﻟﺪﺧﻮل ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم ‪ ,2005‬آﻤﺎ ﺷﻜﻞ‬
‫‪ %2.6‬ﻣﻦ ﺣﺎﻻت اﻟﺪﺧﻮل ﺑﺎﻟﺴﻦ اﻟﻤﺪرﺳﻲ ‪19-4‬ﻋﺎﻣًﺎ‪ ,‬وآﺎن هﻨﺎك ‪ 118‬ﺷﺨﺼًﺎ ﻳﻌﺎﻧﻮن ﻣﻦ اﻟﻤﺮض‪ ,‬ﻣﻨﻬﻢ ‪86‬‬
‫)‪ (%72.9‬ﻣﻮاﻃﻨﻴﻦ و‪ %27.1‬ﻏﻴﺮ ﻣﻮاﻃﻨﻴﻦ‪ ،‬وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ ﺣﺎﻻت اﻟﺴﻜﺮي ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ آﺎن هﻨﺎك ‪ 51‬ﺣﺎﻟﺔ‬
‫)‪ (%59.3‬ذآﻮر و ‪ %40.7‬ﻣﻦ اﻹﻧﺎث‪ ,‬وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﻨﻮع اﻷول ﻣﻦ اﻟﺴﻜﺮي ‪ %93.2‬وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ ﺣﺎﻻت‬
‫اﻟﻨﻮع اﻷول ﺑﺎﻟﻌﻤﺮ آﺎﻧﺖ هﻨﺎك ذروة ﻋﻨﺪ ‪12-11‬ﻋﺎﻣًﺎ‪ ,‬وﻗﺪ ﺷﻜﻠﺖ ﻣﻀﺎﻋﻔﺎت اﻷﺣﻤﺎض اﻟﻜﻴﺘﻮﻧﻴﺔ ‪ %39‬ﻣﻦ‬
‫اﻟﺤﺎﻻت )‪ (%41.3‬و ‪ %38.8‬ﻣﻀﺎﻋﻔﺎت أﺧﺮى وآﺎﻧﺖ هﻨﺎك ‪ %45‬ﻣﻦ اﻟﺤﺎﻻت ﺑﺪون ﻣﻀﺎﻋﻔﺎت )ﺷﻜﻞ رﻗﻢ‬
‫‪ (3‬وآﺎن اﻟﺘﻮزﻳﻊ ﺗﻘﺮﻳﺒ ًﺎ ﻣﺘﺸﺎﺑﻬًﺎ ﻓﻲ اﻟﺬآﻮر واﻹﻧﺎث وان آﺎﻧﺖ ﻧﺴﺒﺔ اﻷﺣﻤﺎض اﻟﻜﻴﺘﻮﻧﻴﺔ ﻋﺎﻟﻴﺔ ﺑﻴﻦ اﻟﺬآﻮر‪.‬‬

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‫هﺬا وآﺎن هﻨﺎك ‪ 597‬ﺷﺨﺼًﺎ ﺗﺤﺖ ‪ 25‬ﻋﺎﻣًﺎ ﻣﻦ اﻟﻌﻤﺮ ﻳﻌﺎﻧﻮن ﻣﻦ داء اﻟﺴﻜﺮي ﺑﺎﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ﻓﻲ‬
‫ﻋﺎم ‪ %55.9 ,2005‬ذآﻮر ‪ %44.1‬ﻣﻦ اﻹﻧﺎث‪ ,‬وآﺎن هﻨﺎك ‪ 27‬ﺣﺎﻟﺔ ﻓﻘﻂ ﺗﺤﺖ ‪ 15‬ﻋﺎﻣًﺎ ﻣﻦ اﻟﻌﻤﺮ وﻗﺪ ﺷﻜﻞ‬
‫اﻟﻨﻮع اﻷول ‪ %43.6‬ﻣﻦ اﻟﺤﺎﻻت واﻟﻨﻮع اﻟﺜﺎﻧﻲ ‪ %56.4‬وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﻤﻮاﻃﻨﻴﻦ ‪.%14.1‬‬

‫اﻟﻮﺻﻒ واﻟﺘﻌﻠﻴﻖ‪:‬‬

‫ﻳﻌﺘﺒﺮ اﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ داء اﻟﺴﻜﺮي ﻇﺎهﺮة ﻣﺮﺿﻴﺔ ﺣﺪﻳﺜﺔ ﻓﻲ اﻷﻃﻔﺎل واﻟﻴﺎﻓﻌﻴﻦ آﻤﺎ اﻧﻪ ﻧﺬﻳﺮ ﻟﺤﺪوث ﻣﺒﻜﺮ‬
‫ﻷﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ واﻋﺘﻼل ﺷﺒﻜﺎت اﻟﻌﻴﻦ واﻟﻜﻠﻴﺔ واﻻﻋﺘﻼل اﻟﻌﺼﺒﻲ واﻟﻤﻮت اﻟﻤﺒﻜﺮ‪ ,‬هﺬا وﻳﻌﺘﻘﺪ‬
‫أن ﺑﺰوغ اﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ اﻟﺴﻜﺮي ﻓﻲ اﻟﺼﻐﺎر ﻳﻜﻮن ﻣﺮﺗﺒﻄ ًﺎ ﺑﺎﻟﺘﻐﻴﺮات ﻓﻲ اﻟﻨﺸﺎط اﻟﺒﺪﻧﻲ واﻟﺘﻐﺬﻳﺔ اﻟﺴﺎﺋﺪة ﻓﻲ‬
‫اﻟﻤﺠﺘﻤﻌﺎت اﻟﺤﺪﻳﺜﺔ‪.‬‬

‫هﺬا وﻳﺠﺐ أن ﺗﺄﺧﺬ اﻟﻮﻗﺎﻳﺔ اﻷهﻤﻴﺔ اﻟﻜﺒﺮى ﻣﻊ اﻟﺘﺮآﻴﺰ ﻋﻠﻰ ﺗﻘﻠﻴﻞ ﺧﻄﻮرة وﺣﺪوث وﻋﻮاﻗﺐ اﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻟﻠﺴﻜﺮي‬
‫ﺑﻴﻦ اﻷﻃﻔﺎل‪ ،‬وﻳﻮﺻﻲ ﺑﻤﺠﻬﺪات اﻟﻮﻗﺎﻳﺔ اﻷوﻟﻴﺔ ﻟﻤﻘﺪﻣﻲ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ ﻓﻲ ﻣﺠﺎﻟﻴﻦ أوﻟﻬﺎ ﺗﺤﺴﻴﻦ ﺻﺤﺔ‬
‫اﻟﻤﺠﺘﻤﻊ واﻟﺘﺜﻘﻴﻒ اﻟﺼﺤﻲ واﻷﻧﺸﻄﺔ اﻹآﻠﻴﻨﻴﻜﻴﺔ‪ ،‬وﻳﺮاﻋﻰ إﻻ ﺗﺘﻜﺮر اﻷﻧﺸﻄﺔ اﻟﻤﺮﺗﻜﺰة إآﻠﻴﻨﻴﻜﻴ ًﺎ ﻣﻊ اﻷﻧﺸﻄﺔ‬
‫اﻟﻤﺠﺘﻤﻌﺔ ﻟﺘﺤﺴﻴﻦ اﻟﺼﺤﺔ وﻟﻜﻦ ﻟﺘﺰﻳﺪ ﻓﺎﺋﺪﺗﻬﺎ‪ ,‬هﺬا وﺗﻌﺘﻤﺪ ﻣﻌﺎﻟﺠﺔ اﻷﻃﻔﺎل ﺑﺎﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ اﻟﺴﻜﺮي ﻋﻠﻰ ﺗﻌﻠﻢ‬
‫اﻟﻤﻌﺎﻟﺠﺔ اﻟﺬاﺗﻴﺔ ﻟﻠﺴﻜﺮي واﻟﻤﻌﺎﻟﺠﺔ اﻟﻐﺬاﺋﻴﺔ واﻟﺘﺪرﻳﺐ اﻟﺒﺪﻧﻲ واﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻷدوﻳﺔ ﻣﻊ ﻣﺮاﻋﺎة اﻟﺠﻮاﻧﺐ اﻟﻨﻔﺴﻴﺔ‬
‫واﻻﺟﺘﻤﺎﻋﻴﺔ‪.‬‬

‫وآﻤﺎ ﻓﻲ اﻟﺒﺎﻟﻐﻴﻦ اﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ اﻟﺴﻜﺮي ﻓﺈن اﻟﻴﺎﻓﻌﻴﻦ ﻳﻤﻜﻨﻬﻢ ﺑﻜﻔﺎءة ﻣﻌﺎﻟﺠﺔ ﺗﻠﻚ اﻟﺤﺎﻟﺔ ﺑﺘﻐﻴﻴﺮ ﻧﻤﻂ‬
‫اﻟﺤﻴﺎة ﻣﻊ اﻟﺘﺮآﻴﺰ ﻋﻠﻰ اﺧﺘﻴﺎر وآﻤﻴﺔ اﻟﻄﻌﺎم وزﻳﺎدة اﻟﻨﺸﺎط اﻟﺒﺪﻧﻲ واﻟﻤﺤﺎﻓﻈﺔ ﻋﻠﻰ وزن اﻟﺠﺴﻢ اﻟﻤﺜﺎﻟﻲ‪ ,‬وآﻤﺎ ﻓﻲ‬
‫اﻟﺒﺎﻟﻐﻴﻦ ﻓﺎن اﻟﺘﻘﻠﻴﻞ اﻟﺒﺴﻴﻂ ﻓﻲ وزن اﻟﺠﺴﻢ ﺗﻨﺘﺞ ﻋﻨﻪ ﻧﺘﺎﺋﺞ ﻣﺜﻴﺮة ﻓﻲ ﺗﺤﻤﻞ اﻟﺴﻜﺮ‪ ,‬وﻳﻌﺘﺒﺮ اﻟﺘﻮﻗﻒ ﻋﻦ اﻟﺘﺪﺧﻴﻦ‬
‫أﺳﺎﺳﻴﺎ ﻻن اﻟﺘﺪﺧﻴﻦ ﻳﺰﻳﺪ ﺧﻄﻮرة ﻣﻀﺎﻋﻔﺎت اﻟﺠﻬﺎز اﻟﺪوري واﻟﻤﺸﺎآﻞ اﻟﺼﺤﻴﺔ اﻟﻤﺼﺎﺣﺒﺔ آﺎرﺗﻔﺎع ﺿﻐﻂ اﻟﺪم‪.‬‬

‫وآﻤﺎ هﻮ ﻣﻌﺮوف ﻓﺈن اﻟﻴﺎﻓﻌﻴﻦ ﻳﻜﻮﻧﻮن اﻗﻞ اﻟﺘﺰاﻣ ًﺎ ﺑﺎﻟﻨﻈﻢ اﻟﻌﻼﺟﻴﺔ وﻳﺰﻳﺪون ﻣﻦ اﻟﺨﻄﻮرة اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺴﻠﻮك وهﺬا‬
‫ﻳﺘﻀﺎﻋﻒ ﺑﺎﻟﺘﺮآﻴﺰ ﻋﻠﻰ اﻷهﺪاف ﻗﺼﻴﺮة اﻟﻤﺪى ﻋﻦ اﻷهﺪاف ﻃﻮﻳﻠﺔ اﻟﻤﺪى اﻟﻤﻨﺎﺳﺒﺔ ﻟﻜﺜﻴﺮ ﻣﻦ اﻟﻴﺎﻓﻌﻴﻦ‪ ,‬وﻳﻌﺘﺒﺮ‬
‫اﻟﺘﺜﻘﻴﻒ اﻟﺠﻴﺪ ﻟﻸﺳﺮة أﺳﺎﺳﻴﺎ ﻟﺰﻳﺎدة اﻻﻟﺘﺰام ﺑﺎﻟﻨﻈﻢ اﻟﻌﻼﺟﻴﺔ ﻻن اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﻮاﻟﺪﻳﻦ ﻗﺪ ﻻ ﻳﻠﺘﺰﻣﻮن ﺑﺎﻟﻌﻼج‬
‫ﺑﺎﻷﻧﺴﻮﻟﻴﻦ‪.‬‬

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‫ﻼ ﻣﺴﺎﻋﺪًا وهﻮ‬
‫هﺬا وﻗﺪ ﻻ ﻳﺘﺤﻤﻞ اﻷﻃﻔﺎل اﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ اﻟﺴﻜﺮي اﻟﺘﺪرﻳﺒﺎت اﻟﺒﺪﻧﻴﺔ آﻤﺎ إن هﻨﺎك ﻋﺎﻣ ً‬
‫ﻗﻠﺔ اﻟﺘﺜﻘﻴﻒ اﻟﺒﺪﻧﻲ ﺑﺎﻟﻤﺪارس وﻟﺬا ﻓﺎن ﻓﻬﻢ ﻣﺎ ﻳﻤﻜﻦ آﻞ ﻃﻔﻞ أن ﻳﻘﺒﻠﻪ ﻳﻜﻮن هﺎﻣًﺎ ﻓﻲ ﺟﻌﻞ اﻷﻃﻔﺎل ﻳﻘﺒﻠﻮن ﻋﻠﻰ‬
‫اﻟﺘﺪرﻳﺒﺎت اﻟﺒﺪﻧﻴﺔ ﻻن وﺻﻒ اﻟﺘﺪرﻳﺒﺎت اﻟﻌﻨﻴﻔﺔ ﻗﺪ ﺗﻘﻠﻞ ﻣﻦ اﻻﻟﺘﺰام وﻳﺤﺒﻂ ﻋﺰﻳﻤﺔ اﻷﻃﻔﺎل وأﺳﺮهﻢ‪ .‬وﻳﻌﺘﺒﺮ اﻟﻤﺸﻲ‬
‫ﺑﺪاﻳﺔ ﺟﻴﺪة ﻟﻸﻃﻔﺎل ﻗﻠﻴﻠﻲ اﻟﺤﺮآﺔ آﻤﺎ اﻧﻪ إذا آﺎن هﻨﺎك رﻳﺎﺿﺔ ﻓﺮق ﻳﺴﺘﻤﺘﻊ ﺑﻬﺎ اﻷﻃﻔﺎل ﻓﺈﻧﻬﺎ ﻗﺪ ﺗﺴﺘﺨﺪم آﺬﻟﻚ‪,‬‬
‫)‪ 20-15‬دﻗﻴﻘﺔ( ﻟﺒﻨﺎء اﻟﺘﺤﻤﻞ ﻻن اﻟﻬﺪف‬ ‫وﻳﺠﺐ أن ﺗﺒﺪأ اﻟﺮﻳﺎﺿﺔ ﺑﺒﻄﻲء أوﻻ )‪ 3‬ﻣﺮات أﺳﺒﻮﻋﻴﺎ( وﻟﻤﺪة ﻗﻠﻴﻠﺔ‬
‫هﻮ ﺗﻮﻟﻴﺪ ﻧﻤﻂ ﺻﺤﻲ ﻟﻠﻨﺸﺎط اﻟﺒﺪﻧﻲ اﻟﻤﻨﻈﻢ وﻟﻴﺲ ﺗﻨﺎﻓﺲ رﻳﺎﺿﻲ‪ ,‬آﻤﺎ ﻳﺠﺐ ﺗﺸﺠﻴﻊ اﻷﺑﺎء وأﻓﺮاد اﻷﺳﺮة اﻵﺧﺮﻳﻦ‬
‫ﻓﻲ اﻟﻤﺸﺎرآﺔ ﻻن هﺬا ﺳﻮف ﻳﺴﺎﻋﺪ آﻞ اﻷﺳﺮة ﻋﻠﻰ اﻟﺘﻘﻴﺪ ﺑﻨﻤﻂ اﻟﺤﻴﺎة اﻟﺼﺤﻲ وﻳﺤﺴﻦ ﻣﻦ اﻻﻟﺘﺰام ﻓﻲ ﻣﻌﻈﻢ‬
‫اﻟﺤﺎﻻت‪ ,‬وﻋﻨﺪﻣﺎ ﺗﺰﻳﺪ ﻗﺪرة اﻟﻄﻔﻞ ﻋﻠﻰ اﻟﻨﺸﺎط اﻟﺒﺪﻧﻲ ﻓﺈن ذﻟﻚ ﻳﺸﺠﻊ ﻋﻠﻰ زﻳﺎدة ﻓﺘﺮة وﺷﺪة اﻟﻨﺸﺎط اﻟﻌﻀﻠﻲ‬
‫آﻤﺎ ﻳﻌﺘﺒﺮ اﻟﺘﻌﻠﻴﻢ اﻟﻐﺬاﺋﻲ رآﻨ ًﺎ هﺎﻣًﺎ ﻓﻲ ﻋﻼج اﻷﻃﻔﺎل ﺑﺎﻟﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ اﻟﺴﻜﺮي ﻻن هﺆﻻء اﻷﻃﻔﺎل ﻏﺎﻟﺒًﺎ ﻣﺎ‬
‫ﻳﻨﺸﺌﻮن ﻓﻲ ﺑﻴﺌﺔ ﻣﻨﺰﻟﻴﺔ ﺗﻔﺘﻘﺪ إﻟﻰ اﻟﻔﻬﻢ اﻟﺼﺤﻴﺢ ﻟﻌﺎدات اﻟﻐﺬاء اﻟﺼﺤﻴﺤﺔ‪ ,‬آﻤﺎ ﻳﺠﺐ ﺗﺸﺠﻴﻊ اﻟﻴﺎﻓﻌﻴﻦ و أﺳﺮهﻢ ﻋﻠﻰ‬
‫اﺳﺘﺨﺪام أﻓﻀﻞ اﻻﺧﺘﻴﺎرات اﻟﻐﺬاﺋﻴﺔ وﻳﺒﺪأ ذﻟﻚ ﺑﺘﺜﻘﻴﻒ اﻟﻮاﻟﺪﻳﻦ ﻣﺎ هﻮ اﻟﻐﺬاء اﻟﺬي ﻳﺠﺐ إﺣﻀﺎرﻩ إﻟﻰ اﻟﻤﻨﺰل وآﻴﻔﻴﺔ‬
‫ﺗﺨﻄﻴﻂ اﻟﻮﺟﺒﺎت اﻷﺳﺎﺳﻴﺔ واﻟﺨﻔﻴﻔﺔ‪.‬‬

‫اﻟﺘﻮﺻﻴﺎت‪:‬‬

‫‪ .1‬ﻳﺤﺘﺎج إﻟﻰ اﻟﻤﺰﻳﺪ ﻣﻦ اﻟﺒﻴﺎﻧﺎت اﻟﻤﻔﺼﻠﺔ واﻟﻤﺆﺷﺮات اﻟﺪﻗﻴﻘﺔ ﻟﺘﺤﺪﻳﺪ ﺣﺠﻢ ﻣﺸﻜﻠﺔ داء اﻟﺴﻜﺮي ﺑﺪﺑﻲ آﺒﺪاﻳﺔ‬
‫ﻹﻋﺪاد ﺧﻄﺔ ﻟﻤﻘﺎﻣﺔ وﻣﻌﺎﻟﺠﺔ اﻟﻤﺮض‪.‬‬

‫‪ .2‬ﺗﻜﻮﻳﻦ ﻣﺠﻤﻮﻋﺔ ﻋﻤﻞ ﻣﻦ داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ووزارة اﻟﺘﻌﻠﻴﻢ ﻟﺪراﺳﺔ ﻃﺒﻴﻌﺔ داء اﻟﺴﻜﺮي‬
‫ﺑﻴﻦ ﺗﻼﻣﻴﺬ اﻟﻤﺪارس ﺑﺪﺑﻲ وإﻋﺪاد ﺑﺮﻧﺎﻣﺞ ﻟﻤﻌﺎﻟﺠﺔ وﻣﻜﺎﻓﺤﺔ اﻟﻤﺮض ﻣﻊ إﺷﺮاك إدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء ﻓﻲ‬
‫هﺬا اﻟﻨﺸﺎط وهﻨﺎك ﺑﺮوﺗﻮآﻮل ﻣﻘﺘﺮح ﻟﺪراﺳﺔ داء اﻟﺴﻜﺮي ﺑﻴﻦ ﺗﻼﻣﻴﺬ اﻟﻤﺪارس ﺑﺪﺑﻲ ﺗﻢ إﻋﺪادﻩ ﺑﺎﻹدارة‪.‬‬

‫‪ .3‬ﻳﺠﺐ أن ﺗﻘﻮم ﻟﺠﻨﺔ اﻟﺒﺤﻮث واﻟﺴﻜﺮي ﺑﺎﻟﺪاﺋﺮة وﺑﺎﻟﺘﻌﺎون ﻣﻊ إدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء وإدارة اﻟﺮﻋﺎﻳﺔ‬
‫اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ ﺑﺎﻟﺪاﺋﺮة ﺑﺘﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ دراﺳﺔ ﻋﻦ داء اﻟﺴﻜﺮي ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ اﻟﺒﺎﻟﻐﻴﻦ ‪ 18‬ﻋﺎﻣًﺎ وأآﺜﺮ‬
‫وهﻨﺎك ﺑﺮوﺗﻮآﻮل ﻣﻌﺪ ﻗﺒﻞ إدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء ﻟﺪراﺳﺔ داء اﻟﺴﻜﺮي‪.‬‬

‫اﻟﻤﺮاﺟﻊ‪ :‬ﺗﺮاﺟﻊ اﻟﻨﺴﺨﺔ اﻹﻧﺠﻠﻴﺰﻳﺔ‪.‬‬

‫‪78‬‬
 Figure (1) Distribution of Emirate Diabe tic C ase s among
School Age C hildre n Diagnose d in Spe cialist Clinics in
DO HMS by Se x , Dubai 2005

47%
Male s
Fe male s
53%

79
Figure (2) Distribution of Emirate Diabe tic C ase s among
School Age C hildre n Diagnose d in Spe cialist C linics in
DO HMS byType , Dubai 2005

9%

Type 1
Type 2

91%

80
 Figure (3) Distribution of Type 1 Diabe te s Me llitus C omplications among
School Age C hildre n in DO HMS, Dubai 2005
‫ﺗﻮزﻳﻊ ﻣﻀﺎﻋﻔﺎت اﻟﻨﻮع اﻷول ﻟﻤﺮض اﻟﺴﻜﺮي ﺑﻴﻦ اﻃﻔﺎل اﻟﺴﻦ اﻟﻤﺪرﺳﻰ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬
2005 ‫ﻓﻲ ﻋﺎم‬

45% 39%

16%

Ketoacidosis Other & Multiple Com plications No Com plication

81
 Diabetes Mellitus in Dubai 2004-2006

There were 4106 cases of diabetes mellitus admitted in DOHMS in 2004-2006.

Females amounted to about two thirds of the cases (62.68%). This can explained by
diabetes mellitus in pregnancy that accounted for more than one half (57.04%) of
admitted female diabetic cases and 50.7% of cases in females in the age group 20-39
years, table (1). Emirates amounted to 57.5% of the admitted diabetic cases. The
percentage of Emirates was more than Expatriates in all age group except the 40-59
age group, table (2). Table (3) shows that number of admitted diabetic cases was
nearly equal in the three selected years 2004-2006 by sex and nationality, table (4).
The percentage of females attended the specialist clinics in DOHMS was 54.89% and
61.22% among Emirates, table (5). More than one half of the cases 57.4% were in the
age group 40-59 years.

There were 95944 cases of diabetes mellitus attended the outpatient private health
clinics in Dubai 2004-2006. The percentage of females was 18.75%. The percentage
of females was less than males in all the years 2004-2006 and nationalities, table (7 &
8). Table (9) and figure () shows that type 1 diabetes was 14.8% of the admitted cases,
type 2 (39.4%), unspecific diabetes mellitus 10.5% and diabetes mellitus in pregnancy
35.2%.

The case fatality rate of diabetes mellitus among admitted cases in DOHMS was 7.18
per 1000. It was 3.28 among Type 1 diabetics and 8.7 per 1000 discharges.

82
 ‫داء اﻟﺴﻜﺮي ﺑﺪﺑﻲ ‪2006 – 2004‬‬

‫آﺎن هﻨﺎك ‪ 4106‬ﺣﺎﻟﺔ ﺳﻜﺮي ﺗﻢ إدﺧﺎﻟﻬﺎ ﺑـﺪاﺋﺮة اﻟـﺼﺤﺔ واﻟﺨـﺪﻣﺎت اﻟﻄﺒﻴـﺔ ﺑـﺪﺑﻲ ﻣـﺎ ﺑـﻴﻦ ﻋـﺎﻣﻲ ‪ 2006 – 2004‬وﻗـﺪ‬
‫ﺷﻜﻠﺖ اﻹﻧﺎث ‪ % 62.68‬ﻣـﻦ اﻟﺤـﺎﻻت وﻳﻜـﻦ ﺗﻔـﺴﻴﺮ ذﻟـﻚ ﺑـﺄن اﻟـﺴﻜﺮي أﺛﻨـﺎء اﻟﺤﻤـﻞ ﻳـﺸﻜﻞ ‪ % 57.04‬ﻣـﻦ اﻟﺤـﺎﻻت‬
‫اﻟﻤﺤﺠﻮزة ﺑﺎﻟﺪاﺋﺮة ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 40 – 20‬ﻋﺎﻣﺎ‪ .‬ﺟـﺪول رﻗـﻢ )‪ .(1‬هـﺬا وﻗـﺪ ﺷـﻜﻞ اﻟﻤﻮاﻃﻨـﻮن ‪ % 57.5‬ﻣـﻦ‬
‫اﻟﺤﺎﻻت وﻗﺪ آﺎﻧﺖ ﻧﺴﺒﺔ اﻟﻤﻮاﻃﻨﻴﻦ أﻋﻠﻰ ﻣﻦ ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ ﻓﻲ ﺟﻤﻴﻊ اﻟﻤﺮاﺣﻞ اﻟﻌﻤﺮﻳﺔ ﻣـﺎ ﻋـﺪا اﻟﻤﺠﻤﻮﻋـﺔ اﻟﻌﻤﺮﻳـﺔ‬
‫‪ 60 – 41‬ﻋﺎﻣﺎ‪ .‬وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﺴﻴﺪات اﻟﻤﺘﺮددات ﻋﻠـﻰ ﻋﻴـﺎدات اﻷﺧـﺼﺎﺋﻴﻴﻦ ﺑﺎﻟـﺪاﺋﺮة ‪ % 45.89‬و ‪ % 61.22‬ﻣـﻮاﻃﻨﻴﻦ‬
‫ﺟﺪول رﻗﻢ )‪ (5‬وآﺎن ‪ % 57.4‬ﻣﻦ اﻟﺤﺎﻻت ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 60 – 41‬ﻋﺎﻣﺎ‬

‫هﺬا وآﺎن هﻨﺎك ‪ 95944‬ﺣﺎﻟﺔ ﺳﻜﺮي راﺟﻌﺖ اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﻟﻠﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨـﺎص ﺑـﺪﺑﻲ ﻣـﺎ ﺑـﻴﻦ ‪2006 – 2004‬‬
‫وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﺴﻴﺪات ‪ % 18.75‬وآﺎﻧﺖ اﻟﺴﻴﺪات أﻗﻞ ﻣﻦ اﻟﺬآﻮر ﻓﻲ آﻞ اﻟﻤﺠﻤﻮﻋﺎت اﻟﻌﻤﺮﻳﺔ وﺑﺘﻮزﻳﻊ اﻟﺠﻨﺴﻴﺔ ﺟﺪول‬
‫رﻗﻢ )‪ .(8 ، 7‬وﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (9‬واﻟﺸﻜﻞ رﻗﻢ )‪ (1‬أن اﻟﻨﻮع اﻷول ﻣﻦ اﻟﺴﻜﺮي ﺷـﻜﻞ ‪ % 14.8‬ﻣـﻦ ﺣـﺎﻻت اﻹرﻗـﺎد‬
‫واﻟﻨﻮع اﻟﺜﺎﻧﻲ ‪ % 39.4‬واﻟﺴﻜﺮي اﻟﻐﻴﺮ ﻣﺤﺪد ‪ % 10.5‬واﻟـﺴﻜﺮى ﺑﺎﻟﺤﻤـﻞ ‪ % 35.2‬وﻗـﺪ ﺑﻠﻐـﺖ وﻓﻴـﺎت اﻟﺤـﺎﻻت ﺑـﺪاﺋﺮة‬
‫اﻟﺼﺤﺔ ‪ 7.18‬ﻓﻲ اﻷﻟﻒ وآﺎﻧﺖ ‪ 3.28‬ﻟﻠﻨﻮع اﻷول و ‪ 8.7‬ﻓﻲ اﻷﻟﻒ ﻟﻠﻨﻮع اﻟﺜﺎﻧﻲ ﻣﻦ اﻟﺴﻜﺮي‪.‬‬

‫‪83‬‬
 Table (1) Distribution of Studied Cases of Diabetes Mellitus Admitted in DOHMS by Age and
Sex, Dubai 2004-2006

Age Group Sex Total

Male Female
<20 202 334 536
20- 79 416 495
30- 140 887 1027
40- 308 321 629
50- 393 230 623
60- 251 238 489
70+ 163 144 307
Total 1536 2570 4106

Table (2) Distribution of Studied Cases of Diabetes Mellitus Admitted in DOHMS by Age and
Nationality, Dubai 2004-2006

Age Group Nationality Total

Emirate Expatriate
<20 341 195 536
20- 309 186 495
30- 645 382 1027
40- 271 358 629
50- 255 368 623
60- 317 172 489
70+ 223 84 307
Total 2361 1745 4106

Table (3) Distribution of the Studied Cases of Diabetes Mellitus Admitted in DOHMS by Sex and
Year of Discharge, Dubai 2004-2006

Year Sex Total

Male Female
2004 533 845 1378
2005 507 832 1339
2006 496 893 1389
Total 1536 2570 4106

84
 Table (4) Distribution of the Studied Cases of Diabetes Mellitus Admitted in DOHMS by
Nationality and Year of Discharge, Dubai 2004-2006

Year Nationality Total

Emirates Expatriates
2004 793 585 1378
2005 783 556 1339
2006 785 604 1389
Total 1536 2570 4106

Table (5) Distribution of Diabetes Mellitus Attending Specialist Clinics in DOHMS by Sex and
Nationality, Dubai 2004-2006

Nationality Sex Total

%
Male Female
% %
Emirates 1291 (38.78) 2038 (61.22) 3329
(100%)
Expatriates 784 (61.68) 487(38.32) 1271
(100%)
Total 2075 2525 4600
(45.11) (54.89) (100.0)

Table (6) Distribution of Diabetes Mellitus Attending Specialist Clinics in DOHMS by Age Group
& Sex, Dubai 2004-2006

Age Group Sex Total

Male Female
<20 112 (5.4) 128(5.1) 240(5.2)
20- 81(3.9) 141(5.5) 222(4.8)
30- 179(8.6) 333(13.2) 512(11.2)
40- 510(24.6) 666(26.4) 1176(25.6)
50- 703(33.9) 762(30.2) 1465(31.8)
60- 332(16.0) 380(15.1) 712(15.5)
70+ 158(7.6) 115(4.5) 273(5.9)
Total 2075(45.11) 2525(54.89) 4600 (100.0)

85
Table (7) Distribution of Diabetes Mellitus Attending Outpatient Clinics in Private Health Sector
in Dubai by Year of Attendance and Sex 2004-2006

Year Sex Total

Male Female
2004 20206 6946 27152
2005 24406 7359 31765
2006 27358 9669 27027

Table (8) Distribution of the studied cases of Diabetes Mellitus cases attending Outpatient Clinics
of Private Health Sector by Sex and Nationality, Dubai 2004-2006

Nationality Sex Total

%
Male Female
Arabs 4920 2302 7222
Asians 58636 16056 74692
Others 3710 1921 5631
UAE 4704 3695 8399
Total 62311 17995 95944

86
Table (9) Distribution of Studied Cases of Diabetes Mellitus Admitted in DOHMS
Hospitals by Age and Type, Dubai 2004-2006

Age Group Diagnosis

Type 1 Type 2 Unspecific DM DM in Pregnancy Total
<20 374 28 16 118 536
20- 86 23 15 371 495
30- 70 98 35 824 1027
40- 45 363 89 133 629
50- 16 487 119 - 623
60- 13 372 104 - 489
70+ 5 247 55 - 307
Total 609 1618 433 1446 4106

Table (10) Fatality Rate of Diabetes Mellitus among Inpatients Admitted in

DOHMS, Dubai 2004-2006

Type Diagnosis Fatality Rate, 1000

Discharges
Discharged No. of Deaths
Type 1 609 2 3.28
Type 2 1618 14 8.7

87
Figure (1) Distribution of Type 1 Diabe te s Me llitus C omplications among
Emirate Inpatie nts in DO HMS, Dubai 2004 -2006

37% 42%

21%

Ketoacidosis Other & Multiple Com plications No Com plication

88
 M Neeooppllaassm
Maalliiggnnaanntt N mss ooff BBrreeaasstt iinn D
DO HM
OH Duubbaaii
MSS,, D

With one million new cases in the world each year, breast cancer is the commonest
malignancy in women and comprises 18% of all female cancers and is the single
commonest cause of death among women aged 40-50, accounting for about a fifth of
all deaths in this age group. For so many women, there is no more dreaded disease
than breast cancer. Breast cancer elicits fears related to loss of body image and
sexuality, surgery, and death. As is the case for most cancers, the exact cause of breast
cancer is not clearly known. Furthermore, there is currently no cure for advanced
disease, and there is no definitive way of preventing it (1).

The incidence of breast cancer increases with age, doubling about every 10 years until
the menopause, when the rate of increase slows dramatically. In some countries there
is a flattening of the age-incidence curve after the menopause. The incidence of breast
cancer is greater in women of higher socio-economic background. The relationship of
breast cancer risk with socio-economic factors is most likely related to the life style,
differences like age at first childbirth and number of pregnancies(1.2).

Data of the national cancer registry in UAE shows that cancer breast was the most
common cancer (27.2%) of all cancers among females and accounted for 9.3% of all
deaths among females in 2003(3). Cancer is the second leading cause of death is Dubai
(14.8%) following cardiovascular diseases that accounted for 22.8 % of all deaths(4).
Information of malignant neoplasms of Breast (C50) diagnosed in DOHMS hospitals
was collected from the electronic network of health information system in DOHMS.
Retrospective case series of cancer discharged during the period 2004- 2005 were
reviewed. Basic data were age, sex, nationality, diagnosis and outcome at discharge.

There were 254 malignant neoplasms of breast (249 females and 5 males) admitted in
DOHMS in 2004-2005. Breast cancer was the most prevalent neoplasm (34.5%) in

89
females. Emirates amounted for 30.1% of cases and Expatriates 69.9.8%, (Table 1).
The mean age of the studied cases was 47.86 ± 13.33 years. It was 49.2 ± 15.30 for
Emirates and 47.28 ± 12.99 for Expatriates. This difference is not significant. As for
the age of distribution, 14.9% was below 35 years, 29.7% were 35-44 years, 28.1% of
cases were in the age group 45-54 years and 27.3% were 55 years and above, (Table 1
& Figure 1). The average length of stay in hospital was 3.37± 6.63 days. It was 5.34
± 10.02 for Emirate females and 2.43 ± 3.8 for expatriates. This difference is
significant (P = 0.001). The case fatality rate was 9.2%. It was 13.33% among
Emirate females and 7.47% among Expatriates. This difference is not significant.

Comments:

Breast cancer is the commonest cancer in women in the world, in both industrialized
and developing countries. It accounts for 1.7% of all female deaths. Incidence rates
are increasing in many countries, although mortality rates are stable or slightly
declining in some. Only a small portion of breast cancer cases can be explained by
known risk factors. Our knowledge of how breast cancer develops is expanding
rapidly. As a result, new medications are being developed to reduce the risk of breast
cancer among women at high risk of contracting this disease. For the majority of
women, lifestyle changes, a healthy diet, cautious use of selected antioxidants,
exercise, and weight reduction can also help reduce the chance of developing breast
cancer. To date, the most important strategy in improving survival is still breast
cancer screening and early detection. Screening as currently practiced can reduce
mortality but not incidence, and then only in a particular age group (5.6) . The UAE has
far implemented Breast Cancer Screening Program since1995. The program provides
three levels of services: health education and training on breast self examination to all
women 18 years or older, annual clinical breast examination (CBE) screening of
women 40 years and over and a bilateral - two view mammogram of those age group
on a biannual basis (3) .

90
Advances in treatment have produced significant but modest survival benefits. A
better appreciation of factors important in the etiology of breast cancer would raise the
possibility of disease prevention. If specific dietary factors are found to be associated
with an increased risk of breast cancer dietary intervention will be possible. However,
reduction of dietary intake of such a factor in whole communities may well be
difficult to achieve without major social and cultural changes(1).

References:
1. K McPherson et Al Breast Cancer Epidemiology, risk factors, & genetics BMJ
2000; 321:624-628 available at
http://bmj.bmjjournals.com/cgi/content/full/321/7261/624
2. American Cancer Society. Breast Cancer, Facts and Figures, 2001-2002. available
at http://www.cancer .org/downloads/STT/Br.CaFF 2001.pdf
3. Annual Report 2004. Preventive medicine Section, Ministry of Health – U.A.
4. Mortality Statistics in Dubai, Dubai Health Profile Statistical Analysis Section,
Dept. of Planning and Statistics, Directorate of the Health and Medical Services,
Dubai 2005, 29:42
5. Linda L. Humphrey; Mark Helfand; Benjamin K.S. Chan; & Steven H. Woolf
Breast Cancer Screening: A Summary of the Evidence for the U.S. Preventive
Services Task Force Volume 137 Issue 5 Part1 | Pages 347-360 available at
http://www.annals.org/cgi/content/abstract/137/5_Part_1/347
6. U.S. Preventive Services Task Force. Screening for Breast Cancer:
Recommendations & Rationale .3 September 2002 | Volume 137 Issue 5 Part 1 |
Pages344-346.Available
http://www.annals.org/cgi/content/abstract/137/5_Part_1/344

91
 ‫أورام اﻟﺜﺪي اﻟﺴﺮﻃﺎﻧﻴﺔ‬

‫ﻳﻌﺘﺒﺮ ﺳﺮﻃﺎن اﻟﺜﺪي أآﺜﺮ اﻟﺴﺮﻃﺎﻧﺎت اﻧﺘﺸﺎرًا ﺑﻴﻦ اﻟﺴﻴﺪات ﺣﻴﺚ ﻳﺸﻜﻞ ‪ %18‬ﻣﻦ اﻟﺴﺮﻃﺎﻧﺎت وﻳﻌﺘﺒﺮ اﻟﺴﺒﺐ‬
‫اﻟﺮﺋﻴﺴﻲ ﻟﻠﻮﻓﺎة ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 50-40‬ﻋﺎﻣًﺎ ﺑﻴﻦ اﻟﺴﻴﺪات ﺣﻴﺚ ﻳﺸﻜﻞ ﺧﻤﺲ اﻟﻮﻓﻴﺎت ﺑﻴﻦ ﺗﻠﻚ اﻟﻤﺠﻤﻮﻋﺔ‬
‫اﻟﻌﻤﺮﻳﺔ‪ ,‬هﺬا وهﻨﺎك ﻣﻠﻴﻮن ﺣﺎﻟﺔ ﺟﺪﻳﺪة ﻣﻦ ﺳﺮﻃﺎن اﻟﺜﺪي ﺗﻈﻬﺮ ﺑﺎﻟﻌﺎﻟﻢ آﻞ ﻋﺎم‪ ,‬وﻳﺸﻜﻞ ﺳﺮﻃﺎن اﻟﺜﺪي ﺧﻮﻓًﺎ ﺑﻴﻦ‬
‫اﻟﺴﻴﺪات ﻣﻦ ﻓﻘﺪان ﺷﻜﻞ اﻟﺠﺴﻢ واﻷﺛﺮ اﻟﺠﻨﺴﻲ واﻟﻮﻓﻴﺎت آﻤﺎ اﻧﻪ ﻻ ﻳﻮﺟﺪ ﺷﻔﺎء ﻟﻠﺤﺎﻻت اﻟﻤﺘﻘﺪﻣﺔ وﻟﻴﺴﺖ هﻨﺎك‬
‫وﺳﻴﻠﺔ أآﻴﺪة ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻤﺮض‪ ,‬وﻳﺰداد ﻣﻌﺪل ﺣﺪوث اﻟﻤﺮض ﺑﺎﻟﺴﻦ ﺣﻴﺖ ﻳﺘﻀﺎﻋﻒ آﻞ ﻋﺸﺮ ﺳﻨﻮات ﺣﺘﻰ ﺳﻦ‬
‫اﻟﻴﺄس ﺣﻴﺚ ﺗﻘﻞ اﻟﺰﻳﺎدة‪ ,‬آﻤﺎ أن ﺣﺪوث اﻟﻤﺮض ﻳﻜﻮن آﺒﻴﺮًا ﺑﻴﻦ اﻟﻄﺒﻘﺎت ﻋﺎﻟﻴﺔ اﻟﻤﺴﺘﻮى اﻻﻗﺘﺼﺎدي واﻻﺟﺘﻤﺎﻋﻲ‪,‬‬
‫وﺗﺮﺟﻊ اﻟﻌﻼﻗﺔ ﺑﻴﻦ ﺳﺮﻃﺎن اﻟﺜﺪي واﻟﻤﺴﺘﻮى اﻻﻗﺘﺼﺎدي واﻻﺟﺘﻤﺎﻋﻲ إﻟﻰ ﻧﻤﻂ اﻟﺤﻴﺎة واﻟﻰ ﺑﻌﺾ اﻻﺧﺘﻼﻓﺎت‬
‫آﺎﻟﻌﻤﺮ ﻋﻨﺪ ﺣﺪوث أول وﻻدة وﻋﺪد ﻣﺮات اﻟﺤﻤﻞ‪.‬‬

‫وﺗﻈﻬﺮ ﺑﻴﺎﻧﺎت اﻟﺴﺠﻞ اﻟﻮﻃﻨﻲ ﻟﻠﺴﺮﻃﺎن ﺑﺪوﻟﺔ اﻹﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة أن ﺳﺮﻃﺎن اﻟﺜﺪي أآﺜﺮ اﻟﺴﺮﻃﺎﻧﺎت‬
‫اﻧﺘﺸﺎرًا )‪ (%27.2‬ﺑﻴﻦ اﻟﺴﻴﺪات وﺷﻜﻞ ‪ %9.3‬ﻣﻦ اﻟﻮﻓﻴﺎت ﻓﻲ ﻋﺎم ‪ ,2003‬وﻳﻌﺘﺒﺮ اﻟﺴﺮﻃﺎن اﻟﺴﺒﺐ اﻟﺜﺎﻧﻲ‬
‫اﻟﻤﺆدي ﻟﻠﻮﻓﺎة )‪ (%14.8‬ﺑﺪﺑﻲ ﺑﻌﺪ أﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ )‪ ,(%22.4‬هﺬا وﻗﺪ ﺗﻢ ﺟﻤﻊ ﺑﻴﺎﻧﺎت اﻷورام‬
‫اﻟﺴﺮﻃﺎﻧﻴﺔ ﻟﻠﺜﺪي اﻟﻤﺸﺨﺼﺔ ﺑﻤﺴﺘﺸﻔﻴﺎت داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﻣﻦ ﺑﻴﺎﻧﺎت اﻟﺸﺒﻜﺔ اﻹﻟﻜﺘﺮوﻧﻴﺔ ﻟﻨﻈﺎم‬
‫اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ ﺑﺪﺑﻲ ﺣﻴﺚ ﺗﻢ ﻣﺮاﺟﻌﺔ ﺣﺎﻻت اﻟﺨﺮوج ﻟﺤﺎﻻت ﺳﺮﻃﺎن اﻟﺜﺪي واﻟﺘﻲ ﺗﻢ ﺗﺸﺨﻴﺼﻬﺎ ﻓﻲ ﻋﺎﻣﻲ‬
‫‪ 2005-2004‬وآﺎﻧﺖ اﻟﻤﻌﻠﻮﻣﺎت اﻷﺳﺎﺳﻴﺔ هﻲ اﻟﻌﻤﺮ واﻟﺠﻨﺴﻴﺔ واﻟﺘﺸﺨﻴﺺ‪.‬‬

‫وآﺎن هﻨﺎك ‪ 254‬ورم ﺳﺮﻃﺎﻧﻲ ﺑﺎﻟﺜﺪي )‪ 249‬ﺑﻴﻦ اﻹﻧﺎث و‪ 5‬ﺑﻴﻦ اﻟﺬآﻮر( ﺗﻢ ﺧﺮوﺟﻬﻢ ﻣﻦ داﺋﺮة اﻟﺼﺤﺔ‬
‫واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﻓﻲ ﻋﺎﻣﻲ ‪ 2005-2004‬وآﺎن ﺳﺮﻃﺎن اﻟﺜﺪي أآﺜﺮ اﻷورام اﻧﺘﺸﺎرًا )‪ (%34.5‬ﺑﻴﻦ اﻹﻧﺎث‪,‬‬
‫وﺗﺸﻜﻞ اﻟﻤﻮاﻃﻨﺎت ‪ %30.1‬ﻣﻦ اﻟﺤﺎﻻت وﻏﻴﺮ اﻟﻤﻮاﻃﻨﺎت ‪ ,%69.9‬ﺟﺪول رﻗﻢ )‪ (1‬وآﺎن ﻣﺘﻮﺳﻂ ﻋﻤﺮ اﻟﺤﺎﻻت‬
‫‪ 47.86‬ﻋﺎﻣ ًﺎ وآﺎن ﺑﻴﻦ اﻟﻤﻮاﻃﻨﺎت ‪ 49‬ﻋﺎﻣ ًﺎ وﻏﻴﺮ اﻟﻤﻮاﻃﻨﺎت ‪47‬ﻋﺎﻣ ًﺎ وﺑﺪون ﻓﺮوق ﺟﻮهﺮﻳﺔ‪ ,‬وآﺎن هﻨﺎك‬
‫‪ %14.9‬ﻣﻦ اﻟﺤﺎﻻت ﺗﺤﺖ ‪ 35‬ﻋﺎﻣ ًﺎ و‪ %29.7‬ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 44-35‬ﻋﺎﻣًﺎ و‪ %28.1‬ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ‬
‫اﻟﻌﻤﺮﻳﺔ ‪ 54-45‬ﻋﺎﻣًﺎ وآﺎن ﻋﻤﺮ ‪ %27.3‬ﻣﻦ اﻟﺴﻴﺪات ‪ 55‬ﻋﺎﻣ ًﺎ وأآﺜﺮ‪ ,‬ﺟﺪول رﻗﻢ )‪ .(1‬ﻳﻌﺘﺒﺮ ﺳﺮﻃﺎن اﻟﺜﺪي‬
‫أآﺜﺮ اﻟﺴﺮﻃﺎﻧﺎت اﻧﺘﺸﺎرًا ﺑﺎﻟﻤﺠﺘﻤﻌﺎت اﻟﺼﻨﺎﻋﻴﺔ واﻟﻨﺎﻣﻴﺔ ﺑﺎﻟﻌﺎﻟﻢ‪ ,‬ﺣﻴﺚ ﻳﺸﻜﻞ ‪ %1.7‬ﻣﻦ وﻓﻴﺎت اﻹﻧﺎث وﺗﺰداد‬
‫ﻣﻌﺪﻻت اﻟﺤﺪوث ﻓﻲ ﺑﻠﺪان ﻋﺪﻳﺪة ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺛﺒﻮت ﻣﻌﺪﻻت اﻟﻮﻓﺎة أو اﻧﺨﻔﺎﺿﻬﺎ ﻓﻲ ﺑﻌﺾ اﻟﺒﻠﺪان‪ ,‬هﺬا وﻳﻤﻜﻦ‬
‫ﺗﻔﺴﻴﺮ ﺣﺪوث ﺟﺰء ﺑﺴﻴﻂ ﻣﻦ ﺳﺮﻃﺎﻧﺎت اﻟﺜﺪي ﺑﻌﻮاﻣﻞ ﺧﻄﻮرة ﻣﻌﺮوﻓﺔ وان آﺎﻧﺖ ﻣﻌﻠﻮﻣﺎﺗﻨﺎ ﻋﻦ آﻴﻔﻴﺔ ﺣﺪوث‬
‫اﻟﺴﺮﻃﺎن ﺗﺰداد ﺑﺪرﺟﺔ آﺒﻴﺮة و آﻨﺘﻴﺠﺔ ﻟﺬﻟﻚ ﻓﺈن هﻨﺎك ﻋﻼﺟﺎت ﺟﺪﻳﺪة ﺗﻢ اﺳﺘﺤﺪاﺛﻬﺎ ﻟﺘﻘﻠﻴﻞ ﺧﻄﻮرة ﺳﺮﻃﺎن اﻟﺜﺪي‬
‫ﺑﻴﻦ اﻟﺴﻴﺪات اﻟﻤﻌﺮﺿﻴﻦ ﻟﺨﻄﻮرة ﻋﺎﻟﻴﺔ ﻟﺤﺪوث اﻟﻤﺮض وﺣﺎﻟﻴ ًﺎ ﻓﺈن أآﺜﺮ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻬﺎﻣﺔ ﻟﺘﺤﺴﻴﻦ اﻟﺒﻘﺎء هﻮ‬

‫‪92‬‬
‫ﻓﺤﺺ اﻟﺜﺪي واﻻآﺘﺸﺎف اﻟﻤﺒﻜﺮ ﻟﻠﺤﺎﻻت‪ ,‬وﻳﻌﺘﺒﺮ ﻓﺤﺺ اﻟﺜﺪي آﻤﺎ هﻮ ﻣﻤﺎرس ﺣﺎﻟﻴ ًﺎ ذو أﺛﺮ آﺒﻴﺮ ﻓﻲ ﺗﻘﻠﻴﻞ‬
‫اﻟﻮﻓﻴﺎت ﻓﻲ ﻣﺠﻤﻮﻋﺔ ﻋﻤﺮﻳﺔ ﻣﻌﻨﻴﺔ وﻟﻴﺲ ﺣﺪوث اﻟﻤﺮض‪ ,‬وﻗﺪ ﺑﺪأت دوﻟﺔ اﻹﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة ﻓﺤﺺ اﻟﺜﺪي‬
‫ﻣﻨﺬ ﻋﺎم ‪ 1995‬ﺣﻴﺚ ﻳﻘﺪم اﻟﺒﺮﻧﺎﻣﺞ ﺛﻼث ﻣﺴﺘﻮﻳﺎت ﻣﻦ اﻟﺨﺪﻣﺔ‪ ,‬اﻟﺘﺜﻘﻴﻒ اﻟﺼﺤﻲ واﻟﺘﺪرﻳﺐ ﻋﻠﻰ اﻟﻔﺤﺺ اﻟﺬاﺗﻲ‬
‫ﻟﻠﺜﺪي ﻟﻜﻞ اﻟﺴﻴﺪات اﻟﺒﺎﻟﻐﺎت ‪ 18‬ﻋﺎﻣًﺎ وأآﺜﺮ واﻟﻔﺤﺺ اﻹآﻠﻴﻨﻴﻜﻲ ﻟﻠﺜﺪي ﻟﻠﺴﻴﺪات اﻟﺒﺎﻟﻐﺎت ‪ 40‬ﻋﺎﻣًﺎ ﻣﻦ اﻟﻌﻤﺮ‬
‫وأآﺜﺮ وﺗﺼﻮﻳﺮ اﻟﺜﺪي آﻞ ﻋﺎﻣﻴﻦ آﻤﺎ ﺷﻜﻞ اﻟﺘﻘﺪم ﻓﻲ اﻟﻌﻼج ﻓﺎﺋﺪة ﺟﻮهﺮﻳﺔ ﻟﻠﺒﻘﺎء وان آﺎن ﺑﺪرﺟﺔ ﻣﺘﻮاﺿﻌﺔ ﻟﺬا‬
‫ﻳﺠﺐ اﻟﺘﺮآﻴﺰ ﻋﻠﻰ اﻟﻌﻮاﻣﻞ اﻟﻤﺴﺒﺒﺔ ﻟﻠﻤﺮض آﺎﻟﺘﺪﺧﻞ اﻟﻐﺬاﺋﻲ إﻻ أن ذﻟﻚ ﻗﺪ ﻳﻜﻮن ﺻﻌﺒًﺎ ﺑﺪون ﺗﻐﻴﺮات ﺛﻘﺎﻓﻴﺔ‬
‫واﺟﺘﻤﺎﻋﻴﺔ آﺒﻴﺮة ﺑﺎﻟﻤﺠﺘﻤﻊ ‪.‬‬

‫‪93‬‬
 Table (1) Summary characteristics of Malignant Neoplasms of Breast among
Inpatients in DOHMS, Dubai 2004-2005

Variable Value
% Among Female Cancer 34.5
Nationality (%)
Emirates 30.1
Expatriates 69.9
Age (%)
<35 14.9
35- 29.7
45- 28.1
55+ 27.3
Case Fatality Rate (%) 9.2%
Mean age (years) 47.86 ± 13.33
Mean Length of stay (days) 3.37 ± 6.63

94
 Figure (1)Distribution of Bre ast C ance r Inpatie nts in DO HMS by Age Group
and Nationality , Dubai 2004-2005
‫ﺗﻮزﻳﻊ ﺣﺎﻻت اﻟﺪﺧﻮل ﻟﺴﺮﻃﺎن اﻟﺜﺪى ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﺑﺎﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔواﻟﺠﻨﺴﻴﺔ‬

35
30
25
20 Emirates
15 Expatriates
10
5
0
<35 35- 45- 55+
Age Group

95
 Cancer in Dubai 2001 -2005

Table (1) shows that about one quarter (24.7%) of the cases admitted in DHA in the
period 2001 – 2005 were Emirates. Among Emirates 41.5% of the admitted cases
were males and 58.5% females, table (2)

As for the distribution by anatomical site those of the blood and haemopiotic tissue
amounted to 37.3% of the neoplasm cases in DHA, benign cases (18.0%), digestive
system 9.9%, Table (3). The same picture was observed among males and females,
but breast cancer amounted for 17.11% of neoplasm and respiratory neoplasm in
males, (5.68).

Among Emirates, diseases of the genitourinary system amounted for 12.0% of the
neoplasm cases, digestive system 12.8%, lymphatic and haemopiotic tissue 14.4%.
Among females breast cancer amounted for 14.3% of the neoplasm and in males,
diseases of the digestive, respiratory and lymphatic and haemopiotic tissue had the
highest frequency, Table (4).

As for age distribution, Table (5) shows that 6.6% were below 15 years, 24.26% in
the age group 15 – 39 years, 43.3% were 40 – 59 years and 25.9% were 60 years and
above. Below 15 years of age, neoplasm of the lymphatic and haemopotic tissues
constituted 45.23% of the inpatient neoplasm and more than half of the cases were in
the age group 15 – 39 years. In the age group 40 – 59 years neoplasm of the lymphatic
and haemopotic tissue, digestive and breast cancer were the most frequent neoplasm.
Digestive and respiratory System neoplasm were more frequent in the age group 60
years and above. Studying the destitution of the pediatric neoplasm, more than half
the cases (51.1%) were in the age group 5 – 9 years, Table (6).

96
 Table (1) Distribution of Neoplasms among Inpatients in DHA by
Nationality , Dubai 2001-2005

Year Nationality Total

Emirates Expatriates

2001 341 (22.78) 1156(77.22) 1497(100.00)

2002 309 (18.47) 1364(81.53) 1673(100.00)

2003 352(22.19) 1234(77.81) 1586(100.00)

2004 36227.16 971(72.84) 1333(100.00)

2005 48434.77 908(65.23) 1392(100.00)

Total 1848(24.70) 5633(75.30) 7481(100.00)

97
Table (2) Distribution of Neoplasms among Emirate Inpatients Admitted in
DOHMS Hospitals by Year and Sex, Dubai 2001-2005

Year Sex Total

Female Male
2001 180 161 341
52.79 47.21
2002 181 128 309
58.58 41.42
2003 197 155 352
55.97 44.03
2004 213 149 362
58.84 41.16
2005 311 173 484
64.26 35.74
Total 1082 766 1848

98
Table (3) Distribution of Neoplasms among Inpatients in DOHMS by Anatomical
Site, Dubai 2001-2005

ICD Sex Total

Female Male
Oral Cavity 17 35 52
0.50 0.86
Digestive 260 480 740
7.62 11.80
Respiratory 63 231 294
1.85 5.68
Bone 4 29 33
0.12 0.71
Skin 11 16 27
0.32 0.39
Soft Tissue 29 54 83
0.85 1.33
Breast 584 9 593
17.11 0.22
Female Genital 182 0 182
5.33 0.00
Male Genital 0 143 143
0.00 3.52
Urinary 50 203 253
1.46 4.99
Brain 43 82 125
1.26 2.02
Thyroid 38 32 70
1.11 0.79
Ill Defined 70 74 144
2.05 1.82
Haemopoitic 791 2003 2794
23.17 49.25
In Situ 21 21 42
0.62 0.52
Benign 1080 267 1347
31.63 6.57
Uncertain 171 388 559
5.01 9.54
Total 3414 4067 7481

99
Table (4) Distribution of Neoplasms among Emirate Inpatients in DOHMS by
Anatomical Site, Dubai 2001-2005

ICD Sex Total

Female Male
Oral Cavity 7 8 15
0.65 1.04
Digestive 93 143 236
8.60 18.67
Respiratory 22 86 108
2.03 11.23
Bone 1 11 12
0.09 1.44
Skin 7 6 13
0.65 0.78
Soft Tissue 8 10 18
0.74 1.31
Breast 155 5 160
14.33 0.65
Female Genital 61 0 61
5.64 0.00
Male Genital 0 57 57
0.00 7.44
Urinary 31 73 104
2.87 9.53
Brain 8 31 39
0.74 4.05
Thyroid 17 8 25
1.57 1.04
Ill Defined 29 20 49
2.68 2.61
Haemopoitic 156 111 267
14.42 14.49
In Situ 10 2 12
0.92 0.26
Benign 410 100 510
37.89 13.05
Uncertain 67 95 162
6.19 12.40
Total 1082(58.5) 766(41.5) 1848

100
 Table (5) Distribution of Neoplasms among Inpatients in DOHMS by Anatomical
Site and Age, Dubai 2001-2005

ICD Age Group Total

<15 15- 40- 60+
Oral Cavity 0 9 22 21 52
0.00 0.50 0.68 1.09
Digestive 3 79 310 348 740
0.61 4.35 9.57 17.98
Respiratory 2 21 81 190 294
0.41 1.16 2.50 9.82
Bone 1 20 7 5 33
0.20 1.10 0.22 0.26
Skin 1 4 13 9 27
0.20 0.22 0.40 0.47
Soft Tissue 18 13 29 23 83
3.65 0.72 0.90 1.19
Breast 0 108 355 130 593
0.00 5.95 10.96 6.72
Female Genital 1 21 88 72 182
0.20 1.16 2.72 3.72
Male Genital 1 22 35 85 143
0.20 1.21 1.08 4.39
Urinary 18 10 92 133 253
3.65 0.55 2.84 6.87
Brain 24 32 34 35 125
4.87 1.76 1.05 1.81
Thyroid 12 26 18 14 70
2.43 1.43 0.56 0.72
Ill Defined 3 14 54 73 144
0.61 0.77 1.67 3.77
Haemopoitic 223 936 1146 489 2794
45.23 51.57 35.39 25.27
In Situ 1 10 13 18 42
0.20 0.55 0.40 0.93
Benign 150 403 709 85 1347
30.43 22.20 21.90 4.39
Uncertain 35 87 232 205 559
7.10 4.79 7.16 10.59
Total 493 1815 3238 1935 7481

101
Table (6) Distribution of Pediatric Neoplasms Cases Admitted in DOHMS by
Anatomical site, Dubai 2001-2005

ICD Age group Total

<5 5- 10-
Digestive 1 1 1 3

Respiratory 1 1 0 2

Bone 0 1 0 1

Skin 0 1 0 1

Soft Tissue 1 11 6 18

Female Genital 1 0 0 1

Male Genital 0 1 0 1

Urinary 6 10 2 18

Brain 1 14 9 24

Thyroid 4 3 5 12

Ill Defined 0 1 2 3

Haemopoitic 29 124 70 223

In Situ 0 1 0 1

Benign 53 69 28 150

Uncertain 8 14 13 35

Total 105 252 136 493

102
 Cancer in Gulf Countries

Despite the achievements made in cancer prevention and control, cancer remains a
public health problem that has not yet received adequate attention. The incidence of
cancer is soaring due to rapidly ageing populations in most countries of the world.
The rapid rise in the magnitude of cancer represents one of the major health
challenges at both global and regional levels. The global burden of cancer is heaviest
in developing countries, where almost 60% of cancer deaths are estimated to occur.
WHO estimates that around two-thirds of all cancer cases that will occur in the
coming two decades will take place in the developing countries.

Over the last 30 to 40 years, the Gulf Council Countries (GCC) has witnessed an
economic boom following the discovery of crude oil. That economic transition had a
major impact on many of the aspects of life of the people in this part of the world.
Substantial changes in dietary habits, smoking patterns, and life styles were observed,
and that has significant influence on disease patterns. Whilst this epidemiological
transition was a natural and a predictable outcome, its occurrence over few decades is
rather unique. For instance, in less than 40 years the live expectancy has almost
doubled. Several decades ago, mortality was mainly attributed to communicable
diseases, and high infant death rates. Maladies of modernization like obesity, diabetes
mellitus, coronary heart disease, and cancer were infrequently encountered.
Simultaneously, the wide spread availability of modern medical facilities and
increasing public awareness of cancer has made it possible the detection and reliable
diagnosis of cancer. This provides a unique opportunity to study the trends in
frequency of different types of cancer overtime that may be expected to accompany
rapid economic and social transformation.

103
UAE is going through an epidemiological transition. The aging of the population,
progressive urbanization and changes in nutritional habits and lifestyle all contribute
to that epidemiologic transition and occurrence of non communicable diseases as the
dominant health problem. The UAE National Cancer Registry office was first
established as a hospital based registry in Tawam Hospital, Al Ain, one of the major
cancer treatment centers in the country offering medical services to all UAE nationals
and expatriates. In 1998 it was made into a National Cancer Registry covering all
cancer patients in the UAE. Data collection on a national scale was initiated on
January 1, 1998 and shortly after a Ministerial Decree made notification of cancer
cases mandatory. Cancer morphology and topography are coded in accordance with
the International Classification of Diseases for Oncology - 2nd edition. Other
information is coded according to the rules and regulations of the Gulf Center for
Cancer Registration (GCCR) operating manual. Data is collected through an "Active
Registration" where by registry staff visit UAE hospitals to collect cancer-related
information from the patient's charts.

The total number of malignant cases reported to GCCR from UAE in 1998 was 225.
Males accounted for 127 (49.8%) of the cases and females accounted for 128 (50.2%).
Cancer occurs more frequently in women than in men. The male to female ratio was
100:101.For all the cases, 1.1% were presented with in-situ stage at time of diagnosis,
18.9% with localized, 34.2% with regional, 27.4% with distant metastasis and 7.9%
with "unknown" stag. In 1998, 8.6% of all malignancies occurred before the age of
15, and 29.4% occurred after the age of 64. The mean age at diagnosis was 55.1 (SD
±22.5) for males and 44.3 (SD ±19.7) for females, with considerable variation among
the sites. In 1998 the crude incidence rate (CIR) of all malignancies in the Emirates
population was 38.8/100,000 for males and 39.8/100,000 for females. The overall
age-standardized incidence rate with a world standard population (ASR) reference
was 76.6/100,000 for Emirate males and 71.4/100,000 for Emirate females. For all
sites, the age-specific incidence rate (AIR) increased with age for both males and
females.

104
 Data of the MOH in UAE (2004) showed that cancer constituted 8.8% of all deaths
and a specific mortality rate of 13.1 per 100,000 population. Among Emirate
population the proportionate mortality rate of cancer was 10.7% of all deaths.

Non-communicable diseases amounted for the majority of deaths (86.8%) and for
more than half (56.0%) of admissions in Department of Health and Medical Services
hospitals. (Dubai Health Profile, 2004).The most common conventional causes of
death in Dubai in 2005 were cardiovascular diseases, cancers and injuries.

Cancer is the second leading cause of death in Dubai (13.4%) following

cardiovascular diseases that accounted for 31.4% of all deaths in 2005. Information of
cancer diagnosed in DOHMS hospitals was collected from the electronic database of
health information system in DOHMS. Retrospective case series of cancer discharged
during 2004 were reviewed. Basic data were age, sex, nationality, diagnosis and
outcome at discharge. Out of the 46166 persons admitted in DOHMS, there were 991
(2.1%) neoplasm. The total number of malignant neoplasm in DOHMS amounted to
681 cases in 2005, 341 males and 340 females. Emirates accounted for 33% of cases.

Out of these cases, there were 109 deaths with a case fatality rate of 16.0%. The rate

was 15.5% among males and 16.4% among females. This difference is not significant.

The crude incidence rate of cancer in 2004 was 64.9 per 100.000 population. It was

45.9 for males and 115.3 per 100.000 for females. The world standardized incidence

rate (ASR) was 193.1 per 100.000 population in Dubai in 2004. Studying the

distribution of the cases by type, neoplasm of lymphatic haemopoietic tissues

amounted to about one fourth of the cases (24.4%) followed by neoplasm of the

digestive system (18.6%). Among males, the most frequent neoplasm was lymphatic

105
and haemopioetic tissues (27.6%) and digestive system neoplasm (22.9%). In females,

cancer breast was the most prevalent (33.5%) neoplasm.

The length of stay for cancer cases was 8.21 ± 22.08 days compared to 4.65 ± 23.46
among other admitted cases. This difference is significant (P= 0.00). Childhood
cancer amounted to 6.9% of malignant neoplasm and 19.6% were in the age group 65
years and above.

Studying the distribution of malignant neoplasm among Emirate population, those of

the genitourinary system accounted for 25.8% of cancer, digestive system 18.7 and
lymphatic and haemopioetic tissues (14.2%) of cases. Among Emirate males the
highest percentage was genitourinary (28.9%), digestive system (22.8%), respiratory
system (15.9%) and lymphatic and haemopioetic tissues (14.0%). In Emirate female’s
breast cancer amounted to 28.8% of cases, genitourinary system 22.9%, digestive
system 15.3 % and cancer of lymphatic haemopioetic tissues (14.4%)

Despite the paucity of morbidity and mortality data in most countries of the Region,
there is enough evidence to indicate that cancer is now becoming a major public
health concern. Published reports on the magnitude of the cancer problem are scarce,
and population-based cancer registries have been established in only a few countries.
Hospital-based frequencies are, however, available from the major cancer treatment
centers from almost all countries in the Region. Though biased, they provide some
insight into the prevailing cancer patterns. Reported mortality statistics from countries
indicate that cancer is emerging as one of the leading causes of death, occupying the
third place in some countries

Estimates provided by the International Agency for Research on Cancer indicate that
over 450 000 new cancer cases occurred in the EMRO Region during 1995. The
common cancer sites in males are lung, lymphoid tissue, urinary bladder, stomach and

106
mouth/pharynx. In females, breast, urinary bladder, lymphoid tissue and uterine
cervix are the common cancer sites. However, regional variations exist, as can be
observed from the country profiles; for example, high frequencies of nasopharyngeal
carcinoma in males and uterine cervical cancer in females are reported in Morocco
and Sudan

Several gulf countries were fortunate enough to recognize the necessity for the
establishment of stat-of-art population-based cancer registries to fulfill their needs for
descriptive cancer epidemiology. Nevertheless, analytical epidemiology is still
lagging behind. Genetic and molecular epidemiological studies are limited to hospital
based cases rather than population. based.

In Oman, cancer was ranked as the second leading cause of death among hospitalized
patients. In Oman, natural cancer registry was established in 1985 as a hospital based
registry. The registry expanded to become a population based registry covering the
entire country. Between January 1993 and December 1997, 4091 cases of Cancer
(2282 males and 1809 females) were reported to the cancer registry. The crude
average annual incidence rate was 57.8 per 100,000 population for males and 47.8 for
females. The corresponding age adjusted rates were 108.4 and 87.0 per 10,000
population for males and females respectively. Stomach cancer was the leading cancer
among males in Oman (11.1%) followed by non-Hodgkin lymphoma (9.6%),
Prostrate cancer (7.6%). Among females, breast cancer was the most malignancy
(13.7%) followed by Cervical cancer (8.8%).

In Saudi Arabia, there were 7251 histological confirmed new cases of Cancer (4117
male and 3134 females) seen the six year period 1979-1984 at the Faisal Specialist
Hospital and Research Center in Riyadh, Saudi Arabia. The most common cancer
sites among males are non-Hodgkin's lymphomas, esophagus, lung, liver and
stomach. Breast cancer was the most common tumor among females.

107
Cancer is the second leading cause of death in Bahrain, causing 12.2% of all deaths.
The leading types of cancer among Bahraini males (1998) are lung (17.3%) and
leukaemia (15.8%), whereas in females they are breast (26.6%) and lung (9.4%).

Female breast cancer 8.8% is the most common cancer among females in all the six
countries of the Gulf Cooperation Council. The highest Age Standardized Incidence
Rate (ASIR) was in Kuwait at 41.1/100 000, followed by Qatar at 31.2/100 000 and
Bahrain at 25.9/100 000. Liver cancer 7.5%. Leukaemia 7.5%. It is among the five
most common cancers in Bahrain, Qatar, Saudi Arabia and Oman. The ASIR for
males in Bahrain was 14.9/100 000, in Qatar was 10.8/100 000, in Saudi Arabia
4.4/100 000 and in Oman 2.5/100 000. Non-Hodgkin lymphoma 7.3%. It ranks first in
Saudi Arabia, second in Kuwait and third in Qatar and the United Arab Emirates. The
highest ASIR was in Qatar (11.15/100000), followed by Saudi Arabia (9/100 000) and
Kuwait (6.5/100 000). Colo-rectal cancer 5.5%. Lung cancer ranks first among males
in Bahrain, Kuwait and Qatar. The highest ASIR for males was in Bahrain (22.6/100
000), followed by Kuwait (15.6/100 000) and Qatar (14.3/100 000). The ASIR in
GCC country nationals was 81.6/100 000. The highest incidence among GCC
countries was in Qatar and the lowest was in United Arab Emirates.

In 2002 chronic diseases amounted for more than two thirds (69.6%) off all deaths in
Iran. Cancer accounted to 11% of all deaths in Iran.

None of the above reports are population based and so it is impossible to calculate
true incidence. In addition without the presence of accurate population census,
standardized incidence rates are difficult to achieve.

108
Comments and recommendation

At least 30% of future cancers could be prevented by comprehensive and carefully

considered action taken now. This will involve creating public awareness about
prevention of cancer. Promoting and supporting healthy lifestyle choices is of the
essence. Nutrition and cancer have a complex relationship, but there is research and
evidence that nutrition and lifestyle offer opportunities for cancer prevention. This
demands dietary surveillance based on assessment of the dietary patterns of countries.
Coverage of the population with hepatitis B immunization is another important
prevention strategy, while the new vaccine against papilloma virus is highly
promising. Breast and cervical cancers should be targeted for early diagnosis and
screening... Early detection should be integrated into primary health care, and the
technical quality of screening tests and the facilities that undertake them should be
carefully monitored.

Cancer survival rates in the population are used to evaluate the impact of the extent to
which new or improved cancer treatments are incorporated in clinical practice.
Comparisons of cancer survival rates are increasingly used to compare the
effectiveness of cancer treatment in different populations. This requires careful
standardization of registry methods, which greatly influence the success of treatment.

Cancer surveillance and registries play a pivotal role in cancer control, and are critical
for assessing the cancer burden, and hence formulating policy and setting priorities.
The value of a cancer registry depends on the quality of its data and the extent to
which this is used in research and health services planning. Issues such as reliability,
completeness and validity have to be seriously considered when establishing a cancer
registry and surveillance;

109
Establishing a national cancer centre is an initial component of an enhanced cancer
control programme. National cancer centres can link health centres and medical
departments, and have proven to be a cost-effective way to maintain quality cancer
health care across the health system.

Cancer prevention should assume a high priority in national cancer control

programmes. Collaboration between Gulf countries is highly desirable and can be
very effective. Collaboration with international agencies has important advantages,
particularly in evaluating cancer health education programmes and in the exchange of
literature. Success requires collaboration from all.

The countries of the Gulf Cooperation Council are in the process of establishing a
unified cancer control programme. They need to set clear cancer control priorities,
analyse the epidemiological situation in each country, identify cancer programme
priorities and develop cancer health information networks in order to foster stronger
linkages.

110
 Obesity in Dubai

Table (1) shows that more than three quarters (77.28%) of obese cases attending specialist
clinics in DOHMS were Emirates and 80.49% were females. Table (2) shows that about three
fifths (59.36%) of obese cases attending outpatient clinics in private health sector in Dubai
2004-2006 were females. Out of the 4611 cases of obesity, 2947 (63.9%) were Expatriates.
Studying the distribution in males and females, the percentage of obesity was higher (65.56%)
among Emirate females. There is a steady increase in the number of attended cases to private
health sector outpatient clinics in Dubai 2004-2006 by year of attendance in both males and
females and by nationality, Table (3).

Arabs amounted to 20.73% of obese cases, Asians 26.39%, other nationalities 16.79% and
Emirate population 36.09% of attended cases to private health sector clinics in Dubai 2004-
2006, Table (4).

A case control study was carried out. Obese cases attending specialist clinics in DOHMS
(E66) in the period 2004-2006 were selected as cases. For each case two controls were
selected. Crude Odds Ratio was calculated and logistic regression analysis was applied. No
significant difference was observed between cases and controls by marital status (P=0.894),
Table 5. Table (6) shows that Expatriates had nearly half the risk of obesity than Emirates.
(cOR=0.541, p=0.0001). Table (7) shows that male cases had more than one third the risk
of obesity as compared to females (cOR=0.360, 0.271-0.478). Cases above 55 years and
above had about half the risk of obesity than those below 55 years (cOR= 0.448, P= 0. 0001),
Table (8) .Applying logistic regression analysis, females and Emirate population had a
higher adjusted risk than relevant categories, Table (9).

111
 ‫اﻟﺴﻤﻨﺔ ﺑﺪﺑﻲ‬

‫ﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (1‬أن أآﺜﺮ ﻣﻦ ﺛﻼﺛﺔ أرﺑﺎع )‪ (%77.28‬ﺣﺎﻻت اﻟﺴﻤﻨﺔ اﻟﻤﺮاﺟﻌﺔ ﻟﻌﻴﺎدات اﻷﺧ ﺼﺎﺋﻴﻴﻦ ﺑ ﺪاﺋﺮة‬
‫اﻟ ﺼﺤﺔ آ ﺎﻧﻮا ﻣ ﻮاﻃﻨﻴﻦ وأن ‪ %80.49‬آ ﺎﻧﻮا ﺑ ﻴﻦ اﻹﻧ ﺎث آ ﻢ ﻳﻈﻬ ﺮ اﻟﺠ ﺪول رﻗ ﻢ )‪ (2‬أن ‪ %59.36‬ﻣ ﻦ ﺣ ﺎﻻت‬
‫اﻟ ﺴﻤﻨﺔ اﻟﻤﺮاﺟﻌ ﺔ ﻟﻠﻌﻴ ﺎدات اﻟﺨﺎرﺟﻴ ﺔ ﻟﻠﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص ﺑ ﺪﺑﻲ ‪ 2006 – 2004‬آﺎﻧ ﺖ إﻧﺎﺛ ﺎ‪ .‬آﻤ ﺎ آ ﺎن ﺑ ﻴﻦ‬
‫‪ 4611‬ﺣﺎﻟﺔ ﺳﻤﻨﺔ ﺑﺎﻟﻘﻄﺎع اﻟﺨﺎص ‪ (%63.9) 2947‬ﺣﺎﻟﺔ ﻏﻴﺮ ﻣ ﻮاﻃﻨﻴﻦ وﺑﺪراﺳ ﺔ اﻟﺘﻮزﻳ ﻊ ﺑ ﻴﻦ اﻟ ﺬآﻮر واﻹﻧ ﺎث‬
‫آﺎﻧﺖ ﻧﺴﺒﺔ اﻹﻧﺎث ﻋﺎﻟﻴﺔ )‪ (%65.56‬ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ‪.‬‬

‫آﻤﺎ آﺎن هﻨﺎك زﻳﺎدة ﻓﻲ ﻋﺪد اﻟﺤﺎﻻت اﻟﻤﺮاﺟﻌﺔ ﻓﻲ ﻋﺎم ‪ 2006‬ﻣﻘﺎرﻧ ﺔ ﺑﻌ ﺎﻣﻲ ‪ 2004‬و ‪ 2005‬ﺑ ﺎﻟﻨﻮع واﻟﺠﻨ ﺴﻴﺔ‪،‬‬
‫ﺟﺪول رﻗﻢ )‪ (3‬وﻗ ﺪ ﺷ ﻜﻞ اﻟﻌ ﺮب ‪ %20.73‬ﻣ ﻦ اﻟﺤ ﺎﻻت واﻵﺳ ﻴﻮﻳﻴﻦ ‪ %26.39‬واﻟﺠﻨ ﺴﻴﺎت اﻷﺧ ﺮى ‪%16.79‬‬
‫واﻟﻤﻮاﻃﻨﻴﻦ ‪ %36.09‬ﻣﻦ اﻟﺤﺎﻻت اﻟﻤﺮاﺟﻌﺔ ﻟﻠﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﺑﺎﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ‪.‬‬

‫هﺬا وﻗﺪ ﺗﻢ ﺗﺼﻤﻴﻢ دراﺳﺔ اﺳﺘﺮﺟﺎﻋﻴﺔ ﺣﻴﺚ ﺗﻢ اﺧﺘﻴﺎر ﺣﺎﻻت اﻟﺴﻤﻨﺔ اﻟﻤﺮاﺟﻌﺔ ﻟﻌﻴﺎدات اﻷﺧﺼﺎﺋﻴﻴﻦ ﺑﺪاﺋﺮة اﻟ ﺼﺤﺔ‬
‫ﺑﺪﺑﻲ )‪ (E66‬ﻓﻲ اﻟﻔﺘﺮة ﻣﻦ ‪ 2006 – 2004‬آﺤﺎﻻت اﻟﺪراﺳﺔ وﺗﻢ اﺧﺘﻴﺎر ﻋﻴﻨﻴﻦ ﺿﺎﺑﻄﺘﻴﻦ ﻟﻜﻞ ﺣﺎﻟﺔ دراﺳﺔ آﻤﺎ ﺗﻢ‬
‫ﺣﺴﺎب ﻣﻌ ﺪل اﻟﻔ ﺮق واﻟﺘﺤﻠﻴ ﻞ اﻻﻧﺤ ﺪار اﻟﻨ ﺴﺒﻲ‪ .‬وﻟ ﻢ ﺗﻮﺟ ﺪ ﻓ ﺮوق ﺟﻮهﺮﻳ ﺔ ﺑ ﻴﻦ اﻟﺤ ﺎﻻت واﻟﻌﻴﻨ ﻴﻦ اﻟ ﻀﺎﺑﻄﺔ ﻓﻴﻤ ﺎ‬
‫ﻳﺘﻌﻠ ﻖ ﺑﺎﻟﺤﺎﻟ ﺔ اﻻﺟﺘﻤﺎﻋﻴ ﺔ – ﺟ ﺪول رﻗ ﻢ )‪ .(5‬وﻳﻮﺿ ﺢ اﻟﺠ ﺪول رﻗ ﻢ )‪ (6‬أن ﺧﻄ ﻮرة اﻟﺘﻌ ﺮض ﻟﻠ ﺴﻤﻨﺔ ﺑ ﻴﻦ ﻏﻴ ﺮ‬
‫اﻟﻤﻮاﻃﻨﻴﻦ آﺎﻧﺖ ﻧﺼﻒ ﻗﻴﻤﺘﻬ ﺎ ﺑ ﻴﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ )ﻣﻌ ﺪل اﻟﻔ ﺮق = ‪ ( ,541‬آﻤ ﺎ آﺎﻧ ﺖ ﺧﻄ ﻮرة اﻟﺘﻌ ﺮض ﻟﻠ ﺴﻤﻨﺔ ﺑ ﻴﻦ‬
‫اﻟ ﺬآﻮر ﺛﻠ ﺚ ﻗﻴﻤﺘﻬ ﺎ ﺑ ﻴﻦ اﻹﻧ ﺎث )ﻣﻌ ﺪل اﻟﻔ ﺮق = ‪ ( ,360‬وآ ﺎن اﻷﺷ ﺨﺎص اﻟﺒ ﺎﻟﻐﻴﻦ ‪ 55‬ﻋﺎﻣ ﺎ ﻣ ﻦ اﻟﻌﻤ ﺮ ﺧﻄ ﻮرة‬
‫اﻟﺘﻌﺮض ﻟﻠ ﺴﻤﻨﺔ ﻟ ﺪﻳﻬﻢ ﺣ ﻮاﻟﻲ ﻧ ﺼﻒ اﻟﻘﻤ ﺔ ﺑ ﻴﻦ اﻟﺤ ﺎﻻت أﻗ ﻞ ﻣ ﻦ ‪ 55‬ﻋﺎﻣ ﺎ ﻣ ﻦ اﻟﻌﻤ ﺮ )ﻣﻌ ﺪل اﻟﻔ ﺮق = ‪( ,448‬‬
‫وﺗﻄﺒﻴﻖ ﺗﺤﻠﻴﻞ اﻻﻧﺤﺪار اﻟﻨﺴﺒﻲ أﻇﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (9‬أن اﻹﻧﺎث واﻟﻤﻮاﻃﻨﻴﻦ ﻟﺪﻳﻬﻢ ﺧﻄﻮرة ﻣﻌﺪﻟﻪ أﻗﻞ ﻟﻠﺴﻤﻨﺔ ﻋ ﻦ‬
‫اﻟﻔﺌﺎت اﻟﻤﻨﺎﻇﺮة‪.‬‬

‫‪112‬‬
Table (1) Distribution of Obese Cases Attending Specialist Clinics in DOHMS,
Dubai 2002 -2006

Nationality Sex Total

Female Male
AE 247 66 313
60.99 16.30 77.28
78.91 21.09
EX 79 13 92
19.51 3.21 22.72
85.87 14.13
Total 326 79 405
80.49 19.51 100.00
x2 =2.19 P = 0.138

113
Table ( 2 ) Distribution of Obese Cases Attending Outpatient Clinics of Private Health
Sector in Dubai by Sex and Nationality Group, 2004 -2006

Sex Nationality Total

Expatriate Emirate
Female 1646.00 1091.00 2737.00
Sum 55.85 65.56 59.36
%
Male Sum 1301.00 573.00 1874.00
% 44.15 34.44 40.64
Total Sum 2947.00 1664.00 4611.00
% 100.00 100.00 100.00

114
 Table (3) Distribution of Obese Cases Attending Outpatient Clinics of Private Health
Sector in Dubai by Sex and Nationality, 2004 -2006

Sex Year Total

2004 2005 2006
Expatriate UAE Expatriate UAE Expatriate UAE
Female Sum 378.00 260.00 607.00 310.00 661.00 521.00 2737.00
% 13.81 9.50 22.18 11.33 24.15 19.04 100.00
Male Sum 332.00 143.00 448.00 209.00 521.00 221.00 1874.00
% 17.72 7.63 23.91 11.15 27.80 11.79 100.00
Total Sum 710.00 403.00 1055.00 519.00 1182.00 742.00 4611.00
% 15.40 8.74 22.88 11.26 25.63 16.09 100.00

115
Table (4) Distribution of Obese Cases Attending Outpatient Clinics of Private Health
Sector in Dubai by Sex and Nationality, 2004 -2006

Sex Nationality Total

Arabs Asians Others UAE
582.00 591.00 473.00 1091.00 2737.00
Female Sum
% 21.26 21.59 17.28 39.86 100.00
Male Sum 374.00 626.00 301.00 573.00 1874.00
% 19.96 33.40 16.06 30.58 100.00
Total Sum 956.00 1217.00 774.00 1664.00 4611.00
% 20.73 26.39 16.79 36.09 100.00

116
Table (5) Distribution of Obese Cases and Controls Attending Specialist
Clinics in DOHMS by Marital Status, Dubai 2004 -2006

Marital Status Control Obese

Ever Married 304 156
40.43 40.84
Single 448 226
59.57 59.16
Total 752 382
2
x =0.0178, P=0.894

cOR= 0.983, CI= 0.765, 1.263

117
Table (6) Distribution of Obese cases and controls attending Specialist Clinics in
DOHMS by Nationality, Dubai 2004 -2006

Nationality Control Obese

Emirate 525 313
64.81 77.28
Expatriate 285 92
35.19 22.72
Total 810 405
2
x =19.615 P=0.0001

cOR= 0.541, CI= 0.412, 0.712

Table (7) Distribution of Obese Cases and Controls Attending Specialist

Clinics in DOHMS by Sex, Dubai 2004 -2006

Sex Control Obese

Female 484 326
59.75 80.49
Male 326 79
40.25 19.51
Total 810 405
2
x =52.267, P=0.0001

cOR= 0.360, CI= 0.271, 0.478

118
Table (8) Distribution of Obese Cases and Controls Attending Specialist
Clinics in DOHMS by Age, Dubai 2004 -2006

Age Control Obese

< 15 77 25
9.51 6.17
15- 97 39
11.98 9.63
25- 166 90
20.49 22.22
35- 193 128
23.83 31.60
45- 143 90
17.65 22.22
55- 90 28
11.11 6.91
65+ 44 5
5.43 1.23
Total 810 405
2
x =31.098, P=0.0001

119
Table (9) Logistic Regression Analysis of Obesity in DOHMS, Dubai 2004-2006
by Certain Epidemiological Variables.

Variable Estimate P

Emirates vs. Expatriates 0.573(0.431, 0.762) 0.0001

(≥55 years v. < 55 years) 1.001(0.992, 1.009) 0.87o6

Females vs. Males 0.369 (0.277,0.492) 0.0001

120
 HE
H
H EA
E AL
A LT
L TH
T HP
H PR
P RO
R OF
OF LE
FIIIL
L EO
E OF
O FE
F EL
E LD
L DE
D ER
ER LY
RL
L YE
Y EM
E M RA
MIIIR
R AT
A TE
T EP
E PO
P OP
O PU
P UL
U LA
LA T ON
TIIIO
AT O N ND
N IIIN
N DU
DU BA
UB
B AIII
A

The 20th century revolution in health – and the consequent demographic transition –

leads inexorably to major changes in the pattern of diseases. Many Arab countries are

going through an epidemiological transition, leaving many of them with the double

burden of infectious and non-communicable diseases. The aging of the population,

progressive urbanization and changes in nutritional habits and life styles all contribute

in that epidemiological transition. Examination of levels, patterns and determinants of

health and disability among the elderly should arguably be one of the most important

concerns in the area of population and health. Not only is the speed and intensity of

aging in developing countries much higher than it ever was in developed countries but

it is also likely to be accompanied by much higher levels of disability and chronic

illnesses with the consequent stress on national budgets and on precarious institutional

contexts.

While the UAE's young population is growing at a mercurial pace, its elderly
population is also growing at a rate of 10.3 % annually, the highest in the world. This
has prompted medical experts to emphasize the need for a substantial increase in
healthcare resources. The elderly here, however, enjoy the social support system
provided by a closely-knit family. This puts them in a better position than their
counterparts even in the West. In 2005, elderly population (60 years and above)

121
amounted to 1.23 % off all the population in Dubai (Dubai Municipality 20060. With
a predicted average annual growth rate in the UAE for those aged 65 and older staying
at 10.3 % (1999-2025), addressing the future needs of the aging population of the
UAE is becoming more urgent.

There was 3768 elderly person in Dubai aged 60 years and above, 58.7% Emirates
and 41.3% expatriates. Out of the 2213 Emirate elderly person admitted in DOHMS,
1268 (57.3%) were males and 945 (42.7.1%) were female (Figure 1). The mean age of
the Emirate inpatients discharged in DOHMS hospitals was 71.54. ± 8.30 for males
and 69.12 ± 7.44 years for females. This difference is significant (F = 35.21, P =
0.000). The average number of admissions was 1.18 ± 0.88. It was 1.20 ± 0.98 for
males and 1.15 ± 0.72 for females, with no significant difference.

Studying the distribution of diseases among the elderly Emirate inpatients using the
ICD 10, diseases of the circulatory system amounted to about one third (27.6%) of the
discharged cases, Endocrine, nutritional and metabolic diseases 10.5%, diseases of the
eye (9.5%), diseases of the respiratory system (7.9%), genitourinary system 7.1%,
diseases of the digestive system (6.4%), and malignant neoplasms 5.7%. The
distribution was nearly the same in both males and females with a higher percentage
(29.2%) among males of diseases of the circulatory system. Among females
endocrine, nutritional and metabolic diseases were 12.9% of all the discharged cases.
Ischaemic heart disease amounted for 12.4% of all discharged Emirate cases, diabetes
mellitus 7.2%, cerebrovascular diseases 3.9%, and heart failure 2.9%. The most
frequent disease in females was diabetes mellitus (10.2%) and in males ischaemic
heart disease (15.5%).

The case fatality rate was 6.8% among Emirate elderly population with no significant
difference between males and females. Infections and parasitic diseases had the

122
highest case fatality rate (48.2%), neoplasms 27.3% and diseases of the circulatory
system (6.1%). Septicemias had the highest case fatality rate (88.5%).

As for the length of stay it was 10.7 ± 25.54 days among Emirate elderly inpatients
and 7.2 ± 14.17 among expatriates in DOHMS. This difference is significant (P =
0.0001). The length of stay was also higher among patients aged 75 years and above
(12.93 ± 28.22 days) compared to 9.9 24.49± among Emirate inpatients aged 60-74
years (P=0.0001). It was also higher among inpatients with mental and behavioral
disorders (16.8 ± 13.67) and injured elderly Emirate inpatients (19.05 ± 23.0), (Figure
2).

Studying the five leading causes of death among elderly emirate inpatients in
DOHMS in 2005, neoplasms amounted for the highest percentage (16.2%),
cardiovascular diseases (13.4), septicemia (12.8%), cerebrovascular diseases (9.5%),
and renal failure (5.0%). As for injuries among elderly population, it accounts for
3.9% of all discharges. More than two fifths (43.1%) of injuries were in the lower
limb, thorax and abdomen 20.5 %, head and neck 7.8%, upper limb 7.8 % and other
injuries 21.7%, (Figure 3). Fracture femur amounted for 38.2% of all injuries among
elderly population and fracture neck femur 14.7% of injuries.

Elderly Emirate population constituted 13.3% of attended Specialist Clinics in

DOHMS with 2.4 visits. Cardiovascular diseases amounted to 19.1% of cases,
endocrine 18.3%, musculoskeletal 13.1%, genitourinary 5.8% and respiratory diseases
4.4 %

Comments and Recommendations

Population aging creates social, economic, and political issues that make systematic,
informed planning of policies concerning the elderly a national imperative. Although
research on aging is a relatively new field, There are five themes in the area of aging

123
that should be emphasized: health and disability of the elderly; living arrangements
among the elderly and patterns of inter- generational transfers (intra and inter family);
and access to and use of health care.

In DOHMS, there are many unresolved tensions concerning the ways in which
medical care for elderly population is or should be organized and financed. Different
systems of care and financing emphasize different responses to the questions listed
below:

1. Should the emphasis be on prevention or cure?

2. What type of practice should be emphasized, primary care or specialty
practice?
3. Should the DOHMS focus exclusively on the people who enter their
institutions or should they be actively involved in promoting the health of the
entire community of Dubai?
4. To what extent is there a tension between low cast and high quality in the care
process?

To answer all these, a comprehensive study for addressing the future needs of the
ageing population of Dubai is becoming more urgent.

124
Table (1) Distribution of Elderly National Inpatients by S ex in DOHMS , 2005
‫ﺗﻮزﻳﻊ اﻟﻤﺮﺿ ﻰ اﻟ ﺪاﺧﻠﻴﻴﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ اﻟﻤﺴ ﻨﻴﻦ ﺑ ﺪﺑﻲ ﺑ ﺎﻟﻨﻮع‬

43%
Male
Fem ale
57%

125
 Figure (2) Length of Stay of Elderly Population in DOHMS Hospitals by
Diagnosis, Dubai 2005
2005 ‫ﻣﻌﺪل ﻓﺘﺮة ﺑﻘﺎء اﻟﻤﺮﻳﺾ ﺑﺎﻟﻤﺴﺘﺸﻔﻰ ﺑﺎﻟﺘﺸﺨﻴﺺ ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم‬

20
18
16
14
12
LOS 10
8
6
4
2
0
Mental Injuriea Other Diseases
Diagnosis

126
 Figure (3) Distribution of injuries am ong elderly population in Dubai,
2005
2005 ‫ﺗﻮزﻳﻊ ﺣﺎﻻت اﻻﺻﺎﺑﺎت ﺑﻴﻦ اﻟﻤﺴﻨﻴﻦ ﺑﺪﺑﻰ ﻓﻰ ﻋﺎم‬

22% 8%

20% 42%
8%

UPPER LIMB LOWER LIMB HEAD AND NECK THORAX & ABDOMEN OTHER INJURIES

127
 ‫اﻟﻮﺿﻊ اﻟﺼﺤـﻲ ﻟﻠﻤﺴﻨﻴــﻦ ﺑﺈﻣـﺎرة دﺑـــــــﻲ ‪2006- 2000‬‬

‫)‪ 65‬ﻋﺎﻣﺎ ﻓﺄآﺜﺮ( اﻟﺬﻳﻦ ﺗﻢ إدﺧﺎﻟﻬﻢ ﻣﺴﺘﺸﻔﻴﺎت اﻟﺪاﺋﺮة ‪ %6.4‬ﻣﻦ‬ ‫ﺑﻠﻐﺖ ﻧﺴﺒﺔ ﺣﺎﻻت اﻟﻤﺴﻨﻴﻦ‬
‫ﻣﺠﻤﻮع ﺣﺎﻻت اﻟﺪﺧﻮل ﻓﻲ اﻟﻔﺘﺮة ‪ 2006-2000‬وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﺬآﻮر ‪ %56.3‬واﻹﻧﺎث‬
‫‪) .%43.7‬ﺷﻜﻞ رﻗﻢ ‪ ،(1‬وآﺎن ﻣﺘﻮﺳﻂ ﻋﻤﺮ اﻟﺤﺎﻻت ‪ 73.8‬ﻋﺎﻣﺎ آﻤﺎ ﺷﻜﻞ اﻟﻤﻮاﻃﻨﻮن ‪%55.6‬‬
‫ﻣﻦ اﻟﺤﺎﻻت‪ .‬وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ اﻟﺤﺎﻻت ﺗﺒﻌًﺎ ﻟﻠﺘﻘﺴﻴﻢ اﻟﺪوﻟﻲ ﻟﻸﻣﺮاض )اﻟﻤﺮاﺟﻌﺔ اﻟﻌﺎﺷﺮة( ﻓﻘﺪ‬
‫ﺷﻜﻠﺖ أﻣﺮاض اﻟﺠﻬﺎز اﻟﺪوري ﺣﻮاﻟﻲ ﺛﻠﺚ )‪ (%29.5‬ﺣﺎﻻت اﻟﺨﺮوج ﺑﻴﻦ اﻟﻤﺴﻨﻴﻦ وأﻣﺮاض‬
‫اﻟﻐﺪد اﻟﺼﻤﺎء واﻟﺘﻐﺬﻳﺔ واﻟﺘﻤﺜﻴﻞ اﻟﻐﺬاﺋﻲ ‪ %9.3‬وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺒﻮﻟﻲ واﻟﺘﻨﺎﺳﻠﻲ ‪%8.2‬‬
‫واﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ ‪ %8.0‬وأﻣﺮاض اﻟﻌﻴﻮن ‪ %7.6‬واﻟﺴﺮﻃﺎﻧﺎت ‪ .%5.4‬وآﺎﻧﺖ اﻟﻨﺴﺒﺔ ﺗﻘﺮﻳﺒ ًﺎ‬
‫ﻣﺘﺸﺎﺑﻬﺔ ً ﺑﻴﻦ اﻟﺬآﻮر واﻹﻧﺎث إﻻ أن أﻣﺮاض اﻟﺠﻬﺎز اﻟﺪوري آﺎﻧﺖ أآﺜﺮ ﺑﻴﻦ اﻟﺮﺟﺎل )‪(%31.6‬‬
‫وأﻣﺮاض اﻟﻐﺪد اﻟﺼﻤﺎء واﻟﺘﻐﺬﻳﺔ واﻟﺘﻤﺜﻴﻞ اﻟﻐﺬاﺋﻲ ﺑﻴﻦ اﻹﻧﺎث)‪ (%11.4‬وآﺎن ﻣﺮض اﻟﺴﻜﺮي‬
‫أآﺜﺮ اﻷﻣﺮاض ﺷﻴﻮﻋًﺎ ﺑﻴﻦ اﻹﻧﺎث )‪ (%9.9‬وﻗﺼﻮر اﻟﺸﺮﻳﺎن اﻟﺘﺎﺟﻲ ﻟﻠﻘﻠﺐ )‪ (%12.4‬ﺑﻴﻦ‬
‫اﻟﺮﺟﺎل‬

‫وآﺎن ﻣﻌﺪل اﻟﻮﻓﻴﺎت ﻟﻠﻤﺴﻨﻴﻦ ‪ .%6.9‬وﻗﺪ آﺎﻧﺖ ﻓﺘﺮة اﻟﺒﻘﺎء ﺑﺎﻟﻤﺴﺘﺸﻔﻰ ‪ 10.3‬ﻳﻮﻣًﺎ وﺑﺪون ﻓﺮوق‬
‫ﺟﻮهﺮﻳﺔ ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ آﻤﺎ آﺎﻧﺖ اﻟﻔﺘﺮة أﻋﻠﻰ ﺑﻴﻦ اﻟﺒﺎﻟﻐﻴﻦ ‪ 75‬ﻋﺎﻣﺎ‬
‫وأآﺜﺮ)‪ 11.3‬ﻳﻮﻣًﺎ(‪ ،‬واﻟﻤﺮﺿﻰ اﻟﻤﺴﻨﻴﻦ اﻟﺬﻳﻦ ﻳﻌﺎﻧﻮن ﻣﻦ اﺿﻄﺮاﺑﺎت ﻧﻔﺴﻴﺔ واﻟﻤﺴﻨﻴﻦ اﻟﻤﺼﺎﺑﻴﻦ‬
‫ﻓﻲ اﻟﺤﻮادث‪ .‬أﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ إﻟﻰ ﺗﻮزﻳﻊ اﻹﺻﺎﺑﺎت ﺑﻴﻦ اﻟﻤﺴﻨﻴﻦ ﻓﻘﺪ ﺷﻜﻠﺖ إﺻﺎﺑﺎت اﻟﻄﺮف اﻟﺴﻔﻠﻲ‬
‫ﺣﻮاﻟﻲ ﻧﺼﻒ اﻹﺻﺎﺑﺎت )ﺷﻜﻞ رﻗﻢ ‪ ،(2‬وﺷﻜﻠﺖ إﺻﺎﺑﺎت ﻋﻈﻢ اﻟﻔﺨﺬ أﻗﻞ ﻣﻦ ﻧﺼﻒ اﻹﺻﺎﺑﺎت‬

‫هﺬا وﻗﺪ ﺷﻜﻞ اﻟﻤﺴﻨﻮن ‪ %8.4‬ﻣﻦ ﻣﺠﻤﻮع ﺣﺎﻻت ﻣﺮاﺟﻌﺔ ﻋﻴﺎدات اﻷﺧﺼﺎﺋﻴﻴﻦ‪ ،‬وآﺎﻧﺖ أﻋﻠﻰ‬
‫ﻧﺴﺐ اﻟﺤﺎﻻت اﻟﻤﺮاﺟﻌﺔ هﻲ أﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ ‪ %21.0‬وأﻣﺮاض اﻟﻐﺪد اﻟﺼﻤﺎء‬
‫‪) %16.6‬ﺷﻜﻞ ﻣﺮض اﻟﺴﻜﺮي ﻣﻌﻈﻢ ﺗﻠﻚ اﻟﺤﺎﻻت( وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺤﺮآﻲ واﻟﻌﻀﻠﻲ‬
‫‪ %11.1‬واﻷﻣﺮاض اﻟﺒﻮﻟﻴﺔ واﻟﺘﻨﺎﺳﻠﻴﺔ ‪ %6.6‬وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ ‪ %4.7‬ﻣﻦ ﻣﺠﻤﻮع‬
‫اﻟﺤﺎﻻت‪.‬‬

‫‪128‬‬
‫‪Table (1) Distribution of Elderly National Inpatients by S ex in DOHMS , 2005‬‬
‫ﺗﻮزﻳﻊ اﻟﻤﺮﺿ ﻰ اﻟ ﺪاﺧﻠﻴﻴﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ اﻟﻤﺴ ﻨﻴﻦ ﺑ ﺪﺑﻲ ﺑ ﺎﻟﻨﻮع‬

‫‪43%‬‬
‫‪Male‬‬
‫‪Fem ale‬‬
‫‪57%‬‬

‫ﺷﻜﻞ رﻗﻢ)‪(2‬‬
‫ﺗﻮزﻳﻊ ﺣﺎﻻت اﻻﺻﺎﺑﺎت ﺑﻴﻦ اﻟﻤﺴﻨﻴﻦ ﺑﺪﺑﻰ ﻓﻰ ﻋﺎم ‪2006-2000‬‬

‫‪21%‬‬ ‫‪7%‬‬

‫‪20%‬‬ ‫‪45%‬‬
‫‪7%‬‬

‫اﻟﻄﺮف اﻟﻌﻠﻮى‬ ‫اﻟﻄﺮف اﻟﺴﻔﻠﻰ‬ ‫اﻟﺮأس واﻟﺮﻗﺒﺔ‬ ‫اﻟﺼﺪر واﻟﺒﻄﻦ‬ ‫اﺻﺎﺑﺎت أﺧﺮى‬

‫‪129‬‬
 Heat Effects in Dubai

There were 7291cases of heat effects attended private health facilities in the working
age group 15-65 years in Dubai in 2004 - 2006. Only 66 cases were Emirates. The
majority of the cases (88.8%) were Asians; Arabs 6.1% and 4.2% were other
nationalities. Males amounted for the majority of the cases (96.6 %). As for age,
14.2% were in the age group 15-24 years, about three fifths of the cases (59.5%) were
in the age group 25.44 years and 26.3% were in the age group 45. -64 years. Heat
exhaustion amounted for about three fourths of the cases (71.4%) , heat fatigue 8.0%
and heat cramps 9.3 %, Table (1). Figure (1) shows that the percentages of the cases
were higher in summer months (June-September).

130
 ‫اﻟﺘﺄﺛﻴﺮات اﻟﺤﺮارﻳﺔ ﺑﺪﺑﻲ‬

‫آ ﺎن هﻨ ﺎك ‪ 7291‬ﺣﺎﻟ ﺔ ﺗ ﺄﺛﻴﺮ ﺣ ﺮاري ﻟﻤﺮاﺟﻌ ﻲ ﻣﺆﺳ ﺴﺎت اﻟﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص ﺑ ﺪﺑﻲ ﻓ ﻲ‬
‫اﻟﻤﺠﻤﻮﻋ ﺔ اﻟﻌﻤﺮﻳ ﺔ اﻟﻌﺎﻣﻠ ﺔ )‪ 64-15‬ﻋﺎﻣ ﺎ( وﻟ ﻢ ﺗﻮﺟ ﺪ إﻻ‪ 66‬ﺣ ﺎﻻت ﺑ ﻴﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ وآ ﺎن ﻣﻌﻈ ﻢ‬
‫اﻟﺤ ﺎﻻت ﻣ ﻦ اﻵﺳ ﻴﻮﻳﻴﻦ )‪ (%88.8‬واﻟﻌ ﺮب )‪ (%6.1‬واﻟﺠﻨ ﺴﻴﺎت اﻷﺧ ﺮى )‪ (%4.2‬وﻗ ﺪ ﺷ ﻜﻞ‬
‫اﻟ ﺬآﻮر ‪ %496.6‬ﻣ ﻦ اﻟﺤ ﺎﻻت وآ ﺎن ﺣ ﻮاﻟﻲ ﺛﻼﺛ ﺔ أﺧﻤ ﺎس اﻟﺤ ﺎﻻت )‪ (%59.9‬ﻓ ﻲ اﻟﻤﺠﻤﻮﻋ ﺔ‬
‫اﻟﻌﻤﺮﻳﺔ ‪ 44-25‬ﻋﺎﻣﺎ و‪ %26.3‬ﻓﻲ اﻟﺒﺎﻟﻐﻴﻦ ‪ 64-.45‬ﻋﺎﻣ ﺎ‪ .‬وﻗ ﺪ ﺷ ﻜﻞ اﻹﻧﻬ ﺎك اﻟﺤ ﺮاري ﺣ ﻮاﻟﻲ‬
‫ﺛﻼﺛﺔ أرﺑﺎع اﻟﺤﺎﻻت )‪ (%71.4‬واﻟﺘﻘﻠﺼﺎت اﻟﺤﺮارﻳﺔ ‪.%8.0‬ﺟ ﺪول رﻗ ﻢ )‪ (1‬وﻳﻈﻬ ﺮ اﻟ ﺸﻜﻞ )‪(1‬‬
‫أن هﻨﺎك ﻋﻼﻗﺔ ﺑﻴﻦ ﻣﺘﻮﺳﻂ درﺟﺎت اﻟﺤﺮارة ﺑﺪﺑﻲ وﻋﺪد ﺣﺎﻻت اﻟﺘﺄﺛﻴﺮ اﻟﺤﺮاري‬

‫‪131‬‬
 Table (1) Summary Characteristics of Heat Effects among Attended Patients to
Private Health Sector Facilities in Dubai 2004 -2006

2006- 2004 ‫ﺗﻮزﻳﻊ اﻟﺘﺄﺛﻴﺮات اﻟﺤﺮارﻳﺔ ﺑﻴﻦ اﻟﻤﺮﺿﻰ اﻟﻤﺮاﺟﻌﻴﻦ ﻟﻌﻴﺎدات اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم‬

Variable Value No. (%)

Nationality 7291

Arabs 446 (6.1)

Asians 6476 (88.8)

Others 303 (4.2)

UAE 66(0.9)

Sex

Males 7045 (96.6)

Females 246 (3.4)

Age
15-24 1038(14.2)
25-44 4342 (59.5)
45-64 1911 (26.3)
ICD

Sun stroke 141 (1.9)

Heat cramps 678(9.3)
Heat exhaustion 5203 (71.4)
Heat fatigue 581 (8.0)
Other heat effects 688 (9.4)

132
 Figure (1) Distribution of Heat Effects among Pattients Attending Private Health
Clinics in Dubai by Mean Maximum Temperature, 2004- 2006

45
40
35
30 Mean daily Maximum
25 Temperature
Value

20 % of Cases
15
10
5
0
ly

t
ay

ne
il

r
ch

r
us

be

be
pr

Ju
M

Ju

ob
ar

ug

em

m
A
M

ct
A

e
pt

ov
Se

Month

133
 A comparative study of Heat Effects in Dubai

The study was carried out with the aim of assessing the impact of Ministerial decree

of Ministry of work in reducing heat effect cases by forbidding work from 12:30

Noon to 4:30 PM in Dubai. The study was essentially a retrospective approach for

cases before and after the Ministerial decree in 2005. All cases of heat effects reported

in online database of private health sector in Dubai were collected during summer

months (July - September) 2004 – 2006. The data were age (15-64 years), sex,

nationality and diagnosis according to ICD 10 (T67) and date of reporting. The study

revealed that heat effect cases had decreased from 2328 in 2004 to 821 cases in 2006

(64.73% decrease). The age group 15 – 24 years had the highest decrease. There were

no significant differences between males and females. The decrease was more

apparent in heat exhaustion, August and among Arab nationalities.

134
 ‫دراﺳﺔ ﻣﻘﺎرﻧﺔ ﻟﺤﺎﻻت اﻟﺘﺄﺛﻴﺮ اﻟﺤﺮاري ﺑﺪﺑﻲ‬
‫اﻟﻬﺪف ﻣﻦ اﻟﺪراﺳﺔ‬
‫ﺗﻘﻴﻴﻢ أﺛﺮ اﻟﻘﺮار اﻟﻮزاري رﻗﻢ ‪ 467‬ﻟﺴﻨﺔ ‪ 2005‬ﻟﻮزارة اﻟﻌﻤـﻞ ﺑﺘـﺎرﻳﺦ ‪ 2005/6/28‬واﻟﺨـﺎص ﺑﺘﻨﻈـﻴﻢ ﺳـﺎﻋﺎت‬
‫اﻟﻌﻤﻞ ﺧﻼل أﺷﻬﺮ اﻟﺼﻴﻒ )أول ﻳﻮﻟﻴﻮ وﺣﺘﻰ ‪ 30‬ﺳﺒﺘﻤﺒﺮ( وﻋﺪم اﻟﻌﻤﻞ ﺑﺎﻷﻣﺎآﻦ اﻟﻤﻌﺮﺿﺔ ﻷﺷﻌﺔ اﻟـﺸﻤﺲ‬
‫ﻣﺎ ﺑﻴﻦ اﻟﺴﺎﻋﺔ اﻟﺜﺎﻧﻴﺔ ﻋﺸﺮة واﻟﻨﺼﻒ ﻇﻬﺮا إﻟﻰ اﻟﺮاﺑﻌﺔ واﻟﻨﺼﻒ ﻣﺴﺎءا ﻋﻠﻰ ﺣﺎﻻت اﻟﺘﺄﺛﻴﺮ اﻟﺤـﺮاري ﺑﺈﻣـﺎرة‬
‫دﺑﻲ‪.‬‬
‫ﻃﺮﻳﻘﺔ اﻟﺒﺤﺚ‬
‫آﺎﻧﺖ اﻟﺪراﺳﺔ أﺳﺎﺳﺎ اﺳﺘﺮﺟﺎﻋﻴﺔ وﻣﻘﺎرﻧﺔ ﻟﺤﺎﻻت اﻟﺘﺄﺛﻴﺮ اﻟﺤﺮاري ﻗﺒﻞ ﺻﺪور اﻟﻘﺎﻧﻮن وﺑﻌﺪﻩ ﺣﻴﺚ ﺗـﻢ ﺟﻤـﻊ‬
‫اﻟﺒﻴﺎﻧﺎت ﻣﻦ اﻟﺸﺒﻜﺔ اﻻﻟﻜﺘﺮوﻧﻴﺔ ﻟﻠﻤﻌﻠﻮﻣﺎت ﻟﻠﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ﺑﻘﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑـﺈدارة‬
‫اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء ﺑـﺪاﺋﺮة اﻟـﺼﺤﺔ واﻟﺨـﺪﻣﺎت اﻟﻄﺒﻴـﺔ ﺑـﺪﺑﻲ و ﺗـﻢ ﻣﺮاﺟﻌـﺔ ﺣـﺎﻻت اﻟﺘـﺄﺛﻴﺮ اﻟﺤـﺮاري ﻟﻠﻘﻄـﺎع‬
‫اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ﺧﻼل أﺷﻬﺮ اﻟﺼﻴﻒ )ﻳﻮﻟﻴﻮ – ﺳﺒﺘﻤﺒﺮ( ‪ 2006 -2004‬وآﺎﻧﺖ اﻟﺒﻴﺎﻧـﺎت اﻷﺳﺎﺳـﻴﺔ هـﻲ‬
‫اﻟﻌﻤــﺮ )‪ 64 – 15‬ﻋﺎﻣــﺎ( واﻟﻨــﻮع واﻟﺘــﺸﺨﻴﺺ ﺗﺒﻌــﺎ ﻟﻠﺘﻘ ـﺴﻴﻢ اﻟــﺪوﻟﻲ ﻟﻸﻣــﺮاض اﻟﻤﺮاﺟﻌــﺔ اﻟﻌﺎﺷــﺮة )‪(T67‬‬
‫واﻟﺠﻨﺴﻴﺔ وﺗﺎرﻳﺦ اﻟﻤﺮاﺟﻌﺔ‪.‬‬
‫اﻟﻨﺘﺎﺋﺞ‬
‫اﻧﺨﻔﻀﺖ ﺣﺎﻻت اﻷﺛﺮ اﻟﺤﺮاري ﺧﻼل أﺷﻬﺮ اﻟﺼﻴﻒ ﻣﻦ ‪ 2328‬ﺣﺎﻟـﺔ ﻓـﻲ ﻋـﺎم ‪ 2004‬إﻟـﻰ ‪ 1582‬ﻓـﻲ ‪2005‬‬
‫ﻟﻴﺼﻞ ﻓﻲ ﻋﺎم ‪ 2006‬إﻟﻰ ‪ 821‬ﺣﺎﻟﺔ وﺑﻤﻌﺪل اﻧﺨﻔـﺎض ‪ % 64.73‬أي اﻧﺨﻔـﻀﺖ اﻟﺤـﺎﻻت إﻟـﻰ ﺛﻠـﺚ ﻗﻴﻤﺘﻬـﺎ‬
‫ﻓﻲ ﻋﺎم ‪ ،2004‬وآﺎﻧﺖ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 24-15‬ﻋﺎﻣﺎ أآﺜـﺮ اﻟﻔﺌـﺎت ﺗـﺄﺛﺮا ﺑـﺎﻟﻘﺮار ﺣﻴـﺚ اﻧﺨﻔـﻀﺖ اﻟﻨـﺴﺒﺔ‬
‫إﻟــﻰ ‪ %77.7‬ﻣﻘﺎرﻧــﺔ ﺑﺎﻟﻔﺌــﺎت اﻟﻌﻤﺮﻳــﺔ اﻷﺧــﺮى ) ‪ % 57.9‬ﻟﻠﻔﺌــﺔ اﻟﻌﻤﺮﻳــﺔ ‪ 25 – 44‬ﻋﺎﻣــﺎ ‪ % 69.8‬ﻟﻠﻔﺌــﺔ‬
‫اﻟﻌﻤﺮﻳﺔ ‪ 64 – 64‬ﻋﺎﻣﺎ(‪ .‬ﺷﻜﻞ رﻗﻢ )‪ ( 1.2‬وﺟﺪول رﻗﻢ ‪1‬‬
‫وﻟﻢ ﺗﻮﺟﺪ ﻓﺮوق ﺟﻮهﺮﻳﺔ ﺑﻴﻦ اﻟﺬآﻮر واﻹﻧﺎث آﻤﺎ آﺎن اﻷﺛـﺮ واﺿـﺤﺎ ﻓﻴﻤـﺎ ﻳﺘﻌﻠـﻖ ﺑﻤﺠـﺎﻻت اﻹﺟﻬـﺎد اﻟﺤـﺮاري‬
‫)‪ (% 92.4‬آﻤﺎ آﺎن اﻻﻧﺨﻔﺎض أآﺜﺮ ﻓﻲ ﺷﻬﺮي أﻏﺴﻄﺲ )‪ (% 66.9‬وﺳﺒﺘﻤﺒﺮ )‪ (% 85‬آﻤﺎ آﺎن اﻻﻧﺨﻔﺎض‬
‫أآﺜﺮ وﺿﻮﺣﺎ ﻓﻲ اﻟﺠﻨﺴﻴﺎت اﻟﻌﺮﺑﻴﺔ )‪(% 90.6‬‬
‫اﻟﺨﻼﺻﺔ واﻟﺘﻮﺻﻴﺎت‬
‫ﺑﺎﻟﺮﻏﻢ ﻣﻦ ﻧﺠﺎح اﻟﻘﺮار اﻟﻮزاري ﻟﻮزارة اﻟﻌﻤﻞ واﻟﺨﺎص ﺑﺘﺤﺮﻳﻢ اﻟﻌﻤﻞ ﺧﻼل أﺷﻬﺮ اﻟـﺼﻴﻒ ﻟﻸﻣـﺎآﻦ اﻟﻤﻌﺮﺿـﺔ‬
‫ﻷﺷﻌﺔ اﻟﺸﻤﺲ ﻣﻦ اﻟﺴﺎﻋﺔ ‪ 12.30‬ﻇﻬﺮا إﻟﻰ اﻟـﺴﺎﻋﺔ اﻟﺮاﺑﻌـﺔ واﻟﻨـﺼﻒ ﻣـﺴﺎءا ﻓـﻲ ﺧﻔـﺾ ﺣـﺎﻻت اﻷﺛـﺮ‬
‫اﻟﺤﺮاري ﻟﻠﻌﺎﻣﻠﻴﻦ ﺑﺘﻠﻚ اﻟﻘﻄﺎﻋﺎت إﻟﻰ اﻟﺜﻠﺚ إﻻ أﻧﻪ ﻣﺎزال هﻨﺎك ﺣﺎﺟﺔ إﻟـﻰ ﻣﺰﻳـﺪ ﻣـﻦ اﻟﺠﻬـﺪ ﻟﺨﻔـﺾ ﺗﻠـﻚ‬
‫اﻟﺤﺎﻻت وﺗﻄﺒﻴﻖ ﻗﻄﺎع اﻟﻤﻘﺎوﻻت ﺑﺎﻹﻣﺎرة ﻟﻠﻘﺎﻧﻮن ﻣﻊ إﺟﺮاء دراﺳﺎت ﻣﺸﺎﺑﻬﺔ ﺑﺎﻹﻣﺎرات اﻷﺧﺮى ﻟﺘﻘﻴﻴﻢ اﻷﺛـﺮ‬
‫ﻋﻠﻰ ﻣﺴﺘﻮى اﻟﺪوﻟﺔ‪.‬‬

‫‪135‬‬
 ‫ﺷﻜﻞ رﻗﻢ) ‪ ( 1‬ﺣﺎﻻت اﻟﺘﺄﺛﻴﺮ اﻟﺤﺮارى ﻗﺒ ﻞ وﺑﻌ ﺪ ﺗﻨﻔﻴ ﺬ اﻟﻘ ﺮار‬
‫اﻟﻮزارى‬

‫اﻟﻌﺎم‬ ‫‪2006‬‬

‫‪2005‬‬

‫‪2004‬‬

‫‪0‬‬ ‫‪500‬‬ ‫‪1000‬‬ ‫‪1500‬‬ ‫‪2000‬‬ ‫‪2500‬‬

‫اﻟﻌﺪد‬

‫‪136‬‬
‫ﺷﻜﻞ رﻗﻢ) ‪ ( 2‬ﻣﻌﺪل اﻧﺨﻔﺎض ﺣﺎﻻت اﻟﺘﺄﺛﻴﺮ اﻟﺤﺮارى ﻗﺒ ﻞ وﺑﻌ ﺪ ﺗﻨﻔﻴ ﺬ اﻟﻘ ﺮار‬
‫اﻟﻮزارى ﺗﺒﻌﺎ ﻟﻠﻌﻤ ﺮ‬

‫‪45-64‬‬
‫اﻟﻌﻤﺮ‬

‫‪25-44‬‬

‫‪15-24‬‬

‫‪0‬‬ ‫‪20‬‬ ‫‪40‬‬ ‫‪60‬‬ ‫‪80‬‬ ‫‪100‬‬

‫‪%‬‬

‫‪137‬‬
 ‫ﺷﻜﻞ رﻗﻢ)‪ ( 3‬ﻣﻌﺪل اﻧﺨﻔﺎض ﺣﺎﻻت اﻟﺘﺄﺛﻴﺮ اﻟﺤﺮارى ﻗﺒﻞ وﺑﻌﺪ ﺗﻨﻔﻴﺬ اﻟﻘﺮار اﻟﻮزارى ﺗﺒﻌﺎ‬
‫ﻟﻨﻮع اﻻﺛﺮ اﻟﺤﺮارى‬

‫اﻷﻋﻴﺎء اﻟﺤﺮارى‬
‫ﻧﻮع اﻷﺛﺮ اﻟﺤﺮارى‬

‫اﻟﺘﻘﻠﺼﺎت اﻟﺤﺮارﻳﺔ‬

‫اﻷﻧﻬﺎك اﻟﺤﺮارى‬

‫‪0‬‬ ‫‪20‬‬ ‫‪40‬‬ ‫‪60‬‬ ‫‪80‬‬ ‫‪100‬‬

‫‪%‬‬

‫‪138‬‬
 ‫ﺟﺪول رﻗﻢ )‪ (1‬ﺗﺄﺛﻴﺮ اﻟﻘﺮار اﻟﻮزاري ﻋﻠﻰ ﺣﺎﻻت اﻟﺘﺄﺛﻴﺮ اﻟﺤﺮاري ﺑﻴﻦ ﻣﺮﺿﻰ اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﻟﻠﻘﻄﺎع‬
‫اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ﺧﻼل ﻓﺘﺮة اﻟﺼﻴﻒ ‪2006 – 2004‬‬

‫اﻟﻌﺎﻣﻞ‬ ‫اﻟﻌﺎم‬ ‫ﻣﻌﺪل اﻻﻧﺨﻔﺎض ‪%‬‬

‫‪2004‬‬ ‫‪2005‬‬ ‫‪2006‬‬

‫اﻟﻌﺪد اﻟﻜﻠﻲ‬ ‫‪2328‬‬ ‫‪1582‬‬ ‫‪821‬‬ ‫‪64.73‬‬

‫اﻟﻌﻤﺮ‬
‫‪15-‬‬ ‫‪368‬‬ ‫‪208‬‬ ‫‪82‬‬ ‫‪77.7‬‬
‫‪25-‬‬ ‫‪1272‬‬ ‫‪1090‬‬ ‫‪535‬‬ ‫‪57.9‬‬
‫‪45-64‬‬ ‫‪688‬‬ ‫‪284‬‬ ‫‪208‬‬ ‫‪69.8‬‬
‫اﻟﺘﺄﺛﻴﺮ اﻟﺤﺮاري‬
‫اﻟﺘﻘﻠﺼﺎت اﻟﺤﺮارﻳﺔ‬ ‫‪191‬‬ ‫‪236‬‬ ‫‪78‬‬ ‫‪59.2‬‬
‫اﻹﻧﻬﺎك اﻟﺤﺮاري‬ ‫‪1802‬‬ ‫‪880‬‬ ‫‪618‬‬ ‫‪65.7‬‬
‫اﻹﻋﻴﺎء اﻟﺤﺮاري‬ ‫‪105‬‬ ‫‪324‬‬ ‫‪8‬‬ ‫‪92.4‬‬
‫ﺗﺄﺛﻴﺮات أﺧﺮى‬ ‫‪230‬‬ ‫‪142‬‬ ‫‪117‬‬ ‫‪49.1‬‬
‫اﻟﺸﻬﺮ‬
‫ﻳﻮﻟﻴﻮ‬ ‫‪764‬‬ ‫‪623‬‬ ‫‪426‬‬ ‫‪44.2‬‬
‫أﻏﺴﻄﺲ‬ ‫‪907‬‬ ‫‪714‬‬ ‫‪300‬‬ ‫‪66.9‬‬
‫ﺳﺒﺘﻤﺒﺮ‬ ‫‪657‬‬ ‫‪245‬‬ ‫‪95‬‬ ‫‪85.5‬‬
‫اﻟﺠﻨﺴﻴﺔ‬
‫ﺁﺳﻴﻮﻳﻮن‬ ‫‪2051‬‬ ‫‪1511‬‬ ‫‪785‬‬ ‫‪61.7‬‬
‫ﻋﺮب‬ ‫‪204‬‬ ‫‪5‬‬ ‫‪19‬‬ ‫‪90.6‬‬
‫ﺟﻨﺴﻴﺎت أﺧﺮى‬ ‫‪54‬‬ ‫‪60‬‬ ‫‪17‬‬ ‫‪68.5‬‬
‫ﻣﻮاﻃﻨﻮن‬ ‫‪19‬‬ ‫‪6‬‬ ‫‪-‬‬ ‫‪100.0‬‬
‫اﻟﻨـــــــﻮع‬
‫ذآﺮ‬ ‫‪2276‬‬ ‫‪1565‬‬ ‫‪804‬‬ ‫‪64.8‬‬
‫أﻧﺜﻰ‬ ‫‪52‬‬ ‫‪17‬‬ ‫‪17‬‬ ‫‪67.3‬‬

‫‪139‬‬
 Effect of Traffic Campaign on Road Traffic Injuries in Dubai

The study was carried out with the aim of studying the effect of traffic campaign
(November 2006 – February 2007) on road traffic injuries in Dubai. Cases attended
DOHMS for road traffic injuries on the period stated was included in the study. A
comparative control of cases attended DOHMS last year (November 2005 – February
2006) for road traffic accidents were studied.

The study revealed that road traffic injuries decreased from 2497 cases in the period
November 2005 – February 2006 to 1884 in the last year study period with a rate of
25 % decrease. The average daily injury of reported cases also decreased from 21.3
injuries to 16.1. The rate of decrease was more among Emirates (27 %) than
Expatriates (24.2 %) with no significant difference and more in females (29.3 %) than
males (23.3 %) and in age group 15 – 24 years (35.5 %).

140
 ‫دراﺳﺔ أﺛﺮ اﻟﺤﻤﻠﺔ اﻟﻤﺮورﻳﺔ ﻋﻠﻰ إﺻﺎﺑﺎت اﻟﻄﺮق ﺑﺪﺑﻲ‬

‫ﻤﻘﺩﻤﺔ‬
‫ﻜﺎﻥ ﻟﻠﺘﻘﺩﻡ ﺍﻻﻗﺘﺼﺎﺩﻱ ﻭﺍﻻﺠﺘﻤﺎﻋﻲ ﺒﺩﻭﻟﺔ ﺍﻹﻤﺎﺭﺍﺕ ﺍﻟﻌﺭﺒﻴﺔ ﺍﻟﻤﺘﺤﺩﺓ ﻭﻤﺎ ﺼﺎﺤﺒﺔ ﻤﻥ ﺍﻟﺘﻐﻴﺭ ﻓﻲ‬
‫ﺍﻟﺨﺼﺎﺌﺹ ﺍﻟﺜﻘﺎﻓﻴﺔ ﻭﺯﻴﺎﺩﺓ ﻤﺭﻜﺒﺎﺕ ﺍﻟﻨﻘل ﺍﻷﺜﺭ ﻓﻲ ﺯﻴﺎﺩﺓ ﺤﻭﺍﺩﺙ ﺍﻟﻁﺭﻕ ﻭﺍﻹﺼﺎﺒﺎﺕ‪.‬‬

‫ﻭﻗﺩ ﺸﻜﻠﺕ ﺤﻭﺍﺩﺙ ﺍﻟﻁﺭﻕ ‪ 17‬ﺤﺎﻟﺔ ﻭﻓﺎﺓ ﻟﻜل ‪ 100000‬ﻤﻥ ﺍﻟﺴﻜﺎﻥ ﺒﺩﺒﻲ ﻓﻲ ﻋﺎﻡ ‪ 2006‬ﻭ‬
‫ﻜﺎﻨﺕ ﻨﺴﺒﺔ ﻭﻓﻴﺎﺕ ﺍﻟﺤﻭﺍﺩﺙ ﻭﺍﻟﺴﻤﻭﻡ ‪ %10.5‬ﻤﻥ ﻤﺠﻤل ﺍﻟﻭﻓﻴﺎﺕ ﺒﺩﺒﻲ ﻓﻲ ﻋﺎﻡ ‪ 2005‬ﻜﻤﺎ‬
‫ﻜﺎﻨﺕ ﺍﻟﺤﻭﺍﺩﺙ ﺍﻜﺒﺭ ﻤﺴﺒﺒﺎﺕ ﺍﻟﻭﻓﻴﺎﺕ ﻓﻲ ﺍﻟﻤﺠﻤﻭﻋﺔ ﺍﻟﻌﻤﺭﻴﺔ ‪ 25-15‬ﻋﺎﻤﺎ‪ .‬ﻭﺇﺤﺴﺎﺴﺎ ﻤﻥ ﺴﻤﻭ‬
‫ﺍﻟﺸﻴﺦ ﻤﺤﻤﺩ ﺒﻥ ﺭﺍﺸﺩ ﺁل ﻤﻜﺘﻭﻡ ﺒﺄﻫﻤﻴﺔ ﻫﺫﺍ ﺍﻟﻤﻭﻀﻭﻉ ﻓﻘﺩ ﺘﻡ ﺇﺼﺩﺍﺭ ﺃﻤﺭ ﻟﺸﺭﻁﺔ ﺩﺒﻲ ﺒﺘﻨﻅﻴﻡ‬
‫ﺤﻤﻠﺔ ﻤﺭﻭﺭﻴﺔ ﻟﻠﺤﺩ ﻤﻥ ﺤﻭﺍﺩﺙ ﺍﻟﻁﺭﻕ ﺒﺩﺒﻲ‪.‬‬

‫ﺍﻟﻬﺩﻑ ﻤﻥ ﺍﻟﺩﺭﺍﺴﺔ‬
‫ﺩﺭﺍﺴﺔ ﺃﺜﺭ ﺍﻟﺤﻤﻠﺔ ﺍﻟﻤﺭﻭﺭﻴﺔ ﺒﺈﻤﺎﺭﺓ ﺩﺒﻲ ﻋﻠﻰ ﺇﺼﺎﺒﺎﺕ ﺍﻟﺤﻭﺍﺩﺙ ﺒﺩﺒﻲ‪.‬‬

‫ﻁﺭﻴﻘﺔ ﺍﻟﺩﺭﺍﺴﺔ‬
‫ﺍﻟﺩﺭﺍﺴﺔ ﺃﺴﺎﺴﺎ ﺍﺴﺘﺭﺠﺎﻋﻴﺔ ﻟﺤﺎﻻﺕ ﺇﺼﺎﺒﺎﺕ ﺍﻟﻁﺭﻕ ﺍﻟﺘﻲ ﺭﺍﺠﻌﺕ ﺩﺍﺌﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺨﺩﻤﺎﺕ‬
‫ﺍﻟﻁﺒﻴﺔ ﺒﺩﺒﻲ ﻓﻲ ﺍﻟﻔﺘﺭﺓ ﻤﻥ ﻨﻭﻓﻤﺒﺭ ‪ 2006‬ﻭﺤﺘﻰ ﻓﺒﺭﺍﻴﺭ ‪ 2007‬ﻭﻗﺩ ﺘﻡ ﺃﺨﺫ ﻋﻴﻨﺔ ﻤﻘﺎﺭﻨﺔ ﻟﻨﻔﺱ‬
‫ﺍﻟﻔﺘﺭﺓ ﻤﻥ ﺍﻟﻌﺎﻡ ﺍﻟﻤﺎﻀﻲ )ﻨﻭﻓﻤﺒﺭ ‪ -2005‬ﻓﺒﺭﺍﻴﺭ‪ (2006‬ﻭﻜﺎﻨﺕ ﺍﻟﺒﻴﺎﻨﺎﺕ ﺍﻷﺴﺎﺴﻴﺔ ﻫﻲ ﺍﻟﻌﻤﺭ‬
‫ﻭﺍﻟﻨﻭﻉ ﻭﺍﻟﺠﻨﺴﻴﺔ‪.‬‬

‫‪141‬‬
 ‫ﺍﻟﻨﺘﺎﺌﺞ‬
‫ﺒﻠﻎ ﻋﺩﺩ ﺍﻹﺼﺎﺒﺎﺕ ﺍﻟﺘﻲ ﺭﺍﺠﻌﺕ ﺩﺍﺌﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻁﺒﻴﺔ ﺒﺩﺒﻲ ﻓﻲ ﺍﻟﻔﺘﺭﺓ ﻤﻥ ﺃﻭل‬
‫ﻨﻭﻓﻤﺒﺭ ‪ 2006‬ﻭﺤﺘﻰ ‪ 26‬ﻓﺒﺭﺍﻴﺭ ‪ 1884 ،2007‬ﺤﺎﻟﺔ ﻤﻘﺎﺭﻨﺔ ﺒﻌﺩﺩ ‪ 2497‬ﻓﻲ ﻨﻔﺱ ﺍﻟﻔﺘﺭﺓ‬
‫)ﻨﻭﻓﻤﺒﺭ ‪ 2005‬ﻭﺤﺘﻰ ‪ 26‬ﻓﺒﺭﺍﻴﺭ ‪ (2007‬ﻤﻥ ﺍﻟﻌﺎﻡ ﺍﻟﻤﺎﻀﻲ ﻭﺒﻤﻌﺩل ﺍﻨﺨﻔﺎﺽ ‪ %25‬ﺃﻱ ﻗﻠﺕ‬
‫ﺍﻹﺼﺎﺒﺎﺕ ﺇﻟﻰ ‪ %75‬ﻤﻥ ﻗﻴﻤﺘﻬﺎ ﻓﻲ ﻨﻔﺱ ﺍﻟﻔﺘﺭﺓ ﻤﻥ ﺍﻟﻌﺎﻡ ﺍﻟﻤﺎﻀﻲ ﻭﻜﺎﻥ ﻤﻌﺩل ﺍﻹﺼﺎﺒﺔ ﺍﻟﻴﻭﻤﻲ‬
‫‪ 16.1‬ﺇﺼﺎﺒﺔ ﺒﻌﺩ ﺘﻁﺒﻴﻕ ﺍﻟﺤﻤﻠﺔ ﺍﻟﻤﺭﻭﺭﻴﺔ ﻤﻘﺎﺭﻨﺔ ﺒﻌﺩﺩ ‪ 21.3‬ﺇﺼﺎﺒﺔ ﻟﻨﻔﺱ ﺍﻟﻔﺘﺭﺓ ﻤﻥ ﺍﻟﻌﺎﻡ‬
‫ﺍﻟﻤﺎﻀﻲ‪) .‬ﺠﺩﻭل ﺭﻗﻡ ‪ 1‬ﻭ ﺸﻜل ﺭﻗﻡ ‪1‬ﺃ ‪1 ،‬ﺏ(‬

‫ﻫﺫﺍ ﻭﻗﺩ ﺍﻨﺨﻔﻀﺕ ﺍﻟﻨﺴﺒﺔ ﺇﻟﻰ ‪ %27‬ﺒﻴﻥ ﺍﻟﻤﻭﺍﻁﻨﻴﻥ ﻭ ‪ %24.2‬ﺒﻴﻥ ﻏﻴﺭ ﺍﻟﻤﻭﻁﻨﻴﻥ ﻭﺒﺩﻭﻥ‬
‫ﻓﺭﻭﻕ ﺠﻭﻫﺭﻴﺔ ﺤﻴﺙ ﺍﻨﺨﻔﺽ ﻋﺩﺩ ﺍﻹﺼﺎﺒﺎﺕ ﻤﻥ ‪ 319‬ﺒﻴﻥ ﺍﻟﻤﻭﺍﻁﻨﻴﻥ ﻓﻲ ﺍﻟﻔﺘﺭﺓ ﻤﻥ ﻨﻭﻓﻤﺒﺭ‬
‫‪ - 2005‬ﻓﺒﺭﺍﻴﺭ ‪ 2006‬ﺇﻟﻰ ‪ 233‬ﺤﺎﻟﺔ ﺒﻌﺩ ﺘﻁﺒﻴﻕ ﺍﻟﺤﻤﻠﺔ ﻭﻤﻥ ‪ 2178‬ﺇﻟﻰ ‪ 1651‬ﺤﺎﻟﺔ ﺒﻴﻥ‬
‫ﻏﻴﺭ ﺍﻟﻤﻭﺍﻁﻨﻴﻥ‪) .‬ﺠﺩﻭل ﺭﻗﻡ ‪ 1‬ﻭ ﺸﻜل ﺭﻗﻡ ‪(2‬‬

‫ﻭﻗﺩ ﺍﻨﺨﻔﻀﺕ ﺍﻹﺼﺎﺒﺎﺕ ﺒﻴﻥ ﺍﻹﻨﺎﺙ ﻤﻥ ‪ 518‬ﺤﺎﻟﺔ ﻗﺒل ﺘﻁﺒﻴﻕ ﺍﻟﺤﻤﻠﺔ ﺇﻟﻰ ‪ 366‬ﺒﻌﺩ ﺘﻁﺒﻴﻕ‬
‫ﺍﻟﺤﻤﻠﺔ )‪ (%29.3‬ﺒﻴﻨﻤﺎ ﻜﺎﻨﺕ ﺍﻟﻨﺴﺒﺔ ﺒﻴﻥ ﺍﻟﺫﻜﻭﺭ ‪) .%23.3‬ﺠﺩﻭل ﺭﻗﻡ ‪(1‬‬

‫ﻭ ﻴﻅﻬﺭ ﺍﻟﺸﻜل ﺭﻗﻡ ‪ 3‬ﻭ ﺍﻟﺠﺩﻭل ﺭﻗﻡ ‪ 1‬ﺃﻥ ﺍﻟﻤﺠﻤﻭﻋﺔ ﺍﻟﻌﻤﺭﻴﺔ ‪ 25-15‬ﻋﺎﻤﺎ ﻜﺎﻨﺕ ﺃﻜﺜﺭ‬
‫ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﻌﻤﺭﻴﺔ ﺘﺄﺜﺭﺍ ﺒﺎﻟﺤﻤﻼﺕ ﺍﻟﻤﺭﻭﺭﻴﺔ ﺇﺫ ﺍﻨﺨﻔﻀﺕ ﺍﻟﻨﺴﺒﺔ ﺒﻌﺩ ﺍﻟﺤﻤﻠﺔ ﺇﻟﻰ ‪ 35.5%‬ﻤﻥ‬
‫ﻗﻴﻤﺘﻬﺎ ﻓﻲ ﺍﻟﻌﻴﻨﺔ ﺍﻟﻤﻘﺎﺭﻨﺔ ﻤﻥ ﺍﻟﻌﺎﻡ ﺍﻟﻤﺎﻀﻲ ﻭ ﻜﺎﻥ ﻫﺫﺍ ﺍﻟﻔﺭﻕ ﺠﻭﻫﺭﻴﺎ‪.‬‬

‫ﺍﻟﺨﻼﺼﺔ‪:‬‬
‫‪ .1‬ﺃﻅﻬﺭﺕ ﺍﻟﺩﺭﺍﺴﺔ ﺍﻨﺨﻔﺎﻀﺎ ﺒﻌﺩﺩ ﺤﺎﻻﺕ ﺇﺼﺎﺒﺎﺕ ﺍﻟﻁﺭﻕ ﺒﺩﺒﻲ ﺒﻌﺩ ﺘﻁﺒﻴﻕ ﺍﻟﺤﻤﻼﺕ‬
‫ﺍﻟﻤﺭﻭﺭﻴﺔ ﺒﻤﻘﺩﺍﺭ ‪ %25‬ﻋﻥ ﺍﻟﻌﻴﻨﺔ ﺍﻟﻤﻘﺎﺭﻨﺔ ﻤﻥ ﺍﻟﻌﺎﻡ ﺍﻟﻤﺎﻀﻲ‪.‬‬

‫‪142‬‬
 ‫‪ .2‬ﻜﺎﻥ ﺍﻻﻨﺨﻔﺎﺽ ﺃﻜﺜﺭ ﺒﻴﻥ ﺍﻹﻨﺎﺙ ﻭﺍﻟﻤﻭﺍﻁﻨﻴﻥ ﻭﺍﻟﻤﺠﻤﻭﻋﺔ ﺍﻟﻌﻤﺭﻴﺔ ‪ 25-15‬ﻋﺎﻤﺎ‪.‬‬
‫ﺍﻟﺘﻭﺼﻴﺎﺕ‪:‬‬
‫‪ .1‬ﻤﺎ ﺯﺍل ﻫﻨﺎﻙ ﺤﺎﺠﺔ ﺇﻟﻰ ﺍﺴﺘﻤﺭﺍﺭ ﺍﻟﺤﻤﻼﺕ ﺍﻟﻤﺭﻭﺭﻴﺔ ﺒﺩﺒﻲ‬
‫‪ .2‬ﺘﻘﻭﻴﺔ ﺍﻟﺘﻌﺎﻭﻥ ﺒﻴﻥ ﺍﻟﺩﻭﺍﺌﺭ ﺒﺩﺒﻲ ﻭ ﺘﻨﺴﻴﻕ ﺍﻟﺠﻬﻭﺩ ﻤﻥ ﺍﺠل ﻤﻜﺎﻓﺤﺔ ﺤﻭﺍﺩﺙ ﺍﻟﻁﺭﻕ‬

‫‪143‬‬
‫ﺟﺪول رﻗﻢ )‪ ( 1‬ﺗﻮزﻳﻊ إﺻﺎﺑﺎت اﻟﻄﺮق اﻟﺘﻲ راﺟﻌﺖ داﺋﺮة اﻟﺼﺤﺔ و اﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﻗﺒﻞ و ﺑﻌﺪ اﻟﺤﻤﻠﺔ اﻟﻤﺮو‬

‫ﺑﻌﺪ اﻟﺤﻤﻠﺔ‬ ‫ﻗﺒﻞ اﻟﺤﻤﻠﺔ‬

‫اﻟﻔﺮق)‬ ‫اﻟﻌﺎﻣﻞ‬
‫ﻧﻮﻓﻤﺒﺮ ‪ -2006‬ﻓﺒﺮاﻳﺮ ‪2007‬‬ ‫ﻧﻮﻓﻤﺒﺮ ‪ -2005‬ﻓﺒﺮاﻳﺮ ‪2006‬‬
‫‪.00%‬‬ ‫‪1884‬‬ ‫‪2497‬‬ ‫ﻋﺪد اﻹﺻﺎﺑﺎت‬
‫‪.00%‬‬ ‫‪16.1‬‬ ‫‪21.3‬‬ ‫ﻣﻌﺪل اﻹﺻﺎﺑﺔ اﻟﻴﻮﻣﻲ‬

‫اﻟﺠﻨﺴﻴﺔ‬
‫‪.00%‬‬ ‫‪233‬‬ ‫‪319‬‬ ‫اﻟﻤﻮاﻃﻨﻮن‬
‫‪.25%‬‬ ‫‪1651‬‬ ‫‪2178‬‬ ‫ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ‬

‫اﻟﻨﻮع‬
‫‪.30%‬‬ ‫‪1518‬‬ ‫‪1975‬‬ ‫اﻟﺬآﻮر‬
‫‪.30%‬‬ ‫‪366‬‬ ‫‪518‬‬ ‫اﻹﻧﺎث‬

‫اﻟﺴﻦ *‬
‫‪.80%‬‬ ‫‪117‬‬ ‫‪169‬‬ ‫ﺗﺤﺖ ‪ 15‬ﻋﺎﻣﺎ‬
‫‪.70%‬‬ ‫‪447‬‬ ‫‪695‬‬ ‫‪15-24‬‬
‫‪.40%‬‬ ‫‪1096‬‬ ‫‪1344‬‬ ‫‪25-44‬‬
‫‪.50%‬‬ ‫‪224‬‬ ‫‪289‬‬ ‫و أآﺜﺮ ﻋﺎﻣﺎ‪45‬‬

‫اﻟﻔﺮق ﺟﻮهﺮي )‪* (P=0.01‬‬

‫‪144‬‬
 ‫ﺷﻜﻞ رﻗﻢ‪-1-‬أ‬
‫ﻣﻌﺪل اﻻﺻﺎﺑﺔ اﻟﻴﻮﻣﻰ ﻻﺻﺎﺑﺎت ﺣﻮادث اﻟﻄﺮق اﻟﺘﻰ راﺟﻌﺖ داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻰ‬

‫‪21.3‬‬
‫‪25‬‬

‫‪16.1‬‬
‫‪20‬‬

‫‪15‬‬

‫اﻟﻌﺪد‬
‫‪10‬‬

‫‪5‬‬

‫‪0‬‬

‫ﻧﻮﻓﻤﺒﺮ ‪- 2005‬ﻓﺒﺮاﻳﺮ ‪2006‬‬ ‫ﻧﻮﻓﻤﺒﺮ ‪- 2006‬ﻓﺒﺮاﻳﺮ ‪2007‬‬

‫اﻟﻔﺘﺮة‬

‫‪145‬‬
 ‫ﺷﻜﻞ رﻗﻢ‪-1-‬ب‬
‫ﺗﻮزﻳﻊ اﺻﺎﺑﺎت اﻟﻄﺮق ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻰ ‪2007- 2005‬‬
‫‪800‬‬

‫‪718‬‬
‫‪700‬‬ ‫‪685‬‬

‫‪600‬‬
‫‪580‬‬
‫‪500‬‬
‫‪528‬‬ ‫‪514‬‬
‫‪455‬‬ ‫‪472‬‬
‫‪429‬‬
‫‪ 400‬اﻟﻌﺪد‬
‫‪300‬‬

‫‪200‬‬

‫‪100‬‬

‫‪0‬‬

‫ﻧﻮﻓﻤﺒﺮ‬ ‫دﻳﺴﻤﺒﺮ‬ ‫ﻳﻨﺎﻳﺮ‬ ‫ﻓﺒﺮاﻳﺮ‬

‫اﻟﺸﻬﺮ‬

‫ﻗﺒﻞ اﻟﺤﻤﻠﺔ‬ ‫ﺑﻌﺪ اﻟﺤﻤﻠﺔ‬

‫‪146‬‬
 ‫ﺗﻮزﻳﻊ اﺻﺎﺑﺎت اﻟﻄﺮق اﻟﺘﻰ راﺟﻌﺖ داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻰ ﺑﺎﻟﺠﻨﺴﻴﺔ‬ ‫ﺷﻜﻞ رﻗﻢ‪2-‬‬

‫‪2500‬‬
‫‪2178‬‬

‫‪2000‬‬
‫‪1651‬‬

‫‪1500‬‬

‫اﻟﻌﺪد‬
‫‪1000‬‬

‫‪319‬‬
‫‪500‬‬ ‫‪233‬‬

‫‪0‬‬

‫اﻟﻤﻮاﻃﻨﻴﻦ‬ ‫ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ‬

‫اﻟﺠﻨﺴﻴﺔ‬
‫ﻧﻮﻓﻤﺒﺮ ‪- 2005‬ﻓﺒﺮاﻳﺮ ‪2006‬‬ ‫ﻧﻮﻓﻤﺒﺮ ‪- 2006‬ﻓﺒﺮاﻳﺮ ‪2007‬‬

‫‪147‬‬
 Eye Diseases in Dubai
Table (1) shows that disorder of conjunctiva amounted to about one half of eye cases
(45.73%) attended specialist clinics in DOHMS, Dubai 1999-2006, disorders of ocular
muscles, accommodation and refraction (35.32%), disorders of eyelid and lachrymal
system 10.21%, disorders of lens 5.79% and other disorders of eye and adnexa 2.95%.

The percentage of eye diseases attending outpatient clinics in private health sector
was 16% among Arabs, 35% among Asians, 13% among other nationalities and 36%
of Emirate population. Male percentage was more among Asians (42.0%) and females
(43.0%) among Emirates, Table (2).

Figure (1) shows the age distribution of disorders of eye and adnexa, The percentage
was 10% among those below 15 years, 11% in the age group 15-24 years, 30% in the
age group 25-44 years and about half the cases (49%) were 45 years and above.

Disorders of Conjunctiva amounted to 19% of all eye and adnexa disorders among
cases attending private health sector clinics in Dubai 2004-2006. Disorders of eyelid
and lachrymal system 9%, disorders of lens 7%, Table (3).

148
 ‫أﻣﺮاض اﻟﻌﻴﻮن ﺑﺪﺑﻲ‬

‫ﻳﻈﻬ ﺮ اﻟﺠ ﺪول رﻗ ﻢ )‪ (1‬أن اﻋ ﺘﻼل اﻟﻤﻠﺘﺤﻤ ﺔ ﺗ ﺸﻜﻞ ﺣ ﻮاﻟﻲ ﻧ ﺼﻒ ﺣ ﺎﻻت اﻟﻌﻴ ﻮن )‪ (%45.73‬ﻣ ﻦ ﻣﺮاﺟﻌ ﺎت‬
‫ﻋﻴ ﺎدات اﻷﺧ ﺼﺎﺋﻴﻴﻦ ﺑ ﺪاﺋﺮة اﻟ ﺼﺤﺔ ﺑ ﺪﺑﻲ ﻓ ﻲ اﻟﻔﺘ ﺮة ﻣ ﻦ ‪ 2006 – 1999‬آﻤ ﺎ آﺎﻧ ﺖ اﻋ ﺘﻼل ﻋ ﻀﻼت اﻟﻌ ﻴﻦ‬
‫واﻟﺘﻜﻴ ﻒ واﻻﻧﺤﺮاﻓ ﺎت ‪ %35.32‬واﻋ ﺘﻼﻻت ﺟﻔ ﻦ اﻟﻌ ﻴﻦ واﻟﺠﻬ ﺎز اﻟ ﺪﻣﻌﻲ ‪ %10.21‬واﺿ ﻄﺮاﺑﺎت ﻋﺪﺳ ﺔ اﻟﻌ ﻴﻦ‬
‫‪ %5.79‬واﻻﺿﻄﺮاﺑﺎت اﻷﺧﺮى ﻟﻠﻌﻴﻦ ‪.%2.95‬‬

‫آﻤﺎ آﺎﻧﺖ ﻧﺴﺒﺔ ﺣﺎﻻت أﻣﺮاض اﻟﻌﻴﻦ اﻟﻤﺮاﺟﻌﺔ ﻟﻠﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﻟﻠﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨ ﺎص ﺑ ﺪﺑﻲ ﺑﺎﻟﺠﻨ ﺴﻴﺔ ‪%16‬‬
‫ﺑ ﻴﻦ اﻟﻌ ﺮب و ‪ %35‬ﺑ ﻴﻦ اﻵﺳ ﻴﻮﻳﻴﻦ ‪ %13‬ﺑ ﻴﻦ اﻟﺠﻨ ﺴﻴﺎت ‪ %36‬ﻟﻠﻤ ﻮاﻃﻨﻴﻦ‪ .‬وآﺎﻧ ﺖ ﻧ ﺴﺒﺔ اﻟ ﺬآﻮر ﻋﺎﻟﻴ ﺔ ﺑ ﻴﻦ‬
‫اﻵﺳﻴﻮﻳﻴﻦ )‪ (%42‬واﻟﺴﻴﺪات ﺑ ﻴﻦ اﻟﻤ ﻮﻃﻨﻴﻦ )‪ (%43‬ﺟ ﺪول رﻗ ﻢ )‪ .(2‬وﻳﻈﻬ ﺮ اﻟ ﺸﻜﻞ رﻗ ﻢ )‪ (1‬اﻟﺘﻮزﻳ ﻊ اﻟﻌﻤ ﺮي‬
‫ﻻﻋﺘﻼل اﻟﻌﻴﻦ و أن ‪ %10‬ﻣﻦ اﻟﺤﺎﻻت آﺎﻧﺖ ﺗﺤﺖ ‪ 10‬ﺳﻨﻮات ﻣﻦ اﻟﻌﻤﺮ‪ %11 ،‬ﻓﻲ اﻟﻤﺠﻤﻮﻋ ﺔ اﻟﻌﻤﺮﻳ ﺔ ‪24 -15‬‬
‫ﻋﺎﻣ ﺎ و ‪ %30‬ﻓﻴﻤ ﺎ ﺑ ﻴﻦ ‪ 44 -25‬ﻋﺎﻣ ﺎ وان ﺣ ﻮاﻟﻲ ﻧ ﺼﻒ اﻟﺤ ﺎﻻت )‪ (%49‬آﺎﻧ ﺖ ‪ 45‬ﻋﺎﻣ ﺎ وأآﺜ ﺮ ﻣ ﻦ اﻟﻌﻤ ﺮ‪.‬‬
‫وآﺎﻧﺖ اﻋﺘﻼل اﻟﻤﻠﺘﺤﻤﺔ ‪ %19‬ﻣﻦ ﺣﺎﻻت أﻣﺮاض اﻟﻌﻴﻮن اﻟﻤﺮاﺟﻌﺔ ﻟﻠﻌﻴ ﺎدات اﻟﺨﺎرﺟﻴ ﺔ ﻟﻠﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص‬
‫ﺑﺪﺑﻲ ﻓﻴﻤﺎ ﺑﻴﻦ ‪ 2006 – 2004‬وآﺎﻧﺖ اﺿﻄﺮاﺑﺎت ﺟﻔﻦ اﻟﻌﻴﻦ واﻟﺠﻬ ﺎز اﻟ ﺪﻣﻌﻲ ‪ %9‬واﻋ ﺘﻼل ﻋﺪﺳ ﺔ اﻟﻌ ﻴﻦ ‪،%7‬‬
‫ﺟﺪول رﻗﻢ )‪.(3‬‬

‫‪149‬‬
 Table (1) Frequency Distribution of Diseases of the Eye & Adnexa Attending
Specialist Clinics in DOHMS, Dubai, 1999-2006

Disorder %

Eyelid & Lacrimal System 10.21

Disorders of Conjunctiva 45.73

Sclera, Cornea, Iris & Ciliary body 2.25

Lens 5.79

Choroids & Retina 1.97

Glaucoma 3.26

Vitreous body & globe 0.31

Optic Nerve of visual pathways 0.45

Ocular muscles of Accommodation &
35.32
Refraction
Visual Disturbances & Blindness 4.37

Other Diseases of Eye & Adnexa 0.73

Total 100.00

150
 Table (2) Frequency Distribution of Outpatient Attendance for Private Health
Sector of Diseases of the Eye & Adnexa by Sex & Nationality, Dubai 2004-2006

Sex Total
Nationality
Males Females
No. % No. % No. %
Arabs 25419 16% 20652 16% 46071 16%

Asians 68480 42% 35087 27% 103567 35%

Others 18885 12% 19292 15% 38177 13%

UAE 49584 30% 57332 43% 106916 36%

Total 162368 100% 132363 100% 294731 100%

151
 Table (3) Distribution of Eye Cases Attending Private Sector Outpatient
Clinics in Dubai 2004 -2006

Disorders Frequency No. %

Eyelid, Lacrimal System & Orbit 25849 9%

Disorders of Conjunctiva 57053 19%
Lens 20696 7%
Glaucoma 18336 6%
Visual Disturbances & Blindness 6293 2%
Ocular muscles, Binocular Movement, Accommodation &
17967 6%
Refraction
Other Diseases of Eye & Adnexa 148537 50%
Total 294731 100%

152
 SSuurrggiiccaall O DO
Oppeerraattiioonn iinn D HM
OH MSS

Out of the 103244 surgical operations and procedures coded in DOHMS, Dubai
2001-2006, 37163 (36.00%) were Emirates. The percentage was nearly the same in
both males and females, Table (1). There is a steady increase in the number of coded
surgical operations by year of admission, (62.6% increase in 2006), Table (2).
Studying the distribution by specialty, Obstetric and gynecology constituted 28.5% of
all surgical operations and procedures, surgery 12.29%, trauma 9.56% and oncology
9.38%, Table (3). Episiotomy occupied the top of the 15 surgical operations and
procedures in DOHMS (8.3%), cesarean section (8.15%), Evacuation of products of
conception from uterus 6.87%, Table (4).

As for the length of stay in hospital, neurosurgery had the highest length of stay
(24.75 days), followed by trauma surgery (15.99) and cardiac surgery 12.8 days. The
least was gynecology (2.85) and ENT 2.34 days, Table (5).
General surgery amounted to 17.6% of all coded operations in DOHMS hospitals
(OPSC4), gynecology 28.24%, orthopedic and trauma surgery 10.58% of all coded
surgical operations, Table (6).

Studying surgical mortality in DOHMS hospitals during the period 2001-2006, there
were 459 deaths with a surgical mortality rate of 4.6 per 1000 operations. Rashid
hospital had a higher rate (11.0/1000 operation) than Dubai Hospital (2.5/1000) and
AlWasl Hospital (0.4/1000) with a significant difference, Table (7). There is increase
in surgical deaths by year of admission, Table (8).The rate of surgical deaths was 3.2
per 1000 among those below one year, 1.9 in the age group 1-4 years, 1.5 in the age
groups 5-14 years with a steady increase by age to reach 38.1 per 1000 among the
elderly age group (65 years and above), Table (9) Figure (1). The surgical mortality
rate was higher in males than females; Table10). Expatriates had a higher rate (5.4 per
1000) than Emirates 3.2, Table (11).

153
 ‫اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ‬

‫آ ﺎن هﻨ ﺎك ‪ 103244‬ﻋﻤﻠﻴ ﺔ ﺟﺮاﺣﻴ ﺔ وإﺟ ﺮاء ﺗ ﻢ ﺗﻜﻮﻳ ﺪهﺎ ﺑ ﺪاﺋﺮة اﻟ ﺼﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ ﺑ ﺪﺑﻲ ﻓ ﻲ اﻟﻔﺘ ﺮة ﻣ ﻦ‬
‫‪ 2006-2001‬وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﻤﻮاﻃﻨﻴﻦ ‪ %36‬وآﺎﻧﺖ اﻟﻨ ﺴﺒﺔ ﺗﻘﺮﻳﺒ ًﺎ ﻣﺘ ﺴﺎوﻳﺔ ﺑ ﻴﻦ اﻟ ﺬآﻮر واﻹﻧ ﺎث )ﺟ ﺪول رﻗ ﻢ ‪(1‬‬
‫وآﺎن هﻨﺎك زﻳﺎدة ﻓﻲ ﻋﺪد اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ اﻟﻤﻜﻮدة واﻹﺟﺮاءات ﺑﺴﻨﻮات اﻟﺪﺧﻮل ﺣﻴﺚ آﺎﻧ ﺖ اﻟﺰﻳ ﺎدة ‪%62.06‬‬
‫ﻓﻲ ﻋﺎم ‪ 2006‬ﻣﻘﺎرﻧﺔ ﺑﻌﺎم ‪) 2001‬ﺟﺪول رﻗﻢ ‪.(2‬‬

‫وﺑﺪراﺳ ﺔ ﺗﻮزﻳ ﻊ اﻟﺤ ﺎﻻت ﺑﺎﻟﺘﺨﺼ ﺼﺎت ﺑﺎﻟ ﺪاﺋﺮة ﻓﻘ ﺪ ﺷ ﻜﻠﺖ أﻣ ﺮاض اﻟﻨ ﺴﺎء واﻟ ﻮﻻدة ‪ %28.5‬ﻣ ﻦ آ ﻞ اﻟﻌﻤﻠﻴ ﺎت‬
‫اﻟﺠﺮاﺣﻴﺔ واﻹﺟ ﺮاءات واﻟﺠﺮاﺣ ﺔ اﻟﻌﺎﻣ ﺔ ‪ %12.29‬واﻟﺤ ﻮادث ‪ %9.56‬واﻟﻌ ﻼج اﻟﻜﻴﻤ ﺎوي ﻟﻠ ﺴﺮﻃﺎﻧﺎت ‪%9.38‬‬
‫)ﺟﺪول رﻗﻢ ‪ ،(3‬وﻗﺪ اﺣﺘﻞ اﻟﺸﻖ اﻟﺠﺮاﺣﻲ ﻟﻠﻤﻬﺒ ﻞ ﻗﺎﺋﻤ ﺔ اﻟﺨﻤ ﺴﺔ ﻋ ﺸﺮ ﻋﻤﻠﻴ ﺔ ﺟﺮاﺣﻴ ﺔ وإﺟ ﺮاء ﺑﺎﻟ ﺪاﺋﺮة )‪(%8.3‬‬
‫واﻟﻌﻤﻠﻴ ﺔ اﻟﻘﻴ ﺼﺮﻳﺔ )‪ (%8.15‬وﻋﻤﻠﻴ ﺎت آﺤ ﺖ اﻟ ﺮﺣﻢ وﺗﻔﺮﻳﻐ ﻪ ‪) %6.87‬ﺟ ﺪول رﻗ ﻢ ‪ .(4‬وﺑﺪراﺳ ﺔ ﻓﺘ ﺮة اﻟﺒﻘ ﺎء‬
‫ﺑﺎﻟﻤﺴﺘ ﺸﻔﻰ ﻓﻘ ﺪ آﺎﻧ ﺖ أﻋﻠ ﻰ اﻟﻔﺘ ﺮات ﻟﺠﺮاﺣ ﺔ اﻷﻋ ﺼﺎب )‪ 24.75‬ﻳﻮﻣ ًﺎ( وﺟﺮاﺣ ﺎت اﻟﺤ ﻮادث )‪ 15.99‬ﻳﻮﻣ ًﺎ(‬
‫وﺟﺮاﺣﺎت اﻟﻘﻠﺐ ‪ 12.8‬ﻳﻮﻣًﺎ( وآﺎﻧﺖ اﻗﻞ ﻓﺘﺮات اﻟﺒﻘﺎء ﺑﺎﻟﻤﺴﺘﺸﻔﻰ أﻣ ﺮاض اﻟﻨ ﺴﺎء واﻟ ﻮﻻدة )‪ 2.85‬ﻳﻮﻣ ًﺎ( واﻷﻧ ﻒ‬
‫واﻹذن واﻟﺤﻨﺠﺮة ‪ 2.34‬ﻳﻮﻣﺎ )ﺟﺪول رﻗﻢ ‪ .(5‬وﺑﺎﺳﺘﺨﺪام ﺗﻜﻮﻳ ﺪ اﻟﺠﺮاﺣ ﺎت واﻹﺟ ﺮاءات اﻟ ﺪاﺋﺮة )‪ (OPSC 4‬ﻓﻘ ﺪ‬
‫ﺷﻜﻠﺖ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﺔ ‪ %17.6‬وأﻣﺮاض اﻟﻨﺴﺎء واﻟﺘﻮﻟﻴ ﺪ ‪ %28.24‬وﺟﺮاﺣ ﺎت اﻟﻌﻈ ﺎم واﻟﺤ ﻮادث ‪ %10.58‬ﻣ ﻦ‬
‫ﻣﺠﻤﻮع اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ واﻹﺟﺮاءات اﻟﻤﻜﻮدة ﺑﺎﻟﺪاﺋﺮة )ﺟﺪول رﻗﻢ ‪.(6‬‬

‫وﺑﺪارﺳﺔ وﻓﻴﺎت اﻟﺠﺮاﺣﺔ ﺑﻤﺴﺘ ﺸﻔﻴﺎت اﻟ ﺪاﺋﺮة ﻓ ﻲ اﻟﻔﺘ ﺮة ‪ ،2006 –2001‬آ ﺎن هﻨ ﺎك ‪ 459‬ﺣﺎﻟ ﺔ وﻓ ﺎة وﺑﻌ ﺪل وﻓ ﺎة‬
‫‪ 4.6‬ﻓﻲ اﻷﻟﻒ‪ ،‬وآﺎﻧﺖ أﻋﻠﻰ اﻟﻤﻌﺪﻻت ﺑﻤﺴﺘﺸﻔﻰ راﺷﺪ )‪ 11.0‬ﻓﻲ اﻷﻟﻒ( ودﺑﻲ )‪ 2.5‬ﻓ ﻲ اﻷﻟ ﻒ( واﻟﻮﺻ ﻞ )‪0.4‬‬
‫ﻓﻲ اﻷﻟ ﻒ( وﺑﻔ ﺮق ﺟ ﻮهﺮي )ﺟ ﺪول رﻗ ﻢ ‪ .(7‬آﻤ ﺎ آ ﺎن هﻨ ﺎك زﻳ ﺎدة ﻓ ﻲ ﻣﻌ ﺪل اﻟﻮﻓﻴ ﺎت ﺑ ﺴﻨﻮات اﻟ ﺪﺧﻮل ﺑﺎﻟ ﺪاﺋﺮة‬
‫)ﺟﺪول رﻗﻢ ‪ ،(8‬وآﺎن ﻣﻌﺪل اﻟﻮﻓﻴ ﺎت )‪ 3.2‬ﻓ ﻲ اﻷﻟ ﻒ( ﺗﺤ ﺖ ﻋ ﺎم ﻣ ﻦ اﻟﻌﻤ ﺮ و ‪ 1.9‬ﻓ ﻲ اﻟﻤﺠﻤﻮﻋ ﺔ اﻟﻌﻤﺮﻳ ﺔ ‪4-1‬‬
‫ﺳﻨﻮات و ‪ 1.5‬ﻓﻲ اﻷﻟﻒ ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 5–14‬ﻋﺎﻣﺎ وﺑﺰﻳﺎدة ﻣﻄﺮدة ﺑﺎﻟﻌﻤﺮ ﻟﻴ ﺼﻞ إﻟ ﻰ ‪ 38.1‬ﻟﻜ ﻞ ‪1000‬‬
‫ﻋﻤﻠﻴﺔ ﺟﺮاﺣﻴﻦ وإﺟﺮاء ﺑﻴﻦ اﻟﻤﺴﻨﻴﻦ )‪ 65‬ﻋﺎﻣﺎ وأآﺜﺮ( )ﺷﻜﻞ رﻗﻢ ‪ (1‬و)ﺟﺪول رﻗ ﻢ ‪ ،(9‬ه ﺬا وآ ﺎن ﻣﻌ ﺪل اﻟﻮﻓﻴ ﺎت‬
‫اﻟﺠﺮاﺣﻴﺔ أﻋﻠﻰ ﻓﻲ اﻟﺬآﻮر ﻋﻦ اﻹﻧﺎث )ﺟﺪول رﻗﻢ ‪ (10‬آﻤﺎ آﺎن أﻋﻠﻰ ﺑﻴﻦ ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ )ﺟﺪول رﻗﻢ ‪.(11‬‬

‫‪154‬‬
Table (1) Distribution of Surgical Operations in DOHMS by Sex and
Nationality, Dubai 2001-2006

Sex Nationality Total

Emirate Expatriate
Female 21001 30138 51139
20.34 29.19 49.53
56.51 45.61
Male 16162 35943 52105
15.65 34.81 50.47
43.49 54.39
Total 37163 66081 103244
36.00 64.00 100.00

155
Table (2) Distribution of Surgical Operations in DOHMS by Year and
Nationality, Dubai 2001-2006

Nationality Total
Year Emirate Expatriate
Sex Sex
Female Male Female Male

2001 2298 1463 5055 4974 13790

2002 2435 1689 5181 5142 14447

2003 2831 2165 5366 5647 16009

2004 3634 2909 4269 6443 17255

2005 4631 3672 4713 6302 19318

2006 5172 4264 5554 7435 22425

Total 21001 16162 30138 35943 103244

156
Table (3) Distribution of Surgical Operations and Procedures in DOHMS by
Specialty, Dubai 2001-2006

Operation & Procedure Frequency Percent

Obstetric & Gynecology 29461 28.53

Surgery 12686 12.29
Trauma 9865 9.56
oncology 9683 9.38
ENT 6122 5.93
Ophthalmology 4576 4.45
Urology 4480 4.34
Pediatric Surgery 4223 4.09
Orthopedic surgery 1930 1.86
Neurosurgery 1713 1.66

157
 Table (4) Frequency of Top (15) Surgical Operations and Procedures Coded in
DOHMS, Dubai 2001-2006

Operation & Procedure Frequency Percent

(N = 103244)
Episiotomy (R27.1) 8573 8.30
Cesarean Section (R17-R18) 8415 8.15
Evacuation of Products of 7102 6.87
Conception from Uterus (Q11.Q3)
Circumcision (N30.4) 4641 4.5
Reduction Of Bones (W19-W24) 4480 4.33
Operations of Appendix (H2-H3) 3707 3.59
Repair of Hernia (T19-T27) 2798 2.71
Operations of Adenoid (E20) 2395 3.32
Lens Operation(C71-C81) 2385 2.31
Coronary Artery 1563 1.51
Operations(K41-K50)
Excision of gall bladder (J18) 1009 0.98
Operations of Gravid 729 0.71
Uterus(R12)
Restoration of Teeth (F13) 679 0.66
Operations of Breast (B27-B37) 645 0.62
Surgical Removal of Teeth 628 0.61
(F9-10)

158
Table (5) Mean Length of Stay of Surgical Operations in DOHMS by Specialty,
Dubai 2001-2006

Specialty Mean S. D Number

Cardiac Surgery 12.80 10.09 706

ENT 2.34 1.83 6122
Gynecology 2.85 4.59 10688
Neurosurgery 24.75 63.73 1713
Ophthalmology 4.91 5.56 4325
Orthopedic Surgery 12.00 19.37 1924
Oral Surgery 3.91 6.42 385
Pediatric Surgery 2.92 6.38 4223
Plastic Surgery 12.84 24.57 909
General Surgery 6.96 15.64 12686
Trauma 9.62 14.65 9865
Trauma Surgery 15.99 18.79 101
Urology 3.53 6.15 4480
Vascular Surgery 11.66 21.76 556

159
 Table (6) Distribution of Coded Surgical Operations and Procedures in
DOHMS by Specialty, Dubai 2001-2006

OPCS4 Frequency Percent

General Surgery 18168 17.60

Ophthalmology 4684 4.54
ENT 5132 4.97
Thoracic Surgery 7385 7.15
Vascular Surgery 1151 1.11
Neurosurgery 900 0.87
Urosurgery And Procedures 10007 9.69
Gynecology 29152 28.24
Plastic Surgery 3526 3.42
Orthopedic And Trauma Surgery 10928 10.58
Other 12211 11.83

160
 Table (7) Distribution of Surgical Deaths in DOHMS by Hospital,
Dubai 2001-2006

Hospital death Total

Discharged Dead
DH 57115 145 57260
99.75 0.25
RH 27660 308 27968
98.90 1.10
WH 14622 6 14628
99.96 0.04
Total 99397 459 99856

x2 = 360.98 P =0.0001

161
Table (8) Distribution of Surgical Deaths in DOHMS by Hospital,
Dubai 2001-2006
Year Discharges Total
Alive Dead
2001 12943 38 12981
99.71 0.29
2002 13790 57 13847
99.59 0.41
2003 15393 65 15458
99.58 0.42
2004 16559 75 16634
99.55 0.45
2005 18728 117 18845
99.38 0.62
2006 21984 107 22091
99.52 0.48
Total 99397 459 99856

x2 = 20.145 P = 0.0012

162
 Table (9) Distribution of Surgical Deaths in DOHMS by
Age Group, Dubai 2001-2006

Age Discharges Total

Alive Dead
<1 year 5286 17 5303
99.68 0.32
1- 5892 11 5903
99.81 0.19
5- 7152 11 7163
99.85 0.15
15- 13419 47 13466
99.65 0.35
25- 46274 163 46437
99.65 0.35
45- 19500 222 19722
98.87 1.13
65 & more 5045 200 5245
96.19 3.81
Total 102568 671 103239
2
X = 1020 P= 0.0001

163
 Figure (1) Surgical Mortality Rate in DOHMS by Age,
Dubai 2001-2006

45
40
35
30
Rate Per 1000

25
20
15
10
5
0
<1 1- 5- 15- 25- 45- 65+
Age Group

164
Table (10) Distribution of Surgical Deaths in DOHMS by
Sex, Dubai 2001-2006

Sex Discharges Total

Alive Dead
Female 49228 129 49357
99.74 0.26
Male 50169 330 50499
99.35 0.65
Total 99397 459 99856

165
Table (11) Distribution of Surgical Deaths in DOHMS by
Nationality, Dubai 2001-2006

Nationality Discharge Total

Alive Dead
Emirate 35790 114 35904
99.68 0.32
Expatriate 63607 345 63952
99.46 0.54
Total 99397 459 99856
2
x = 24.75 P = 0.0001

166
 SSuurrggiiccaall M DO
Moorrttaalliittyy iinn D HM
OH MSS aass aann IInnddiiccaattoorr ooff H Quuaalliittyy
Hoossppiittaall Q

Context Surgical mortality rates are increasingly used to measure hospital quality. It
is not clear; however, how many hospitals in DOHMS have sufficient caseloads to
reliably identify quality problems.

Objective To determine whether the 6 operations for which mortality has been
advocated as a quality indicator by the Agency for Healthcare Research and Quality in
USA (coronary artery bypass graft [CABG] surgery, pancreatic resection, esophageal
resection, pediatric heart surgery, craniotomy, hip replacement) are performed
frequently enough to reliably identify hospitals with increased mortality rates.

Design and Setting The DOHMS average mortality rates and hospital caseloads of
the 6 operations were determined using the discharged Inpatient in DOHMS, 2001-
2006, and sample size calculations were performed to determine the minimum
caseload necessary to reliably detect increased mortality rates in poorly performing
hospitals. A six year hospital caseload was used for the baseline analysis, and poor
performance was defined as a mortality rate doubles the average in DOHMS.

Main Outcome Measure Proportion of hospitals in DOHMS that performed more

than the minimum caseload for each operation.

Results The DOHMS average mortality rates for the 6 procedures examined ranged
from 3.3% for hip replacement to 8.16% for craniotomy, Table (1). Minimum hospital
caseloads necessary to detect a doubling of the mortality rate were 33 cases for

167
craniotomy and 91 for hip replacement. For only craniotomy operation did the
hospitals in DOHMS exceed the minimum caseload and hip replacement (90.1%),
Table (2).

Conclusion Except for craniotomy surgery, the operations for which surgical
mortality has been advocated as a quality indicator is not performed frequently enough
in DOHMS to judge hospital quality.

168
 ‫اﻟﻮﻓﻴﺎت اﻟﺠﺮاﺣﻴﺔ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ آﻤﺆﺷﺮ ﻟﺠﻮدة اﻟﻤﺴﺘﺸﻔﻴﺎت‬

‫ﻣﻘﺪﻣﺔ ﺗﺴﺘﺨﺪم ﻣﻌﺪﻻت اﻟﻮﻓﻴﺎت اﻟﺠﺮاﺣﻴﺔ ﺑﺪرﺟﺔ آﺒﻴﺮة ﻟﻘﻴﺎس اﻟﺠﻮدة‪ ،‬وﺑﺎﻟﺮﻏﻢ ﻣﻦ ذﻟﻚ ﻓﺎﻧﻪ ﻣﻦ ﻏﻴﺮ اﻟﻮاﺿﺢ آ ﻢ‬
‫ﻋﺪد اﻟﻤﺴﺘﺸﻔﻴﺎت ﺑﺎﻟﺪاﺋﺮة اﻟﺘﻲ ﺑﻬﺎ ﻋﺒﺊ ﺣﺎﻻت ﺟﺮاﺣﻴﺔ آﺎﻓﻴﺔ ﺗﻌﻜﺲ ﺑﺼﺪق اﻟﺠﻮدة ﺑﺎﻟﻤﺴﺘﺸﻔﻴﺎت‪.‬‬

‫اﻟﻬ ﺪف ﺗﺤﺪﻳ ﺪ إذا ﻣ ﺎ آ ﺎن اﻟ ﺴﺖ ﻋﻤﻠﻴ ﺎت اﻟﺘ ﻲ ﺗﻌﻜ ﺲ اﻟﻮﻓﻴ ﺎت ﻓﻴﻬ ﺎ ﻣﺆﺷ ﺮًا ﻟﻠﺠ ﻮدة ﺗﺒﻌ ًﺎ ﻟﻮآﺎﻟ ﺔ ﺑﺤ ﻮث اﻟﺮﻋﺎﻳ ﺔ‬
‫اﻟ ﺼﺤﻴﺔ واﻟﺠ ﻮدة ﺑﺎﻟﻮﻻﻳ ﺎت اﻟﻤﺘﺤ ﺪة اﻷﻣﺮﻳﻜﻴ ﺔ )ﻋﻤﻠﻴ ﺎت اﻟ ﺸﺮﻳﺎن اﻟﺘ ﺎﺟﻲ ﻟﻠﻘﻠ ﺐ‪ ،‬اﻻﺳﺘﺌ ﺼﺎل ﻟﻠﺒﻨﻜﺮﻳ ﺎس‪،‬‬
‫اﻻﺳﺘﺌﺼﺎل اﻟﺠﺰﺋﻲ ﻟﻠﻤﺮئ‪ ،‬ﻋﻤﻠﻴﺎت اﻟﻘﻠﺐ ﻟﻸﻃﻔﺎل‪ ،‬ﻓ ﺘﺢ اﻟﺠﻤﺠﻤ ﺔ‪ ،‬اﺳ ﺘﺒﺪال ﻣﻔ ﺼﻞ اﻟ ﻮرك( ﺗﺠ ﺮى ﺑﺈﻋ ﺪاد آﺎﻓﻴ ﺔ‬
‫ﻟﺘﺤﺪﻳﺪ وﺑﻤﺼﺪاﻗﻴﺔ اﻟﻤﺴﺘﺸﻔﻴﺎت ذات اﻟﻮﻓﻴﺎت اﻟﻌﺎﻟﻴﺔ‪.‬‬

‫ﻃﺮﻳﻘﺔ اﻟﺒﺤﺚ ﺗﻢ ﺗﺤﺪﻳﺪ ﻣﻌﺪل اﻟﻮﻓﻴﺎت ﺑﻤﺴﺘﺸﻔﻴﺎت اﻟ ﺪاﺋﺮة وأﻋ ﺪاد اﻟﺤ ﺎﻻت اﻟﺠﺮاﺣﻴ ﺔ ﻟﺘﻠ ﻚ اﻟﻌﻤﻠﻴ ﺎت ﻣ ﻦ ﻣﺮﺿ ﻰ‬
‫اﻟﺨﺮوج ﻟﻠﺪاﺋﺮة ﻓﻲ اﻟﻔﺘﺮة ﻣﻦ ‪ ،2006-2001‬آﻤ ﺎ ﺗ ﻢ ﺣ ﺴﺎب ﺣﺠ ﻢ اﻟﻌﻴﻨ ﺔ ﻟﺘﺤﺪﻳ ﺪ اﻗ ﻞ اﻟﺤ ﺎﻻت اﻟﺠﺮاﺣﻴ ﺔ اﻟﻼزﻣ ﺔ‬
‫ﻟﺪارﺳ ﺔ زﻳ ﺎدة ﻣﻌ ﺪﻻت اﻟﻮﻓ ﺎة ﺑﺎﻟﻤﺴﺘ ﺸﻔﻴﺎت ذات اﻷداء اﻟﻤﺘ ﺪﻧﻲ‪ ،‬ه ﺬا وﻗ ﺪ اﺳ ﺘﺨﺪم ﻋﺒ ﺊ اﻟﺤ ﺎﻻت ﻓ ﻲ اﻟﻔﺘ ﺮة ﻣ ﻦ‬
‫‪ 2006-2001‬ﻟﻠﻘﻴﺎس واﻋﺘﺒﺮ اﻷداء اﻟﻤﺘﺪﻧﻲ ﺿﻌﻒ ﻣﻌﺪل اﻟﻮﻓﺎة ﺑﺎﻟﺪاﺋﺮة‪.‬‬

‫اﻟﻤﺤﺼﻠﺔ اﻷﺳﺎﺳﻴﺔ ﻗﻴﺎس ﻧﺴﺒﺔ اﻟﻤﺴﺘﺸﻔﻴﺎت ﺑﺎﻟﺪاﺋﺮة اﻟﺘﻲ ﺗﺠﺮى ﺑﻬﺎ ﻋﻤﻠﻴ ﺎت ﺟﺮاﺣﻴ ﺔ أآﺜ ﺮ ﻣ ﻦ اﻗ ﻞ ﻋﺒ ﺊ ﺣ ﺎﻻت‬
‫ﻟﻜﻞ ﻋﻤﻠﻴﺔ ﻣﻦ اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ اﻟﺴﻨﺔ‪.‬‬

‫ﻣ ﻦ ‪ %3.3‬ﻟﻌﻤﻠﻴ ﺎت اﺳ ﺘﺒﺪال ﻋﻈ ﻢ اﻟ ﻮرك إﻟ ﻰ ‪%8.16‬‬ ‫اﻟﻨﺘ ﺎﺋﺞ ﺗ ﺮاوح ﻣﻌ ﺪل اﻟﻮﻓﻴ ﺎت ﻟﻠﻌﻤﻠﻴ ﺎت اﻟﺠﺮاﺣﻴ ﺔ‬
‫ﻟﻌﻤﻠﻴﺎت ﻓﺘﺢ اﻟﺠﻤﺠﻤﺔ‪ ،‬وآﺎن ﻋﺒﺊ اﻟﺤﺎﻻت اﻟﻼزم ﻟﻤﻀﺎﻋﻔﺔ ﻣﻌﺪل اﻟﻮﻓﻴ ﺎت ‪ 33‬ﺣﺎﻟ ﺔ ﻟﻌﻤﻠﻴ ﺎت ﻓ ﺘﺢ اﻟﺠﻤﺠﻤ ﺔ و‪91‬‬
‫ﺣﺎﻟﺔ ﻟﻌﻤﻠﻴﺎت اﺳﺘﺒﺪال ﻋﻈﻢ اﻟﻮرك‪ ،‬وآﺎﻧﺖ ﻋﻤﻠﻴﺎت ﻓ ﺘﺢ اﻟﺠﻤﺠﻤ ﺔ ه ﻲ اﻟﻌﻤﻠﻴ ﺔ اﻟﺠﺮاﺣﻴ ﺔ اﻟﻮﺣﻴ ﺪة اﻟﺘ ﻲ ﺗﻌ ﺪت اﻗ ﻞ‬
‫ﻋﺒﺊ ﺣﺎﻻت واﺳﺘﺒﺪال ﻋﻈﻤﺔ اﻟﻔﺨﺬ ‪.%91.1‬‬

‫اﻟﺨﻼﺻﺔ ﻓﻴﻤﺎ ﻋﺪا ﻋﻤﻠﻴﺎت ﻓﺘﺢ اﻟﺠﻤﺠﻤﺔ ﻓﺎن اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ اﻟﺘﻲ ﺗﻌﺘﺒﺮ اﻟﻮﻓﻴﺎت ﻣﻨﻬﺎ ﻣﺆﺷ ﺮًا ﻟﻠﺠ ﻮدة ﻻﺗﺠ ﺮى‬
‫ﺑﺈﻋﺪاد ﺗﺴﻤﺢ ﻟﺘﻘﻴﻴﻢ آﻔﺎءة اﻟﻤﺴﺘﺸﻔﻴﺎت ﺑﺎﻟﺪاﺋﺮة‪.‬‬

‫‪169‬‬
 Table (1) Distribution of Advocated Operations as Indicators
of Hospital Quality, DOHMS, Dubai, 2001-2006
Operation Discharges Total
Dead Alive
Craniotomy 16 180 196
5.00 56.25 61.25
8.16 91.84
Hip Replacement 1 29 30
0.31 9.06 9.38
3.33 96.67
Pediatric Cardiac Surgery 0 33 33
0.00 10.31 10.31
0.00 100.00
Coronary Artery Bypass 0 54 54
Graph 0.00 16.88 16.88
0.00 100.00
Pancreatic resection 0 5 5
0.00 1.56 1.56
0.00 100.00
Esophageal resection 0 2 2
0.00 0.63 0.63
0.00 100.00
Total 17 303 320
5.31 94.69 100.00

170
 Table (2) Distribution of Advocated Operations as Indicators
of Hospital Quality, DOHMS, Dubai, 2001-2006

Operation Hospital Total

DH RH WH
Esophageal resection - 1 1 2
0.63

Pancreatic resection - 5 - 5
1.56

Pediatric Cardiac Surgery 29 4 - 33

10.31

Coronary Artery Bypass 48 5 1 54

Graph 16.88

Craniotomy - 196 - 196

61.25

Hip Replacement 2 28 - 30
9.38

Total 79 239 2 320

24.69 74.69 0.63 100.00

171
 Hospital Mortality in DOHMS Dubai 2000 -2006

Research has confirmed that the rate of mortality in hospitals for certain procedures
and conditions may be associated with quality of care. To assess the Quality of health
services, the crude hospital death rate should be calculated. Out of the 338652
inpatients in DOHMS in 2000 - 2006, it was possible to identify 4099 deaths with
crude hospital mortality rate of 11.9 / 1000 discharges. The rate was 11.1 among
Emirate population and 12.5 per thousand discharges among expatriate. This
difference is significant. (P=0.0001).Figure (1) shows that Rashid hospital had the
highest mortality rate. The standardized mortality ratio was 287.4. It was 228.2 for
Dubai Hospital, 350 for Rashid Hospital and 489 for Al Wasl Hospital.

Studying the rate among Emirate population, it was 17.6 among Emirate males and
7.9 per 1000 among females, Figure (2). This difference is significant (P= 0.0000).
Figure (3) shows that Emirate female inpatients had higher crude hospital death rate
than males except in the age groups 5-45 years. Studying the linear trend for crude
hospital mortality in DOHMS, it appears from Figure (4) that there was 24%
reduction in risk of hospital mortality in 2006 compared with 1995. Studying the
distribution of deaths among Emirate inpatients by cause, about one fourth of deaths
(24.4%) were due to diseases of the circulatory system, cancer (17.1%), congenital
anomalies and conditions originating in perinatal period (15.9%), infectious and
parasitic diseases (10.6%), respiratory diseases (7.3%), injuries and poisoning (4.7%),
and other causes of death (20.0%), Figure (5). Figure (6) shows that among Emirate
inpatients, cancer had the highest crude hospital mortality rate (117 per 1000
discharges, infection and parasitic diseases (74 / 1000), cardiovascular diseases (58 /
1000) congenital anomalies and conditions originating in perinatal period (22.8 /
1000), injuries and poisoning (14 / 1000) and Respiratory disease 15 per 1000
discharges.

172
 ‫ﻭﻓﻴــﺎﺕ ﺍﳌﺴﺘﺸﻔﻴــﺎﺕ ﺑﺪﺍﺋـــﺮﺓ ﺍﻟﺼﺤـــﺔ ﻭﺍﳋﺪﻣـــﺎﺕ ﺍﻟﻄﺒﻴـــﺔ‬

‫ﻟﺘﻘﻴﻴﻡ ﻜﻔﺎﺀﺓ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻴﺤﺘﺎﺝ ﺇﻟﻰ ﺤﺴﺎﺏ ﻭﻓﻴﺎﺕ ﺍﻟﻤﺴﺘﺸﻔﻴﺎﺕ ‪ .‬ﺒﻴﻥ ‪ 334652‬ﺤﺎﻟـﺔ ﺇﺩﺨـﺎل‬
‫ﺒﺩﺍﺌﺭﺓ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻁﺒﻴﺔ ﺒﺩﺒﻲ ﻓﻲ ﺍﻟﻔﺘﺭﺓ ﻤﻥ ‪ 2006-2000‬ﺃﻤﻜﻥ ﺍﻟﺘﻌﺭﻑ ﻋﻠﻰ ‪ 4099‬ﺤﺎﻟـﺔ‬
‫ﻭﻓﺎﺓ ﻭﺒﻤﻌﺩل ﻭﻓﻴﺎﺕ ﺨﺎﻡ ‪ 11.9‬ﻟﻜل ‪ 1000‬ﺤﺎﻟﺔ ﺨﺭﻭﺝ ﻭﻜﺎﻥ ﺃﻋﻠﻰ ﻤﻌﺩل ﺒﻤﺴﺘﺸﻔﻰ ﺭﺍﺸـﺩ )ﺸـﻜل‬
‫ﺭﻗﻡ ‪ . (1‬ﻭﻜﺎﻥ ﺍﻟﻤﻌﺩل ‪ 11.1‬ﻟﻠﻤﻭﺍﻁﻨﻴﻥ ﻭ ‪ 12.5‬ﺒﻴﻥ ﺤﺎﻻﺕ ﺍﻟﺨﺭﻭﺝ ﻟﻐﻴﺭ ﺍﻟﻤـﻭﺍﻁﻨﻴﻥ ﻭﻜـﺎﻥ ﻫـﺫﺍ‬
‫ﺍﻟﻔﺭﻕ ﺠﻭﻫﺭﻴﺎﹰ‪ ،‬ﻫﺫﺍ ﻭﻜﺎﻥ ﻤﻌﺩل ﺍﻟﻭﻓﻴﺎﺕ ﺍﻟﻤﻌﻴﺎﺭﻱ ‪ 287.4‬ﺤﻴﺙ ﻜﺎﻥ ‪ 228.2‬ﻟﻤﺴﺘﺸﻔﻰ ﺩﺒـﻲ ﻭ ‪350‬‬
‫ﻟﻤﺴﺘﺸﻔﻰ ﺭﺍﺸﺩ ﻭ ‪ 489‬ﻟﻤﺴﺘﺸﻔﻰ ﺍﻟﻭﺼل‪ ،‬ﻭﺒﺩﺭﺍﺴﺔ ﺍﻟﻤﻌﺩل ﺒﻴﻥ ﺍﻟﻤﻭﺍﻁﻨﻴﻥ ﻓﻘﺩ ﻜـﺎﻥ ﺍﻟﻤﻌـﺩل ‪17.6‬‬
‫ﻟﻠﻤﻭﺍﻁﻨﻴﻥ ﺍﻟﺫﻜﻭﺭ ﻭ ‪ 7.9‬ﻟﻺﻨﺎﺙ )ﺸﻜل ﺭﻗﻡ ‪ (2‬ﻭﻜﺎﻥ ﺍﻟﻔﺭﻕ ﺠﻭﻫﺭﻴﹰﺎ‪.‬‬

‫ﻭﻴﻅﻬﺭ ﺍﻟﺸﻜل ﺭﻗﻡ )‪ (3‬ﺃﻥ ﻭﻓﻴﺎﺕ ﺍﻟﻤﺴﺘﺸﻔﻴﺎﺕ ﻜﺎﻨﺕ ﺃﻋﻠﻰ ﺒﻴﻥ ﺍﻹﻨﺎﺙ ﺍﻟﻤﻭﺍﻁﻨﺎﺕ ﻋﻥ ﺍﻟﺫﻜﻭﺭ ﻓﻲ ﻜل‬
‫ﺍﻷﻋﻤﺎﺭ ﻤﺎﻋﺩﺍ ﺍﻟﻤﺠﻤﻭﻋﺔ ﺍﻟﻌﻤﺭﻴﺔ ‪ 45-5‬ﻋﺎﻤﹰﺎ‪.‬‬
‫ﻭﺒﺩﺭﺍﺴﺔ ﺍﻻﻨﺤﺩﺍﺭ ﺍﻟﺨﻁﻲ ﻟﻭﻓﻴﺎﺕ ﺍﻟﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺨﺎﻡ ﺒﺎﻟـﺩﺍﺌﺭﺓ ﻴﻅﻬـﺭ ﺍﻟـﺸﻜل ﺭﻗـﻡ )‪ (4‬ﺃﻥ ﻫﻨـﺎﻙ‬
‫ﺍﻨﺨﻔﺎﻀﺎﺕ ﻓﻲ ﺨﻁﻭﺭﺓ ﺍﻟﺘﻌﺭﺽ ﺇﻟﻰ ﻭﻓﻴﺎﺕ ﺍﻟﻤﺴﺘﺸﻔﻴﺎﺕ ﺒﻤﻘﺩﺍﺭ ‪ %24‬ﻓﻲ ﻋﺎﻡ ‪ 2006‬ﻤﻘﺎﺭﻨـﺔ ﺒﻌـﺎﻡ‬
‫‪.1995‬‬

‫ﻭﺒﺩﺭﺍﺴﺔ ﺘﻭﺯﻴﻊ ﺍﻟﻭﻓﺎﺓ ﺒﻴﻥ ﺤﺎﻻﺕ ﺍﻟﺨﺭﻭﺝ ﺍﻟﻤﻭﺍﻁﻨﻴﻥ ﺒﺎﻟﺴﺒﺏ ﻓﻘﺩ ﺸﻜﻠﺕ ﺃﻤﺭﺍﺽ ﺍﻟﺠﻬﺎﺯ ﺍﻟﺩﻭﺭﻱ ﺭﺒﻊ‬
‫ﺍﻟﺤﺎﻻﺕ ﺘﻘﺭﻴﺒﹰﺎ )‪ (%24.4‬ﻭﺍﻟﺘﺸﻭﻫﺎﺕ ﺍﻟﺨﻠﻘﻴﺔ ﻭﺤﺎﻻﺕ ﻤﺎ ﺤﻭل ﺍﻟﻭﻻﺩﺓ ‪ %15.9‬ﻭﺍﻟﺴﺭﻁﺎﻨﺎﺕ ‪%17.1‬‬
‫ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻌﺩﻴﺔ ‪ %10.6‬ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﺘﻨﻔﺴﻴﺔ ‪ %7.3‬ﻭﺍﻷﺫﻯ ﻭﺍﻟﺴﻤﻭﻡ ‪ %4.7‬ﻭﺍﻷﺴﺒﺎﺏ ﺍﻷﺨـﺭﻯ‬
‫ﻟﻠﻭﻓﺎﺓ ‪)%20.0‬ﺸﻜل ﺭﻗﻡ ‪. (5‬‬
‫‪.‬‬

‫ﻭﻴﻅﻬﺭ ﺍﻟﺸﻜل ﺭﻗﻡ )‪ (6‬ﺃﻥ ﺍﻟﺴﺭﻁﺎﻨﺎﺕ ﺘﺸﻜل ﺃﻋﻠﻰ ﻤﻌﺩل ﻭﻓﺎﺓ ﺒﻴﻥ ﺍﻟﻤﻭﺍﻁﻨﻴﻥ ‪ 117‬ﻟﻜل ‪ 1000‬ﺤﺎﻟـﺔ‬
‫ﺨﺭﻭﺝ ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻌﺩﻴﺔ ﻭﺍﻟﻁﻔﻴﻠﻴﺔ ‪ 74‬ﻟﻜل ‪ 1000‬ﻭﺃﻤﺭﺍﺽ ﺍﻟﻘﻠﺏ ﻭﺍﻷﻭﻋﻴـﺔ ﺍﻟﺩﻤﻭﻴـﺔ ‪ 58‬ﻟﻜـل‬
‫‪ 1000‬ﻭﺍﻟﺘﺸﻭﻫﺎﺕ ﺍﻟﺨﻠﻘﻴﺔ ﻭﺤﺎﻻﺕ ﻤﺎ ﺤـﻭل ﺍﻟـﻭﻻﺩﺓ ‪ %22.8‬ﻭﺍﻷﺫﻯ ﻭﺍﻟـﺴﻤﻭﻡ ‪ 14‬ﻟﻜـل ‪1000‬‬
‫ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﺘﻨﻔﺴﻴﺔ ‪ 15‬ﻟﻜل ‪ 1000‬ﺤﺎﻟﺔ ﺨﺭﻭﺝ‪.‬‬

‫‪173‬‬
 ‫‪Figure (1) Hospital Mortality in DOHMS, Dubai 2000- 2006‬‬
‫وﻓﻴﺎت اﻟﻤﺴﺘﺸﻔﻴﺎت ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻰ ﻓ ﻰ ﻋ ﺎم ‪2006-2000‬‬

‫‪25‬‬

‫‪20‬‬

‫‪CHMR /1000‬‬ ‫‪15‬‬

‫‪dIcharges‬‬
‫‪ 10‬ﻣﻌﺪل وﻓﻴﺎت اﻟﻤﺴﺘﺸﻔﻴﺎت‬

‫‪5‬‬

‫‪0‬‬
‫‪RH‬‬ ‫‪DH‬‬ ‫‪WH‬‬ ‫‪MKH‬‬
‫‪Hospital‬‬
‫اﻟﻤﺴﺘﺸﻔﻰ‬

‫‪174‬‬
 Figure (2) Crude Hospital Mortality Rate among Emirate
Inpatients by Sex, DOHMS, Dubai 2000-2006
‫وﻓﻴﺎت اﻟﻤﺴﺘﺸﻔﻴﺎت اﻟﺨﺎم ﺑﻴﻦ اﻟﻤﺮﺿﻰ اﻟﺪاﺧﻠﻴﻴﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ ﺑ ﺪاﺋﺮة اﻟﺼ ﺤﺔ‬
2006-2000 ‫واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻰ ﻓﻰ ﻋ ﺎم‬

18
16
Crude Hospital 14
12
Mortality
10
Rate/1000
8
Discharges
6
‫ ﻣﻌﺪل وﻓﻴﺎت اﻟﻤﺴﺘﺸﻔﻴﺎت‬4
2
0
Males Females

Sex
‫اﻟﻨ ﻮع‬

175
 Figure (3) Distribution of Hospital Mortality Rate among
Inpatients in DOHMS By Age and Sex , Dubai 2000 -2006

200

150
CHMR

Male
100
Fem ale
50

0
<1 1- 5- 25- 35- 45- 55- 65+
Age Group

176
 Table (4) Linear Trend for Crude Hospital Mortality Rate in
DOHMS Dubai ,UAE 1995- 2006

1.2

0.8
Odds Ratio

0.6

0.4

0.2

0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Year

177
 Figure (5) Distribution of Deaths among Emirate Inpatients by Cause of
Death in DOHMS, Dubai, UAE 2000- 2006
‫ﺗﻮزﻳﻊ اﻟﻮﻓﻴﺎت ﺑﻴﻦ اﻟﻤﺮﺿﻰ اﻟﺪاﺧﻠﻴﻴﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ ﺑﺴ ﺒﺐ اﻟﻮﻓ ﺎة ﺑ ﺪاﺋﺮة اﻟﺼ ﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ‬
2006-2000 ‫ﺑﺪﺑﻰ ﻓﻰ ﻋ ﺎم‬

Others

RS
Cause of Death ‫ﺳﺒﺐ اﻟﻮﻓﺎة‬

CA&PP

Inf & PD

Inj &Pois

Cancer

CVD

0 5 10 15 20 25

178
 Comparative Study of Hospital Mortality in DOHMS, Dubai 2000 -2006

The study was carried out with the aim of studying the nature of hospital mortality in
the Department of Health and Medical Services (DOHMS), Dubai, UAE. The
information was collected from the electronic network of health information system in
DOHMS. Retrospective case series discharged during the period 2000 -2006 were
reviewed. Basic data were age, sex, nationality, diagnosis, outcome at discharge and
month of admission. Crude odds ratio was calculated. Logistic regression model was
applied for assessing the independent influence of each variable on mortality. Table
(1) shows that the hospital mortality rate (HMR) was 1.8% among males and 0.8%
among females. This difference is significant (P=0.04). There was a significant
difference in the HMR by age, nationality, hospital, year of discharge and by
Diagnosis Studying the risk factors for mortality in DOHMS hospitals.

Table (2) shows that those aged 55 years and above, Emirate inpatients, males,
inpatients in Rashid hospitals, ever married inpatients and those discharged before
2005 had higher risk of mortality than relevant categories. Applying logistic
regression analysis to assess the independent influence of each variable on death,
adjusted risks associated with those aged 55 years and above Emirate inpatients,
males, inpatients in Rashid hospitals, ever married and those discharged before 2005
were significantly increased compared to the relevant categories, Table (3).

179
 ‫دراﺳﺔ ﻣﻘﺎرﻧﺔ ﻟﻮﻓﻴﺎت اﻟﻤﺴﺘﺸﻔﻴﺎت ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬
‫‪2006 - 2000‬‬

‫أﺟﺮﻳﺖ هﺬﻩ اﻟﺪراﺳﺔ ﺑﻬﺪف دراﺳﺔ ﻃﺒﻴﻌﺔ وﻓﻴﺎت اﻟﻤﺴﺘﺸﻔﻴﺎت ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ ﻓ ﻲ‬
‫اﻟﻔﺘﺮة ﻣﺎ ﺑﻴﻦ ‪ 2006 - 2000‬ﺑﺪﺑﻲ ﺑﺎﻹﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة‪.‬وآﺎﻧ ﺖ اﻟﺪراﺳ ﺔ أﺳﺎﺳ ًﺎ اﺳ ﺘﺮﺟﺎﻋﻴﺔ‬
‫ﻟﺤﺎﻻت أﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴ ﺔ اﻟﺪﻣﻮﻳ ﺔ وﻗ ﺪ ﺗ ﻢ ﺟﻤ ﻊ اﻟﺒﻴﺎﻧ ﺎت ﻣ ﻦ ﺷ ﺒﻜﺔ اﻟﻤﻌﻠﻮﻣ ﺎت اﻹﻟﻜﺘﺮوﻧﻴ ﺔ‬
‫ﺑﺎﻟ ﺪاﺋﺮة آﻤ ﺎ ﺗ ﻢ ﻣﺮاﺟﻌ ﺔ ﺧ ﺮوج ﺣ ﺎﻻت ﺧ ﺮوج اﻟﻤﺴﺘ ﺸﻔﻴﺎت ﻣ ﻦ أﻋ ﻮام ‪ 2006 - 2000‬وآﺎﻧ ﺖ‬
‫اﻟﺒﻴﺎﻧﺎت اﻷﺳﺎﺳﻴﺔ هﻲ اﻟﻌﻤﺮ واﻟﻨﻮع واﻟﺘﺸﺨﻴﺺ واﻟﻮﺿﻊ ﻋﻨﺪ اﻟﺨﺮوج وﺗﺎرﻳﺦ اﻟﺪﺧﻮل‪.‬‬

‫هﺬا وﻗﺪ أﻇﻬ ﺮت اﻟﺪراﺳ ﺔ أن هﻨ ﺎ ﻓ ﺮوق ﺟﻮهﺮﻳ ﺔ ﻓ ﻲ ﻣﻌ ﺪل وﻓﻴ ﺎت اﻟﻤﺴﺘ ﺸﻔﻴﺎت ﺑﺎﻟ ﺴﻦ واﻟﺠﻨ ﺴﻴﺔ‬
‫واﻟﻤﺴﺘ ﺸﻔﻰ واﻟﺘ ﺸﺨﻴﺺ ﻓ ﻲ اﻷﻋ ﻮام ‪ ،2006-2000‬وﺑﺪراﺳ ﺔ ﻋﻮاﻣ ﻞ اﻟﺨﻄ ﻮرة ﻟﻠﻮﻓﻴ ﺎت‬
‫ﺑﻤﺴﺘ ﺸﻔﻴﺎت داﺋ ﺮة اﻟ ﺼﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ ﺑ ﺪﺑﻲ آ ﺎن اﻟﻤﻮاﻃﻨ ﻮن واﻟ ﺬآﻮر و اﻟ ﺬﻳﻦ ﺳ ﺒﻖ ﻟﻬ ﻢ‬
‫‪2005‬ﻟ ﺪﻳﻬﻢ ﺧﻄ ﻮرة أآﺜ ﺮ ﻋ ﻦ‬ ‫اﻟﺰواج وﺣﺎﻻت اﻟﺨﺮوج ﺑﻤﺴﺘﺸﻔﻰ راﺷﺪ وﺣﺎﻻت اﻟﺨﺮوج ﻗﺒﻞ‬
‫اﻟﻔﺌﺎت اﻟﻤﻘﺎرﻧﺔ‪ ،‬وﺑﺘﻄﺒﻴ ﻖ ﺗﺤﻠﻴ ﻞ اﻟﻤﺨﻄ ﻂ اﻻرﺗ ﺪادي اﻟﻤﻨﻄﻘ ﻲ ﻟﺪراﺳ ﺔ اﻷﺛ ﺮ اﻟﻤ ﺴﺘﻘﻞ ﻟﻜ ﻞ ﻣﺘﻐﻴ ﺮ‬
‫ﻋﻠﻰ ﺣﺪة ﻓﻘﺪ وﺟﺪ أن اﻟﺨﻄﻮرة اﻟﻤﻌﺪﻟﺔ آﺎﻧﺖ زاﺋﺪة ﺑﺪرﺟ ﺔ ﺟﻮهﺮﻳ ﺔ ﺑ ﻴﻦ اﻟﺒ ﺎﻟﻐﻴﻦ ‪ 55‬ﻋﺎﻣ ًﺎ وأآﺜ ﺮ‬
‫و اﻟﻤﻮاﻃﻨ ﻮن واﻟ ﺬآﻮر و اﻟ ﺬﻳﻦ ﺳ ﺒﻖ ﻟﻬ ﻢ اﻟ ﺰواج وﺣ ﺎﻻت اﻟﺨ ﺮوج ﺑﻤﺴﺘ ﺸﻔﻰ راﺷ ﺪ وﺣ ﺎﻻت‬
‫اﻟﺨﺮوج ﻗﺒﻞ ‪ 2005‬ﻣﻘﺎرﻧﺔ ﺑﺎﻟﻔﺌﺎت اﻷﺧﺮى‪.‬‬
‫ﻟﻤﺰﻳﺪ ﻣﻦ اﻟﺘﻔﺎﺻﻴﻞ ﺗﺮاﺟﻊ اﻟﻨﺴﺨﺔ اﻻﻧﺠﻠﻴﺰﻳﺔ‪.‬‬

‫‪180‬‬
 Table (1) Summary Characteristics of Hospital Mortality in DOHMS According
to Some Epidemiological Characteristics, Dubai 2000- 2006

Viable Value Significance

Age (HMR %)

< 55 years 0.7 x2= 5233.74

≥ 55 years 4.7 P = 0.0000

Nationality (HMR %)

Nationals 1.1 x2 = 12.68

Expatriates 1.2 P = 0.000

Sex (CFR %)

Males 1.8 x2 = 4.09

Females 0.8 P = 0.042

Hospital (HMR %)

Dubai 1.3 x2 = 6.5

Al Wasal 0.4
Rashid 2.4
Al Maktoum 0.60. P= 0.000

Year (HMR %)
2000 0.8
2001 1.2 x2 =57.16
2002 1.2 P=0.0000
2003 1.2
2004 1.2
2005 1.2
2006 1.2

Diagnosis (HMR %)

CVD 4.3
IPD 5.1 x2 = 6221.0
Neoplasm 7.1 P = 0.0000
Other 0.7

181
 Table (2) Crude Odds Ratio of Mortality in DOHMS Hospitals by Certain
Epidemiological Variables, Dubai 2000- 2006

Variable Crude Odds Ratio x2 P

Nationality
Nationals v. Expatriate .0.89 (0.84,0.95) 12.75 P= 0.000
Age
< 55 years v. ≥ 55 years 0.0.129 (0.115, 1443 P= 0.000
0.144)
Sex
Females v. Males 0.42 (0.39, 0.45) 378.16 P= 0.000

Hospital

Other v. Rashid 0.33 (0.29, 0.36) 530.42 P= 0.000

Marital Status
(other v. Ever married 0.52 (0.51, 0.61) 160.21 P= 0.0000
Year
<2005 v. ≥2005 0.8(0.72, 0.88) 18.34 P= 0.0000

182
 Table (3) Adjusted Odds Ratio of Hospital Mortality in DOHMS by Certain
Epidemiological Variables, Dubai 2000- 2006

Variable B Exp (B) P

Age
(≥55 years v. < 55 years) -2.143 0.117 0.0000
Sex
Males v. Females 0.261 1.298 0.000
Nationality
Nationals v. Expatriate 0.081 1.084 0.004
Marital Status
(Ever married v. Other ) 0.474 1.606 0.000
Hospital
Rashid v. Other 0.229 1.1349 0.000
Diagnosis
Neoplasm v. Other 0.964 2.623 0.000
Year
<2005 v. ≥2005 - 0.127 0.881 0.000

183
 Outpatient Attendances in DOHMS 2000 -2006

There were 10587676 outpatient attendances in DHA in the period 2000 -2006.
Emirates constituted about two thirds (60.27%) of attendances and expatriates
39.73%, Table (1). Males amounted for 45.81% of the cases and females 54.19%.
Among Emirates more than three fifths (59.53 %) of the cases were females

Table (2) shows also that general practice clinics amounted for 36.55 % of
attendances, specialist clinics (39.58%), accident & emergency (5.11 %), antenatal
care 4.16% and walk in clinics for only 2.41%. Comparing the distribution among
Emirate and Expatriate population, general practice (39.68%) and specialist clinics
attendance was more (25.3%) among Emirates and accident & emergency attendance
was more among expatriates (9.33%). specialist clinics attendance was more
(42.44%) among females and accident & emergency attendance was more among
males (6.53%), Table 3.

New cases amounted to 32.0% of all attended cases to outpatient services in DOHMS;
the percentage was nearly the same in both locals and expatriates, Table (4). Table
5A, B, C & D) shows that there was a decline in outpatient attendances in 2004 -2006
.The picture was more apparent among expatriates and males.

Studying the distribution of the attendant cases by health facility, Table (6) shows that
PHC amounted to 78.6 of the cases, RH 10.52%, DH 5.64% and WH 5.24 %. The
percentage was more (6.78%) among Emirates attending DH clinics and RH
(11.91%) among Expatriates. Morning work hours amounted for 45.02 of attendant
cases in DHA and afternoon working hours 54.98%.The picture was observed in both
males and females, Table 7.

184
Recommendation:

- Referral system in DOHMS should be reviewed.

- Specialty referral guidelines should be developed in DOHMS for evaluation
and management. Primary Care Physicians treating patients should be
provided by a set of guidelines that are balanced and appropriate from the
perspectives of major members of the patient health care team. Clinical
thresholds that generally indicate the need for referral to a specialist, such as
signs and symptoms, disease progression, laboratory, diagnostic, prognostic
studies and respond to therapy should be determined.

185
 ‫ﻣﺮاﺟﻌــﺎت اﻟﻌﻴــﺎدات اﻟﺨـﺎرﺟﻴــﺔ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ‪2006- 2000‬‬

‫ﺑﻠﻎ ﻋﺪد اﻟﻤﺮاﺟﻌﻴﻦ ﻟﻠﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ‪10587676‬‬
‫ﻣﺮاﺟﻌًﺎ ﻓﻲ اﻟﻔﺘﺮة ﻣﻦ ‪ .2006- 2000‬هﺬا وﻗﺪ ﺷﻜﻞ اﻟﻤﻮاﻃﻨﻮن ﺣﻮاﻟﻲ ﺛﻠﺜﻲ اﻟﺤﺎﻻت )‪(%60.27‬‬
‫واﻷﺟﺎﻧﺐ ‪ %39.73‬ﺟﺪول رﻗﻢ )‪ ،(1‬آﻤﺎ ﺷﻜﻞ اﻟﺬآﻮر ‪ %45.81‬ﻣﻦ اﻟﺤﺎﻻت واﻟﺴﻴﺪات‬
‫‪ %54.19‬وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﺴﻴﺪات ‪ % 59.53‬ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ وﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (2‬أن ﻋﻴﺎدات‬
‫اﻟﻤﻤﺎرس اﻟﻌﺎم ﺷﻜﻠﺖ ‪ %36.55‬ﻣﻦ ﺣﺎﻻت اﻟﻤﺮاﺟﻌﺔ وﻋﻴﺎدات اﻷﺧﺼﺎﺋﻴﻴﻦ ‪%39.58‬‬
‫واﻟﺤﻮادث واﻟﻄﻮارئ ‪ %5.11‬وﻋﻴﺎدات اﻟﺤﻮاﻣﻞ ‪ %4.16‬اﻟﻌﻴﺎدات اﻹﺿﺎﻓﻴﺔ ‪ %2.41‬ﻓﻘﻂ‪.‬‬
‫وﺑﻤﻘﺎرﻧﺔ ﺗﻮزﻳﻊ ﺣﺎﻻت اﻟﻤﺮاﺟﻌﺔ ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ ﻓﻘﺪ آﺎﻧﺖ ﻧﺴﺒﺔ اﻟﻤﻮاﻃﻨﻴﻦ ﻋﺎﻟﻴﺔ‬
‫ﺑﻌﻴﺎدات اﻟﻤﻤﺎرس اﻟﻌﺎم )‪ (%39.68‬واﻷﺧﺼﺎﺋﻴﻴﻦ )‪ (%25.3‬وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ ﻋﺎﻟﻴﺔ ﺑﺎﻟﺤﻮادث‬
‫واﻟﻄﻮارئ )‪ .(%9.33‬وآﺎﻧﺖ ﺣﺎﻻت اﻟﻤﺮاﺟﻌﺔ ﻟﻌﻴﺎدات اﻷﺧﺼﺎﺋﻴﻴﻦ أﻋﻠﻰ ﺑﻴﻦ‬
‫اﻹﻧﺎث)‪ %(%42.44‬واﻟﺤﻮادث واﻟﻄﻮارئ أﻋﻠﻰ ﺑﻴﻦ اﻟﺬآﻮر)‪,(%6.53‬ﺟﺪول رﻗﻢ)‪(3‬‬

‫وﻗﺪ ﺷﻜﻠﺖ اﻟﺤﺎﻻت اﻟﺠﺪﻳﺪة ‪ %30.0‬ﻣﻦ ﻣﺮاﺟﻌﺎت اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت‬
‫اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‪ ،‬وآﺎﻧﺖ اﻟﻨﺴﺒﺔ ﺗﻘﺮﻳﺒًﺎ ﻣﺘﺴﺎوﻳﺔ ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ‪) ,‬ﺟﺪول رﻗﻢ ‪(4‬‬
‫وﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ ‪ ,5‬ا‪ ,‬ب‪ ,‬ج‪ ,‬د( أن هﻨﺎك اﻧﺨﻔﺎض ﻓﻲ ﻋﺪد اﻟﺤﺎﻻت ﻓﻲ ﻋﺎﻣﻲ ‪- 2004‬‬
‫وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ‪ .‬وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ ﺣﺎﻻت‬ ‫‪.2006‬وآﺎﻧﺖ اﻟﺼﻮرة ﻣﺘﺸﺎﺑﻬﺔ ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ‬
‫اﻟﻤﺮاﺟﻌﺔ ﺑﺎﻟﻤﺆﺳﺴﺎت اﻟﺼﺤﻴﺔ ﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (6‬أن أآﺜﺮ ﻣﻦ ﺛﻼﺛﺔ أرﺑﺎع اﻟﺤﺎﻻت‬
‫)‪ (%78.6‬راﺟﻌﺖ ﻣﺮاآﺰ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ و ‪ %10.52‬ﻣﺴﺘﺸﻔﻰ راﺷﺪ و ‪%5.64‬‬
‫ﻣﺴﺘﺸﻔﻰ دﺑﻲ و ‪ % 5.24‬ﻣﺴﺘﺸﻔﻰ اﻟﻮﺻﻞ‪ .‬هﺬا وآﺎﻧﺖ ﻧﺴﺒﺔ اﻟﻤﻮاﻃﻨﻴﻦ ﻋﺎﻟﻴﺔ )‪(%6.78‬‬
‫ﺑﻤﺴﺘﺸﻔﻰ دﺑﻲ وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ )‪ (%11.91‬ﺑﻤﺴﺘﺸﻔﻰ راﺷﺪ‪ ،‬آﻤﺎ ﺷﻜﻠﺖ اﻟﻮردﻳﺎت اﻟﺼﺒﺎﺣﻴﺔ‬
‫‪ %45.02‬ﻣﻦ اﻟﺤﺎﻻت اﻟﻤﺮاﺟﻌﺔ ﺑﺎﻟﺪاﺋﺮة واﻟﻮردﻳﺎت اﻟﻤﺴﺎﺋﻴﺔ ‪. %54.98‬وآﺎﻧﺖ اﻟﺼﻮرة‬
‫ﻣﺘﺸﺎﺑﻬﺔ ﺑﻴﻦ اﻟﺬآﻮر واﻹﻧﺎث ‪ ,‬ﺟﺪول رﻗﻢ )‪(7‬‬

‫‪186‬‬
 ‫اﻟﺘﻮﺻﻴــﺎت‪:‬‬
‫‪ .1‬ﻣﺮاﺟﻌﺔ ﻧﻈﺎم اﻟﺘﺤﻮﻳﻞ ﺑﺎﻟﺪاﺋﺮة‪.‬‬

‫‪ .2‬ﻳﺠﺐ ﻋﻤﻞ دﻻﺋﻞ اﻟﺘﺤﻮﻳﻞ ﻟﻸﺧﺼﺎﺋﻲ ﻣﻊ ﻣﺮاﺟﻌﺘﻬﺎ وﺗﻘﻴﻴﻤﻬﺎ ﺣﻴﺚ ﻳﺠﺐ إﻋﺪاد أﻃﺒﺎء اﻟﺮﻋﺎﻳﺔ‬
‫اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ ﺑﺎﻟﺪﻻﺋﻞ اﻟﻼزﻣﺔ آﻤﺎ ﻳﺠﺐ ﺗﺤﺪﻳﺪ اﻟﻈﻮاهﺮ اﻹآﻠﻴﻨﻴﻜﻴﺔ واﻟﻤﻌﻤﻠﻴﺔ وﺗﻘﻴﻴﻢ‬
‫اﻟﻤﺮﺿﻰ واﻻﺳﺘﺠﺎﺑﺔ ﻟﻠﻌﻼج واﻟﺘﻲ ﻳﺘﻢ ﻋﻠﻰ أﺳﺎﺳﻬﺎ ﺗﺤﻮﻳﻞ اﻟﺤﺎﻻت إﻟﻰ اﻷﺧﺼﺎﺋﻲ‪.‬‬

‫‪187‬‬
Table ( 1 ) Distribution of The Outpatient Attendances in DOHMS By Sex
and Nationality , Dubai 2000 -2006

Sex Nationality Total

Emirate Expatriate
Female 3798228 1939530 5737758
35.87 18.32 54.19
59.53 46.10
Male 2582460 2267458 4849918
24.39 21.42 45.81
40.47 53.90
Total 6380688 4206988 10587676
60.27 39.73 100.00

188
 Table ( 2 ) Distribution of The Outpatient Attendances in DOHMS By
Function Code and Nationality , Dubai 2000 -2006

Function Code Nationality Total

Emirate Expatriate
Accident & Emergency 148853 392686 541539
1.41 3.71 5.11
2.33 9.33
Antenatal Care 229923 210754 440677
2.17 1.99 4.16
3.60 5.01
Child Health Services 334172 479665 813837
3.16 4.53 7.69
5.24 11.40
General Practice 2531966 1338044 3870010
23.91 12.64 36.55
39.68 31.81
Physiotherapy 314003 127885 441888
2.97 1.21 4.17
4.92 3.04
Specialist 2678759 1511944 4190703
25.30 14.28 39.58
41.98 35.94
Thalassaemia 16497 17303 33800
0.16 0.16 0.32
0.26 0.41
Walk-in 126515 128707 255222
1.19 1.22 2.41
1.98 3.06
Total 6380688 4206988 10587676
60.27 39.73 100.00

189
 Table ( 3 ) Distribution of The Outpatient Attendances in DOHMS By
Function Code and Sex , Dubai 2000 -2006

Function Code Sex Total

Female Male
Accident & Emergency 224679 317045 541724
2.12 2.99 5.12
3.92 6.53
Antenatal Care 439751 952 440703
4.15 0.01 4.16
7.66 0.02
Child Health Services 392699 421154 813853
3.71 3.98 7.69
6.84 8.68
General Practice 1895577 1975965 3871542
17.90 18.66 36.56
33.04 40.73
Physiotherapy 212058 229830 441888
2.00 2.17 4.17
3.70 4.74
Specialist 2435227 1755664 4190891
23.00 16.58 39.58
42.44 36.19
Thalassaemia 15519 18281 33800
0.15 0.17 0.32
0.27 0.38
Walk-in 122441 132818 255259
1.16 1.25 2.41
2.13 2.74
Total 5737951 4851709 10587676
54.18 45.82 100.00

190
Table ( 4) Distribution of The Outpatient Attendances in DOHMS By
Appointment Category Code and Nationality , Dubai 2000 -2006

Appointment Category Nationality Total

Emirate Expatriate
Follow Up 4429219 2770624 7199843
41.83 26.17 68.00
69.42 65.86
New 1951469 1436364 3387833
18.43 13.57 32.00
30.58 34.14
Total 6380688 4206988 10587676
60.27 39.73 100.00

191
 Table ( 5A ) Distribution of Outpatient Attendances in DOHMS by
Nationality and Year of Attendance , Dubai 2000 -2006

Year of Attendance Nationality Total

Emirate Expatriate
2000 736475 908752 1645227
6.96 8.58 15.54
11.54 21.60
2001 827969 802503 1630472
7.82 7.58 15.40
12.98 19.08
2002 867842 675195 1543037
8.20 6.38 14.57
13.60 16.05
2003 930857 612085 1542942
8.79 5.78 14.57
14.59 14.55
2004 935771 442727 1378498
8.84 4.18 13.02
14.67 10.52
2005 1008600 364914 1373514
9.53 3.45 12.97
15.81 8.67
2006 1073174 400812 1473986
10.14 3.79 13.92
16.82 9.53
Total 6380688 4206988 10587676
60.27 39.73 100.00

192
Table (5 B) Distribution of Outpatient Attendances in DOHMS by Sex and
Year of Attendance, Dubai 2000 -2006

Year of Attendance Sex Total

Female Male
2000 837853 807705 1645558
7.91 7.63 15.54
14.60 16.65
2001 861334 770582 1631916
8.13 7.28 15.41
15.01 15.88
2002 837660 705402 1543062
7.91 6.66 14.57
14.60 14.54
2003 852916 690063 1542979
8.05 6.52 14.57
14.86 14.22
2004 755630 622871 1378501
7.14 5.88 13.02
13.17 12.84
2005 766639 606904 1373543
7.24 5.73 12.97
13.36 12.51
2006 825919 648182 1474101
7.80 6.12 13.92
14.39 13.36
Total 5737951 4851709 10587676
54.18 45.82 100.00

193
Table (5 C) Distribution of Emirate Outpatient Attendances in DHA by Sex
and Year of Attendance, Dubai 2000 -2006

Year of Attendance Sex Total

Female Male
2000 396402 512350 908752
9.42 12.18 21.60
20.44 22.60
2001 371341 431162 802503
8.83 10.25 19.08
19.15 19.02
2002 326268 348927 675195
7.76 8.29 16.05
16.82 15.39
2003 297968 314117 612085
7.08 7.47 14.55
15.36 13.85
2004 196995 245732 442727
4.68 5.84 10.52
10.16 10.84
2005 164736 200178 364914
3.92 4.76 8.67
8.49 8.83
2006 185820 214992 400812
4.42 5.11 9.53
9.58 9.48
Total 1939530 2267458 4206988
46.10 53.90 100.00

194
Table ( 5D ) Distribution of Emirate Outpatient Attendances in DOHMS By
Sex and Year of Attendance , Dubai 2000 -2006

Year of Attendance Sex Total

Female Male
2000 441286 295189 736475
6.92 4.63 11.54
11.62 11.43
2001 489979 337990 827969
7.68 5.30 12.98
12.90 13.09
2002 511389 356453 867842
8.01 5.59 13.60
13.46 13.80
2003 554943 375914 930857
8.70 5.89 14.59
14.61 14.56
2004 558635 377136 935771
8.76 5.91 14.67
14.71 14.60
2005 601897 406703 1008600
9.43 6.37 15.81
15.85 15.75
2006 640099 433075 1073174
10.03 6.79 16.82
16.85 16.77
Total 3798228 2582460 6380688
59.53 40.47 100.00

195
 Table ( 6 ) Distribution of Outpatient Attendances in DOHMS by
Nationality and Hospital , Dubai 2000 -2006

Hospital Nationality Total

Emirate Expatriate
DH 432754 164265 597019
4.09 1.55 5.64
6.78 3.90
RH 613259 500941 1114200
5.79 4.73 10.52
9.61 11.91
WH 308509 245831 554340
2.91 2.32 5.24
4.84 5.84
PHC 5026166 3295951 8322117
47.47 31.13 78.60
78.77 78.34
Total 6380688 4206988 10587676
60.27 39.73

Table ( 7 ) Distribution of the Outpatient Attendances in DOHMS by Sex and

Time of Attendance , Dubai 2006

Sex Nationality Total

Female Male
AM 387684 275944 663628
26.30 18.72 45.02
46.94 42.57
PM 438235 372244 810479
29.73 25.25 54.98
53.06 57.43
Total 825919 648188 1474107
56.03 43.97 100.00

196
 Inpatient Services in DOHMS

There were 441299 coded inpatient discharges in DOHMS in the period 2000 -2006.
Emirates constituted 41.77% of admission and expatriates 58.23%, Table (1). Males
amounted for 43.45% of the cases and females 56.55%. Among Emirates about two
thirds (64.22 %) of the cases were females

Table (2) shows that there was a slight decline in admissions in 2004 -2005 .The
picture was more apparent among expatriates and Dubai Hospital, Table 3. Studying
the distribution of the admitted cases by health facility, table (3) shows also that DH
amounted to 35.55% of the admitted cases, RH 19.14%, 5.64% WH 44.27 % and MH
only 1.04% of the cases.

Applying the International Classification of Diseases (ICD 10), Table (4) shows that
pregnancy, childbirth and the puerperium constituted more than one fourth (26.7%) of
the admitted persons in DHOMS and about one half of the admitted cases in females
(47.21%). Injury and poisoning amounted to 6.32%, diseases of the circulatory system
(6.53%), disease of the digestive system (4.71%) and diseases of the respiratory
system 4.11%. Infectious ad parasitic diseases amounted for only 1.9% of the
admitted persons in DHOMS.

The average length of stay in DOHMS hospitals was 5.11±16.526 days. There was a
significant difference in the average length of stay in DOHMS hospitals by sex,
nationality, Table (5)

It is also apparent from table (6) that the total number of the coded deaths in DHA
2000-2006 was 4708 with a case fatality rate of 1.07%. The rate was 0.96% among
Emirates and 1.15% among Expatriates. This difference is significant (P= 0.0001)

197
 ‫ﺧﺪﻣﺎت اﻹرﻗﺎد ﻓﻲ داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ‬

‫آﺎن هﻨﺎك ‪ 441299‬ﺣﺎﻟﺔ إرﻗﺎد ﺑﻤﺴﺘﺸﻔﻴﺎت داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﻓﺎﻟﻔﺘﺮة ﻣﻦ ‪ 2006 – 2000‬وﻗﺪ ﺷ ﻜﻞ‬
‫اﻟﻤﻮاﻃﻨﻮن ‪ % 41.45‬ﻣﻦ ﺣﺎﻻت اﻹرﻗﺎد وﻏﻴﺮ اﻟﻤﻮﻃﻨﻴﻦ ‪ % 28.23‬ﺟﺪول رﻗﻢ )‪ .(1‬وآﺎﻧﺖ اﻹﻧﺎث ﺣﻮاﻟﻲ ﺛﻠﺜ ﻲ‬
‫اﻟﺤﺎﻻت )‪ (% 62.22‬ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ‪ .‬وﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (2‬أن هﻨ ﺎك اﻧﺨﻔ ﺎض ﺑ ﺴﻴﻂ ﻓ ﻲ ﻋ ﺪد ﺣ ﺎﻻت اﻹرﻗ ﺎد‬
‫ﻓﻴﻤ ﺎ ﺑ ﻴﻦ ‪ 2005 – 2004‬وآﺎﻧ ﺖ اﻟ ﺼﻮرة أآﺜ ﺮ وﺿ ﻮﺣﺎ ﺑ ﻴﻦ ﻏﻴ ﺮ اﻟﻤ ﻮاﻃﻨﻴﻦ وﻣﺴﺘ ﺸﻔﻰ دﺑ ﻲ ﺟ ﺪول رﻗ ﻢ )‪.(3‬‬
‫وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ اﻟﺤﺎﻻت ﺑﺎﻟﻤﺆﺳﺴﺎت اﻟﺼﺤﻴﺔ ﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (3‬أﻳﻀﺎ أن ﻧﺴﺒﺔ اﻹرﻗ ﺎد ﺑﻤﺴﺘ ﺸﻔﻰ دﺑ ﻲ آﺎﻧ ﺖ‬
‫‪ % 35.55‬ﻣﻦ ﺣﺎﻻت اﻹرﻗﺎد وﻣﺴﺘﺸﻔﻰ راﺷﺪ ‪ % 19.14‬واﻟﻮﺻﻞ ‪ % 44.27‬واﻟﻤﻜﺘﻮم ‪.% 1.04‬‬

‫وﺗﻄﺒﻴﻖ اﻟﺘﻘﺴﻴﻢ اﻟﺪوﻟﻲ ﻟﻸﻣﺮاض)اﻟﻤﺮاﺟﻌﺔ اﻟﻌﺎﺷﺮة( ﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪ (4‬أن اﻟﺤﻤ ﻞ واﻟ ﻮﻻدة ﺷ ﻜﻠﺖ أآﺜ ﺮ ﻣ ﻦ‬
‫رﺑ ﻊ)‪ (% 26.7‬ﻣ ﻦ ﺣ ﺎﻻت اﻹدﺧ ﺎل ﺑﺎﻟ ﺪاﺋﺮة وﺣ ﻮاﻟﻲ ﻧ ﺼﻒ اﻟﺤ ﺎﻻت ﺑ ﻴﻦ اﻹﻧ ﺎث واﻟ ﺴﻤﻮم واﻷذى ‪% 6.32‬‬
‫وأﻣ ﺮاض اﻟﺠﻬ ﺎز اﻟ ﺪوري ‪ % 6.53‬وأﻣ ﺮاض اﻟﺠﻬ ﺎز اﻟﻬ ﻀﻤﻲ ‪ % 4.71‬وأﻣ ﺮاض اﻟﺠﻬ ﺎز اﻟﺘﻨﻔ ﺴﻲ ‪% 4.11‬‬
‫واﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ واﻟﻄﻔﻴﻠﻴﺎت ‪ % 1.9‬ﻣﻦ ﺣﺎﻻت اﻹدﺧﺎل ﺑﺎﻟﺪاﺋﺮة‪.‬‬

‫وآﺎن ﻣﺘﻮﺳﻂ ﻓﺘﺮة اﻟﺒﻘﺎء ﺑﺎﻟﻤﺴﺘﺸﻔﻰ ﺑﺎﻟﺪاﺋﺮة ‪ 5.11‬ﻳﻮﻣﺎ وآﺎن هﻨﺎك ﻓﺮوق ﺟﻮهﺮﻳ ﺔ ﺑ ﻴﻦ ﻓﺘ ﺮات اﻟﺒﻘ ﺎء ﺑﺎﻟﻤﺴﺘ ﺸﻔﻰ‬
‫ﺑﻴﻦ اﻟﺬآﻮر واﻹﻧﺎث وﺑﺎﻟﺠﻨﺴﻴﺔ‪ ،‬ﺟﺪول رﻗﻢ )‪ .(5‬وﻳﻈﻬﺮ ﻓﻲ اﻟﺠﺪول رﻗﻢ )‪ (6‬أن ﻋﺪد اﻟﻮﻓﻴ ﺎت اﻟﻤﻜ ﻮن ﻓ ﻲ اﻟ ﺪاﺋﺮة‬
‫‪ 47.8‬ﻓ ﻲ اﻟﻔﺘ ﺮة ‪ 2006 – 2000‬وﺑﻤﻌ ﺪل وﻓ ﺎة ﺑﺎﻟﻤﺴﺘ ﺸﻔﻰ ‪ % 1.07‬وآ ﺎن اﻟﻤﻌ ﺪل ‪ % 0.96‬ﺑ ﻴﻦ اﻟﻤ ﻮاﻃﻨﻴﻦ و‬
‫‪ % 1.15‬ﺑﻴﻦ ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ‪ ،‬وآﺎن هﺬا اﻟﻔﺮق ﺟﻮهﺮﻳﺎ‪.‬‬

‫‪198‬‬
 Table (1) Distribution of Admitted Cases in DOHMS by
Nationality and Sex, Dubai 2001 -2006

Sex Nationality Total

Emirate Expatriate
Female 118367 131175 249542
26.82 29.73 56.55
64.22 51.04
Male 65940 125812 191752
14.94 28.51 43.45
35.78 48.96
Total 184307 256987 441294
41.77 58.23 100.00

199
 Table ( 2 ) Distribution of Admitted Cases in DOHMS by Year
of Admission and Nationality, Dubai 2001 -2006

Year Nationality Total

Emirate Expatriate
2001 24811 44392 69203
6.09 10.90 16.99
14.38 18.91
2002 26394 45004 71398
6.48 11.05 17.53
15.30 19.17
2003 27314 41503 68817
6.71 10.19 16.90
15.83 17.68
2004 29740 32958 62698
7.30 8.09 15.39
17.24 14.04
2005 32406 33451 65857
7.96 8.21 16.17
18.78 14.25
2006 31858 37443 69301
7.82 9.19 17.02
18.47 15.95
Total 172523 234751 407274
42.36 57.64 100.00

200
Table ( 3 ) Distribution of Admitted Cases in DOHMS by Hospital and Year
of Admission, Dubai 2001 -2006

Year Hospital Total

DH MH RH WH
2001 26281 948 12304 29632 69165
6.45 0.23 3.02 7.28 16.98
18.15 22.42 15.79 16.44
2002 25776 939 13704 30972 71391
6.33 0.23 3.37 7.61 17.53
17.80 22.20 17.58 17.18
2003 23966 691 13681 30478 68816
5.89 0.17 3.36 7.48 16.90
16.55 16.34 17.55 16.91
2004 20008 617 13601 28472 62698
4.91 0.15 3.34 6.99 15.40
13.82 14.59 17.45 15.79
2005 23138 540 12107 30070 65855
5.68 0.13 2.97 7.38 16.17
15.98 12.77 15.53 16.68
2006 25619 494 12546 30641 69300
6.29 0.12 3.08 7.52 17.02
17.69 11.68 16.10 17.00
Total 144788 4229 77943 180265 407225
35.55 1.04 19.14 44.27 100.00

201
Table ( 4) Distribution of Inpatients in DOHMS by ICD code, Nationality and Sex, Dubai
2001 -2006

ICD Classification Emirate Expatriate Total

(ICD Code)
Sex All Sex All Sex
Female Male Female Male Female Male
No. % No. % No. No. % No. % No. Total
% % No. % No. %
No. %
Infectious & Parasitic 1291 1411 2702 1578 4092 5670 2869 5503 8372
Diseases (A00- B99)
1.09 2.14 1.47 1.20 3.25 2.21 1.15 2.87 1.90
Neoplasm (C00- D48) 1461 1032 2493 2942 3918 6860 4403 4950 9353
1.23 1.57 1.35 2.24 3.11 2.67 1.76 2.58 2.12
Diseases of the Blood & 9159 10501 19660 11142 13187 24329 20301 23688 43989
Blood Forming Organs 7.74 15.93 10.67 8.49 10.48 9.47 8.14 12.35 9.97
(D50 - D89)
Endocrine, Nutritional & 2484 1853 4337 1790 3155 4945 4274 5008 9282
Metabolic Discuses (E00 – 2.10 2.81 2.35 1.36 2.51 1.92 1.71 2.61 2.10
E90)
Mental & Behavioral 988 1219 2207 1057 2127 3184 2045 3346 5391
disorders 0.83 1.85 1.20 0.81 1.69 1.24 0.82 1.74 1.22
(F00 – F99)
Diseases of the Nervous 959 930 1889 899 1921 2820 1858 2851 4709
System 0.81 1.41 1.02 0.69 1.53 1.10 0.74 1.49 1.07
(G00 – G99)
Diseases of the Eye & 1285 1366 2651 1145 2149 3294 2430 3515 5945
Adnexa 1.09 2.07 1.44 0.87 1.71 1.28 0.97 1.83 1.35
(H00 – H59)
Diseases of the Ear & 399 452 851 241 377 618 640 829 1469
Mastoid Process (H60 – 0.34 0.69 0.46 0.18 0.30 0.24 0.26 0.43 0.33
H62)
Diseases of the 2895 4289 7184 3480 18160 21640 6375 22449 28824
Circulatory System 2.45 6.50 3.90 2.65 14.43 8.42 2.55 11.71 6.53
(I00 – I99)

Diseases of the 3803 4916 8719 3258 6155 9413 7061 11071 18132
Respiratory System 3.21 7.46 4.73 2.48 4.89 3.66 2.83 5.77 4.11
(J00 – J99)
Diseases of the Digestive 3127 3930 7057 3155 10564 13719 6282 14494 20776
System 2.64 5.96 3.83 2.41 8.40 5.34 2.52 7.56 4.71
(K00 – K93)
Diseases of the Skin & 583 735 1318 607 1598 2205 1190 2333 3523
Subcutaneous tissue (L00 0.49 1.11 0.72 0.46 1.27 0.86 0.48 1.22 0.80
– L99)
Diseases of the 1790 1164 2954 1982 2129 4111 3772 3293 7065
Musculoskeletal System 1.51 1.77 1.60 1.51 1.69 1.60 1.51 1.72 1.60
(M00 – M99)

Diseases of the 4386 2515 6901 5351 5689 11040 9737 8204 17941
Genitourinary System 3.71 3.81 3.74 4.08 4.52 4.30 3.90 4.28 4.07
(N00 – N99)

202
 Cont. Distribution of Inpatients in DOHMS by ICD code, Nationality and Sex, Dubai
2001 -2006

ICD Classification Emirate Expatriate Total

(ICD Code)
Sex All Sex Sex
Female Male Female Male All Female Male
No. % No. % No. % No. % No. % Total
No. % No. % No. %
No. %
Pregnancies Childbirth 57941 - 57941 59864 - 59864 117809 117809
& the Puerperium (O00 48.95 0.00 31.44 45.64 0.00 23.29 47.21 0.00 26.70
– O99)
Perinatal Period (P00 – 3294 3915 7209 4462 5836 10298 7756 9751 17507
P96) 2.78 5.94 3.91 3.40 4.64 4.01 3.11 5.09 3.97
Congenital 1445 3376 4821 1275 3103 4378 2720 6479 9199
Malformations, 1.22 5.12 2.62 0.97 2.47 1.70 1.09 3.38 2.08
Deformities &
Chromosomal
Abnormalities (Q00 –
Q99)
Symptoms, Signs 2473 2020 4493 3103 4224 7327 5576 6245 11821
Unclassified 2.09 3.06 2.44 2.37 3.36 2.85 2.23 3.26 2.68
(R00 – R99)

2046 3742 5788 3481 18228 21709 5527 21970 27497

Injury & Poisoning and 1.73 5.67 3.14 2.65 14.49 8.45 2.21 11.46 6.23
External causes of
Morbidity & Mortality
(S00 – Y98)
Factors Influencing 16560 16572 33132 20364 19199 39563 36924 35771 72695
Health Status (Z00 – 13.99 25.13 17.98 15.52 15.26 15.39 14.80 18.65 16.47
Z99)
Total 118367 65940 184307 131175 125812 256987 249546 191753 441299
100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00

203
 Table ( 5 ) Mean Length of stay among Inpatients in DOHMS by Sex and
Nationality, Dubai 2000 -2006

Length of Hospital Stay

Nationality Sex Mean Std Dev
Emirate Female 4.4042763 16.4235327
Male 5.6702390 18.2689943
Expatriate Female 4.2185207 12.1940432
Male 6.4345256 19.3422763

204
 Table ( 6) Case Fatality Rate of Admissions in DOHMS by
Nationality, Dubai 2000 -2006

Dead Nationality Total

Emirate Expatriate
Discharged 182541 254041 436582
41.37 57.57 98.93
99.04 98.85
Dead 1763 2945 4708
0.40 0.67 1.07
0.96 1.15
Total 184304 256986 441290
41.76 58.24 100.00
x2= 36.479 P= 0.0001

cOR = 1.2 (1.13, 1.27)

205
 Infectious Diseases Admitted in DOHMS 2000 – 2006

Table (1) shows that about two third of the admitted infectious diseases in DOHMS
(63.93%) were males and Expatriates 62.02%. Expatriate males constituted 42.98% of
admitted infectious diseases in DHA, Dubai 2000 – 2006. There is steady increase in
the number of admitted infectious diseases by year of admission with increase in case
fatality rate. This difference is significant (P = 0.0044). The mean age of admitted
infectious diseases in DHA, 2000 – 2006 was 18.51 ± 20.87 years. It is apparent from
table (3) that it was 14.28 ± 21.506 years for Emirate females, 13.16 ± 21.815 for
males and 16.51 ± 19.68 years for Expatriate females and 23.68 ± 19.42 years for
males. There is a peak of admission for infectious diseases in December, Figure (1).
The mean length of stay for admitted infectious diseases in DHA was 7.18 ± 25.333
days. It was 7.03 ± 54.198 days for Emirate females, 6.29 + 16.27 males, 7.43 ±
11.62 for Expatriate females and 7.55 ± 77.81 days for males, Table (4). More than
one fourth of the admitted infectious diseases were vital pneumonia, (26.9%) diarrhea
(13.2%), tuberculosis (10.8%) and influenza 8.9%, Table (5).

206
 ‫اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ ﺑﻤﺴﺘﺸﻔﻴﺎت داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬

‫ﻳﻮﺿﺢ اﻟﺠﺪول رﻗﻢ )‪ (1‬أن ﺣﻮاﻟﻲ ﺛﻠﺜﻲ اﻟﺤﺎﻻت )‪ (% 63.93‬اﻟﺘﻲ ﺗﻢ دﺧﻮﻟﻬﺎ ﻣﺴﺘﺸﻔﻴﺎت داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت‬
‫اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ آﺎﻧﺖ ذآﻮرا وأن ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ ﻗﺪ ﺷﻜﻠﻮا ‪ % 62.02‬ﻣﻦ اﻟﺤﺎﻻت‪ .‬آﻤﺎ ﺷﻜﻞ اﻟﺬآﻮر ﻏﻴ ﺮ اﻟﻤ ﻮاﻃﻨﻴﻦ‬
‫‪ %42.98‬ﻣﻦ ﻣﺠﻤﻮع اﻟﺤﺎﻻت اﻟﻤﺤﺠﻮزة‪ .‬هﺬا وآﺎن هﻨﺎك زﻳﺎدة ﻓﻲ ﻋﺪد اﻟﺤﺎﻻت ﺑﺴﻨﻮات اﻹدﺧﺎل ﻣ ﻊ زﻳ ﺎدة ﻓ ﻲ‬
‫ﻣﻌﺪل وﻓﻴﺎت اﻟﺤﺎﻻت وآﺎن هﺬا اﻟﻔ ﺮق ﺟﻮهﺮﻳ ﺎ‪ .‬وﻗ ﺪ ﺑﻠ ﻎ ﻣﺘﻮﺳ ﻂ ﻋﻤ ﺮ اﻟﺤ ﺎﻻت ‪ 15.5‬ﻋﺎﻣ ﺎ وآ ﺎن ﻣﺘﻮﺳ ﻂ ﻋﻤ ﺮ‬
‫اﻹﻧ ﺎث اﻟﻤﻮاﻃﻨ ﺎت ‪ 14.28‬و ‪ 13.16‬ﻋﺎﻣ ﺎ ﻟﻠ ﺬآﻮر اﻟﻤ ﻮﻃﻨﻴﻦ و ‪ 16.51‬ﻋﺎﻣ ﺎ ﻟﻺﻧ ﺎث ﻏﻴ ﺮ اﻟﻤﻮاﻃﻨ ﺎت و ‪23.68‬‬
‫ﻋﺎﻣﺎ ﻟﻠﺬآﻮر ﻏﻴﺮ اﻟﻤﻮﻃﻨﻴﻦ ﺟﺪول )‪ .(3‬وآﺎن ذروة إدﺧﺎل اﻟﺤﺎﻻت ﻓﻲ ﺷﻬﺮ دﻳﺴﻤﺒﺮ )ﺷﻜﻞ رﻗﻢ ‪ ( 1‬وﺑﻠ ﻎ ﻣﺘﻮﺳ ﻂ‬
‫ﻓﺘﺮة اﻟﺒﻘﺎء ﺑﺎﻟﻤﺴﺘﺸﻔﻰ ﻟﻠﺤﺎﻻت ‪ 7.18‬ﻳﻮﻣﺎ )ﺟ ﺪول رﻗ ﻢ ‪ .(4‬ه ﺬا وﻗ ﺪ ﺷ ﻜﻞ اﻻﻟﺘﻬ ﺎب اﻟﺮﺋ ﻮي اﻟﻔﻴﺮوﺳ ﻲ أآﺜ ﺮ ﻣ ﻦ‬
‫رﺑﻊ اﻟﺤﺎﻻت اﻟﺘﻲ ﺗﻢ إدﺧﺎﻟﻬﺎ )‪ (% 26.9‬واﻹﺳﻬﺎل )‪ (% 13.2‬وﻟﺪرن )‪ (% 10.8‬واﻷﻧﻔﻠ ﻮﻧﺰا )‪ ،(% 8.9‬ﺟ ﺪول‬
‫رﻗﻢ )‪(5‬‬

‫‪207‬‬
Table (1) Distribution of Admitted Infectious Diseases in DOHMS by Nationality
and Sex, Dubai 2000 -2006

Sex Nationality Total

Emirate Expatriate
Female 2802 3131 5933
17.04 19.04 36.07
44.85 30.69
Male 3445 7070 10515
20.94 42.98 63.93
55.15 69.31
Total 6247 10201 16448
37.98 62.02 100.00
x2 =336.89 P= 0.0001

208
Table ( 2 ) Distribution of Admitted Infectious Diseases in DOHMS by Prognosis
and Year of Admission, Dubai 2000 -2006

Year Prognosis Total

Alive Dead
2000 1033 16 1049
6.28 0.10 6.38
98.47 1.53
2001 2150 52 2202
13.07 0.32 13.39
97.64 2.36
2002 2064 74 2138
12.55 0.45 13.00
96.54 3.46
2003 2509 75 2584
15.25 0.46 15.71
97.10 2.90
2004 2373 90 2463
14.43 0.55 14.97
96.35 3.65
2005 2684 98 2782
16.32 0.60 16.91
96.48 3.52
2006 3120 110 3230
18.97 0.67 19.64
96.59 3.41
Total 15933 515 16448
96.87 3.13 100.00

x2 =18.86 P= 0.0044

209
Table ( 3 ) Distribution of Mean and S.D. of Age of Admitted Infectious
Diseases in DOHMS by Sex and Nationality, Dubai 2000 -2006

Nationality Sex Number Of Mean S.D.

Observations
Emirate Female 2802 14.2820421 21.5067198
Male 3445 13.1680697 21.8155322
Expatriate Female 3131 16.5158096 19.6825442
Male 7070 23.6813871 19.4277847

210
 Figure (1 ) S easonality of Admitted Infectious Diseases in DOHMS ,
Dubai, 2000-2006

2000
1800
1600
1400
No. of Cases

1200
1000
800
600
400
200
0

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ry

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J a er
ov er

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Fe ry
D ber
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ua

Ap
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Ju
a

M
ar
em

nu
em
tem

Au
br
ct

M
ec
O
p
Se

Month

211
Table ( 4 ) Distribution of Mean and S.D. of Length of Stay of Admitted
Infectious Diseases in DOHMS by Sex and Nationality, Dubai 2000 -2006

Nationality Sex Number Of Mean S.D.

Observations
Emirate Female 2802 7.0346181 54.1987353
Male 3445 6.2972424 16.2740006
Expatriate Female 3131 7.4324497 11.6278896
Male 7070 7.5575672 11.8198391

212
 Table (5) Distribution of Admitted Infections Diseases in DOHMS, Dubai
2000 -2006

Code Disease Name Number %

A01 Typhoid 418 2.5

A08 –A09 Diarrhea 2171 13.2
A15- A16 Tuberculosis 1776 10.8
A37 Whooping Cough 59 0.4
A39.0 Meningococcal Infection 54 2.9
A40 – A41 Septicemia 482 2.9
A87 Viral Meningitis 150 0.9
B01 Chicken Pox 395 2.4
B02 Herpes Zoster 81 0.5
B15 Viral Hepatitis A 123 0.7
B16 Viral Hepatitis B 113 0.7
B17.1 Viral Hepatitis C 155 0.9
B18 Chronic Viral Hepatitis 379 2.3
B19 Unspecific Viral Hepatitis 220 1.3
B50 – B54 Malaria 375 2.3
G00 –G01 Bacterial Meningitis 323 2.0
J10 - J 11 Influenza 1472 8.9
J12- J18 Viral Pneumonia 4434 26.9
T61 - T62 Food Poisoning 49 0.3
Others 3337 20.3

Total number of cases 16448

213
 Private Health Sector Statistics in Dubai
Traditionally, many governments and international institutions have focused most of
their resources and efforts to public service delivery to address health outcome.
Although improvements in health outcomes have been achieved, this approach has not
yielded adequate progress in reducing morbidity and mortality rates

Engaging the private sector has the potential to improve the quality of services,
expand the supply of health goods and services, remove unnecessary burdens from
government and increase the utilization of health services.

The government of Dubai has made impressive progress in the health sector within
the framework of top priority given to the health of citizens by the Dubai Emirate. In
Dubai, private health sector exerts a significant and critical influence on health and
nutritional outcome. The private sector also plays a significant role in a number of
other areas critical for health such as marketing of fortified foods, vaccines and other
critical items.

There were 5914209 outpatient attendances in the private health sector in Dubai in
2004 -2006 with an annual daily encounter visit rate of 6.04 visits per 1000 population
and 1.64 visits per person. Emirates constituted 14.46% of attendances, Arabs
11.23%, Asians 59.63% and other nationalities 14.49%. Males amounted to 60.8% of
outpatient attendances and females 39.2%, Table (1). There was a peak of cases in
December; Figure (1).There is a steady increase in the number of reported outpatient
attendances by year of attendance. The distribution was nearly the same among
nationalities, Table 2

Studying the distribution of both males and females by age group, Table (3) shows
that about half the cases (46.18%) were in the age group 25-44 years and 22.73%

214
were 45-64 years old. A higher percentage was observed among females below 45
years and in males 45 years and above

Applying the International Classification of Diseases (ICD 10), table (4) shows that
respiratory diseases constituted 19.98% off all attended cases, diseases of the
musculoskeletal system 8.19%, injury and poisoning 6.67%, diseases of the eye
5.65%, genitourinary system 6.53%, skin diseases 4.94%, digestive system 4.93%,
infectious and parasitic diseases 4.29%, and cardiovascular diseases 3.65% of all
attended cases to Private Health Sector in Dubai. As for sex, respiratory system
diseases were more (22.24%) among males and genitourinary system (10.31%)
among females. respiratory system diseases were also more (23.37%) among males
And eye diseases among (13.43%) among Emirates, Table 5.

The number of inpatients admitted to the health facilities in the private health sector in
Dubai 2004 -2006 was 79459. Emirate inpatients amounted to 22.4% of admitted
cases and Expatriated 77.6% of the admitted cases in private health sector. Females
amounted for 55.22% of cases and there is increase in number of cases by year of
admission, Table 6.

Out of the 60900 surgical operations carried out in the private health sector in Dubai
in 2004 -2006, 50.61 % were major and 83.9% were scheduled, Table (7). Figure
(42) shows that Emirate population amounted for 21.37% of operations, Arabs
20.97%, Asians 31.96% and other nationalities 25.70%. There was 128% increase of
operations in 2006 as compared to 2004, Table 8 and Figure 2). General surgery,
obstetric and gynecology, orthopedics and ophthalmology were the main specialties

215
 ‫إﺣﺼﺎءات اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻰ‬

‫ﻟﻘﺪ وﺟﻬﺖ اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﺤﻜﻮﻣﺎت ﻣﻌﻈﻢ إﻣﻜﺎﻧﻴﺎﺗﻬﺎ وﺟﻬﺪهﺎ ﻟﻠﺨﺪﻣﺎت اﻟﺤﻜﻮﻣﻴﺔ ﻟﺘﺤﺴﻴﻦ اﻟﻮﺿﻊ‬
‫اﻟﺼﺤﻲ وﺑﺎﻟﺮﻏﻢ ﻣﻦ ﺗﺤﻘﻴﻖ اﻟﺘﻘﺪم ﻓﻲ اﻷوﺿﺎع اﻟﺼﺤﻴﺔ إﻻ أن هﺬا اﻟﻤﺴﻠﻚ ﻟﻢ ﻳﺤﻘﻖ اﻟﺘﻘﺪم اﻟﻤﺮﺟﻮ‬
‫ﻓﻲ ﺧﻔﺾ ﻣﻌﺪﻻت اﻟﻮﻓﻴﺎت واﻷﻣﺮاض‪ .‬ﻟﺬا آﺎن إﺷﺮاك اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺣﻴﻮي ﻓﻲ‬
‫ﺗﺤﺴﻴﻦ آﻔﺎءة اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﺗﺨﻔﻴﻒ اﻟﻌﺐء ﻏﻴﺮ اﻟﻀﺮوري ﻋﻦ اﻟﺤﻜﻮﻣﺎت وزﻳﺎدة اﺳﺘﺨﺪام‬
‫اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪ .‬ﻟﺬا آﺎن ﻟﺰاﻣًﺎ إﻧﺸﺎء ﺷﺮاآﺔ ﻣﻊ اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﻟﻺﻣﺪاد ﺑﺎﻟﺒﻴﺎﻧﺎت‬
‫اﻟﺼﺤﻴﺔ اﻟﻼزﻣﺔ ﻹﺑﺮاز اﻻﺣﺘﻴﺎﺟﺎت اﻟﺼﺤﻴﺔ وﺗﺄآﻴﺪ وﺻﻮل اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪.‬‬

‫وﻳﻌﺘﺒﺮ إﺷﺮاك اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ذو اﺛﺮ ﺑﺎﻟﻎ ﻓﻲ ﺗﺤﺴﻴﻦ ﺟﻮدة اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ واﻹﻣﺪاد‬
‫ﺑﺎﻟﻤﻮاد اﻟﺼﺤﻴﺔ ﻣﻊ ﺗﺨﻔﻴﻒ اﻟﻌﺐء ﻏﻴﺮ اﻟﻀﺮوري ﻋﻦ اﻟﺤﻜﻮﻣﺎت ﻣﻊ زﻳﺎدة اﺳﺘﺨﺪام اﻟﺨﺪﻣﺎت‬
‫اﻟﺼﺤﻴﺔ‬

‫وﻗﺪ ﻗﺎﻣﺖ إﻣﺎرة دﺑﻲ ﺑﺠﻬﺪ ﻣﺆﺛﺮ ﻓﻲ اﻟﻘﻄﺎع اﻟﺼﺤﻲ ﻣﻦ ﺧﻼل ﻣﻨﻈﻮﻣﺔ اﻷهﻤﻴﺔ اﻟﻜﺒﺮى اﻟﻤﻮﺟﻬﺔ‬
‫ﻟﺼﺤﺔ اﻟﻤﻮاﻃﻨﻴﻦ ﺑﺪﺑﻲ ‪.‬وﺑﺸﻜﻞ اﻟﻘﻄﺎع اﻟﺨﺎص دورًا ﺟﻮهﺮﻳﺎ وهﺎﻣﺎ ﻓﻲ اﻟﺼﺤﺔ واﻟﺘﻐﺬﻳﺔ وﻓﻲ‬
‫ﺟﻮاﻧﺐ ﻣﺘﻌﻠﻘﺔ ﺑﺎﻟﺼﺤﺔ آﺘﺴﻮﻳﻖ اﻷﻃﻌﻤﺔ اﻟﺼﺤﻴﺔ واﻟﺘﻄﻌﻴﻤﺎت‪.‬‬

‫وﻗﺪ ﺑﻠﻎ ﻋﺪد زﻳﺎرات اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﺑﺎﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ‪5914209‬زﻳﺎرة ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم‬
‫وﺑﻤﻌﺪل ‪ 1.64‬زﻳﺎرة ﻟﻜﻞ ﺷﺨﺺ ﺑﺪﺑﻲ و‪ 6.04‬زﻳﺎرة ﻳﻮﻣﻴﺔ ﻟﻜﻞ ‪ 1000‬ﻣﻦ‬ ‫‪2004-2006‬‬
‫اﻟﺴﻜﺎن وﻗﺪ ﺷﻜﻞ اﻟﻤﻮاﻃﻨﻮن ‪ %6.46‬ﻣﻦ اﻟﺰﻳﺎرات واﻟﻌﺮب ‪ %11.23‬واﻵﺳﻴﻮﻳﻮن ‪%59.63‬‬
‫واﻟﺠﻨﺴﻴﺎت اﻷﺧﺮى ‪ %14.49‬ﻣﻦ اﻟﺰﻳﺎرات آﻤﺎ ﺷﻜﻞ اﻟﺬآﻮر ‪ %60.8‬ﻣﻦ اﻟﺰﻳﺎرات‬
‫واﻹﻧﺎث‪) %39.2‬ﺟﺪول رﻗﻢ ‪ .(1‬وآﺎن هﻨﺎك زﻳﺎدة ﻓﻰ ﻋﺪد اﻟﺤﺎﻻت ﻓىﺸﻬﺮ دﻳﺴﻤﺒﺮ‪) ,‬ﺷﻜﻞ رﻗﻢ‬
‫‪ (1‬وﻣﻊ زﻳﺎدة ﻓﻲ ﻋﺪد اﻟﺤﺎﻻت اﻟﻤﺮاﺟﻌﺔ ﻓﻲ ﻋﺎم ‪ 2006‬ﻓﻲ اﻟﻤﻮاﻃﻨﻴﻦ وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ)ﺟﺪول‬
‫رﻗﻢ ‪ (2‬وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ اﻟﺤﺎﻻت ﻓﻲ اﻟﺬآﻮر واﻹﻧﺎث ﺑﺎﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪(3‬‬
‫أن ﺣﻮاﻟﻲ ﻧﺼﻒ اﻟﺤﺎﻻت )‪ (%46.18‬آﺎﻧﺖ ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 44-25‬ﻋﺎﻣًﺎ و‪ %22.73‬ﻓﻲ‬

‫‪216‬‬
‫اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 64-45‬ﻋﺎﻣًﺎ وأن ﻧﺴﺒﺔ اﻹﻧﺎث آﺎﻧﺖ ﻋﺎﻟﻴﺔ ﺗﺤﺖ ‪ 45‬ﻋﺎﻣﺎ ﻣﻦ اﻟﻌﻤﺮ واﻟﺬآﻮر‬
‫‪ 45‬ﻋﺎﻣﺎ وأآﺜﺮ‪.‬‬

‫وﺑﺘﻄﺒﻴﻖ اﻟﺘﻘﺴﻴﻢ اﻟﺪوﻟﻲ ﻟﻸﻣﺮاض )اﻟﻤﺮاﺟﻌﺔ اﻟﻌﺎﺷﺮة( ﺷﻜﻠﺖ أﻣﺮاض اﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ ‪%19.98‬‬
‫ﻣﻦ اﻟﺤﺎﻻت اﻟﻤﺮاﺟﻌﺔ وأﻣﺮاض اﻟﺠﻬﺎز اﻟﻌﻀﻠﻲ واﻟﺤﺮآﻲ ‪ %8.19‬وأﻣﺮاض اﻟﻌﻴﻦ ‪%5.65‬‬
‫وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺒﻮﻟﻲ واﻟﺘﻨﺎﺳﻠﻲ ‪ %6.53‬واﻷذى واﻹﺻﺎﺑﺎت ‪ %6.67‬وأﻣﺮاض اﻟﺠﻬﺎز‬
‫اﻟﻬﻀﻤﻲ ‪ %4.93‬واﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ واﻟﻄﻔﻴﻠﻴﺔ ‪ %4.29‬وأﻣﺮاض اﻟﺠﻠﺪ ‪ %4.94‬وأﻣﺮاض‬
‫اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ ‪ %3.63‬ﻣﻦ اﻟﺤﺎﻻت اﻟﻤﺮاﺟﻌﺔ ﻟﻌﻴﺎدات اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ‬
‫آﻤﺎ هﻮ ﻣﻮﺿﺢ ﺑﺎﻟﺠﺪول رﻗﻢ )‪ .((4‬وﺑﺪراﺳﺔ اﻟﺘﻮزﻳﻊ ﺑﺎﻟﻨﻮع آﺎﻧﺖ ﻧﺴﺒﺔ أﻣﺮاض اﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ‬
‫ﻋﺎﻟﻴﺔ )‪ (%22.24‬ﺑﻴﻦ اﻟﺬآﻮر و وأﻣﺮاض اﻟﻌﻴﻦ ﺑﻴﻦ ﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ) ‪ ,(%13.43‬ﺟﺪول رﻗﻢ‬
‫)‪.(5‬‬

‫وﺑﻠﻎ ﻋﺪد اﻟﻤﺮﺿﻰ اﻟﺬﻳﻦ ﺗﻢ إدﺧﺎﻟﻬﻢ اﻟﻤﺆﺳﺴﺎت اﻟﺼﺤﻴﺔ ﻟﻠﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ‪79459‬‬
‫ﺣﺎﻟﺔ‪ .‬وﺷﻜﻞ اﻟﻤﻮاﻃﻨﻮن ‪ %22.4‬ﻣﻦ اﻟﺤﺎﻻت وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ ‪ . % 77.6‬وﺑﻠﻐﺖ ﻧﺴﺒﺔ اﻟﻌﻤﻠﻴﺎت‬
‫اﻟﺠﺮاﺣﻴﺔ اﻟﻜﺒﺮى ‪ %50.61‬وآﺎن‪ %83.9‬ﻣﻦ اﻟﻌﻤﻠﻴﺎت ﻣﺪرﺟﺔ )ﺟﺪول رﻗﻢ ‪ (7‬وﻳﻈﻬﺮ اﻟﺠﺪول‬
‫رﻗﻢ )‪ (8‬أن ﻧﺴﺒﺔ اﻟﻤﻮﻃﻨﻴﻦ آﺎﻧﺖ ‪ %21.37‬واﻟﻌﺮب ‪ %20.97‬واﻷﺳﻴﻮﻳﻴﻦ ‪ %31.96‬اﻟﺠﻨﺴﻴﺎت‬
‫اﻷﺧﺮى ‪ %25.7‬وآﺎﻧﺖ هﻨﺎك زﻳﺎدة ‪ %128‬ﻓﻲ ﻋﺪد اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ ﻓﻲ ‪ 2006‬ﻣﻘﺎرﻧﺔ ﺑﻌﺎم‬
‫‪ .2004‬وﻗﺪ ﺷﻜﻠﺖ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﺔ واﻟﻨﺴﺎء واﻟﻮﻻدة وﺟﺮاﺣﺔ اﻟﻌﻈﺎم واﻟﻤﺴﺎﻟﻚ اﻟﺒﻮﻟﻴﺔ ‪.‬‬

‫‪217‬‬
 Table ( 1 ) Distribution of Outpatient Attendances to Private
Health Clinics in Dubai 2004 2006

Sex Total
Nationality Female Male
312111.00 352070.00 664181.00
Arabs Sum
% 13.46 9.79 11.23
Asians Sum 1077381.00 2448989.00 3526370.00
% 46.45 68.13 59.63
Others Sum 456293.00 412271.00 868564.00
% 19.67 11.47 14.69
UAE Sum 473629.00 381465.00 855094.00
% 20.42 10.61 14.46

218
 Figure (1) Seasonality of Outpatient Attendances in Private
Health Sector in Dubai in 2004 - 2006
2006- 2004 ‫ﻣﻮﺳﻤﻴﺔ ﻣﺮاﺟﻌﺎت اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﻟﻠﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨ ﺎص ﺑ ﺪﺑﻲ ﻓ ﻲ ﻋ ﺎم‬

560000
540000
520000
500000
480000
460000
440000
420000
400000

st
ril

ne

ly

r
r
y

ch

ay
y

r
r

be
e
be
gu

be
ar

ar

Ju
Ap

ob
Ju
M
ar

em
bu
nu

m
em
Au

ct
M

e
Fe
Ja

ec
O
pt

ov
Se

D
N

219
 Table (2) Distribution of Cases Attending Private Health
Sector Outpatient Clinics in Dubai 2004 -2006

Nationality year All

2004 2005 2006
Arabs Sum 187066.00 214743.00 262372.00 664181.00

% 11.40 10.95 11.35 11.23

Asians Sum 960727.00 1170531.00 1395112.00 3526370.00
58.53 59.71 60.34 59.63
%
Others Sum 241866.00 287483.00 339215.00 868564.00
% 14.73 14.66 14.67 14.69
UAE Sum 251863.00 287685.00 315546.00 855094.00
% 15.34 14.67 13.65 14.46
All Sum 1641522.00 1960442.00 2312245.00 5914209.00

220
 Table (3) Distribution of Cases Attending Private Health
Sector Outpatient Clinics in Dubai 2004 -2006

Age Sex All

Female Male
0D- Sum 3496.00 3909.00 7405.00
0.15 0.11 0.13
%
7D- Sum 7548.00 8009.00 15557.00
% 0.33 0.23 0.27
29D- Sum 56587.00 70307.00 126894.00
% 2.46 1.99 2.17
1- Sum 150229.00 175326.00 325555.00
% 6.53 4.95 5.58
5- Sum 182080.00 209988.00 392068.00
% 7.92 5.93 6.72
15- Sum 352497.00 378256.00 730753.00
% 15.33 10.69 12.52
25- Sum 1048825.00 1647102.00 2695927.00
% 45.62 46.54 46.18
45- Sum 417948.00 910397.00 1328345.00
% 18.18 25.73 22.75
65- Sum 79749.00 135620.00 215369.00
% 3.47 3.83 3.69

221
Table ( 4 ) Distribution of Cases Attending Outpatient Private Health Clinics by ICD Code and Sex in
Dubai 2004 -2006

ICD CLASSIFICATION Sex

Female Male Total
(ICD CODE) No. (%) No. (%) No. (%)
Infectious & Parasitic Diseases 91467.00 162527.00 253994.00
(A00- B99) 3.94 4.51 4.29
Neoplasm (C00- D48) 7881.00 9424.00 17305.00
0.34 0.26 0.29
Diseases of the Blood & Blood 6299.00 3531.00 9830.00
Forming Organs (D50 - D89) 0.27 0.10 0.17
Endocrine, Nutritional & Metabolic 54894.00 110404.00 165298.00
Discuses (E00 – E90) 2.37 3.07 2.79
Mental & Behavioral disorders 32517.00 49170.00 81687.00
(F00 – F99) 1.40 1.37 1.38
Diseases of the Nervous System 31170.00 52781.00 83951.00
(G00 – G99) 1.34 1.47 1.42
Diseases of the Eye & Adnexa (H00 – 147758.00 186829.00 334587.00
H59) 6.37 5.19 5.65
Diseases of the Ear & Mastoid Process 53730.00 89475.00 143205.00
(H60 – H62) 2.31 2.48 2.42
Diseases of the Circulatory System 55277.00 160636.00 215913.00
(I00 – I99) 2.38 4.46 3.65
Diseases of the Respiratory System 382693.00 800754.00 1183447.00
(J00 – J99) 16.49 22.24 19.98
Diseases of the Digestive System 88617.00 203575.00 292192.00
(K00 – K93) 3.82 5.65 4.93
Diseases of the Skin & Subcutaneous 120950.00 202349.00 341316
tissue (L00 – L99) 6.70 5.62 5.77
Diseases of the Musculoskeletal 155525.00 298361.00 435869.00
System (M00 – M99) 5.92 8.29 7.36
Diseases of the Genitourinary System 239195.00 147320.00 386515.00
(N00 – N99) 10.31 4.09 6.53
Pregnancies Childbirth & the 88659.00 - 88659.00
Puerperium (O00 – O99) 3.82 - 1.50
3109.00 3609.00 6718.00
Perinatal Period (P00 – P96)
0.13 0.10 0.11
Congenital Malformations, 2489.00 2576.00 5065.00
Deformities & Chromosomal 0.11 0.07 0.09
Abnormalities (Q00 – Q99)
Symptoms, Signs Unclassified 233649.00 536640.00 770289.00
(R00 – R99) 10.07 14.90 13.01
120412.00 274474.00 394886.00
Injury & Poisoning and External 5.19 7.62 6.67
causes of Morbidity & Mortality (S00
– Y98)
Factors Influencing Health Status 404773.00 306617 711390.00
(Z00-Z99) 17.45 8.52 12.01

222
 Table ( 5 ) Distribution of Cases Attending Outpatient Private Health Clinics by Nationality in
Dubai 2004 -2006

Diagnosis Nationality Total

Arabs Asians Others UAE
Infectious & Parasitic Diseases Sum 26242.00 157118.00 34705.00 35929.00 253994.00
(A00- B99)
% 3.95 4.45 3.99 4.20 4.29

Sum 3522.00 7878.00 3846.00 2059.00 17305.00

Neoplasm (C00- D48)
% 0.53 0.22 0.44 0.24 0.29
Diseases of the Blood & Blood Sum 1570.00 4907.00 1294.00 2059.00 9830.00
Forming Organs % 0.24 0.14 0.15 0.24 0.17
(D50 - D89)
Endocrine, Nutritional & Metabolic Sum 17687.00 113205.00 14629.00 19777.00 165298.00
Discuses % 2.66 3.20 1.68 2.31 2.79
(E00 – E90)
Mental & Behavioral disorders Sum 14499.00 30583.00 19830.00 16775.00 81687.00
(F00 – F99) % 2.18 0.87 2.28 1.96 1.38
Diseases of the Nervous System Sum 12707.00 48892.00 10243.00 12109.00 83951.00
(G00 – G99) % 1.91 1.38 1.18 1.41 1.42
Diseases of the Eye & Adnexa (H00 Sum 52438.00 122006.00 45165.00 114978.00 334587.00
– H59) % 7.88 3.45 5.20 13.43 5.65
Diseases of the Ear & Mastoid Sum 21985.00 69927.00 28563.00 22730.00 143205.00
Process (H60 – H62) % 3.31 1.98 3.29 2.66 2.42
Diseases of the Circulatory System Sum 23886.00 144824.00 27581.00 19623.00 215914.00
(I00 – I99) % 3.59 4.10 3.17 2.29 3.65
Diseases of the Respiratory System Sum 97099.00 825538.00 106468.00 154342.00 1183447.00
(J00 – J99) % 14.60 23.37 12.26 18.03 19.98
Diseases of the Digestive System Sum 30259.00 184859.00 40400.00 36674.00 292192.00
(K00 – K93) % 4.55 5.23 4.65 4.29 4.93
Diseases of the Skin & Sum 37580.00 151243.00 42062.00 61391.00 292276.00
Subcutaneous tissue 5.65 4.28 4.84 7.17 4.94
(L00 – L99)
Diseases of the Musculoskeletal Sum 63340.00 284693.00 80719.00 56427.00 484909.00
System (M00 – M99) % 9.48 8.06 9.29 5.31 8.19
Diseases of the Genitourinary Sum 53119.00 214555.00 62714.00 56127.00 386515.00
System % 7.99 6.07 7.22 6.56 6.53
(N00 – N99)
Pregnancies Childbirth & the Sum 12955.00 43511.00 6726.00 25467.00 88659.00
Puerperium (O00 – O99) % 1.95 1.23 0.77 2.98 1.50
Perinatal Period Sum 716.00 4023.00 639.00 1340.00 6718.00
(P00 – P919.6) % 0.11 0.11 0.07 0.16 0.11
Congenital Malformations, Sum 1438.00 1376.00 698.00 1553.00 5065.00
Deformities & Chromosomal % 0.22 0.04 0.08 0.18 0.09
Abnormalities (Q00 – Q99)
Symptoms, Signs Unclassified (R00 Sum 55533.00 560403.00 86712.00 67641.00 770289.00
– R99) % 8.35 15.86 9.98 7.90 13.01
Sum 46993.00 233363.00 72067.00 42463.00 394886.00
Injury & Poisoning and % 7.06 6.61 8.30 4.96 6.67
External causes of Morbidity &
Mortality (S00 – Y98)
Factors Influencing Health Status Sum 91893.00 329433.00 183686.00 106378.00 711390.00
(Z00 – Z99) % 13.81 9.33 21.14 12.43 12.01

223
 Table (6) Distribution of Inpatients in Private Health Sector Facilities by
Year of Admission, Sex and Nationality in Dubai , 2004 -2006

Year Nationality Total

Arabs Asians Others UAE
F M F M F M F M
2004 Sum 1467.00 1392.00 2565.00 2754.00 2507.00 1748.00 3152.00 2095.00 17680.00
% 18.39 20.38 18.58 20.85 21.82 21.09 29.71 28.88 22.25
2005 Sum 3179.00 2611.00 5226.00 4741.00 4877.00 3571.00 3926.00 2649.00 30780.00
% 39.86 38.23 37.86 35.89 42.45 43.08 37.00 36.52 38.74
2006 Sum 3329.00 2826.00 6013.00 5715.00 4104.00 2970.00 3532.00 2510.00 30999.00
% 41.74 41.38 43.56 43.26 35.72 35.83 33.29 34.60 39.01
Total Sum 7975.00 6829.00 13804.00 13210.00 11488.00 8289.00 10610.00 7254.00 79459.00
% 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00 100.00

224
Table (7) Distribution of Surgical Operation in Private Health Sector by Type
and Schedule in Dubai in 2004-2006
‫ﺗﻮزﻳﻊ اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ ﺑﺎﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ﺑﺎﻟﻨﻮع‬
Schedule Total
Type of Operation
Scheduled Emergency
No. (%)
No. (%) No. (%)

Major 26522(43.55) 4302 (7.06) 30824(50.61)

Minor 24575(40.35) 5501(9.04) 30076(49.39)
Total 51097(83.9) 9803(16.10) 60900(100.0)

Table ( 8 ) Distribution of Operations in Private Health Sector

by Nationality and year , Dubai 2004 -2006

Year Nationality Total

Arabs Asians Others UAE
Sum 2789.00 3371.00 3827.00 3376.00 13363.00
2004 % 21.84 17.32 24.45 25.94 21.94
2005 Sum 3454.00 4902.00 4711.00 3992.00 17059.00
% 27.05 25.18 30.10 30.67 28.01
2006 Sum 6528.00 11192.00 7112.00 5646.00 30478.00
% 51.12 57.50 45.44 43.38 50.05
All Sum 12771.00 19465.00 15650.00 13014.00 60900.00

225
 Infectious Diseases Reported in Private Health Sector in Dubai 2006

Data were collected from the electronic data base of the infectious diseases
notification system in DOHMS. Table (1) shows that out of the 2227 cases of
infectious diseases reported from the private health sector in Dubai, there were 1999
(89.76%) cases among expatriates and male expatriates constituted about two thirds
(64.21%) of the reported cases. It is apparent from table (2) that about one third of the
reported cases (32.96%) were in the age group (25 – 34 years). Among males the
majority of the cases were in the working age group (15 – 54 years) and in females in
the younger age groups. As for Emirates, more than half of the cases (53.07%) were
below 15 years, Table (3). The same distribution was observed among males and
females. Figure (1) shows that the distribution of chicken pox and infectious diseases
cases reported by private health sector was nearly the same. Iranian hospital reported
more than one quarter of communicable diseases (26.05%). Cedars – Jabel Ali
International hospital 16.97% and Zulekha hospital 9.38% of infectious diseases from
the private health sector in Dubai, Table (4). About one half of the reported infectious
diseases were chicken pox, (47.06%) viral hepatitis (17.29%) and viral pneumonia
(8.17%), Table (5).

226
 ‫اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ اﻟﻤﺒﻠﻐﺔ ﻣﻦ اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ‬

‫ﺗﻢ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت ﻣﻦ ﻗﺎﻋﺪة اﻟﻤﻌﻠﻮﻣﺎت اﻻﻟﻜﺘﺮوﻧﻴﺔ ﻟﻠﺘﺒﻠﻴﻎ ﻋ ﻦ اﻷﻣ ﺮاض اﻟﻤﻌﺪﻳ ﺔ ﺑ ﺪاﺋﺮة اﻟ ﺼﺤﺔ واﻟﺨ ﺪﻣﺎت اﻟﻄﺒﻴ ﺔ‬
‫ﺑﺪﺑﻲ‪ .‬وﻳﻮﺿﺢ اﻟﺠﺪول رﻗﻢ )‪ (1‬أﻧﻪ ﺑﻴﻦ ‪ 2227‬ﺣﺎﻟﺔ أﻣﺮاض ﻣﻌﺪﻳﺔ ﺗﻢ اﻹﺑﻼغ ﻋﻨﻬ ﺎ ﻣ ﻦ اﻟﻘﻄ ﺎع اﻟ ﺼﺤﻲ اﻟﺨ ﺎص‬
‫ﺑ ﺪﺑﻲ ‪ 1999‬ﺣﺎﻟ ﺔ )‪ (%89.76‬ﺑ ﻴﻦ ﻏﻴ ﺮ اﻟﻤ ﻮاﻃﻨﻴﻦ وﺷ ﻜﻞ اﻟ ﺬآﻮر ﻏﻴ ﺮ اﻟﻤ ﻮاﻃﻨﻴﻦ ﺣ ﻮاﻟﻲ ﺛﻠﺜ ﻲ اﻟﺤ ﺎﻻت‬
‫)‪ (%64.21‬اﻟﻤﺒﻠﻐﺔ‪ .‬وآﻤﺎ هﻮ واﺿﺢ ﻣﻦ اﻟﺠﺪول رﻗﻢ )‪ (2‬ﺑﺄن ﺣﻮاﻟﻲ ﺛﻠﺚ اﻟﺤﺎﻻت اﻟﻤﺒﻠﻐ ﺔ )‪ (%32.96‬آ ﺎن ﻣ ﻦ‬
‫اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 34 - 25‬ﻋﺎﻣﺎ‪ .‬وآﺎﻧﺖ اﻟﻐﺎﻟﺒﻴﺔ ﺑﻴﻦ اﻟﺬآﻮر ﻣﻦ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 54 - 15‬ﻋﺎﻣﺎ وﻓ ﻲ اﻹﻧ ﺎث‬
‫ﻣﻦ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ اﻟﺼﻐﻴﺮة‪ .‬أﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﻮاﻃﻨﻴﻦ ﻓﻘ ﺪ آ ﺎن أآﺜ ﺮ ﻣ ﻦ ﻧ ﺼﻒ اﻟﺤ ﺎﻻت )‪ (%53.07‬ﺗﺤ ﺖ ‪15‬‬
‫ﻋﺎﻣﺎ ﻣﻦ اﻟﻌﻤﺮ )ﺟﺪول رﻗﻢ ‪ .(3‬وﻗﺪ ﻟﻮﺣﻆ هﺬا اﻟﺘﻮزﻳﻊ ﺗﻘﺮﻳﺒﺎ ﺑﻴﻦ اﻟﺬآﻮر واﻹﻧﺎث‪ .‬وﻗﺪ ﻟﻮﺣﻆ أن اﻟﺘﻮزﻳﻊ اﻟ ﺸﻬﺮي‬
‫ﻟﻠﺠﺪﻳﺮي اﻟﻤﺎﺋﻲ وﺣﺎﻻت اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ آﺎن ﻣﺘﺴﺎوﻳﺎ‪ .‬وﻗ ﺪ ﻗ ﺎم اﻟﻤﺴﺘ ﺸﻔﻰ اﻹﻳﺮاﻧ ﻲ ﺑ ﺎﻟﺘﺒﻠﻴﻎ ﻋ ﻦ أآﺜ ﺮ ﻣ ﻦ رﺑ ﻊ‬
‫ﺣﺎﻻت اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ )‪ (%26.05‬وﻣﺴﺘﺸﻔﻰ ﺳﻴﺪار ﺟﺒﻞ ﻋﻠ ﻲ اﻟ ﺪوﻟﻲ ‪ %16.97‬وﻣﺴﺘ ﺸﻔﻰ زﻟﻴﺨ ﺔ ‪،%9.38‬‬
‫ﺟﺪول رﻗﻢ )‪ .(4‬وآﺎﻧﺖ ﺣﺎﻻت اﻟﺠﺪﻳﺮي اﻟﻤﺎﺋﻲ ﺣ ﻮاﻟﻲ ﻧ ﺼﻒ ﺣ ﺎﻻت اﻷﻣ ﺮاض اﻟﻤﻌﺪﻳ ﺔ )‪ (%47.06‬واﻻﻟﺘﻬ ﺎب‬
‫اﻟﻜﺒﺪي اﻟﻔﻴﺮوﺳﻲ ‪ %17.29‬واﻻﻟﺘﻬﺎب اﻟﺮﺋﻮي اﻟﻔﻴﺮوﺳﻲ ‪ %8.17‬ﺟﺪول رﻗﻢ )‪.(5‬‬

‫‪227‬‬
 Table (1) Distribution of the Studied cases of Reported Infectious Diseases in
Private Health Sector by Nationality and Sex, Dubai 2006

Sex
Total
Nationality Male Female
No % No % No %
Emirates 139 6.24 89 4.00 228 10.24

Expatriates 1430 64.21 569 25.55 1999 89.76

Total 1569 70.45 658 29.55 2227 100.00

Table ( 2 ) Distribution of Notified Cases of Infectious

Diseases in Private Health Sector by Age , Dubai 2006

Age Sex Total

Female Male
<5 99 157 256
15.04 10.01
5- 158 140 298
24.01 8.92
15- 63 191 254
9.57 12.17
25- 171 563 734
25.99 35.88
35- 81 281 362
12.31 17.91
45- 36 114 150
5.47 7.27
55- 31 82 113
4.71 5.23
65+ 19 41 60
2.89 2.61
Total 658 1569 2227
x2= 120.57 P =0.0001

228
Table ( 3 ) Distribution of the Emirate Notified Cases of Infectious
Diseases in Private Health Sector by Age , Dubai 2006

Age Sex Total

Female Male
<5 30 46 76
33.71 33.09
5- 21 24 45
23.60 17.27
15- 9 11 20
10.11 7.91
25- 12 23 35
13.48 16.55
35- 5 17 22
5.62 12.23
45- 2 4 6
2.25 2.88
55- 6 5 11
6.74 3.60
65+ 4 9 13
4.49 6.47
Total 89 139 228

229
 Figure ( 1 ) Seasonality of Reported Com m unicable Disease in
Private Health Sector in Dubai 2006

300
250
No. of Cases

200
ID
150
CP
100
50
0
O er

ne
r

ch
Fe ary

ri l

Au y
ry

ay

st
be

be
N obe

l
Ju
b

gu
Ap
ua

Ju
M
ar
em

em

em

nu

M
ct

br
Ja
pt

ov

ec
Se

Month

Table ( 4 ) Distribution of Reported Infectious Diseases Cases from Private

Health Sector by Hospital in Dubai in 2006

Hospital Frequency Percent

Belhoul Specialty Hospital (L.L.C) 192 8.62
Cedars - Jebel Ali International Hospital 378 16.97
Iranian Hospital - Dubai 580 26.05
Prime Medical Center 171 7.68
Welcare Hospital 122 5.48
Zulekha Hospital (L L C ) 209 9.38
Other Hospitals 575 25.82

230
 Table (5) Distribution of the Notified cases of Infections Diseases in Private
Health Sector to DOHMS, Dubai 2006
2006 ‫ﺗﻮزﻳﻊ ﺣﺎﻻت اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ اﻟﻤﺒﻠﻐﺔ ﻣﻦ اﻟﻘﻄﺎع اﻟﺼﺤﻰ اﻟﺨﺎص ﺑﺪﺑﻰ ﺗﺒﻌًﺎ ﻟﻨﻮع اﻟﻤﺮض ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم‬

Code Disease Name Number %

A01 Typhoid & Paratyphoid 25 1.12

A02 Salmonellosis 27 1.21
A15 Tuberculosis 87 3.91
A38 Scarlet Fever 12 0.54
B01 Chicken Pox 1048 47.06
B02 Herpes Zoster 70 3.14
B15 Viral Hepatitis A 20 0.9
B16 Viral Hepatitis B 221 9.92
B17 Viral Hepatitis C 144 6.47
B26 Mumps 22 0.99
B15 Malaria 20 0.9
G00 Bacterial Meningitis 13 0.58
J12 Viral Pneumonia 182 8.17
T62 Food Poisoning 46 2.7

Other Infectious Diseases 292 13.11

Total number of cases 2227

231
 Mortality Statistics in Dubai

Life extension requires not only awareness of the mechanism of aging, but also an
awareness of the most common conventional causes of death and appropriate
countermeasures. Because Dubai is representative of most Gulf communities and
since so much data is available for Dubai, detailing information available from Dubai
are well enough to have reasonably good statistics.

The total number of deaths in Dubai in 2006 was 1869 with a crude mortality rate of
1.44 per 1000 population with an age standardized mortality rate of 536.3 per
100.000 population based on the world population data base 2006. Males amounted
for 77.9 % of the deaths and females 22.09%. Emirate population amounted for
21.55% of deaths and Expatriates 78.45%, Table 1. DOHMS reported 84.81% of
deaths in Dubai, MOH 4.74% and Private sector 10.45%, Figure 1.

Studying the distribution of mortality in Dubai by age and sex, table (2) shows that
2.29% of deaths were below one year, 3.19% were 1-14 year, 4.58% were 15-25
years, 15.69% were 25-35 years, 15.85% were in the age group 35-44 years, 17.73%
in the age group 45-54 years, 15.6% in the age group 55-64 years and 25.08% were 65
and above years.

As for nationals, the majority of dead personnel were married (86%), 8% single 6%
were divorced and widowed, Figure 2. Comparing males and females, 6.48% of
females were widowed. The difference in the distribution between males and females
were significant (P = 0.0003).

232
Professionals and semiprofessionals amounted for 11% of deaths, technical & manual
workers 32 housewives 31% of deaths. Among (Figure 3). As for religion, the
majority (80.0%) of deaths were Moslems and 6.6% Christians, Figure 4.

More than half of deaths (56.0%) occurred ante meridian and 44.0% postmeridian,
Figure 7. As for seasonality of deaths in Dubai there was a peak in February, Figure 8.

Applying the International Classification of Diseases (ICD 10), the total number of
the coded deaths in Dubai was 678 in 2006. Males amounted to about two thirds
(68.29%) of the deaths and females 31.71%. The percentage of Emirates was 33.33%
and Expatriates 66.7%. Cardiovascular diseases constituted 27.73% off all deaths,
neoplasm 15.78%, injury and poisoning 7.23%, infectious and parasitic diseases
6.93%, respiratory diseases 6.5%, genitourinary system 6.34% and digestive system
3.6% of the coded deaths in DOHMS, Table 2a.

The Leading causes of Death in Dubai

The most common conventional causes of death in Dubai in 2006 are cardiovascular
diseases, cancer and injuries, (Table 3a, b). It is apparent from Table (4) that the top
leading cause for those aged 15-24 years in Dubai was injuries (30%). As for the
elderly population the five leading causes of death were neoplasm (20.75. %),
ischaemic heart disease (19.8%), , renal failure 8.0%, cerebrovascular diseases (7.5)
and septicemia (6.1%) and of all deaths among those aged 60 years and above, Table
(5).

233
Conclusion and recommendation

Socio-economic development in UAE accompanied by the characteristics cultural

changes observed in developed societies elsewhere, improved sanitation and
consequent reduction in the occurrence of communicable diseases has led to
increasing life expectancy, changing nutritional habits, decreasing habitual physical
activity and the emergency of non-communicable diseases as the dominant feature of
ill health in the community. Non-communicable diseases amounted for about three
quarters (74.6%) of deaths in Dubai. Infectious and parasitic diseases constituted only
6.9% of all deaths among Emirate population in Dubai in 2004.

The main recommendations are:

• More studies are needed to determine the magnitude and risk factors of non-
communicable diseases especially among Emirate females in Dubai with the
aim of determining the prevalence amongst Emirate population and studying
the risk factors most related to the occurrence of these diseases as
cardiovascular diseases, cancer, injuries and diabetes mellitus.
• There is a need for developing and implementing a plan of action for
prevention and control of noncommunicable diseases in Dubai. The plan
should be a component of the health care system designed for health
protection and promotion of the general population in Dubai.

• Completeness of death certificate is required together with coding of deaths on

arrival to hospitals is required.

234
 ‫إﺣﺼﺎءات اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ‬

‫ﻧﻈﺮًا ﻻن دﺑﻲ ﺗﻤﺜﻞ ﻣﻌﻈﻢ اﻟﻤﺠﺘﻤﻌﺎت اﻟﺨﻠﻴﺠﻴﺔ اﻟﻤﺘﻘﺪﻣﺔ وﻟﺘﻮﻓﺮ اﻟﺒﻴﺎﻧﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﻮﻓﻴﺎت ﻣﻦ ﺷﺒﻜﺔ اﻟﻤﻌﻠﻮﻣﺎت‬
‫اﻹﻟﻜﺘﺮوﻧﻴﺔ ﺑﺎﻟﺪاﺋﺮة وﺗﺒﻠﻴﻎ اﻟﻮﻓﻴﺎت ﻣﻦ اﻟﻘﻄﺎع اﻟﺨﺎص ووزارة اﻟﺼﺤﺔ آﺎن ﻟﺰاﻣًﺎ ﺗﺤﻠﻴﻞ ﺑﻴﺎﻧﺎت اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ‬
‫واﻟﺘﻲ ﺗﻌﻜﺲ ﺣﺠﻢ اﻻﻧﺨﻔﺎض ﻓﻲ ﻣﻌﺪﻻت اﻟﻮﻓﻴﺎت واﻟﺘﺤﻮل ﻓﻲ ﻣﺴﺒﺒﺎت اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ‪.‬‬

‫هﺬا وﻗﺪ ﺑﻠﻎ ﻋﺪد اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ ‪ 1869‬ﻓﻲ ‪ 2006‬وﺑﻤﻌﺪل وﻓﻴﺎت ﺧﺎم ‪ 1.44‬ﻟﻜﻞ أﻟﻒ ﻣﻦ اﻟﺴﻜﺎن‪ .‬وآﺎن ﻣﻌﺪل‬
‫اﻟﻮﻓﻴﺎت اﻟﻤﻌﺪل ‪ 537.9‬ﻟﻜﻞ ‪ 100.000‬ﻣﻦ اﻟﺴﻜﺎن ﺑﻨﺎءا ﻋﻞ ﺗﻌﺪاد اﻟﻌﺎﻟﻢ ﻓﻲ ‪ 2006‬ﻟﻠﻤﻮاﻃﻨﻴﻦ‪ .‬وآﺎﻧﺖ ﻧﺴﺒﺔ‬
‫اﻟﺬآﻮر ‪ %77.9‬واﻹﻧﺎث ‪ %22.1‬آﻤﺎ ﺑﻠﻐﺖ ﻧﺴﺒﺔ وﻓﻴﺎت اﻟﻤﻮاﻃﻨﻴﻦ ‪ %21.55‬وﻏﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ ‪ .%78.45‬وﻗﺪ‬
‫ﻗﺎﻣﺖ هﻴﺌﺔ اﻟﺼﺤﺔ ﺑﺪﺑﻲ ﺑﺎﻟﺘﺒﻠﻴﻎ ﻋﻦ ‪ %81.81‬ﻣﻦ اﻟﻮﻓﻴﺎت ووزارة اﻟﺼﺤﺔ ‪ %4.47‬واﻟﻘﻄﺎع اﻟﺨﺎص ﺑﺪﺑﻲ‬
‫‪ ,%10.45‬ﺷﻜﻞ رﻗﻢ )‪.(1‬‬

‫وﺑﺪراﺳﺔ ﺗﻮزﻳﻊ اﻟﻮﻓﻴﺎت ﺑﺎﻟﺴﻦ ﻓﻘﺪ ﺑﻠﻎ ﻧﺴﺒﺔ اﻟﻮﻓﻴﺎت ﺗﺤﺖ ﻋﺎم ﻣﻦ اﻟﻌﻤﺮ ‪ %2.29‬و‪ %3.19‬ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ‬
‫اﻟﻌﻤﺮﻳﺔ ‪14-1‬ﻋﺎﻣًﺎ و ‪ %4.58‬ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪24-15‬ﻋﺎﻣ ًﺎ و‪ %15.69‬ﻓﻲ اﻟﺒﺎﻟﻐﻴﻦ ‪34-25‬ﻋﺎﻣًﺎ و‬
‫‪ %15.85‬ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 44-35‬ﻋﺎﻣًﺎ و ‪ %17.73‬ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 54-45‬ﻋﺎﻣ ًﺎ و ‪ %15.6‬ﻓﻲ‬
‫اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 64-55‬ﻋﺎﻣًﺎ وأآﺜﺮ ﻣﻦ رﺑﻊ اﻟﺤﺎﻻت)‪ (%25.08‬ﻓﻲ اﻟﺒﺎﻟﻐﻴﻦ ‪ 65‬ﻋﺎﻣًﺎ أو أآﺜﺮ ﻣﻦ اﻟﻌﻤﺮ‪.‬‬

‫وﻗﺪ ﺑﻠﻐﺖ ﻧﺴﺒﺔ اﻟﻤﺘﺰوﺟﻴﻦ ﺑﻴﻦ اﻟﻤﻮﺗﻰ اﻟﻤﻮاﻃﻨﻴﻦ ‪ %86‬واﻟﻌﺰاب ‪ %8‬واﻟﻤﻄﻠﻘﺎت واﻷراﻣﻞ ‪ .%6‬ﺷﻜﻞ رﻗﻢ‬
‫)‪ .(2‬وﻗﺪ ﺑﻠﻐﺖ ﻧﺴﺒﺔ اﻟﻤﻮﺗﻰ ﺑﻴﻦ اﻟﻤﻬﻨﻴﻴﻦ وﺷﺒﻪ اﻟﻤﻬﻨﻴﻴﻦ ﺑﻴﻦ اﻟﻤﻮﺗﻰ ‪ %11‬واﻟﻌﻤﺎل اﻟﻤﻬﺮة واﻟﻌﻤﺎل اﻟﻌﺎدﻳﻴﻦ‬
‫‪ %32‬ورﺑﺎت اﻟﺒﻴﻮت‪ % 31‬وآﺎﻧﺖ ﻏﺎﻟﺒﻴﺔ اﻟﻮﻓﻴﺎت )‪ (%80‬ﻣﻦ اﻟﻤﺴﻠﻤﻴﻦ واﻟﻤﺴﻴﺤﻴﻴﻦ ‪, %6.0‬ﺷﻜﻞ رﻗﻢ )‪.( 4‬‬

‫وﻗﺪ ﺣﺪث أآﺜﺮ ﻣﻦ ﻧﺼﻒ اﻟﻮﻓﻴﺎت )‪ (%56.0‬ﻓﻲ اﻟﻔﺘﺮة اﻟﺼﺒﺎﺣﻴﺔ و‪ % 44.0‬ﺑﺎﻟﻔﺘﺮة اﻟﻤﺴﺎﺋﻴﺔ‪ .‬ﺷﻜﻞ رﻗﻢ )‪ (5‬آﻤﺎ‬
‫آﺎن هﻨﺎك زﻳﺎدة ﻓﻲ ﻋﺪد اﻟﺤﺎﻻت ﻓﻲ ﺷﻬﺮ ﻓﺒﺮاﻳﺮ ﺷﻜﻞ رﻗﻢ )‪.(6‬‬

‫وﻗﺪ ﺑﻠﻎ ﻋﺪد اﻟﺤﺎﻻت اﻟﻤﻜﻮدة ﺑﺎﻟﺘﻘﺴﻴﻢ اﻟﺪوﻟﻲ ﻟﻸﻣﺮاض )اﻟﻤﺮاﺟﻌﺔ اﻟﻌﺎﺷﺮة( ‪ 678‬ﺣﺎﻟﺔ وﻗﺪ ﺷﻜﻠﺖ أﻣﺮاض اﻟﻘﻠﺐ‬
‫واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ ‪ %27.73‬ﻣﻦ اﻟﺤﺎﻻت واﻟﺴﺮﻃﺎﻧﺎت ‪ %15.78‬واﻷذى و اﻟﺴﻤﻮم ‪ %7.23‬واﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ‬
‫‪ %6.93‬اﻷﻣﺮاض اﻟﻨﻔﺴﻴﺔ ‪ %6.5‬وأﻣﺮاض اﻟﺠﻬﺎز اﻟﺒﻮﻟﻲ و اﻟﺘﻨﺎﺳﻠﻲ ‪) %6.34‬ﺟﺪول رﻗﻢ ‪.(2a‬‬

‫‪235‬‬
 ‫اﻷﺳﺒﺎب اﻟﻤﺆدﻳﺔ ﻟﻠﻮﻓﺎة ﺑﺪﺑﻲ‬
‫ﻳﻈﻬﺮ اﻟﺠﺪول رﻗﻢ )‪3‬أ‪,‬ب( أن أﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ واﻟﺴﺮﻃﺎﻧﺎت واﻟﺤﻮادث هﻲ اﻷﺳﺒﺎب اﻟﺮﺋﻴﺴﻴﺔ‬
‫ﻟﻠﻮﻓﺎة ﺑﺪﺑﻲ وآﺎﻧﺖ اﻟﺤﻮادث أآﺜﺮ أﺳﺒﺎب اﻟﻮﻓﺎة ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 24-15‬ﻋﺎﻣًﺎ آﻤﺎ هﻮ ﻣﺒﻴﻦ ﻓﻲ ﺟﺪول )‪(4‬‬
‫وآﺎن ﻣﺮض ﻗﺼﻮر اﻟﺸﺮﻳﺎن اﻟﺘﺎﺟﻲ ﻟﻠﻘﻠﺐ )‪ (%19.8‬واﻟﺴﺮﻃﺎﻧﺎت ‪ %20.75‬وأﻣﺮاض ﺷﺮاﻳﻴﻦ اﻟﻤﺦ )‪(%7.5‬‬
‫هﻲ أآﺜﺮ ﻣﺴﺒﺒﺎت اﻟﻮﻓﺎة ﺑﺎﻟﻤﺴﻨﻴﻦ‪ ,‬ﺟﺪول )‪.(5‬‬

‫اﻟﺨﻼﺻﺔ واﻟﺘﻮﺻﻴﺎت‬
‫آﺎن ﻟﻠﺘﻘﺪم اﻻﺟﺘﻤﺎﻋﻲ واﻻﻗﺘﺼﺎدي ﺑﺪوﻟﺔ اﻹﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة وﻣﺎ ﺻﺎﺣﺒﻪ ﻣﻦ اﻟﺘﻐﻴﺮ ﻓﻲ اﻟﺨﺼﺎﺋﺺ اﻟﺜﻘﺎﻓﻴﺔ‬
‫واﻟﺘﺤﺴﻦ اﻟﺒﻴﺌﻲ وﻣﺎ ﺗﺒﻌﻪ ﻣﻦ اﻻﻧﺨﻔﺎض ﻓﻲ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ وزﻳﺎدة ﻋﻤﺮ اﻟﺴﻜﺎن واﻟﺘﻐﻴﻴﺮ ﻓﻲ اﻟﻌﺎدات اﻟﻐﺬاﺋﻴﺔ‬
‫وﻗﻠﺔ اﻟﻨﺸﺎط اﻟﺒﺪﻧﻲ إﻟﻰ ﻇﻬﻮر اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ آﻈﺎهﺮة ﻏﺎﻟﺒﻴﺔ ﻟﺘﺪهﻮر اﻟﺼﺤﺔ ﺑﺎﻟﻤﺠﺘﻤﻊ‪ .‬هﺬا وﻗﺪ ﺳﺒﺒﺖ‬
‫اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻏﺎﻟﺒﻴﺔ اﻟﻮﻓﻴﺎت وﺷﻜﻠﺖ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ ‪ %8.0‬ﻣﻦ اﻟﻮﻓﻴﺎت ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ‪.‬‬

‫واﻟﺘﻮﺻﻴﺎت اﻟﺮﺋﻴﺴﻴﺔ هﻲ‬

‫‪ .1‬هﻨﺎك ﺣﺎﺟﺔ ﻋﻠﻰ وﺟﻮد دراﺳﺎت ﻟﺘﺤﺪﻳﺪ ﺣﺠﻢ وﻋﻮاﻣﻞ اﻟﺨﻄﻮرة ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﺪﺑﻲ‪.‬‬

‫‪ .2‬إﻧﺸﺎء وﺗﻨﻔﻴﺬ ﺧﻄﺔ ﻋﻤﻞ ﻟﻠﻮﻗﺎﻳﺔ واﻟﻤﻜﺎﻓﺤﺔ ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ آﺄﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ‬
‫واﻟﺴﺮﻃﺎﻧﺎت واﻟﺴﻜﺮي واﻟﺤﻮادث ﺑﺪﺑﻲ وﻋﻠﻰ أن ﺗﻜﻮن اﻟﺨﻄﺔ ﺟﺰءا ﻣﻦ ﻧﻈﺎم اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﻤﺼﻤﻢ‬
‫ﻟﺘﺤﺴﻴﻦ اﻟﺼﺤﺔ وﻣﻘﺎوﻣﺔ اﻟﻤﺮض ﻟﻠﺴﻜﺎن ﺑﺪﺑﻲ‪.‬‬

‫‪ .3‬اﺳﺘﻜﻤﺎل ﺑﻴﺎﻧﺎت ﺷﻬﺎدة اﻟﻮﻓﺎة وﺗﻜﻮﻳﺪ ﺳﺒﺐ اﻟﻮﻓﺎة ﻟﻠﺬﻳﻦ ﻳﺼﻠﻮن اﻟﻤﺴﺘﺸﻔﻴﺎت وهﻢ ﻣﻮﺗﻰ‪.‬‬

‫‪236‬‬
Table (1) Distribution of Deaths in Dubai by Sex and Nationality, 2006

Sex Nationality Total

Emirate Expatriate
Female 121 169 290
9.22 12.87 22.09
41.72 58.28
Male 162 861 1023
12.34 65.58 77.91
15.84 84.16
Total 283 1030 1313
21.55 78.45 100.00
x2 = 89.56 P= 0.000

237
Table (2) Distribution of Deaths in Dubai by Age Group, 2006

Age Group Sex Total

Female Male
<1 13 15 28
1.06 1.23 2.29
4.63 1.59
1- 9 12 21
0.74 0.98 1.72
3.20 1.27
5- 5 13 18
0.41 1.06 1.47
1.78 1.38
15- 12 44 56
0.98 3.59 4.58
4.27 4.67
25- 10 182 192
0.82 14.87 15.69
3.56 19.30
35- 16 178 194
1.31 14.54 15.85
5.69 18.88
45- 27 190 217
2.21 15.52 17.73
9.61 20.15
55- 46 145 191
3.76 11.85 15.60
16.37 15.38
65- 83 81 164
6.78 6.62 13.40
29.54 8.59
75+ 60 83 143
4.90 6.78 11.68
21.35 8.80
Total 281 943 1224
22.96 77.04 100.00

238
Figure ( 1) Distribution of De aths in Dubai by Re porting Site , Dubai
2006
2006 ‫ﺗﻮزﻳﻊ ﺣﺎﻻت اﻟﻮﻓﺎة ﺑﺪﺑﻲ ﺑﻤﻮاﻗﻊ اﻟﺘﺒﻠﻴﻎ ﻓﻲ ﻋﺎم‬

10.45
4.74
DOHMS
MOH
Private Sector
84.81

239
Figure (2) Distribution of De aths among Emirate s by Marital
Status in Dubai 2006
2006 ‫ﺗﻮزﻳﻊ اﻟﻮﻓﻴﺎت ﺑﻴﻦ اﻟﻤﻮاﻃﻨﻴﻦ ﺑﺪﺑﻲ ﺑﺎﻟﺤﺎﻟﺔ اﻻﺟﺘﻤﺎﻋﻴﺔ ﻓﻲ ﻋﺎم‬

8% 6%

Married
Single
Widow ed & Divorced
86%

240
 Figure (3) Distribution of Deaths by Occupation in Dubai, 2004
2006 ‫ﺗﻮزﻳﻊ اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ ﺑﺎﻟﻤﻬﻨﺔ ﻓﻲ ﻋﺎم‬

3% 1% 11%
22%

32%

31%

Professional & Semiprofessional Technical & Manual Workers Housew ives

Retired Student Neoborn

241
 Figure (4) Distribution of Deaths in Dubai by Religion, Dubai 2006
2006 ‫ﺗﻮزﻳﻊ اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ ﺑﺎﻟﺪﻳﺎﻧﺔ ﻓﻲ ﻋﺎم‬

Others

Hindu
Religion

Christian

Muslim

0 20 40 60 80 100

242
 Figure (5) Distribution of Deaths in Dubai by Tim e of
Death in 2006
2006 ‫ﺗﻮزﻳﻊ اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ ﺑﻮﻗﺖ اﻟﻮﻓﺎة ﻓﻲ ﻋﺎم‬

44%
AM
PM
56%

243
 Figure (6) Se asonality of Mortality in Dubai 2006
2006 ‫ﻣﻮﺳﻤﻴﺔ اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ ﻓﻲ ﻋﺎم‬

180
160
Number of Deaths

140
120
100
80
60
40
20
0
l

ay
ch

ly

r
st
ne
y

ri
y

be

be
ar

ar

be
Ju

gu
Ap

ob
ar

Ju

em

em
nu

bu

em
Au
M

ct
Ja

Fe

ec
O
pt

No
Se

D
Month

244
 Table (2a) Distribution of Deaths by ICD code, Sex and Nationality in Dubai 2006
2006 ‫ﺘﻭﺯﻴﻊ ﺤﺎﻻﺕ ﺍﻟﻭﻓﺎﺓ ﺒﺎﻟﺘﻘﺴﻴﻡ ﺍﻟﺩﻭﻟﻲ ﻟﻸﻤﺭﺍﺽ ﻭﺍﻟﻨﻭﻉ ﻭﺍﻟﺠﻨﺴﻴﺔ ﺒﺩﺒﻲ ﻓﻲ ﻋﺎﻡ‬

Nationality
Total
ICD Classification UAE Expatriate
(ICD Code)
Males Females Total Males Females Total Males Females Total
No. (%)
Infectious & Parasitic
Diseases 10 3 13 24 10 34 52 18 47 (6.93)
(A00- B99)
107
Neoplasm (C00- D48) 22 18 40 40 27 67 62 45
(15.78)
Diseases of the Blood &
Blood Forming Organs (D50 1 - 1 1 - 1 2 - 2 (0.29)
- D89)
Endocrine, Nutritional &
Metabolic Discuses (E00 – 5 11 16 15 7 22 20 18 38 (5.6)
E90)
Mental & Behavioral
disorders 2 - 2 - - - 2 - 2 (0.29)
(F00 – F99)
Diseases of the Nervous
System 3 2 5 - 2 2 3 4 7 (1.03)
(G00 – G99)
Diseases of the Circulatory
188
System 35 26 61 100 27 127 135 53
(27.73)
(I00 – I99)
Diseases of the Respiratory
14 8 22 14 5 19 28 13 41 (6.5)
System (J00 – J99)
Diseases of the Digestive
System 5 3 8 10 1 11 15 4 19 (2.80)
(K00 – K93)
Diseases of the
Musculoskeletal System 1 - 1 - 1 1 1 1 2 (0.29)
(M00.0-M99.9)
Diseases of the
Genitourinary System (N00 7 11 18 15 10 25 22 21 43 (6.34)
– N99)
Perinatal Period (P00 –
4 6 10 7 4 11 11 10 21 (3.1)
P919.6)
Congenital Malformations,
Deformities &
- - - 3 4 7 3 4 7 (1.03)
Chromosomal
Abnormalities (Q00 – Q99)
Symptoms, Signs
105
Unclassified 15 13 28 67 10 77 82 23
(15.49)
(R00 – R99)

Injury & Poisoning and

External causes of 1 - 1 42 6 48 43 6 49 (7.23)
Morbidity & Mortality (S00
– Y98)
101 338 114 463 215 678
Total (%) 125(55.31) 226(100.0) 452 (100.0)
(44.69) (74.78) (25.22) (68.29) (31.71) (100.0)
Not stated 1191

245
 Table (3a) The Ten Leading causes of Death in Dubai 2006
2006 ‫ﺍﻷﺴﺒﺎﺏ ﺍﻟﻌﺸﺭﺓ ﺍﻟﻤﺅﺩﻴﺔ ﻟﻠﻭﻓﺎﺓ ﺒﺩﺒﻲ ﻓﻲ ﻋﺎﻡ‬

Causes No. %
Ischaemic Heart Disease 130 17.78
Cancer 125 17.01
Cerebrovascular Diseases 50 6.84
Renal Failure 48 6.57
Septicemia 40 5.47
Diabetes Mellitus 39 5.34
Injuries of the head 39 5.34
Condition Originating in prenatal period 32 4.38
Pneumonia 31 4.24
Liver Diseases 15 2.05
Total No. of Coded Deaths in Dubai 731
* Unspecific 183

246
 Table (3b) The Ten Leading causes of Death among Emirate population in Dubai
2006
2006 ‫ﺍﻷﺴﺒﺎﺏ ﺍﻟﻌﺸﺭﺓ ﺍﻟﻤﺅﺩﻴﺔ ﻟﻠﻭﻓﺎﺓ ﺒﻴﻥ ﺍﻟﻤﻭﺍﻁﻨﻴﻥ ﺒﺩﺒﻲ ﻓﻲ ﻋﺎﻡ‬

Causes No. %
Cancer 34 17.1
Ischaemic Heart Disease 33 16.6
Pneumonia 16 16.6
Renal Failure 16 16.6
Cerebrovascular Diseases 16 16.6
Diabetes Mellitus 16 16.6
Septicemia 11 5.5
Condition Originating in prenatal period 10 5.0
Heart Failure 4 2.0
Liver Diseases 3 1.5
Total No. of Coded Deaths 199

* Unspecific 28

247
 Table (4) The Five Leading causes of Death among Ages 15-24 Years, Dubai, 2006
2006 ‫ ﻋﺎﻤ ﹰﺎ ﺒﺩﺒﻲ ﻓﻲ ﻋﺎﻡ‬24-15 ‫ﺍﻷﺴﺒﺎﺏ ﺍﻟﺨﻤﺴﺔ ﺍﻟﻤﺅﺩﻴﺔ ﻟﻠﻭﻓﺎﺓ ﻓﻲ ﺍﻟﻤﺠﻤﻭﻋﺔ ﺍﻟﻌﻤﺭﻴﺔ‬

Causes No. Percent of Top 5

Injury 6 30
Infectious Diseases 4 20
Cardiovascular Diseases 3 15
Neoplasm 2 10
Respiratory 1 5
Total No. of Coded Deaths 20
Unspecific 5

248
 Table (5) The Five Leading causes of Death among Elderly population in Dubai, 2006

2006 ‫ﺍﻷﺴﺒﺎﺏ ﺍﻟﺨﻤﺴﺔ ﺍﻟﻤﺅﺩﻴﺔ ﻟﻠﻭﻓﺎﺓ ﺒﻴﻥ ﺍﻟﻤﺴﻨﻴﻥ ﺒﺩﺒﻲ ﻓﻲ ﻋﺎﻡ‬

Causes No. Percent of Top 5

Neoplasm 44 20.75
Ischaemic heart disease 42 19.8
Renal Failure 17 8.0
Cerebrovascular Diseases 16 7.5
Septicemia 13 6.1
Total No. of Coded Deaths 212

Unspecific 27

249
 Situation of Statistical Analysis in DOHMS

Situational analysis

The Consultant Epidemiologist in the Statistical Analysis Section conducted a

situation analysis describing exiting statistical analysis system in DOHMS and
showed why change is required .The analysis was carried out during briefing of the
activities of DOHMS. The writer identified the purpose for which data are currently
used and showed how needs are currently met. The exiting statistical analysis process,
data collection, forms, data flow and reporting mechanisms was also checked. The
situation analysis identified what is working, what is not and what is indifferent so
that the parts of the system that needs to use changed can be identified and those that
do work can be retained.

Meeting and briefing with Director Generals of Departments, Directors of Hospitals

& PHC and Head of sections in DOHMS was carried out.

In order to get oriented and to carry out the situation analysis of the existing statistical
analysis system, the Consultant Epidemiologist carried out several meeting and field
visits inside the DOHMS with the key personnel for medical records in the hospitals
visited.

The process was carried following three main procedures:

• Revising & reviewing the data collection forms, routine data collection
methods, recording, reporting, data flow, processing, quality of data and
communication standard.
• Field visits to medical records in the hospitals visited and data generator
departments in Headquarter in DOHMS

250
 • Meeting and discussion with the health care officials in DOHMS.

The review of the statistical services covered the overall statistical activities set up of
DOHMS, information collection, processing and utilization.

• Statistical Analysis Section

The statistical analysis section is a part of the Department of Planning & Statistics.
Although many personnel in the section are qualified in statistics and the demand
for reliable statistics is increasing, there is a shortage of in usage of professional
statistical packages and respective health authorities are much concerned about
this. Although a number of staff prepares some kinds of statistics; there is no clear
statement of who is responsible for statistical work. The link between the section
and periphery level needs to be strengthened, as there is no central administrative
authority on the statistical personnel at the hospitals or PHC level. In addition
there is weak coordination or co-operation between the section and other data
generating departments and services at the central level.

The Statistical Analysis Section issues an Annual Statistical Report based

on the annual report of hospitals and PHC. A Statistical Newsletter is
issued quarterly and Dubai Health Profile was prepared by the writer

• Hospital Statistics. In all hospitals there are medical records sections.

Hospital data included in the reports are prepared from the hospital records
and electronic network available in DOHMS. It differs from one hospital to
another and is not standardized. The data include number of admission,

251
 attendance to specialty clinics, operations and diagnosis at discharge.
Statistics on bed utilization, duration of stay, hospital births and deaths and
statistics on support services.

• Primary Health Care: The catchments area of each PHC is well defined.
Each patient should be treated in the health center belonging to his
residence. So that the referral system from PHC to hospital is well defined
and patients cannot attend the hospital directly. PHC centers offer curative
and preventive services and their activities are reported monthly.

There are some constrains facing the statistical analysis in DOHMS:

1. Inadequate appreciation of the value of statistical information for decision-

making.
2. Different health departments and hospitals act independently with each other.
3. The Statistical Analysis System inside DOHMS is not unified.
4. Data routinely reported by health services staff are considered of dubious validity
and completeness.
5. Despite considerable investment in computers, statistical analysis in some places
is still manual.
6. Shortage in training personnel in statistical analysis.

Needs Assessment:

A full need assessment is required as a basis for effective statistical analysis system
development and as a prerequisite for computing work to be commissioned. Needs
assessment involved formal analysis of the requirements of HIS; the data required to

252
meet those needs and the data flows. The needs assessment should be linked with the
current situation analysis to show how the existing system should be modified to meet
management requirements more effectively. To identify the basic information needs
and feasible health indication for all decision-makers at all levels of the health system,
a survey should be carried out.

As the countries and institutions began to design a new strategy for strengthening
statistical departments, a high level of interest among senior decision makers in
DOHMS and among service staff in improving the use of existing health data and in
managing better the collection, analysis and presentation of data at all service levels is
appreciated.

Recommendation

As analysis of data is an essential element of health information system, there should

be an adequate statistical analysis of data capable of providing information required
by all levels of health care personnel. The main recommendations are:
• Strengthening the Statistical Analysis Section in DOHMS.
• Building an epidemiologic capabilities in the Department of planning &
Statistics and DOHMS
• Establishment of a Research Section in Department of planning & Statistics
and DOHMS
• Establishment of a Non-Communicable Diseases Control Section in DOHMS

253
 Project Plans of Design & Implementation of

Statistical Analysis System in DOHMS

A major project such as design and implementation of a new statistical analysis

system in DOHMS requires a statement of goal, objectives, priorities and
achievement millstones. There should be some flexibility in designing plans and if
necessary, updating. However there should be no sequestional changes unless they
are absolutely required for successful completion of the project.

Goal:

To improve planning and management of health services at DOHMS

Objective:

To develop statistical analysis system in DOHMS capable to use a set of resources

and technology within a management organization to collect, process, analyze and
disseminate relevant, accurate, reliable information needed by all potential users of
health information. The process of development will include updating and developing
the main components or subsystems of health information:

Targets:

• Development of a unified statistical analysis system in DOHMS .All

health professionals should abide to that system.
• Definition of the information needs for decision-makers at all levels of
the health system, the basic data required to calculate various indicators
together with the sources and methods of collection to provide these
data.
• Routine procedures should be the main method for data collection, but non-
routine methods (as health surveys and health system research) definitely
have their role in providing information that cannot other wise be obtained.
• Ensure routine reporting has needed information from lower level to upper
levels and vice versa.
• Standardize the data input forms so as to ensure data integrity, reduction of
redundancy and errors.

254
 • Modern technologies for data processing, storage and retrieving when
required are to be installed and used to meet these purposes.
• Education, training and technical assistance of statistical analysis in
DOHMS staff on the proper use of the information made available.

Terms of Reference:

Statistical analysis system in DOHMS divided into 2 phases: phase (I) designing an
appropriate statistical analysis system and phase (II) Implementation of the system.

Phase (1) includes designing a HIS by defining its:

• Objectives;
• Institutional responsibilities at the ministerial, governorate, district and
family levels;
• Scope, nature, and type of data to be collected, processed, aggregated;

• Dissemination tools and data collection forms (periodic reports, Monitoring

indicators);
• Quality assurance mechanisms;
• Flow of information between statistical analysis system in DOHMS and
hospitals and PHC centers.
• Mechanisms for collecting data.
• Training needs to ensure effective implementation.
• Operating resource requirements (e.g., number of staff)
• Selection criteria for staff working with the statistical analysis system in
DOHMS.

Coverage:

It will cover all health facilities, preventive and curative with statistical services
through the unified statistical analysis system in DOHMS.

Strategy:
To develop a statistical analysis system in DOHMS the following phases will be
adopted:
• Review / analysis phase (situation analysis of the existing statistical
analysis system in DOHMS.

255
 • Development / Design phase of the statistical analysis system in
DOHMS
• Field-testing phase of new system.
• Implementation phase.

Methodology:

The process of development will include updating and developing the main
components or subsystems statistical analysis system in DOHMS. The following
methodological process will be adopted:
1. Detailed System Analysis for existing statistical analysis system in
DOHMS. The scope of analysis included all activities of DOHMS.
2. Information Needs Assessment
3. Reorganizing the flow of data from the facility level to upper levels.
4. Specifying the health indicators for all health activities of the DOHMS
5. Optimum utilization of the computerized HIS network in DOHMS to
support data input and output analysis reports.
6. Conducting training for all Levels staff involved in statistical analysis in
activities in DOHMS.
7. Supporting hospitals and PHC level with technical support in
implementing the statistical analysis system in DOHMS

Project Stages:

The following activities and tasks are included as the project stages to be listed in
the project plan.

1. Situation analysis

2. Needs assessment

3. System design and testing

i. Updating field collection and reporting forms.

ii testing of information network.

iii- Updating of routine tables

256
 iv- Drafting and testing of field manuals and guidelines.

4. Implementation

Data Items

When the specific needs to be served is defined, an analysis is made of the data items,
collection processes and recording systems to meet these needs. Thus determine what
data items should be collected, the specific source of data items and the manner of
collection. When the data items had been identified, the proposed data collection is
documented and the proposed standards and definitions are included.

• Standardization

One of the main requirements from a statistical point of view is to be ensuring

standardization of information collected from hospital and PHC. The essential data
items to be collected should be declared and managed as part of a National Minimum
Data Set (NMDS), which defines the list of data items to be collected by all service
units throughout DOHMS. In addition to the NMDS it is desirable to create a data
directory, which contains standard definition of all data items, collected, whether or
not they are included in the NMDS.

• Design

Design of the data collection forms, recording and reporting instruments involved
making specific decisions on who collects, what and how.
The following specific collection design tasks were performed:

1. Selecting the data collection, recording and reporting procedures. This

involved making a final decision on who initially records and who collects
data at various points in the information system, the way it will be collected
and the way it will be processed.
2. Making a draft of the data collection forms when existing patient and health
facility recording systems were not operating efficiently or did not have
appropriate data items, they were revised with assistance of IT Department.

257
 • Information Flow

The specific design of the flow of information from one level to the next should be
specified. It is recommended that the data be summarized at each step in the
processing sequence. It is not necessary to duplicate local data basis throughout the
system or even to have all data retained statistical analysis section. Supervisors at
each level should routinely provide feedback.

• Field Manual and Guidelines

When the data collection and processing procedures have been designed, field
manuals and guidelines should be drafted. The IT Department in DOHMS should be
consulted in the formulation of information processing procedures.

Design the Statistical Analysis System Manual

The purpose of the Statistical Analysis System Manual is to provide a set of guidelines
by which Statistical Analysis in DOHMS can be refocused to improve the timeliness,
quality access and use of management information. The guidelines describe the
activities and tasks that be considered and addressed before work can begin to avoid
some of the more common pitfalls observed in Statistical Analysis System in DOHMS
.It is also a good tool that helps various categories of health personnel whose work is
related to health information.

The manual includes the following:

I. The overall organization of DOHMS.

II. The statistical services set up in DOHMS
III. The forms designed data collection, instructions for filling the forms,
channels and periodicity of reporting.
IV. The indicators to be used for monitoring and evaluation of health services.
V. Definition of terms and nomenclatures commonly included in health and
health- related indicators.

Design of output tables

The following main types of routine tables should be generated:

1. Output tables: Designed to support management and decision-making. Output

258
 tables should provide information on the extent to which DOHMS goals and
targets have been achieved.
2. Performance indicators: They provide information on same intermediate or proxy
measures, which can be used to gauge the success of the system
3. Tables specifically designed to support the conduct of the services. These tables
provide details of specific activities such as use of resources, finance and supplies.
4. Efficiency tables: These tables relate outcome, or activities to resource use. They
indicate the cost of carrying out the services or some component of it.
5. Efficiency tables: These tables relate treatment and health care activities to specific
health outcome to illustrate service effectiveness.

Institutional Responsibilities

Statistical Analysis Section:

y Issue of annual statistical reports.

y Application of feedback mechanisms for lower levels.
y Review and analysis of data and information.
y Using secondary data in DOHMS and private Health Sector in carrying out
research
y Training and conduction of workshops.

Hospitals:

y The same but more data and information according to type of hospital.
y Sugary operations in the hospital.
y Inpatients statistics
y Calculation of rates and indicators for measuring performance level in the
hospital.

Primary Health care center:

y Collection and registration of vital data (Births & Deaths).

y Registration of patients treated.
y Registration of preventive activities.
y Reporting of communicable diseases.
y Registration of cases refereed to higher levels for treatment.
y Registration of drugs used.
y Preparation of report

259
 ‫ﻣﺸﺮوع ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ ﻧﻈﺎم اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ اﻟﻤﻄﻮر ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬

‫ﻳﺤﺘﺎج ﻣﺸﺮوع ﺗﺨﻄﻴﻂ وﺗﻨﻔﻴﺬ ﻧﻈﺎم ﺟﺪﻳﺪ ﻟﻠﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة ﺗﺤﺪﻳﺪ اﻟﻤﺮاﻣﻰ واﻷهﺪاف واﻷوﻟﻮﻳﺎت وﻣﻌﺎﻟﻢ‬
‫اﻹﻧﺠﺎز‪ .‬هﺬا وﻳﺠﺐ أن ﻳﻜﻮن هﻨﺎك ﺑﻌﺾ اﻟﻤﺮوﻧﺔ ﻓﻲ ﺗﺼﻤﻴﻢ اﻟﺨﻄﻂ ﻋﻨﺪ اﻟﻀﺮورة إﻻ اﻧﻪ ﻻ ﻳﺠﺐ أن ﺗﺤﺪث‬
‫ﺗﻐﻴﺮات ﻣﺘﻌﺎﻗﺒﺔ ﻣﺎ ﻟﻢ ﺗﻜﻦ هﻨﺎك ﺣﺎﺟﺔ ﻣﻠﺤﺔ ﻟﻺﺗﻤﺎم اﻟﻨﺎﺟﺢ ﻟﻠﻤﺸﺮوع‪.‬‬

‫ﺍﻟﻐﺮﺽ )‪(Goal‬‬

‫ﺗﺤﺴﻴﻦ ﺗﺨﻄﻴﻂ وإدارة اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﺑﺪﺑﻲ‪.‬‬

‫ﺍﻷﻫﺪﺍﻑ )‪(Objectives‬‬

‫إﻧﺸﺎء ﻧﻈﺎم ﺗﺤﻠﻴﻞ إﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة ﻗﺎدر ﻋﻠﻰ اﺳﺘﺨﺪام اﻟﻤﻮارد واﻟﺘﻘﻨﻴﺎت ﻣﻦ ﺧﻼل إدارة ﻧﻈﺎم هﻴﻜﻠﻲ ﻟﺠﻤﻊ‬
‫وﺗﺤﻠﻴﻞ وﺗﻮزﻳﻊ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺪﻗﻴﻘﺔ واﻟﺼﺤﻴﺤﺔ وذات اﻟﻌﻼﻗﺔ واﻟﺘﻲ ﺗﺤﺘﺎج إﻟﻴﻬﺎ ﻣﺴﺘﺨﺪﻣﻲ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬

‫ﺍﳌﺮﺍﻣﻰ )‪(Targets‬‬

‫إﻧﺸﺎء ﻧﻈﺎم ﺗﺤﻠﻴﻞ إﺣﺼﺎﺋﻲ ﻣﻮﺣﺪ ﺑﺎﻟﺪاﺋﺮة ﻳﻠﺘﺰم ﺑﻪ آﻞ اﻟﻤﻬﻨﻴﻴﻦ اﻟﺼﺤﻴﻴﻦ اﻟﻌﺎﻣﻠﻴﻦ ﺑﺎﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ‬ ‫‪.1‬‬
‫ﺑﺎﻟﺪاﺋﺮة‪.‬‬
‫ﺗﺤﺪﻳﺪ اﻻﺣﺘﻴﺎﺟﺎت اﻟﻤﻌﻠﻮﻣﺎﺗﻴﺔ ﻟﻤﺴﺘﺨﺪﻣﻲ اﻟﻘﺮار ﻋﻠﻰ آﺎﻓﺔ ﻣﺴﺘﻮﻳﺎت اﻟﻨﻈﺎم اﻟﺼﺤﻲ واﻟﺒﻴﺎﻧﺎت اﻹﺣﺼﺎﺋﻴﺔ‬ ‫‪.2‬‬
‫اﻟﺘﻲ ﺗﺤﺘﺎج إﻟﻴﻬﺎ ﻟﺤﺴﺎب ﻣﺨﺘﻠﻒ اﻟﻤﺆﺷﺮات إﺿﺎﻓﺔ إﻟﻰ ﻣﺼﺎدر وﻃﺮق ﺟﻤﻊ ﺗﻠﻚ اﻟﺒﻴﺎﻧﺎت‪.‬‬
‫ﻳﺠﺐ أن ﺗﻜﻮن اﻟﺴﺒﻞ اﻟﺮوﺗﻴﻨﻴﺔ هﻲ اﻟﻄﺮﻳﻘﺔ اﻟﺮﺋﻴﺴﻴﺔ ﻟﺠﻤﻊ اﻟﺒﻴﺎﻧﺎت ﻟﻜﻨﻪ ﻳﻤﻜﻦ اﻻﺳﺘﻌﺎﻧﺔ ﺑﺎﻟﻤﺴﻮﺣﺎت اﻟﺼﺤﻴﺔ‬ ‫‪.3‬‬
‫وﺑﺤﻮث اﻟﻨﻈﻢ اﻟﺼﺤﻴﺔ ﻟﺘﻘﺪﻳﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﻲ ﻳﺤﺘﺎج إﻟﻴﻬﺎ و اﻟﺘﻰ ﻻ ﻳﻤﻜﻦ ﺗﻮﻓﻴﺮهﺎ ﺑﺎﻟﺴﺒﻞ اﻟﺮوﺗﻴﻨﻴﺔ‪.‬‬
‫ﺗﺄآﻴﺪ اﻟﺘﺒﻠﻴﻎ اﻟﺮوﺗﻴﻨﻰ ﻟﻠﺒﻴﺎﻧﺎت اﻟﻤﺤﺘﺎج إﻟﻴﻬﺎ ﻣﻦ اﻟﻤﺴﺘﻮﻳﺎت اﻟﺴﻔﻠﻲ إﻟﻰ اﻟﻤﺴﺘﻮﻳﺎت اﻟﻌﻠﻴﺎ وﺑﺎﻟﻌﻜﺲ‪.‬‬ ‫‪.4‬‬
‫ﻣﻌﺎﻳﺮة واﺧﺘﺒﺎر أﺷﻜﺎل ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت ﻟﺘﺄآﻴﺪ ﺳﻼﻣﺔ اﻟﺒﻴﺎﻧﺎت وﺗﻘﻠﻴﻞ زﻳﺎدة اﻟﺒﻴﺎﻧﺎت واﻷﺧﻄﺎء‪.‬‬ ‫‪.5‬‬
‫اﺳﺘﺨﺪام اﻟﺘﻘﻨﻴﺎت اﻟﺤﺪﻳﺜﺔ ﻟﺘﺠﻤﻴﻊ اﻟﺒﻴﺎﻧﺎت وﺗﺨﺰﻳﻨﻬﺎ واﺳﺘﺮدادهﺎ ﻋﻨﺪ اﻟﺤﺎﺟﺔ إﻟﻴﻬﺎ‪.‬‬ ‫‪.6‬‬
‫اﻟﺘﻌﻠﻴﻢ واﻟﺘﺪرﻳﺐ واﻟﻤﺴﺎﻋﺪة اﻟﺘﻘﻨﻴﺔ ﻟﻠﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﻟﻠﻌﺎﻣﻠﻴﻦ ﺑﺎﻟﺪاﺋﺮة ﻋﻦ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺘﻮﻓﺮة ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.7‬‬

‫ﺣﺪﻭﺩ ﺍﳌﺮﺍﺟﻌﺔ )‪(Terms of Reference‬‬

‫ﺳﻮف ﻳﻨﻘﺴﻢ ﻣﺸﺮوع ﺗﺤﺪﻳﺚ اﻟﻨﻈﺎم اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة إﻟﻰ ﻣﺮﺣﻠﺘﻴﻦ‪:‬‬

‫‪ .1‬ﺗﺼﻤﻴﻢ ﻧﻈﺎم ﺗﺤﻠﻴﻞ إﺣﺼﺎﺋﻲ ﻣﻨﺎﺳﺐ‪.‬‬

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 ‫‪ .2‬ﺗﻨﻔﻴﺬ هﺬا اﻟﻨﻈﺎم‪.‬‬

‫هﺬا وﺳﻴﺸﻤﻞ ﺗﺼﻤﻴﻢ اﻟﻨﻈﺎم اﻹﺣﺼﺎﺋﻲ ﺗﺤﺪﻳﺪ‪:‬‬

‫‪ .1‬أهﺪاف ﻧﻈﺎم اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ‪.‬‬

‫‪ .2‬ﺗﺤﺪﻳﺪ اﻟﻤﺴﺌﻮﻟﻴﺎت اﻟﻬﻴﻜﻠﻴﺔ ﻋﻠﻰ ﻣﺴﺘﻮى ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ واﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ‪.‬‬
‫‪ .3‬ﻣﺠﺎل وﻃﺒﻴﻌﺔ وﻧﻮع اﻟﺒﻴﺎﻧﺎت اﻟﺘﻲ ﻳﺮاد ﺗﺠﻤﻴﻌﻬﺎ ودﻣﺠﻬﺎ‪.‬‬
‫‪ .4‬ﺳﺒﻞ ﺗﻮزﻳﻊ اﻟﺒﻴﺎﻧﺎت واﺳﺘﻤﺎرات ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت )اﻟﺘﻘﺎرﻳﺮ اﻟﺪورﻳﺔ‪ -‬ﻣﺆﺷﺮات اﻟﻤﺮاﻗﺒﺔ(‪.‬‬
‫‪ .5‬ﺗﻘﻨﻴﺔ ﺗﺄآﻴﺪ اﻟﺠﻮدة‪.‬‬
‫‪ .6‬ﺗﺪﻓﻖ اﻟﺒﻴﺎﻧﺎت ﺑﻴﻦ ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة واﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ‪.‬‬
‫‪ .7‬ﺗﻘﻨﻴﺔ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت‪.‬‬
‫‪ .8‬اﺣﺘﻴﺎﺟﺎت اﻟﺘﺪرﻳﺐ ﻟﺘﺄآﻴﺪ اﻟﺘﻨﻔﻴﺬ اﻟﻔﻌﺎل‪.‬‬
‫‪ .9‬اﺣﺘﻴﺎﺟﺎت اﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ‪.‬‬
‫‪ .10‬ﻣﻘﺎﻳﻴﺲ اﻻﺧﺘﻴﺎر ﻟﻠﻌﺎﻣﻠﻴﻦ ﺑﻨﻈﺎم اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة‪.‬‬

‫ﺍﻟﺘﻐﻄﻴﺔ )‪(Coverage‬‬

‫ﺳﻮف ﻳﻐﻄﻲ اﻟﻨﻈﺎم آﻞ اﻟﻤﺆﺳﺴﺎت اﻟﺼﺤﻴﺔ اﻟﻮﻗﺎﺋﻴﺔ واﻟﻌﻼﺟﻴﺔ ﺑﺎﻟﺨﺪﻣﺎت اﻹﺣﺼﺎﺋﻴﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬

‫ﺍﻻﺳﱰﺍﺗﻴﺠﻴﺔ )‪(Strategic‬‬

‫ﻟﺘﺤﺪﻳﺚ ﻧﻈﺎم اﻹﺣﺼﺎء ﺑﺎﻟﺪاﺋﺮة ﻳﺠﺐ أن ﻳﺘﺒﻨﻰ اﻟﻤﺮاﺣﻞ اﻟﺘﺎﻟﻴﺔ‪:‬‬

‫ﻣﺮﺣﻠﺔ اﻟﻤﺮاﺟﻌﺔ واﻟﺘﺤﻠﻴﻞ )ﺗﺤﻠﻴﻞ اﻟﻮﺿﻊ ﻟﻠﻨﻈﺎم اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة(‪.‬‬ ‫‪.1‬‬
‫ﻣﺮﺣﻠﺔ اﻹﻧﺸﺎء واﻟﺘﺼﻤﻴﻢ ﻟﻨﻈﺎم إﺣﺼﺎﺋﻲ ﺟﺪﻳﺪ ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.2‬‬
‫ﻣﺮﺣﻠﺔ اﻻﺧﺘﺒﺎر اﻟﺤﻘﻠﻲ ﻟﻠﻨﻈﺎم اﻟﺠﺪﻳﺪ‪.‬‬ ‫‪.3‬‬
‫ﻣﺮﺣﻠﺔ اﻟﺘﻨﻔﻴﺬ‪.‬‬ ‫‪.4‬‬

‫ﺍﳌﻨﻬﺠﻴﺔ )‪(Methodology‬‬

‫ﺳﺘﺸﻤﻞ ﻃﺮﻳﻘﺔ اﻟﺘﻄﻮﻳﺮ ﺗﺤﺪﻳﺚ وﺗﻄﻮﻳﺮ ﺟﻤﻴﻊ ﻣﻜﻮﻧﺎت ﻧﻈﺎم اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة‪ .‬هﺬا وﺳﻮف ﺗﺘﺒﻊ اﻟﺴﺒﻞ‬
‫اﻟﻤﻨﻬﺠﻴﺔ اﻟﺘﺎﻟﻴﺔ‪:‬‬

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 ‫ﺗﺤﻠﻴﻞ اﻟﻮﺿﻊ اﻟﺘﻔﺼﻴﻠﻲ ﻟﻨﻈﺎم اﻹﺣﺼﺎء اﻟﺤﺎﻟﻲ ﺑﺎﻟﺪاﺋﺮة وﻳﺸﻤﻞ ﻣﺠﺎل اﻟﺘﺤﻠﻴﻞ آﻞ أﻧﺸﻄﺔ اﻟﺪاﺋﺮة‪.‬‬ ‫‪.1‬‬
‫ﺗﺤﺪﻳﺪ اﻻﺣﺘﻴﺎﺟﺎت اﻟﻤﻌﻠﻮﻣﺎﺗﻴﺔ‪.‬‬ ‫‪.2‬‬
‫إﻋﺎدة ﺗﻨﻈﻴﻢ ﺗﺪﻓﻖ اﻟﻤﻌﻠﻮﻣﺎت ﻣﻦ اﻟﻤﺆﺳﺴﺎت اﻟﺪﻧﻴﺎ إﻟﻰ اﻟﻤﺴﺘﻮﻳﺎت اﻟﻌﻠﻴﺎ‪.‬‬ ‫‪.3‬‬
‫ﺗﺤﺪﻳﺪ اﻟﻤﺆﺷﺮات اﻟﺼﺤﻴﺔ ﻟﻜﻞ اﻷﻧﺸﻄﺔ اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.4‬‬
‫اﻻﺳﺘﺨﺪام اﻷﻣﺜﻞ ﺑﺸﺒﻜﺔ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ اﻹﻟﻜﺘﺮوﻧﻴﺔ ﺑﺎﻟﺪاﺋﺮة ﻟﺪﻋﻢ ﺗﻘﺎرﻳﺮ ﺗﺤﻠﻴﻞ ﻣﺪاﺧﻞ وﻣﺨﺎرج اﻟﺒﻴﺎﻧﺎت‬ ‫‪.5‬‬
‫ﺑﺎﻟﺪاﺋﺮة‪.‬‬
‫إﺟﺮاء اﻟﺘﺪرﻳﺒﺎت ﻟﺠﻤﻴﻊ ﻣﺴﺘﻮﻳﺎت اﻟﻌﺎﻣﻠﻴﻦ اﻟﻤﻨﻮﻃﻴﻦ ﺑﺄﻧﺸﻄﺔ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.6‬‬
‫دﻋﻢ اﻟﻤﺴﺘﺸﻔﻴﺎت وﻣﺮاآﺰ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ ﺑﺎﻟﺪﻋﻢ اﻟﺘﻘﻨﻲ ﻟﺘﻨﻔﻴﺬ اﻟﻨﻈﺎم اﻹﺣﺼﺎﺋﻲ اﻟﻤﻄﻮر ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.7‬‬

‫ﻣﺮﺍﺣﻞ ﺍﳌﺸﺮﻭﻉ )‪(Project Stages‬‬

‫ﺳﻮف ﺗﻀﻢ ﺧﻄﺔ اﻟﻤﺸﺮوع اﻷﻧﺸﻄﺔ واﻟﻤﻬﺎم اﻟﺘﺎﻟﻴﺔ‪:‬‬

‫‪ .1‬ﺗﺤﻠﻴﻞ اﻟﻮﺿﻊ‪.‬‬
‫‪ .2‬ﺗﺤﺪﻳﺪ اﻻﺣﺘﻴﺎﺟﺎت‪.‬‬
‫‪ .3‬ﺗﺼﻤﻴﻢ واﺧﺘﺒﺎر اﻟﻨﻈﺎم ا ﻹﺣﺼﺎﺋﻲ اﻟﻤﻄﻮر‪.‬‬
‫• ﺗﺤﺪﻳﺚ اﺳﺘﻤﺎرات ﺟﻤﻊ وﺗﺒﻠﻴﻎ اﻟﺒﻴﺎﻧﺎت اﻟﺤﻘﻠﻴﺔ‪.‬‬
‫• اﺧﺘﺒﺎر ﺷﺒﻜﺔ اﻟﻤﻌﻠﻮﻣﺎت اﻹﻟﻜﺘﺮوﻧﻴﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬
‫• ﺗﺤﺪﻳﺚ اﻟﺠﺪاول اﻟﺮوﺗﻴﻨﻴﺔ‪.‬‬
‫• إﻋﺪاد ﻣﺴﻮدة دﻻﺋﻞ اﻟﻌﻤﻞ اﻟﺤﻘﻠﻴﺔ واﻹرﺷﺎدات واﺧﺘﺒﺎرهﺎ‪.‬‬

‫‪ .4‬ﺗﻨﻔﻴﺬ اﻟﻨﻈﺎم اﻹﺣﺼﺎﺋﻲ اﻟﻤﻄﻮر‪.‬‬

‫ﺑﻨﻮﺩ ﺍﻟﺒﻴﺎﻧﺎﺕ )‪(Data Items‬‬

‫ﻳﺠﺐ ﺗﺤﺪﻳﺪ ﺑﻨﻮد وﻧﻈﻢ ﺟﻤﻊ وﺗﺴﺠﻴﻞ اﻟﺒﻴﺎﻧﺎت ﻟﻤﻘﺎﺑﻠﺔ اﻻﺣﺘﻴﺎﺟﺎت اﻟﻨﻮﻋﻴﺔ ﻟﻠﺒﻴﺎﻧﺎت وﺑﻬﺬا ﻳﻤﻜﻦ ﺗﺤﺪﻳﺪ ﻧﻮﻋﻴﺔ‬
‫اﻟﺒﻴﺎﻧﺎت وﻣﺼﺎدر ﺟﻤﻊ ﺗﻠﻚ اﻟﺒﻴﺎﻧﺎت وﻃﺮﻳﻘﺔ اﻟﺠﻤﻊ ﻣﻊ ﺗﻮﺛﻴﻖ ﺗﻠﻚ اﻟﺴﺒﻞ ﻣﺘﻀﻤﻨ ًﺎ اﻟﻤﻌﺎﻳﻴﺮ واﻟﺘﻌﺮﻳﻔﺎت‪.‬‬

‫‪ .1‬اﻟﻤﻌﺎﻳﺮة )‪(Standardization‬‬

‫ﻳﻌﺘﺒﺮ ﺗﺄآﻴﺪ ﻣﻌﻴﺎرﻳﺔ اﻟﺒﻴﺎﻧﺎت اﻟﺘﻲ ﻳﺘﻢ ﺟﻤﻌﻬﺎ ﻣﻦ اﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ أﺣﺪ اﻟﻤﺘﻄﻠﺒﺎت اﻷﺳﺎﺳﻴﺔ‬
‫ﻟﻠﻨﻈﻢ اﻹﺣﺼﺎﺋﻴﺔ‪ .‬ﻟﺬا ﻓﺈن ﺗﺤﺪﻳﺪ اﻟﺒﻴﺎﻧﺎت اﻷﺳﺎﺳﻴﺔ اﻟﺘﻲ ﻳﺠﺐ ﺟﻤﻌﻬﺎ آﺠﺰء ﻣﻦ رآﻴﺰة اﻟﺒﻴﺎﻧﺎت ) ‪Minimum‬‬
‫‪ (Data Set‬واﻟﺘﻲ ﺗﻌﺮف ﻗﺎﺋﻤﺔ ﺑﻨﻮد اﻟﺒﻴﺎﻧﺎت اﻟﺘﻲ ﻳﺠﺐ ﺟﻤﻌﻬﺎ ﻋﻦ ﻃﺮﻳﻖ ﺟﻤﻴﻊ وﺣﺪات اﻟﺨﺪﻣﺔ ﺑﺎﻟﺪاﺋﺮة‪ .‬هﺬا‬
‫وﻣﻦ اﻟﻤﺴﺘﺤﺴﻦ ﺧﻠﻖ ﻣﻌﺠﻢ ﻟﻠﺒﻴﺎﻧﺎت ‪ Data Dictionary‬ﻳﺤﺘﻮي ﻋﻠﻰ اﻟﺘﻌﺮﻳﻔﺎت اﻟﻤﻌﻴﺎرﻳﺔ ﻟﺒﻨﻮد اﻟﻤﻌﻠﻮﻣﺎت‬
‫اﻟﻤﺠﻤﻌﺔ ﺳﻮاء ﺗﻢ ﺿﻤﻬﺎ ﺑﺮآﻴﺰة اﻟﻤﻌﻠﻮﻣﺎت أم ﻻ‪.‬‬

‫‪ .2‬اﻟﺘﺼﻤﻴﻢ )‪(Design‬‬

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‫ﻳﺠﺐ أن ﻳﻀﻢ ﺗﺼﻤﻴﻢ اﺳﺘﻤﺎرات ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت وﺗﺴﺠﻴﻠﻬﺎ وﺳﺒﻞ ﺗﺒﻠﻴﻐﻬﺎ إﻧﺸﺎء اﻟﻘﺮارات اﻟﺨﺎﺻﺔ ﺑﺎﻟﻘﺎﺋﻤﻴﻦ ﻋﻠﻰ‬
‫ﺟﻤﻊ ﺗﻠﻚ اﻟﺒﻴﺎﻧﺎت وﻣﺎذا ﺗﺠﻤﻊ وآﻴﻔﻴﺔ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت هﺬا وﻳﺠﺐ ﻋﻤﻞ اﻟﻤﻬﺎم اﻟﺘﺎﻟﻴﺔ‪:‬‬

‫‪ .1‬اﺧﺘﻴﺎر ﺳﺒﻞ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت وﺗﺴﺠﻴﻠﻬﺎ وﺗﺒﻠﻴﻐﻬﺎ وهﺬا ﻳﺸﻤﻞ اﻟﻘﺮارات ﻋﻦ ﺗﺤﺪﻳﺪ اﻟﻤﺴﺠﻞ اﻷول ﻟﻠﺒﻴﺎﻧﺎت وﻣﻦ‬
‫ﻳﻘﺪم ﺑﺠﻤﻊ اﻟﺒﻴﺎﻧﺎت ﻓﻲ ﻣﺨﺘﻠﻒ ﻧﻘﺎط ﻧﻈﺎم اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ وﻃﺮﻳﻘﺔ ﺟﻤﻌﻬﺎ وآﻴﻔﻴﺔ ﺗﺪاوﻟﻬﺎ‪.‬‬
‫‪ .2‬ﻋﻤﻞ ﻣﺴﻮدة ﻋﻦ اﺳﺘﻤﺎرات ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت ﻋﻨﺪﻣﺎ ﻳﻜﻮن اﻟﻨﻈﺎم اﻟﺤﺎﻟﻲ ﻟﺘﺴﺠﻴﻞ اﻟﺒﻴﺎﻧﺎت ﻻ ﻳﻌﻤﻞ ﺑﻜﻔﺎءة أو ﻻ‬
‫ﺗﻮﺟﺪ ﺑﻨﻮد اﻟﺒﻴﺎﻧﺎت اﻟﻤﻼﺋﻤﺔ وﻳﺠﺐ ﻣﺮاﺟﻌﺘﻬﺎ ﻣﻊ إدارة اﻟﻤﻌﻠﻮﻣﺎت ﺑﺎﻟﺪاﺋﺮة‪.‬‬
‫ﺗﺪﻓﻖ ﺍﳌﻌﻠﻮﻣﺎﺕ )‪(Information Flow‬‬

‫ﻳﺠﺐ ﺗﺼﻤﻴﻢ ﺗﺪﻓﻖ اﻟﻤﻌﻠﻮﻣﺎت ﻣﻦ ﻣﺴﺘﻮى إﻟﻰ ﻣﺴﺘﻮى‪ .‬هﺬا وﻳﻮﺻﻰ ﺑﺘﺨﻠﻴﺺ اﻟﺒﻴﺎﻧﺎت ﻋﻦ آﻞ ﺧﻄﻮة ﻣﻦ ﺗﺴﻠﺴﻞ‬
‫اﻟﻌﻤﻠﻴﺎت‪ .‬هﺬا وﻟﻴﺲ ﻣﻦ اﻟﻀﺮورة ﺗﻜﺮار ﻗﺎﻋﺪة اﻟﺒﻴﺎﻧﺎت اﻟﻤﺤﻠﻴﺔ ﺧﻼل اﻟﻨﻈﺎم أو اﻻﺣﺘﻔﺎظ ﺑﻜﻞ اﻟﺒﻴﺎﻧﺎت ﺑﻘﺴﻢ‬
‫اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ‪ .‬هﺬا وﻳﺠﺐ أن ﻳﻮﻓﺮ اﻟﻤﺸﺮﻓﻮن اﻟﺘﻐﺬﻳﺔ اﻟﺮاﺟﻌﺔ روﺗﻴﻨﻴﺎ ﻋﻨﺪ آﻞ ﻣﺴﺘﻮى‪.‬‬

‫ﺩﻻﺋﻞ ﺍﻟﻌﻤﻞ ﺍﳊﻘﻠﻲ ﻭﺍﻹﺭﺷﺎﺩﺍﺕ )‪(Field Manual and Guidelines‬‬

‫ﻋﻨﺪ اﻻﻧﺘﻬﺎء ﻣﻦ ﺗﺼﻤﻴﻢ ﻃﺮﻳﻘﺔ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت واﻟﻌﻤﻠﻴﺎت ﻳﺠﺐ ﻋﻤﻞ ﻣﺴﻮدة ﻟﺪﻻﺋﻞ اﻟﻌﻤﻞ اﻟﺤﻘﻠﻲ واﻹرﺷﺎدات‪ .‬هﺬا‬
‫وﻳﺠﺐ اﺳﺘﺸﺎرة إدارة اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ وﺑﺎﻗﻲ اﻹدارات ﻋﻨﺪ إﻋﺪاد دﻻﺋﻞ اﻟﻌﻤﻞ اﻟﺤﻘﻠﻲ واﻹرﺷﺎدات‪.‬‬

‫ﺗﺼﻤﻴﻢ ﺩﻟﻴﻞ ﻋﻤﻞ ﻧﻈﺎﻡ ﺍﻟﺘﺤﻠﻴﻞ ﺍﻹﺣﺼﺎﺋﻲ ‪(Design of Statistical Analyses System‬‬
‫)‪Manual‬‬

‫اﻟﻬﺪف إﺻﺪار دﻟﻴﻞ ﻋﻤﻞ ﻧﻈﺎم اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة هﻮ اﻹﻣﺪاد ﺑﻤﺠﻤﻮﻋﺔ اﻟﺘﻮﺟﻴﻬﺎت اﻟﺘﻲ ﺗﻤﻜﻦ ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ‬
‫اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة ﻣﻦ ﺗﺤﺴﻴﻦ اﻟﺘﻮﻗﻴﺖ اﻟﻤﻨﺎﺳﺐ وﺟﻮدة اﻟﺤﺼﻮل واﺳﺘﺨﺪام إدارة اﻟﻤﻌﻠﻮﻣﺎت‪ .‬هﺬا وﺗﺼﻒ‬
‫اﻹرﺷﺎدات اﻷﻧﺸﻄﺔ واﻟﻤﻬﺎم اﻟﺘﻲ ﻳﺠﺐ اﻋﺘﺒﺎرهﺎ وﺗﻮﺿﻴﺤﻬﺎ ﻗﺒﻞ ﺑﺪاﻳﺔ اﻟﻌﻤﻞ وذﻟﻚ ﻟﺘﻔﺎدي ﺑﻌﺾ اﻷﺧﻄﺎء اﻟﺘﻲ‬
‫ﺗﻮاﺟﻪ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ‪ .‬آﻤﺎ أﻧﻬﺎ وﺳﻴﻠﺔ ﺟﻴﺪة ﻟﻤﺴﺎﻋﺪة ﻣﺨﺘﻠﻒ ﻃﻮاﺋﻒ اﻟﻌﺎﻣﻠﻴﻦ اﻟﺼﺤﻴﻴﻦ اﻟﺬﻳﻦ ﻳﺮﺗﺒﻂ ﻋﻤﻠﻬﻢ‬
‫ﺑﺎﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬

‫هﺬا وﻳﺠﺐ أن ﻳﻀﻢ اﻟﺪﻟﻴﻞ اﻵﺗﻲ‪:‬‬

‫اﻟﻬﻴﻜﻞ اﻟﺘﻨﻈﻴﻤﻲ ﻟﻠﺪاﺋﺮة‪.‬‬ ‫‪.1‬‬

‫اﻟﺨﺪﻣﺎت اﻹﺣﺼﺎﺋﻴﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.2‬‬
‫اﻻﺳﺘﻤﺎرات اﻟﻤﺼﻤﻤﺔ ﻟﺠﻤﻊ اﻟﺒﻴﺎﻧﺎت وإرﺷﺎدات آﻴﻔﻴﺔ ﺟﻤﻌﻬﺎ وﻗﻨﻮات ودورﻳﺔ اﻟﺘﺒﻠﻴﻎ‪.‬‬ ‫‪.3‬‬
‫اﻟﻤﺆﺷﺮات اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ ﻣﺘﺎﺑﻊ وﺗﻘﻴﻴﻢ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.4‬‬
‫ﺗﻌﺮﻳﻒ اﻟﻤﺼﻄﻠﺤﺎت واﻟﻤﺴﻤﻴﺎت اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ اﻟﺼﺤﺔ واﻟﻤﺆﺷﺮات اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺼﺤﺔ‪.‬‬ ‫‪.5‬‬

‫ﺗﺼﻤﻴﻢ ﺟﺪﺍﻭﻝ ﺍﳌﺨﺮﺟﺎﺕ )‪(Design of Output Table‬‬

‫‪263‬‬
 ‫ﻳﺠﺐ ﺗﺼﻤﻴﻢ اﻷﻧﻮاع اﻟﺮوﺗﻴﻨﻴﺔ اﻟﺘﺎﻟﻴﺔ ﻣﻦ اﻟﺠﺪاول‪:‬‬

‫ﺟﺪاول اﻟﻤﺨﺮﺟﺎت اﻟﻤﺼﻤﻤﺔ ﻟﺪﻋﻢ إدارة واﺗﺨﺎذ اﻟﻘﺮار آﻤﺎ ﺗﻮﺿﺢ درﺟﺔ ﺗﺤﻘﻴﻖ اﻟﺪاﺋﺮة ﻷﻏﺮاﺿﻬﺎ وﻣﺮاﻣﻴﻬﺎ‪.‬‬ ‫‪.1‬‬
‫ﻣﺆﺷﺮات اﻷداء واﻟﺘﻲ ﺗﻘﺪم اﻟﻤﻌﻠﻮﻣﺎت آﻘﻴﺎﺳﺎت وﺳﻴﻄﺔ واﻟﺘﻲ ﻗﺪ ﺗﺴﺘﺨﺪم ﻟﻘﻴﺎس ﻧﺠﺎح اﻟﻨﻈﺎم‪.‬‬ ‫‪.2‬‬
‫ﺟﺪاول اﻟﺨﺪﻣﺎت وﺗﻀﻢ ﺑﻴﺎﻧﺎت ﺗﻔﺼﻴﻠﻴﺔ ﻋﻦ اﺳﺘﺨﺪام اﻟﻤﻮارد واﻟﺘﻜﺎﻟﻴﻒ واﻹﻣﺪادات‪.‬‬ ‫‪.3‬‬
‫ﺟﺪاول اﻟﻜﻔﺎءة وهﻲ اﻟﺘﻲ ﺗﺮﺑﻂ اﻟﻨﺘﻴﺠﺔ أو اﻷﻧﺸﻄﺔ إﻟﻰ اﺳﺘﺨﺪام اﻟﻤﻮارد وﺗﺪل ﻋﻠﻰ ﺗﻜﻠﻔﺔ ﺗﻨﻔﻴﺬ اﻟﺨﺪﻣﺎت أو‬ ‫‪.4‬‬
‫ﺑﻌﺾ ﻣﻜﻮﻧﺎﺗﻬﺎ‪.‬‬
‫ﺟﺪاول اﻟﺘﺄﺛﻴﺮ وﺗﺮﺑﻂ اﻟﻌﻼج وأﻧﺸﻄﺔ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ إﻟﻰ اﻟﺘﺄﺛﻴﺮات اﻟﺼﺤﻴﺔ اﻟﻨﻮﻋﻴﺔ ﻹﻇﻬﺎر ﻓﻌﺎﻟﻴﺔ‬ ‫‪.5‬‬
‫اﻟﺨﺪﻣﺎت‪.‬‬

‫ﺍﳌﺴﺌﻮﻟﻴﺎﺕ ﺍﳌﺆﺳﺴﻴﺔ )‪(Institutional Responsibities‬‬

‫ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ‪:‬‬

‫إﺻﺪار اﻟﺘﻘﺮﻳﺮ اﻹﺣﺼﺎﺋﻲ اﻟﺴﻨﻮي‪.‬‬ ‫‪.1‬‬

‫ﺗﻄﺒﻴﻖ ﺳﺒﻞ اﻟﺘﻐﺬﻳﺔ اﻟﺮاﺟﻌﺔ إﻟﻰ ا ﻟﻤﺴﺘﻮﻳﺎت اﻷدﻧﻰ‪.‬‬ ‫‪.2‬‬
‫ﻣﺮاﺟﻌﻮ وﺗﺤﻠﻴﻞ اﻟﺒﻴﺎﻧﺎت واﻟﻤﻌﻠﻮﻣﺎت‪.‬‬ ‫‪.3‬‬
‫ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ اﻟﻤﺴﻮﺣﺎت اﻟﺼﺤﻴﺔ ﻣﻊ اﻟﺘﻨﺴﻴﻖ ﻣﻊ اﻷﻗﺴﺎم ﺑﺎﻟﺪاﺋﺮة ﻟﺘﺤﻠﻴﻞ اﻟﻤﺴﻮﺣﺎت اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.4‬‬
‫اﻟﺘﺪرﻳﺐ وﺗﻨﻔﻴﺬ ورﺷﺎت اﻟﻌﻤﻞ ﻓﻲ ﻣﺠﺎل اﻹﺣﺼﺎء‪.‬‬ ‫‪.5‬‬

‫اﻟﻤﺴﺘﺸﻔﻴﺎت‪:‬‬

‫ﻧﻔﺲ أﻧﺸﻄﺔ ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ وﺗﺨﺘﻠﻒ ﺗﺒﻌًﺎ ﻟﻨﻮع اﻟﻤﺴﺘﺸﻔﻰ ﻟﻜﻦ ﺑﻴﺎﻧﺎت أآﺜﺮ ﻋﻦ‪:‬‬

‫اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ ﺑﺎﻟﻤﺴﺘﺸﻔﻰ‪.‬‬ ‫•‬

‫إﺣﺼﺎءات ﺣﺎﻻت اﻟﺪﺧﻮل ﺑﺎﻟﻤﺴﺘﺸﻔﻴﺎت‪.‬‬ ‫•‬
‫ﺣﺴﺎب اﻟﻤﻌﺪﻻت واﻟﻤﺆﺷﺮات ﻟﻘﻴﺎس ﻣﺴﺘﻮى اﻷداء داﺧﻞ اﻟﻤﺴﺘﺸﻔﻰ‪.‬‬ ‫•‬

‫ﻣﺮاآﺰ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ‪:‬‬

‫ﺟﻤﻊ وﺗﺴﺠﻴﻞ اﻟﺒﻴﺎﻧﺎت اﻟﺤﻴﻮﻳﺔ )اﻟﻤﻮاﻟﻴﺪ – اﻟﻮﻓﻴﺎت(‪.‬‬ ‫‪.1‬‬

‫ﺗﺴﺠﻴﻞ اﻟﻤﺮﺿﻰ اﻟﻤﻌﺎﻟﺠﻴﻦ‪.‬‬ ‫‪.2‬‬
‫ﺗﺴﺠﻴﻞ اﻷﻧﺸﻄﺔ اﻟﻮﻗﺎﺋﻴﺔ‪.‬‬ ‫‪.3‬‬
‫اﻟﺘﺒﻠﻴﻎ ﻋﻦ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ‪.‬‬ ‫‪.4‬‬
‫ﺗﺴﺠﻴﻞ اﻟﺤﺎﻻت اﻟﻤﺤﻮﻟﺔ إﻟﻰ اﻟﻤﺴﺘﻮﻳﺎت اﻟﻌﻠﻴﺎ ﻟﻠﻌﻼج‪.‬‬ ‫‪.5‬‬
‫ﺗﺴﺠﻴﻞ اﻟﻌﻘﺎﻗﻴﺮ اﻟﻤﺴﺘﺨﺪﻣﺔ‪.‬‬ ‫‪.6‬‬
‫إﻋﺪاد اﻟﺘﻘﺎرﻳﺮ‪.‬‬ ‫‪.7‬‬

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 COORDINATION AND INTEGRATION OF HEALTH INFORMATION SYSTEM IN DUBAI

THERE ARE MUCH OTHER INFORMATION’S RELEVANT TO THE HEALTH SYSTEM. OTHER
SYSTEMS INCLUDE HOSPITAL, FINANCE, HUMAN RESOURCE MANAGEMENT, AND DISEASE
SPECIFIC AND EVEN SYSTEMS NOT DIRECTLY UNDER THE CONTROL OF HEALTH
AUTHORITY AS CENSUS OR SURVEY SOURCES. THESE SYSTEMS COLLECTIVELY MAKE UP
DUBAI HEALTH MANAGEMENT INFORMATION RESOURCE. THEORETICALLY, IT IS
POSSIBLE TO REPLACE THE MANY DIFFERENT SYSTEM WITH A SINGLE INTEGRATED
SYSTEM. HOWEVER, IN PRACTICE IT IS OFTEN TOO COSTLY TO DO THIS. AN ALTERNATIVE
WAY OF IMPROVING THE FLOW OF HEALTH MANAGEMENT INFORMATION IS TO DEDICATE
RESOURCES SPECIFICALLY TO COORDINATE ACCESS USE AND ONGOING DEVELOPMENT
OF RELEVANT INFORMATION SYSTEMS,

INFORMATION SYSTEM IS COORDINATED AND INTEGRATED WITH OTHER INFORMATION

SYSTEMS TO MAKE ALL SYSTEMS MORE EFFECTIVE FOR MANAGING PURPOSES. THE
MAJOR ACTIVITIES INCLUDE:

1. ENSURING EACH MAJOR INFORMATION SYSTEM IS SYSTEMATICALLY MANAGED.

2. ESTABLISHING HEALTH MANAGEMENT INFORMATION COORDINATION UNIT.
3. ESTABLISHING A COMMITTEE FOR HEALTH INFORMATION SYSTEM IN DUBAI
4. MAINTAINING NATIONAL MINIMUM DATA AND DATA DICTIONARIES.
5. SYSTEMATICALLY PLANNING AND MANAGING INFORMATION SYSTEMS STAFFING
REQUIREMENTS.

ROUTINE INFORMATION SYSTEMMANAGEMENT ACTIVITIES

265
HEALTH MANAGEMENT INFORMATION IS OBTAINED FROM MANY DIFFERENT SOURCES.
ALL SUCH MAJOR INFORMATION SYSTEMS MUST BE SYSTEMATICALLY MANAGED TO
ENSURE THEY OPERATE AND EVOLVE EFFECTIVELY. MANAGEMENT SYSTEMS CAN BEST
BE ACHIEVED THROUGH SMALL-DEDICATED MANAGEMENT UNIT. INFORMATION
MANAGEMENT UNITS CAN BE RESPONSIBLE FOR ONE OR MORE SYSTEM. FOR EXAMPLE
MAJOR SYSTEMS MAY BE MANAGED AS SEPARATE UNITS SHORTLY OFTEN
IMPLEMENTATION, BUT WHEN THE SYSTEM IS WELL ESTABLISHED, IT MAY BE MANAGED
WITH OTHER SYSTEMS IN AN INTEGRATED MANAGEMENT UNIT. A MANAGEMENT UNIT
MAY BE RESPONSIBLE FOR A NUMBER OF SMALL SYSTEMS FROM THE OUTSET.

INFORMATION MANAGEMENT UNITS SHOULD BE SUPPORTED AND DIRECTED BY

ADVISORY COMMITTEES WITH REPRESENTATIVE FOR MAJOR USERS IN HEALTH CARE
PROGRAMS. IN THIS TYPE OF UNIT IT IS APPROPRIATE TO COORDINATE RATHER THAN TO
UNDERTAKE ALL THE WORK CENTRALLY STAFFING OF INFORMATION MANAGEMENT
UNITS SHOULD BE AS SMALL AS POSSIBLE.

THE ROUTINE AND ONGOING FUNCTION OF INFORMATION MANAGEMENT UNITS

INCLUDES:
1- ROUTINE OPERATION OF THE INFORMATION SYSTEM INCLUDING FINAL STAGE
PROCESSING I.E. AGGREGATION OF REPORTS SUBMITTED AND MAINTENANCE OF AN
ONGOING PUBLICATION PROGRAM AND FEEDBACK MECHANISM.
2- FORMULATION AND MANAGEMENT OF INFORMATION SYSTEMS MAINTENANCE PLAN.
3- IMPLEMENTATION OF A QUALITY ASSURANCE PROGRAM.
4- MAINTENANCE OF AN ONGOING EVALUATION AND REVIEW CYCLE.
5- SUPPORT FOR MONITORING OF EMERGING DISEASE PATTERN.
6- COORDINATION OF ACTIVITIES WITH OTHER INFORMATION UNITS AND THE HEALTH
MANAGEMENT INFORMATION COORDINATION UNIT.
7- MAINTENANCE OF TRAINING PROGRAMS RELEVANT TO THE INFORMATION SYSTEM
FOR USERS AND INFORMATION OFFICERS.
8- PROVIDING ONGOING SUPPORT TO INFORMATION USERS AND PROCESSORS. THE USERS
MANUALS SHOULD BE MAINTAINED AND, WHERE, NECESSARY UPDATED, GENERALLY
THE INFORMATION SYSTEM SHOULD BE KEPT RELEVANT TO LOCAL LEVEL HEALTH
WORKER WHO MAINTAIN THE RECORDS AND CREATE THE REPORTS.

THE NATIONAL MINIMUM DATA SET AND DATA DIRECTORY

INFORMATION SYSTEM SHOULD HAVE COMMON DEFINITE, DATA FORMATS AND CODES

266
TO FACILITATE LINKAGES AND THESE SHOULD BE BUILT INTO THE STANDARD DATA

DIRECTORY.

A NATIONAL MINIMUM DATA SET (NMDS) AND DATA DIRECTORY SHOULD FACILITATE
THIS STANDARDIZATION. THE NMDS IDENTIFIES THE CORE DATA ITEMS THAT MUST BE
COLLECTED AS A MINIMUM. THE DATA DIRECTORY CONTAINS AT LEAST THE NMDS
DATA ITEMS BUT MAY CONTAIN OTHER DEFINITIONS.

THE CORE OF NMDS SHOULD BE THE DATA ITEMS COLLECTED BY ALL HEALTH SERVICES
AND PROGRAMS. EXAMPLES OF THE DATA INCLUDE:
U DEMOGRAPHIC CHARACTERISTICS OF THE PATIENTS INCLUDING AGE AND SEX.
U SIZE AND GENDER COMPOSITION OF THE POPULATION BEING TARGETED BY EACH
PROGRAM, FOR EXAMPLE, THE NUMBER OF POPULATION IN DEFINED AGE\SEX
GROUP, ELDERLY, AND WOMEN OF CHILD BEARING AGE.
U HEALTH STATUS OF THE TARGET POPULATION MEASURED BY SELECTED INAND
LEVELS OF COVERAGE BY PROGRAM, FOR EXAMPLE, NUMBER OF ANTENATAL VISITS
OR COMMUNICABLE DISEASE INOCULATIONS.
U SERVICE ACTIVITIES INCLUDING NUMBER OF PATIENTS AND RESOURCES
CONSUMED BY PROGRAM, FOR EXAMPLE, NUMBER OF CONTACT BY TYPE OF
CONTACT, TYPE OF CARE GIVEN AND LEVEL OF NEED FOR CARE.
U IDENTIFYING INFORMATION TO HELP LINK DATA AND TABULATE IT INTO
APPROPRIATE CLASSIFICATION FOR EXAMPLE, PROGRAM CLINIC AND TYPE OF
HEALTH WORKER PROVIDING SERVICES AS WELL AS GEOGRAPHIC LOCATION OF THE
SERVICES AND THE RESIDENTIAL ORIGIN OF THE PATIENT.
U COST OF SERVICES INCLUDING STAFFING COSTS, MEDICINE, TRANSPORTATION
COSTS AND CAPITAL EQUIPMENT SUCH AS BUILDINGS AND OTHER EQUIPMENT.
U CATCHMENTS AREA AND POPULATION OF SERVICE CENTERS, HOSPITALS…ETC.

THE FOLLOWING TASKS ARE REQUIRED TO MAINTAIN A NMDS AND DATA DIRECTORY.

1. DATA ITEMS COLLECTED, AS PART OF HIS SHOULD BE DECLARED TO BE

STRATEGIC DATA REQUIREMENT.
2. DATA ITEMS SHOULD BE MANAGED AS A VALUABLE SYSTEM RESOURCE
AND APPROPRIATE RESOURCES SHOULD BE ALLOCATED TO THE
FORMULATION AND MANAGEMENT OF NMDS AND DATA DIRECTORY.
3. THE NMDS AND DATA DIRECTORY SHOULD BE REVISED AS PART OF THE
ONGOING MANAGEMENT OF NMDS.

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 DOHMS Statistical Committee

Purpose
Collection, analysis, and dissemination of health and health-related information are a
crucial aspect of the responsibilities of Directorate of Health and Medical Services.
DHA is charged with monitoring and improving the state of health by collecting,
analyzing, and disseminating information on vital events, on determinants of health,
on the extent and nature of illness and disability of the population in Dubai, and on the
population's well-being. The Directorate is one of the most important sources of
information about the health resources and the supply of health services in Dubai and
about health care costs and financing.

This Committee shall serve as forum on health data and information systems. It is
intended to be a forum for collaboration of interested parties to accelerate the
evolution of public health information toward more uniform, shared data standards. A
long-term purpose of the Committee is to promote increased interoperability of
diverse health systems. The Committee shall encourage the evolution of a shared,
public national health information infrastructure that will promote the availability of
valid, credible, timely, and comparable health data. With sensitivity to policy
considerations and priorities, the Committee will provide scientific technical advice
and guidance regarding the design and operation of health statistics and services on
the coordination of health data requirements. The Committee will inform decision
making about data policy. Committee members are expected to bring their expertise,
perspectives, and concerns to the forum, and to take back to their respective fields the
collective concerns, recommendations, and rationale of the committee

Function

(A) Monitor the health data needs and current approaches to meet those needs;
identify emerging health data issues, including methodologies and technologies
and databases that could improve the ability to meet those needs.
(B) Identify strategies and opportunities to achieve long-term consensus on common
health data standards that will promote (I) the availability of valid, credible, and
timely health information, and (ii) Multiple uses of data collected once;

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 recommend actions of all departments DHA can take to promote such a
consensus.
(C) Make recommendations regarding health terminology, definitions, classifications,
and guidelines.
(D) Identify strategies and opportunities for evolution from single-purpose, narrowly
focused and categorical health data collection strategies to more multi-purpose,
integrated, and shared data collection strategies.
(E) Identify statistical design issues bearing on health and health services data that are
of local or international interest; identify strategies and opportunities to facilitate
interoperability and networking.
(F) Advise on health data collection needs and strategies; review and monitor the data
and information systems to identify needs, opportunities, and problems; consider
the likely effects of emerging health information technologies on the data and
systems, and impact of the information policies and systems on the development
of emerging technologies.
(G) Stimulate the study of health data and information systems issues by other
organizations and agencies, whenever possible.
(H) Review and comment on findings and proposals developed by other organizations
and agencies with respect to health data and information systems and make
recommendations for their adoption or implementation.

In these matters, the Committee shall consult with all components of DHA, other
governmental entities, and non-governmental organizations, as appropriate.

Structure

The members of the Committee shall be appointed by HE the Director General of

DHA from among persons who have distinguished themselves in the fields of health
statistics, epidemiology, of health care information, population-based public health,
purchasing or financing health care services, integrated computerized health
information systems, health services research, pharmacy and other specialties when
necessary. Director Department of Planning and Statistics will act as a chair.

Standing and ad hoc subcommittees, composed solely of members of the parent

Committee, may be established to address specific issues and to provide the
Committee with background study and proposals for consideration and action. The
Chair shall appoint members from the parent Committee to the subcommittees and
designate a Chair for each subcommittee. The subcommittees shall make their
recommendations to the parent Committee.
Meetings
Meetings shall be every two months at the call of the Chair. Meetings of the
subcommittees shall be held at the call of the Chair. Meetings shall be conducted and
records of the proceedings kept, as required by the applicable laws and DOHMS

269
regulations.

Reports
A report will be prepared containing, as a minimum, a list of members and their
business addresses, the Committee's functions, dates and places of meetings, and a
summary of Committee activities and recommendations made during the fiscal year.

270
 ‫ﺗﺸﻜﻴﻞ ﻟﺠﻨﺔ اﻹﺣﺼﺎء ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻰ‬

‫اﻟﻤﺸﻜﻠﺔ واﻟﻤﺒﺮرات‪:‬‬

‫ﺗﻌﺘﺒﺮ اﻟﺘﻨﻤﻴﺔ اﻟﺼﺤﻴﺔ ﺟﺰء ﻣﻦ اﻟﺘﻨﻤﻴﺔ اﻻﻗﺘﺼﺎدﻳﺔ واﻻﺟﺘﻤﺎﻋﻴﺔ اﻟﺸﺎﻣﻠﺔ ﺑﺪﺑﻲ‪ .‬وﻧﻈﺮا ﻟﻮﺟﻮد‬
‫اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﺒﻴﺎﻧﺎت واﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﻲ ﻳﺤﺘﺎج إﻟﻴﻬﺎ ﻣﻦ آﺎﻓﺔ اﻟﻤﺆﺳﺴﺎت اﻟﻘﺎﺋﻤﺔ ﻋﻠﻰ ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت‬
‫اﻟﺼﺤﻴﺔ ﺑﺎﻹﻣﺎرة وﻟﻤﺎ آﺎﻧﺖ داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﺑﺼﺪد إﻧﺸﺎء ﻧﻈﺎم إﺣﺼﺎﺋﻲ‬
‫ﺷﺎﻣﻞ ﻟﺠﻤﻴﻊ اﻷﻧﺸﻄﺔ واﻟﻔﻌﺎﻟﻴﺎت اﻟﺼﺤﻴﺔ ﺑﺈﻣﺎرة دﺑﻲ ﻣﻦ ﺧﻼل ﺗﺤﺴﻴﻦ ﺟﻤﻊ وﺗﺪﻓﻖ اﻟﻤﻌﻠﻮﻣﺎت‬
‫وﺗﺴﺨﻴﺮ اﻟﻤﻮارد ﻟﺘﻨﺴﻴﻖ وﺻﻮل اﻟﻤﻌﻠﻮﻣﺎت واﺳﺘﺨﺪاﻣﻬﺎ وﺗﻄﻮﻳﺮ ﻧﻈﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ‬
‫ﺑﺎﻹﻣﺎرة‪ .‬ﻟﺬا آﺎن ﻟﺰاﻣﺎ إﻧﺸﺎء ﺷﺮاآﺔ ﻣﻊ آﺎﻓﺔ اﻟﻤﺆﺳﺴﺎت اﻟﺼﺤﻴﺔ ﺑﺪﺑﻲ ﻟﻺﻣﺪاد ﺑﺎﻟﺒﻴﺎﻧﺎت اﻟﺼﺤﻴﺔ‬
‫اﻟﻼزﻣﺔ ﻹﺑﺮاز اﻻﺣﺘﻴﺎﺟﺎت اﻟﺼﺤﻴﺔ وﺗﺄآﺪ وﺻﻮل اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪.‬‬

‫و ﻟﻜﻮن ﺟﻤﻊ وﺗﺤﻠﻴﻞ وﻧﺸﺮ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ واﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺼﺤﺔ ﺟﺰءا أﺳﺎﺳﻴﺎ ﻣﻦ‬
‫ﻣﺴﺌﻮﻟﻴﺎت هﻴﺌﺔ اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﻟﺬا ﻓﺈن اﻟﺪاﺋﺮة ﺳﻮف ﺗﻜﻮن ﻣﻌﻴﻨﺔ ﺑﻤﺘﺎﺑﻌﺔ وﺗﺤﺴﻴﻦ‬
‫ﺟﻤﻊ وﺗﺤﻠﻴﻞ وﻧﺸﺮ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺒﻴﺎﻧﺎت اﻟﺤﻴﻮﻳﺔ وﻣﺤﺪدات اﻟﺼﺤﺔ وﻃﺒﻴﻌﺔ اﻷﻣﺮاض‬
‫إﺿﺎﻓﺔ إﻟﻰ اﻟﺤﺎﻟﺔ اﻟﺼﺤﻴﺔ ﻟﻠﺴﻜﺎن ﺑﺪﺑﻲ‪ .‬هﺬﻩ ﻣﻦ ﻧﺎﺣﻴﺔ وﻣﻦ ﻧﺎﺣﻴﺔ أﺧﺮى ﺑﻔﺎن اﻟﺪاﺋﺮة هﻲ أﺣﺪ‬
‫أهﻢ ﻣﺼﺎدر اﻟﻤﻌﻠﻮﻣﺎت ﻋﻦ اﻹﻣﻜﺎﻧﻴﺎت اﻟﺼﺤﻴﺔ وﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺔ وآﻠﻔﺔ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﺑﺪﺑﻲ‪.‬‬

‫هﺬا وﺳﺘﻜﻮن ﻟﺠﻨﺔ اﻹﺣﺼﺎء ﻣﻨﻮﻃﺔ ﺑﺎﻟﺒﻴﺎﻧﺎت واﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ ﻣﻦ ﺧﻼل ﺗﻌﺎون آﻞ اﻟﻘﻄﺎﻋﺎت‬
‫ﻻ إﻟﻰ اﻟﺒﻴﺎﻧﺎت اﻟﻤﻮﺣﺪة واﻟﻘﻴﺎﺳﻴﺔ‪.‬‬
‫اﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﺼﺤﺔ ﺑﺪﺑﻲ وﺻﻮ ً‬

‫ا وﺳﻮف ﺗﺘﻮﻟﻰ اﻟﻠﺠﻨﺔ اﻟﻘﻴﺎم ﺑﺎﻟﻤﻬﺎم اﻟﺘﺎﻟﻴﺔ‪:‬‬

‫‪ .1‬ﻣﺘﺎﺑﻌﺔ اﺣﺘﻴﺎﺟﺎت اﻟﺒﻴﺎﻧﺎت اﻟﺼﺤﻴﺔ واﻟﺴﺒﻞ اﻟﺤﺎﻟﻴﺔ ﻟﺘﺤﻘﻴﻖ ﺗﻠﻚ اﻻﺣﺘﻴﺎﺟﺎت ﻣﻊ اﻟﺘﻌﺮف ﻋﻠﻰ‬
‫اﻟﺒﻴﺎﻧﺎت اﻟﺼﺤﻴﺔ اﻟﻄﺎرﺋﺔ ﻣﺘﻀﻤﻨًﺎ ﻃﺮق وﺗﻘﻨﻴﺔ وﻣﺼﺎدر اﻟﺒﻴﺎﻧﺎت ﻟﺘﺤﺴﻴﻦ اﻟﻘﺪرة ﻟﺘﺤﻘﻴﻖ ﺗﻠﻚ‬
‫اﻻﺣﺘﻴﺎﺟﺎت‪.‬‬
‫‪ .2‬ﺗﺤﺪﻳﺪ إﺳﺘﺮاﺗﻴﺠﻴﺎت وﻓﺮص اﻻﺗﻔﺎق ﻋﻠﻰ اﻟﻤﺪى اﻟﺒﻌﻴﺪ ﻟﻠﺒﻴﺎﻧﺎت اﻹﺣﺼﺎﺋﻴﺔ اﻟﻤﻌﻴﺎرﻳﺔ ﻟﺘﺤﺴﻴﻦ‬
‫ﺗﻮﻓﺮ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ واﻟﻤﻮﺛﻮق ﺑﻬﺎ وﻓﻲ اﻟﻮﻗﺖ اﻟﻤﻨﺎﺳﺐ ﻣﻊ اﻻﺳﺘﺨﺪام اﻟﻤﺘﻜﺮر ﻟﺘﻠﻚ‬
‫اﻟﺒﻴﺎﻧﺎت اﻟﺘﻲ ﺗﻢ ﺟﻤﻌﻬﺎ‪.‬‬
‫‪ .3‬إﺻﺪار اﻟﺘﻮﺻﻴﺎت ﻋﻦ اﻟﻤﺼﻄﻠﺤﺎت اﻟﺼﺤﻴﺔ واﻟﺘﻌﺎرﻳﻒ واﻟﺘﻘﺴﻴﻤﺎت واﻟﺪﻻﺋﻞ اﻹﺣﺼﺎﺋﻴﺔ‪.‬‬

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‫ﺗﺤﺪﻳﺪ اﺳﺘﺮاﺗﻴﺠﻴﺎت وﻓﺮص اﻟﺘﺤﺮر ﻣﻦ ﻃﺮق ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت اﻟﻀﻴﻖ وذات اﻟﻬﺪف اﻟﻮاﺣﺪ إﻟﻰ‬ ‫‪.4‬‬
‫اﻻﺳﺘﺨﺪام اﻟﻤﺘﻌﺪد اﻷهﺪاف واﻟﻤﺘﻜﺎﻣﻞ واﺳﺘﺮاﺗﻴﺠﻴﺎت ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت اﻟﻤﺸﺘﺮك‪.‬‬
‫ﺗﺤﺪﻳﺪ اﻟﺘﺼﺎﻣﻴﻢ اﻹﺣﺼﺎﺋﻴﺔ ذات اﻟﻌﻼﻗﺔ واﻻهﺘﻤﺎم ﺑﺎﻟﺼﺤﺔ ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻤﺤﻠﻲ واﻟﺪوﻟﻲ ﻣﻊ‬ ‫‪.5‬‬
‫ﺗﺤﺪﻳﺪ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت واﻟﺴﺒﻞ ﻟﺘﺴﻬﻴﻞ اﻟﺘﻌﺎون واﻟﺘﻨﺴﻴﻖ‪.‬‬
‫إﺑﺪاء اﻟﻤﺸﻮرة ﻟﻄﺮق ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت واﻹﺳﺘﺮاﺗﻴﺠﻴﺎت ﻣﻊ ﻣﺘﺎﺑﻌﺔ ﻧﻈﻢ اﻟﻤﻌﻠﻮﻣﺎت ﻟﻠﺘﻌﺮف ﻋﻠﻰ‬ ‫‪.6‬‬
‫اﻻﺣﺘﻴﺎﺟﺎت واﻟﻤﺸﺎآﻞ‪.‬‬
‫ﺗﺤﻔﻴﺰ دراﺳﺔ اﻟﺒﻴﺎﻧﺎت اﻟﺼﺤﻴﺔ وﻧﻈﻢ اﻟﻤﻌﻠﻮﻣﺎت ﺑﺎﻟﻤﺆﺳﺴﺎت واﻟﻬﻴﺌﺎت اﻷﺧﺮى أن أﻣﻜﻦ ذﻟﻚ‪.‬‬ ‫‪.7‬‬
‫اﻟﻤﺮاﺟﻌﺔ واﻟﺘﻌﻠﻴﻖ ﻋﻠﻰ اﻟﺘﻘﺎرﻳﺮ اﻟﻤﻌﺪة ﺑﺎﻟﻬﻴﺌﺎت واﻟﻤﻨﻈﻤﺎت اﻷﺧﺮى ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺒﻴﺎﻧﺎت‬ ‫‪.8‬‬
‫اﻟﺼﺤﻴﺔ ﻣﻊ ﻋﻤﻞ اﻟﺘﻮﺻﻴﺎت ﺑﺸﺎن ﺗﻨﻔﻴﺬ ﺗﻠﻚ اﻟﺘﻮﺻﻴﺎت‪.‬‬

‫ﺗﺘﻜﻮن اﻟﻠﺠﻨﺔ ﺑﻘﺮار ﻣﻦ ﺳﻌﺎدة ﻣﺪﻳﺮ ﻋﺎم اﻟﻬﻴﺌﺔ ﻣﻦ‪:‬‬

‫‪ .1‬ﻣﺪﻳﺮ إدارة اﻹﺣﺼﺎء واﻟﺘﺨﻄﻴﻂ‪.‬‬

‫‪ .2‬ﻣﻤﺜﻞ ﻋﻦ ﺑﻠﺪﻳﺔ دﺑﻲ‪.‬‬
‫‪ .3‬ﻣﻤﺜﻞ ﻋﻦ ﻣﺪﻳﺮﻳﺔ اﻟﺸﺆون اﻟﺼﺤﻴﺔ ﺑﺪﺑﻲ‪.‬‬
‫‪ .4‬رﺋﻴﺲ ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ ﺑﺎﻟﻬﻴﺌﺔ‪.‬‬
‫‪ .5‬اﺳﺘﺸﺎري اﻟﻮﺑﺎﺋﻴﺎت ﺑﻘﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ‬
‫‪ .6‬ﻣﻤﺜﻞ ﻋﻦ آﻞ ﻣﺴﺘﺸﻔﻰ وﻣﻤﺜﻞ ﻣﻦ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ‪.‬‬
‫‪ .7‬ﻣﺪﻳﺮ إدارة ﻧﻈﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ ﺑﺎﻟﻬﻴﺌﺔ‬
‫‪ .8‬ﻣﻤﺜﻞ ﻋﻦ إدارة اﻟﺸﺆون اﻟﺼﺤﻴﺔ ﺑﺸﺮﻃﺔ دﺑﻲ‪.‬‬
‫‪ .9‬ﻣﻤﺜﻞ ﻋﻦ اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ‪.‬‬
‫‪ .10‬ﻣﻤﺜﻞ ﻋﻦ اﻟﺸﺆون اﻟﺼﻴﺪﻟﻴﺔ‪.‬‬

‫اﻻﺟﺘﻤﺎﻋﺎت‪:‬‬

‫ﺳﻮف ﺗﻌﻘﺪ اﻟﻠﺠﻨﺔ اﺟﺘﻤﺎﻋﺎت ﺷﻬﺮﻳًﺎ ﺑﺪﻋﻮة ﻣﻦ رﺋﻴﺲ اﻟﻠﺠﻨﺔ‪.‬‬

‫اﻟﺘﻘﺎرﻳﺮ‪:‬‬

‫ﻳﻘﺪم رﺋﻴﺲ اﻟﻠﺠﻨﺔ ﺗﻘﺎرﻳﺮ دورﻳﺔ ﻋﻦ ﺳﻴﺮ ﻋﻤﻞ اﻟﻠﺠﻨﺔ إﻟﻰ ﺳﻌﺎدة ﻣﺠﻴﺮ ﻋﺎم اﻟﻬﻴﺌﺔ ﻣﺘﻀﻤﻨ ًﺎ أﻧﺸﻄﺔ‬
‫وﺗﻮﺻﻴﺎت اﻟﻠﺠﻨﺔ ﻟﻠﺘﻮﺟﻴﻪ ﺑﻤﺎ ﻳﺮاﻩ ﻣﻨﺎﺳﺒ ًﺎ ﻓﻲ‬

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 Epidemiologic Tasks

Introduction

Epidemiology is the study of which group of people get which diseases and why.
Today, epidemiology is formally understood as the study of the distribution and
determinants of disease in human. The two main branches of the subject correspond to
the two elements of this definition is descriptive and analytical epidemiology. Often
the investigator has used descriptive studies as the basis for hypothesis about what
causes a disease or makes its onset more likely. The study of epidemiology, by
necessity, requires a deep conceptual understanding of the statistics that underlying
the science.

The Department has been actively utilizing the mydohms web page as another avenue
to manage this important function efficiently, many key epidemiological data should
be posted on the web page and regularly updated and make available through the web
the information most frequently requested in a standardized.

Building Future Epidemiological Capacity in DOHMS

Epidemiological data is essential to guide decision making in all aspects of

formulating, implementing, monitoring and evaluating health policies and programs.
In addition it is also required for all health services profilers in DOHMS. Every
section in DOHMS should have a minimum core of epidemiological services to
undertake all or some of the following activities on an on going basis.

• Measure indicators of health status and quantify the magnitude of disease

problems.

• Evaluate the effectiveness of health service delivery and utilization of health

services.

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• Disseminate appropriately analyzed and interpreted health information in a timely
manner.

The Department of Planning and Statistics is ideally positioned to be a training site for
epidemiology in DOHMS in collaboration with other departments and units in
DOHMS. Associates of the Department include a Consultant epidemiologist who is a
Professor and ex- chair of Epidemiologist Department, High Institute of Public
Health, Alexandria University.

In order to build this capacity the unit can offer two training modules (2 weeks in
total) on basic epidemiology and research methods. A Health Research Methodology
Workshop was carried out by the writer in May 2005

Communicable Diseases Surveillance:

Pursuant to major mandate for surveillance of communicable diseases, The

Department of Planning and Statistics should continue to work collaboratively with
CDC in DOHMS to improve the quality, reliability and timeliness of data generated.
Following script of these reports, the data are consolidated into a database from which
it is analyses, interpreted and appropriate reposts generated.

Non-communicable Diseases Surveillance:

A hospital – hazed injury surveillance system should be implemented. The

development of apposite software to facilitate data entry, processing and report
generation together with training and reference manuals should be carried out.
Through this hospital based injury surveillance and its flexible software and its pilot
sited, it will be possible to validate it against the International Classification of
Diseases. Diabetes and cancer (cancer Breast, uteri, cervix and prostate) can be
selected as conditions for surveillance. Currently available sources of data suitable
for surveillance purposes will be considered. While it was recognized that mortality
data could provide data on chronic diseases, existing morbidity data systems (hospital
patient registration, clinic records and disease registries) will be utilized to generate
relevant information.

Nosocomial Infection Control:

A workshop on hospital infection control is sought to educate a wider cadre of nurses

staff attrition may negatively imaging on the smooth operation and the sustainability
of DOHMS infection control program.

274
Human Resource Development:

In order continually update and enhance knowledge and skills to meat the enhancing
challenges of workplace, associates of the Statistical Analysis Unit should attend or
participate in training courses or related activities.

Epidemiologic Tasks of the Department of Planning and Statistics

1. Review of data collection and processing in the DOHMS. This includes the
most important data collection techniques post processing technique, methods
availability and content of data sources, aspects of data quality, linkage of data
for various services, use of data bank (e.g. as data sets for reference), data
protection (how to collect data in away that agrees with the country data
collection laws) and data security (how to protect data from loss, modification
or illegal access).
2. Review of health indicators used in the DOHMS and development of a catalogue
of health indicators that should reflect:
- Socioeconomic indicators economic in cilantros.
- The population dimension of the health system.
- Availability of health facilities.
- Availability of health manpower.
- Utilization of health services.
- Productivity and efficiency of the health system.
- Financing and cost of heath services.
- Quality of health services.
- Disease outcome.
- Other indicators as:
- Human resources for health.
- Financial resources for health.
- Drugs and other supplies.
- International partnership for health.
- Life style.

3. Collaborate with other units in DOHMS in designing and implementing some

researches that can help in planning, management and evaluation of health
services. This should include:

275
 a. Sampling design including determination of sample size and.
b. Sample selection of study to be used.
c. Methods of data collection including questionnaire design and art of interviewing
together with the survey instruments.
d. Plan for implementation of the survey.
e. Plan for analysis and presentation of data.

4- Designing and carrying out training workshops that can empower the health service
personnel to improve the health of the community through development of data
mentality and introducing them to the main components of research. Training
workshops that can be carried out by the unit of Statistical Analysis in
collaboration with other units in DOHMS will be in the field of

- Uses of Epidemiology in public health practices.

- Research methods.
- Surveillance.
- Health information system.
- Statistical packages used in Epidemiology as Epi- info and SPSS and SAS.
- Epidemiology of non-communicable diseases.

5- Sharing in scientific multidisciplinary committees in DOHMS through helping in

carrying out situation analysis, assessment of needs, providing indicators,
determination of strategies and specific activities and its integrations and
evaluation of such activities.

6- Collaborate with the concerned sections in the DOHMS in planning and evaluation
of health programmers

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 ‫اﻟﻤﻬﺎم اﻟﻮﺑﺎﺋﻴﺔ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ‬

‫ﻟﻤﺎ آﺎن ﻋﻠﻢ اﻟﻮﺑﺎﺋﻴﺎت هﻮ دراﺳﺔ ﺣﺪوث اﻷﻣﺮاض واﻟﻈﻮاهﺮ اﻟﺼﺤﻴﺔ ﺑﻴﻦ اﻟﺴﻜﺎن واﻟﻌﻮاﻣﻞ اﻟﻤﺮﺗﺒﻄﺔ ﺑﺤﺪوث‬
‫ﺗﻠﻚ اﻷﻣﺮاض ﺑﻬﺪف وﺿﻊ إﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻤﻘﺎرﻧﺔ وﻣﻜﺎﻓﺤﺔ ﺗﻠﻚ اﻷﻣﺮاض‪ .‬ﻟﺬا ﻓﺎن هﻨﺎك ﻓﺮﻋﻴﻦ أﺳﺎﺳﻴﻴﻦ ﻟﻬﺬا اﻟﻌﻠﻢ‬
‫هﻤﺎ اﻟﻮﺑﺎﺋﻴﺎت اﻟﻮﺻﻔﻴﺔ واﻟﻮﺑﺎﺋﻴﺎت اﻟﺘﺤﻠﻴﻠﻴﺔ‪ .‬وﻏﺎﻟﺒًﺎ ﻣﺎ ﻳﺴﺘﺨﺪم اﻟﺒﺎﺣﺜﻮن اﻟﺪراﺳﺎت اﻟﻮﺻﻔﻴﺔ أﺳﺎس ﻟﻮﺿﻊ‬
‫اﻻﻓﺘﺮاﺿﺎت ﻋﻦ أﺳﺒﺎب اﻷﻣﺮاض واﺣﺘﻤﺎﻻت ﺣﺪوﺛﻬﺎ‪ .‬هﺬا وﺗﺤﺘﺎج دراﺳﺔ اﻟﻮﺑﺎﺋﻴﺎت إدراك ﻣﻔﺎهﻴﻤﻲ ﻟﺪورا‬
‫ﻹﺣﺼﺎء ﻓﻲ هﺬا اﻟﻌﻠﻢ‪.‬‬

‫ﺑﻨﺎء ﻣﻘﺪرة وﺑﺎﺋﻴﺔ ﻣﺴﺘﻘﺒﻠﻴﺔ ﺑﺎﻟﺪاﺋﺮة‬

‫ﺗﻌﺘﺒﺮ اﻟﺒﻴﺎﻧﺎت اﻟﻮﺑﺎﺋﻴﺔ أﺳﺎﺳﻴﺔ ﻹرﺷﺎد ﻣﺘﺨﺬي اﻟﻘﺮار ﻓﻲ ﺟﻤﻴﻊ ﻣﺠﺎﻻت ﺻﻴﺎﻏﺔ وﺗﻨﻔﻴﺬ وﻣﺮاﻗﺒﺔ وﺗﻘﻴﻴﻢ اﻟﺴﻴﺎﺳﺎت‬
‫اﻟﺼﺤﻴﺔ واﻟﺒﺮاﻣﺞ‪ .‬وﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ ﻓﺎﻧﻪ ﻳﺤﺘﺎج إﻟﻴﻬﺎ آﻞ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ ﺑﺎﻟﺪاﺋﺮة‪ .‬هﺬا وﻳﺠﺐ إن ﻳﻜﻮن ﺑﻜﻞ ﻗﺴﻢ‬
‫ﺑﺎﻟﺪاﺋﺮة ﺣﺪ أدﻧﻰ ﻣﻦ اﻟﻤﻔﺎهﻴﻢ اﻟﻮﺑﺎﺋﻴﺔ وذﻟﻚ ﻹﺟﺮاء آﻞ أو ﺑﻌﺾ اﻷﻧﺸﻄﺔ اﻟﺘﺎﻟﻴﺔ ﺑﺼﻴﻐﺔ دورﻳﺔ‪.‬‬

‫‪ .1‬ﻗﻴﺎس ﻣﺆﺷﺮات اﻟﺤﺎﻟﺔ اﻟﺼﺤﻴﺔ وﻗﻴﺎس ﺣﺠﻢ اﻟﻤﺸﺎآﻞ اﻟﺼﺤﻴﺔ‪.‬‬

‫‪ .2‬ﻗﻴﺎس آﻔﺎءة ﺗﻘﺪﻳﻢ واﺳﺘﺨﺪام اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬
‫‪ .3‬ﻧﺸﺮ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ اﻟﻤﺤﻠﻠﺔ واﻟﻤﻔﺴﺮة ﻓﻲ اﻟﻮﻗﺖ اﻟﻤﻨﺎﺳﺐ‪.‬‬

‫هﺬا وﻳﻌﺘﺒﺮ ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة ﻣﺆهﻼ ﻟﻴﻜﻮن ﻣﺮآﺰ ﺗﺪرﻳﺐ ﻟﻠﻮﺑﺎﺋﻴﺎت ﺑﺎﻟﺪاﺋﺮة ﺑﺎﻟﺘﻌﺎون ﻣﻊ اﻷﻗﺴﺎم‬
‫واﻟﻮﺣﺪات اﻷﺧﺮى ﺑﺎﻟﺪاﺋﺮة ﺣﻴﺚ ﻳﻀﻢ اﻟﻘﺴﻢ آﻮادر ﻣﺘﺨﺼﺼﺔ آﺎﺳﺘﺸﺎري اﻟﻮﺑﺎﺋﻴﺎت ﺑﺎﻟﺪاﺋﺮة وهﻮ أﺳﺘﺎذ ﻟﻌﻠﻢ‬
‫اﻟﻮﺑﺎﺋﻴﺎت ﺑﺠﺎﻣﻌﺔ اﻹﺳﻜﻨﺪرﻳﺔ‪.‬‬

‫‪ .1‬ﻣﺮاﻗﺒﺔ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ‬

‫إﺿﺎﻓﺔ إﻟﻰ اﻟﺪور اﻟﻬﺎم واﻟﺤﻴﻮي اﻟﺬي ﻳﻘﻮم ﺑﻪ ﻗﺴﻢ ﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ ﺑﺎﻟﺪاﺋﺮة ﻓﻲ ﻣﺮاﻗﺒﺔ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ‬
‫ﻓﺈﻧﻪ ﻳﺠﺐ أن ﻳﺴﺘﻤﺮ اﻟﺘﻌﺎون ﻣﻊ ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﻣﻦ أﺟﻞ اﻻرﺗﻘﺎء ﺑﺠﻮدة اﻟﺒﻴﺎﻧﺎت اﻟﻤﺴﺘﺨﺮﺟﺔ وﻣﺼﺪاﻗﻴﺘﻬﺎ‬
‫وﺣﺪاﺛﺘﻬﺎ ﺛﻢ ﺗﺤﻠﻴﻠﻬﺎ وإﻋﺪاد اﻟﺘﻘﺎرﻳﺮ اﻟﻤﻨﺎﺳﺒﺔ‪.‬‬

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 ‫‪ .2‬ﻣﺮاﻗﺒﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﺎﻟﺪاﺋﺮة‬

‫ﻳﺠﺐ وﺿﻊ ﻧﻈﺎم ﻟﻤﺮاﻗﺒﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﺎﻟﺪاﺋﺮة ﻣﻊ اﺧﺘﻴﺎر ﺑﻌﺾ اﻷﻣﺮاض آﺎﻟﺴﻜﺮي واﻟﺴﺮﻃﺎﻧﺎت‬
‫)ﺳﺮﻃﺎن اﻟﺜﺪي‪ -‬ﺳﺮﻃﺎن ﻋﻨﻖ اﻟﺮﺣﻢ‪-‬ﺳﺮﻃﺎن اﻟﺒﺮوﺳﺘﺎﺗﺎ( ﻟﻮﺿﻊ ﻧﻈﺎم ﻣﺮاﻗﺒﺔ ﻟﻬﺎ‪ .‬ﻣﻊ اﻋﺘﺒﺎر اﻟﻤﺼﺎدر اﻟﻤﺘﺎﺣﺔ‬
‫ﺣﺎﻟﻴًﺎ واﻟﻤﻨﺎﺳﺒﺔ ﻷﻏﺮاض اﻟﻤﺮاﻗﺒﺔ آﻮﻓﻴﺎت اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ وﻧﻈﻢ ﺑﻴﺎﻧﺎت اﻷﻣﺮاﺿﻴﺔ )ﺳﺠﻼت ﻣﺮﺿﻰ‬
‫اﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﻌﻴﺎدات وﺳﺠﻼت اﻷﻣﺮاض ﺑﺎﻟﺪاﺋﺮة آﺴﺠﻞ اﻟﺴﺮﻃﺎن( واﻟﺘﻲ ﺗﻮﺟﺪ ﺑﺎﻟﺸﺒﻜﺔ اﻹﻟﻜﺘﺮوﻧﻴﺔ اﻟﻤﻄﺒﻘﺔ‬
‫ﺑﺎﻟﺪاﺋﺮة ﻟﻠﺤﺼﻮل ﻋﻠﻰ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﻨﺎﺳﺒﺔ‪.‬‬

‫‪ .3‬ﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى ﺑﺎﻟﻤﺴﺘﺸﻔﻴﺎت‬

‫ﻣﻦ اﻟﻤﻤﻜﻦ أن ﻳﺴﺎهﻢ ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﻓﻲ ﺗﺤﻠﻴﻞ ﺑﻴﺎﻧﺎت اﻟﻌﺪوى ﺑﺎﻟﻤﺴﺘﺸﻔﻴﺎت إﺿﺎﻓﺔ إﻟﻰ اﻟﻤﺴﺎهﻤﺔ ﻓﻲ‬
‫ﺑﺮاﻣﺞ اﻟﺘﺪرﻳﺐ ﻟﻠﻤﻤﺮﺿﺎت ﻋﻠﻰ ﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى وآﻴﻔﻴﺔ اﻻﺳﺘﻘﺼﺎء واﻟﻤﺮاﻗﺒﺔ ﻟﻠﻌﺪوى ﺑﺎﻟﻤﺴﺘﺸﻔﻴﺎت‪.‬‬

‫‪ .4‬ﺗﻨﻤﻴﺔ اﻟﻘﻮى اﻟﺒﺸﺮﻳﺔ‬

‫ﻣﻦ أﺟﻞ اﻻرﺗﻘﺎء اﻟﻤﺴﺘﻤﺮ واﻟﺘﺤﺪﻳﺚ ﻟﻠﻤﻌﻠﻮﻣﺎت واﻟﻤﻬﺎرات ﻟﻤﻘﺎﺑﻠﺔ ﺗﻌﺰﻳﺰ ﻣﻮاﺟﻬﺔ اﻟﺘﻐﻴﺮات ﻓﻲ ﻣﺠﺎﻻت اﻟﻌﻤﻞ‬
‫واﻟﺨﺒﺮات اﻟﻤﺴﺘﺤﺪﺛﺔ ﻓﺈن ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﻣﻦ اﻟﻤﻤﻜﻦ أن ﻳﺸﺎرك ﻓﻲ اﻟﺪورات وورﺷﺎت اﻟﻌﻤﻞ ذات اﻟﻌﻼﻗﺔ‬
‫آﻤﺠﺎﻻت اﻹﺣﺼﺎء واﻟﻮﺑﺎﺋﻴﺎت‪.‬‬

‫‪ -5‬إﻧﺸﺎء وﺣﺪة ﻟﻠﺒﺤﻮث اﻟﺼﺤﻴﺔ ﺑﻘﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺎﻟﺪاﺋﺮة‬

‫اﻟﻤﻬﺎم اﻟﻮﺑﺎﺋﻴﺔ ﺑﻘﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ‬

‫‪ .1‬ﻣﺮاﺟﻌﺔ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت وﺗﺪاوﻟﻬﺎ ﺑﺎﻟﺪاﺋﺮة وﻳﺸﻤﻞ هﺬا ﺳﺒﻞ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت وﻣﺤﺘﻮﻳﺎﺗﻬﺎ اﻟﺒﻴﺎﻧﺎت وﻣﺼﺎدرهﺎ‬
‫وﺟﻮاﻧﺐ ﺟﻮدة اﻟﺒﻴﺎﻧﺎت ورﺑﻂ اﻟﺒﻴﺎﻧﺎت ﻟﺨﺪﻣﺎت ﻣﺘﻌﺪدة ﻣﻊ اﺳﺘﺨﺪام ﺑﻨﻚ اﻟﺒﻴﺎﻧﺎت وﺣﻤﺎﻳﺔ اﻟﺒﻴﺎﻧﺎت )آﻴﻔﻴﺔ ﺟﻤﻊ‬
‫اﻟﺒﻴﺎﻧﺎت ﺑﻄﺮﻳﻘﺔ ﺗﺘﻨﺎﺳﺐ ﻣﻊ ﻗﻮاﻧﻴﻦ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت( وﺳﺮﻳﺔ اﻟﺒﻴﺎﻧﺎت )آﻜﻴﻔﻴﺔ ﺣﻔﻆ اﻟﺒﻴﺎﻧﺎت ﻣﻦ اﻟﻀﻴﺎع واﻟﺘﻐﻴﻴﺮ‬
‫واﻟﻮﺻﻮل اﻟﻴﻬﺎ ﺑﺎﻟﻄﺮق ﻏﻴﺮ اﻟﻤﺸﺮوﻋﺔ(‪.‬‬
‫‪ .2‬ﻣﺮاﺟﻌﺔ اﻟﻤﺆﺷﺮات اﻟﺼﺤﻴﺔ اﻟﻤﺴﺘﺨﺪﻣﺔ ﺑﺎﻟﺪاﺋﺮة وﻋﻤﻞ دﻟﻴﻞ ﻟﻠﻤﺆﺷﺮات اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة ﺑﻌﻜﺲ‪:‬‬

‫اﻟﻤﺆﺷﺮات اﻻﻗﺘﺼﺎدﻳﺔ واﻻﺟﺘﻤﺎﻋﻴﺔ‪.‬‬ ‫•‬

‫اﻟﺒﻌﺪ اﻟﺴﻜﺎﻧﻲ اﻟﺼﺤﻲ‪.‬‬ ‫•‬
‫ﺗﻮﻓﺮ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬ ‫•‬
‫اﺳﺘﺨﺪام اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬ ‫•‬
‫إﻧﺘﺎﺟﻴﺔ وآﻔﺎءة اﻟﻨﻈﺎم اﻟﺼﺤﻲ‪.‬‬ ‫•‬
‫ﺗﻤﻮﻳﻞ وﺗﻜﻠﻔﺔ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬ ‫•‬
‫ﺟﻮدة اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬ ‫•‬
‫ﻋﺎﻗﺒﺔ اﻷﻣﺮاض‪.‬‬ ‫•‬
‫ﻣﺆﺷﺮات اﻻرﺗﻘﺎء ﺑﺎﻟﻮﺿﻊ اﻟﺼﺤﻲ‪.‬‬ ‫•‬

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 ‫‪ -3‬اﻟﺘﻌﺎون ﻣﻊ اﻷﻗﺴﺎم اﻷﺧﺮى ﺑﺎﻟﺪاﺋﺮة ﻓﻲ ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ ﺑﻌﺾ اﻟﺒﺤﻮث اﻟﺘﻲ ﺗﺴﺎﻋﺪ ﻓﻲ ﺗﺨﻄﻴﻂ وﺗﻨﻔﻴﺬ وﺗﻘﻴﻴﻢ‬
‫اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﻳﺸﻤﻞ هﺬا‪:‬‬

‫‪ .1‬اﺧﺘﻴﺎر ﻋﻴﻨﺔ اﻟﺒﺤﺚ ﻣﺘﻀﻤﻨًﺎ ﺣﺠﻢ اﻟﻌﻴﻨﺔ‪.‬‬

‫‪ .2‬ﻃﺮق ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت ﻣﺘﻀﻤﻨًﺎ ﺗﺼﻤﻴﻢ اﺳﺘﻤﺎرة اﻟﺒﺤﺚ وﻓﻦ اﻟﻤﻘﺎﺑﻠﺔ وأدوات اﻟﺒﺤﺚ‪.‬‬
‫‪ .3‬ﺧﻄﻂ ﺗﻨﻔﻴﺬ اﻟﻤﺴﻮﺣﺎت‪.‬‬
‫‪ .4‬ﺧﻄﻂ ﺗﺤﻠﻴﻞ وﻋﺮض اﻟﺒﻴﺎﻧﺎت‪.‬‬

‫‪ -4‬ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ ورﺷﺎت اﻟﻌﻤﻞ اﻟﺘﻲ ﺗﻘﻮي اﻟﻌﺎﻣﻠﻴﻦ ﺑﺎﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﻟﺘﺤﺴﻴﻦ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﻣﻦ ﺧﻼل ﺗﻨﻤﻴﺔ‬
‫ﻋﻘﻠﻴﺔ ﺑﻴﺎﻧﺎت ﺑﻴﻨﻬﻢ ووﺿﻌﻬﻢ ﻋﻠﻰ أﻋﺘﺎب ﻣﻜﻮﻧﺎت اﻟﺒﺤﻮث‪ .‬هﺬا وﺗﺸﻤﻞ ورﺷﺎت اﻟﻌﻤﻞ اﻟﺘﻲ ﻳﻤﻜﻦ أن ﻳﺠﺮﻳﻬﺎ اﻟﻘﺴﻢ‬
‫ﺑﺎﻟﺘﻌﺎون ﻣﻊ اﻟﻮﺣﺪات اﻷﺧﺮى ﺑﺎﻟﺪاﺋﺮة اﻟﻤﺠﺎﻻت اﻟﺘﺎﻟﻴﺔ‪:‬‬

‫‪ .1‬اﺳﺘﺨﺪام اﻟﻮﺑﺎﺋﻴﺎت ﻓﻲ ﻣﻤﺎرﺳﺎت اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ‪.‬‬

‫‪ .2‬ﻃﺮق اﻟﺒﺤﺚ‪.‬‬
‫‪ .3‬اﻟﻤﺆﺷﺮات اﻟﺼﺤﻴﺔ‪.‬‬
‫‪ .4‬اﻟﺤﺰم اﻹﺣﺼﺎﺋﻴﺔ ﻓﻲ اﻟﻮﺑﺎﺋﻴﺎت ﻣﺜﻞ ‪.Epi-info, SPSS‬‬
‫‪ .5‬وﺑﺎﺋﻴﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬

‫‪ -5‬اﻟﻤﺸﺎرآﺔ ﻓﻲ اﻟﻠﺠﺎن اﻟﻌﻠﻤﻴﺔ ذات اﻟﺘﺨﺼﺼﺎت اﻟﻤﺘﻌﺪدة ﺑﺎﻟﺪاﺋﺮة ﻣﻦ ﺧﻼل اﻟﻤﺴﺎﻋﺪة ﻓﻲ ﺗﺤﻠﻴﻞ اﻟﻮﺿﻊ وﺗﻘﻴﻴﻢ‬
‫اﻻﺣﺘﻴﺎﺟﺎت وﺗﻘﺪﻳﻢ اﻟﻤﺆﺷﺮات وﺗﺤﺪﻳﺪ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت واﻷﻧﺸﻄﺔ وآﻴﻔﻴﺔ دﻣﺞ وﺗﻘﻴﻴﻢ ﺗﻠﻚ اﻷﻧﺸﻄﺔ‪.‬‬

‫‪ -6‬ﻣﺸﺎرآﺔ اﻷﻗﺴﺎم اﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﺪاﺋﺮة ﻓﻲ ﺗﺨﻄﻴﻂ وﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬

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 Infection Control Program in DOHMS

Infection control (IC) is a quality standard and is essential for the well being and
safety of patients, staff and visitors. It affects most departments of the hospital and
involves issues of quality, risk management, clinical governance and health and
safety. An infection control programme with a firm structure should be in existence in
all institutions that provide health care in order to establish a managed environment
that secures the lowest possible rate of hospital acquired infection and protects staff
and visitors from unnecessary risks

Infection control programs have evolved in an attempt to solve the problem of

nosocomial infections and have shown to be clinically relevant as well as cost
effective to prevent and control nosocomial infection .The key to the control of
infections lies on the infection control committee, the infection control team and the
program itself. A good infection control infrastructure therefore is critical to the
success of implementing these programs to achieve protecting health of the patient,
health care workers and these in the health care environment.

Goal Identify and reduce risks of infection in patients and health care workers,
coordinating all activities related to surveillance, prevention and control of infection,
and improve clinical outcomes using a multidisciplinary team approach and to balance
quality and cost of hospital infection control.

280
Mission The Mission Statement is as follows “Hospital Infection Control Program in
DOHMS is a department with expertise in infection control and related disciplines.
Our Mission is to promote a healthy and safe environment by preventing transmission
of infectious agents among patients, staff and visitors. This will be accomplished in an
efficient and cost effective manner by continual assessment and modification of our
services based on regulations standards, scientific studies, internal evaluation and
guidelines”.

Coverage: the Infection Control Program will cover all health facilities in DOHMS.

Strategy
− Establishment of a Department of Infection Control in DOHMS with infection
control section in Rashid, Dubai and Al Wasl hospitals and Al Maktoum
hospitals (Annex).
− Assessment of the current infection control activities in DOHMS.
− Formulating of an Infection Control Plan in DOHMS.
Activities
− Situational analysis of infection control infection control in DOHMS.
− Evaluation and revision of policies and procedures for each department and
service in DOHMS hospitals.
− Establishment of an infection control section in each hospital in DOHMS.
− Training workshop in hospital Epidemiology and Infection Control.
− Training of a local doctor and a nurse in one of the known centers for
inflection control in United States of America or United Kingdom.
− Appointment of a hospital Epidemiologists in DOHMS.

Activity by Infrastructure
1. Central Infection Control Community

281
 2. Hospital Infection Control Community
3. Infection Control Division in the Hospital
4. Infection Control Team
• Hospital Epidemiologist
• Infection Control Nurse

Manpower requirements
1. Hospital Epidemiologist. 3
2. Infection Control Nurse (A registered nurse, often with a bachelor's degree
with training in infection control and Epidemiology).
3. Secretary.

Assessment of the Current Infection Control Program for compliance with written
standards and guidelines, areas that need improvement and available resources
program assessment should be made internally and externally. An internal resource
may be a well-trained certified infection control practioner or a trained
epidemiologist. An external resource could be microbiology laboratory. An internal
self-assessment of needs might evaluate previous quality improvement projects,
surveillance data or relevant sentinel events. External needs may be assessed by
surveys or questionnaires of hospital staff or patient satisfaction.

Formulating an Infection Control Plan in DOHMS

The infection control program in DOHMS should develop a well-defined written plan
outlining the organizational philosophy regarding infection prevention and control.
The plan should take into account the goals, mission statement and assessment of the
infection prevention and control. It should include statement of authority, and should
review patient demographics including geographic locations of patients served by

282
DOHMS. The scope of responsibilities for actions to be taken to accomplish the goals
should be included in the plan. Data if available should drive the plan that should be
reviewed and revised annually. Each revision should include defining the objective of
the goals, with due dates and responsible parties

Surveillance DOHMS Infection Control Practioners should be disenchanted with

hospital wide surveillance and question the value of generating data without
measurable changes. The concept of surveillance by objective selects a different
surveillance strategy for different sites of infection. Surveillance by objective allows
the ICP’S more time for other responsibilities and provides a method for setting
measurable goals for reduction of infection.

Outbreak investigation
Occasional clusters of patients who are colonized or infected will trigger further
investigation including case control study. A group of patients linked
epidemiologically by time and space with multiply-resistant bacteria should be further
analyzed for evidence of cross transmission.

Communicable disease reporting

The infection control program is responsible for reporting of communicable diseases
in DOHMS hospitals required by law. ICPS need to plan on interacting with
preventive health section in PHC in DOHMS regarding exposure that may need
immediate community follow up.

Policies and Procedures

283
 The ICC must oversee the ongoing review and evaluation of written policies and
procedures outlining prevention and control mechanisms in all patient care and
service areas in DOHMS. The policies and procedures should be based on recognized
guidelines and applicable laws and regulations. The policies should address the
prevention of infection transmission among patients, employees, medical staff,
contractors, volunteers, visitors, and environmental issues. Policies must be reviewed
and approved. The infection control manual must reflect what actual practice in the
institution is because the organization is legally accountable for complying with its
own policies.

Control and Prevention.

Of equal importance in the infection control program are control and prevention
activities.

Teaching and Consulting

All new employees must be taught infection control principles and the isolation
policies and procedures in use in DOHMS. Continuing education in infection control
for all departments and are as of the hospital is also required. Consultation, on a
formal and informal basis, is probably the most important means of preventing and
controlling infections.
Administrative Activities
Another component of the infection control program includes the administrative
activities necessary to implement the decisions of the ICC. The first of these activities
is the review of a hospital wide infection manual. The manual contains all hospital
policies and procedures related to infection control.

Special Studies
Apportion of the infection control program should be devoted to the investigation of
new products , old procedures or other aspects of patient care that could lead to lower
infection risks to patients and hospital staff .

284
Priorities of an Infection Control Program in DOHMS:
The priorities depend upon the size of the institution and (ICP) level of care given ,
the ratio of Infection control practitioners to beds and the stage of development of the
program .As the number of beds in Rashid , Dubai , Al wasl and Al Maktoum
Hospitals are 451, 607, 482 and 56 beds respectively and there are not enough ICPs
to implement the program , not all components will be addressed adequately .In the
development of an infection control program , One of the first priorities is to
determine base line infection rates . So more time should be spent in surveillance and
reporting activities. Priorities can and should change after the infection control
program has been in operation for some time. The time that was used initially in
surveillance should be allotted to prevention and control efforts.

Minimal Administrative Requirements for HIC Section in DOHMS

• A physician and a nurse with responsibilities for infection control.

• A manual of critical infection control policies.
• An educational programme for staff.

Hospital Infection Control Committee in DOHMS

Each hospital in DOHMS should establish a multidisciplinary committee on

infections to devote particular attentions to infections which are acquired in the
hospital so they may be reduced to the lowest level. The chairperson should be a
physician who should have specific training microbiology, epidemiology or infectious
diseases. Membership should include representation from the medical staff
administration, nursing services and the microbiology section of the laboratory. It
should also include representations from surgery, pediatric, pathology and obstetric-
gynecology services and house staff. Representation from other areas should be

285
named to serve on the committee as consultants or ad hoc members, to attend as
needed.
The function of the HICC should include:

1. Identifying the ICP - a staff member who is familiar with the regulations
concerning infection control and occupation regulations, able to implement,
monitor, and evaluate the effectiveness of the facility's infection control
system and competent to oversee the surveillance system, provide staff
education, and assess the effectiveness of the facility's infection control
system.
2. Developing an authority statement for the ICC/ICP to provide decision-
making authority in order to interrupt the transmission of infectious disease.
3. Developing written policies and procedures:

• For all infection control issues and control of specific infections.

• To periodically review, revise, and update policies and procedures.
• To periodically measure staff awareness of and adherence to
infection control polices and procedures.
• For staff education concerning infection control policies and
procedures.

4. Obtaining specific infection control policies from individual departments

regarding items under their responsibility
5. Meeting on both a regular and as-needed basis to:

• Discuss current infection control issues.

• Anticipate and plan for seasonal patterns of infectious disease (e.g.,

address mosquito-borne infections in the summer, organize an
effective immunization plan for Influenza in the fall).

• Review surveillance findings, identify disease trends, and act

accordingly.

286
 • Address an emerging outbreak.

Job Description of Hospital Epidemiologist

He / she are a specialist in infectious diseases and in Epidemiology and have a

particular interest and concern regarding prevention of nosocomial infection.
• Supervises the educational program and surveillance activities.
• Assist in monitoring infection control policies and procedures.
• Serves as an advisor to the hospital doctor, medical staff and nursing staff in
infection control practices.
• Guide the infection control committee in performing mandated duties
regarding the control of infectious diseases within DOHMS through the
provision of ongoing epidemiologic surveillance and the evaluation of relevant
data.
• Set the Agenda of ICC, conduct bimonthly meeting.
• Institute appropriate infection control measures or studies when potential
danger to patients, staff or visitors exists.

Hospital Infection Control Nurse

It is appointed by the hospital director and serves as a liaison between the hospital
infection control committee and all department or services in the hospital to:
• Foster an attitude of cooperation.
• Facilitate clinical and environmental surveillance activities.

287
 • Enhance the effectiveness of the surveillance program.
• Under the direction of the chairperson of HICC, the HIC officer will:

Infection Control Plan Checklist for DOHMS

Administrative

• Authority Statement
• Vision/Mission Statement
• Program Goals and Objectives
• Program Assessment

Personnel
Job Description

• Infection Control Coordinator or Hospital Epidemiologist

• Infection Control Nurse

Clinical
Infection Control Plan

• Surveillance Strategy
• Environmental Monitoring
• Antibiotic Utilization Studies

Investigations

• Outbreak Management

General Organizational Policies

• Occupational Health
• Medical Waste
• Post-exposure Communicable Disease Management

288
 ‫اﻗﺘـﺮاح ﺑـﺈﻧﺸـــﺎء ﻣﻜﺎﺗﺐ ﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى ﺑـﺎﻟﻤﺴﺘﺸﻔﻴــﺎت‬

‫اﻟﻬﺪف‬

‫دﻋ ﻢ اﻟﻤﺴﺘ ﺸﻔﻴﺎت ﺑﺎﻟﻘ ﺪرات اﻟﻼزﻣ ﺔ ﻟﺘﻌﺰﻳ ﺰ ﺳ ﻼﻣﺔ اﻟﻤﺮﺿ ﻰ ﺑﺘﻘﻠﻴ ﻞ ﺧﻄ ﻮرة اآﺘ ﺴﺎب وﻧﻘ ﻞ اﻟﻌ ﺪوى واﻟﺘﻌﻠ ﻴﻢ‬
‫اﻟﻤﺴﺘﻤﺮ واﻟﺘﺪرﻳﺐ ﻓﻲ ﻣﺠﺎل اﻟﻮﺑﺎﺋﻴﺎت وﻋﺪوى اﻟﻤﺴﺘﺸﻔﻴﺎت‪.‬‬

‫اﻟﻮﻇﺎﺋﻒ اﻟﻤﻨﻮﻃﺔ ﺑﺎﻟﻤﻜﺘﺐ‬

‫‪ .1‬ﻣﺮاﻗﺒﺔ وﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﺑﺎﻟﻤﺴﺘﺸﻔﻴﺎت‬

‫‪ −‬اﺳﺘﻘﺼﺎء وﻣﻜﺎﻓﺤﺔ ﻋﺪوى اﻟﻤﺴﺘﺸﻔﻴﺎت وﺑﺆر اﻟﻌﺪوى ﺑﻴﻦ اﻟﻤﺮﺿﻰ واﻟﻌﺎﻣﻠﻴﻦ ﺑﺎﻟﻤﺴﺘﺸﻔﻴﺎت ذات اﻟﻌﻼﻗﺔ‪.‬‬

‫‪ −‬إﻧﺸﺎء ﺳﻴﺎﺳﺎت وﻧﻬﺞ ﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى ﺑﺎﻟﻤﺴﺘﺸﻔﻰ ﺑﺎﻟﺘﻌﺎون ﻣﻊ اﻷﻗﺴﺎم ذات اﻟﻌﻼﻗﺔ‪.‬‬

‫اﻟﻤﻌﺎوﻧﺔ ﻓﻰ إدارة اﺳﺘﺨﺪام ﻣﻀﺎدات اﻟﻤﻴﻜﺮوﺑﺎت‪.‬‬ ‫‪−‬‬

‫‪ −‬اﻟﻤﺴﺎﻋﺪة ﻓﻰ إﻧﺸﺎء اﺳﺘﺮاﺗﻴﺠﻴﺎت ﺟﺪﻳﺪة ﻟﺘﺤﺪﻳﺪ اﻟﻌﺪوى اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪.‬‬

‫‪ .2‬اﻟﺘﻌﻠﻴﻢ اﻟﻤﺴﺘﻤﺮ واﻟﺘﺪرﻳﺐ‬

‫‪ −‬اﻟﺒﺮاﻣﺞ اﻟﺘﻌﻠﻴﻤﻴﺔ ﻟﺘﺄآﻴﺪ ﺟﻮدة رﻋﺎﻳﺔ اﻟﻤﺮﺿﻰ‪.‬‬

‫‪ −‬ﺗﻮﺟﻴﻪ اﻟﻤﻤﺮﺿﺎت اﻟﺠﺪﻳﺪات ﻋﻨﺪ اﻟﺘﻌﻴﻴﻦ‪.‬‬

‫‪ −‬اﻟﺘﺪرﻳﺐ أﺛﻨﺎء اﻟﺨﺪﻣﺔ ﻟﻠﻤﺮﺿﺎت‪.‬‬

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 ‫‪ .3‬وﻇﺎﺋﻒ أﺧﺮى ﻟﻠﻤﻜﺘﺐ‬

‫‪ −‬ﻗﻴﺎس ﻣﻌﺪل اﻟﻌﺪوى واﻟﺠﺮاﺛﻴﻢ اﻟﻤﻤﺮﺿﺔ‪.‬‬

‫‪ −‬ﻣﺮاﻗﺒﺔ ﻗﺎﺑﻠﻴﺔ اﻟﻌﺪوى‪.‬‬

‫‪ −‬ﺗﺤﻠﻴﻞ اﻻﺗﺠﺎهﺎت اﻟﻤﻮﻗﺘﺔ ﻟﻠﺒﻴﺎﻧﺎت اﻟﻤﺠﻤﻌﺔ‪.‬‬

‫‪ −‬ﺗﻘﻴﻴﻢ اﻟﻤﻨﺘﺠﺎت اﻟﺠﺪﻳﺪة اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ ﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى ﺑﺎﻟﻤﺴﺘﺸﻔﻰ‪.‬‬

‫‪ −‬ﺗﻘﻴﻴﻢ اﻟﺒﻴﺎﻧﺎت واﻟﺘﺤﻠﻴﻼت اﻹﺣﺼﺎﺋﻴﺔ ﻟﻠﺒﺤﻮث واﻟﻨﺸﺮ‪.‬‬

‫‪ −‬ﺗﻘﺪﻳﻢ اﻟﺒﻴﺌﺔ اﻟﺴﻠﻴﻤﺔ ﻟﻠﻤﺮﺿﻰ‪.‬‬

‫اﻟﻘﻮى اﻟﺒﺸﺮﻳﺔ اﻟﻤﻄﻠﻮﺑﺔ‬

‫‪Hospital Epidemiologist‬‬ ‫‪ .1‬أﺧﺼﺎﺋﻲ وﺑﺎﺋﻴﺎت ﺑﺎﻟﻤﺴﺘﺸﻔﻰ‬

‫ﻼ ﻋﻠﻰ دﺑﻠﻮم أو ﻣﺎﺟﺴﺘﻴﺮ ﻓﻲ اﻟﻮﺑﺎﺋﻴﺎت أو ﻣﻦ‬

‫وﻳﻘﻮم ﺑﺎﻹﺷﺮاف ﻋﻠﻰ آﺎﻓﺔ وﻇﺎﺋﻒ اﻟﻤﻜﺘﺐ وﻳﺠﺐ أن ﻳﻜﻮن ﺣﺎﺻ ً‬
‫ﺟﺎﻣﻌﺔ ﻣﻌﺘﺮف ﺑﻬﺎ‪ .‬أو ﻃﺒﻴﺐ ذو ﺧﺒﺮة ﻓﻰ اﻟﻮﺑﺎﺋﻴﺎت أو اﻟﻤﻴﻜﺮوﺑﻴﻮﻟﻮﺟﻰ‬

‫‪ .2‬ﻣﻤﺮﺿﺔ ﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى ‪Infection Control Nurse‬‬

‫ﻣﻤﺮﺿﺔ ﻣﺴﺠﻠﺔ ﺣﺎﺻﻠﺔ ﻋﻠﻰ ﺑﻜﺎﻟﻮرﻳﻮس اﻟﺘﻤﺮﻳﺾ وذات ﺧﺒﺮة ﻓﻰ ﻣﺠﺎل ﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى ﺑـﺎﻟﻤﺴﺘﺸﻔﻴــﺎت وﺗﻘﻮم‬
‫ﺑﻤﺴﺎﻋﺪة أﺧﺼﺎﺋﻲ اﻟﻮﺑﺎﺋﻴﺎت ﻓﻲ ﻣﻜﺎﻓﺤﺔ اﻟﻌﺪوى واﺳﺘﻘﺼﺎء اﻷوﺑﺌﺔ وﻣﺮاﻗﺒﺔ اﻷﻣﺮاض‪.‬‬

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 Health Research in DOHMS

Introduction

Health improvement is what public health professionals strive to achieve. Research

has enormous and in great part neglected power to improve health. Improving health
requires. Knowledge is generated by research and is essential for effective action for
health. Research empowers the community and health services personnel to improve
the health of the community.

Health care delivery in the 21st century faces enormous pressures such as population
aging, technology change and ongoing changes in political and social landscape.
Developing effective response to these and the myriad of other challenges faced daily
by decision makers, can not happen other than by discerning, disciplined health
services research and evidence gathering.

Health services research is a multidisciplinary field that investigates the structure,

processes, and effects of health care services. It draws on a variety of clinical and
academic disciplines and, at its most creative, integrates their conceptual frameworks
and methods to provide new ways of studying and understanding the health care
system.

Health care organizations are consolidate , expand, shrinking, reorganizing, or

otherwise changing in ways that are varied, sometimes perplexing, and unclear in
their effects on the cost, quality, and accessibility of health care. In addition hospitals
are complex systems, as they attempt to provide many services, via many resources to
a wide range of types of patient. When the obvious human factors are also taken into
account, e.g. many of the inputs, outputs and resources are human, the complexity
grows. Add to this the setting of health services within societies whose expectations
are drive by many factors within and without the health systems, and the research

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topic is likely to be very rich indeed. In this environment of rapid change and
uncertainty, health services research has an important contribution to make in
documenting and evaluating the effects of health care restructuring. In this era of
evidence-based health care, the findings of health services research could contribute
strongly to the development and delivery of effective and efficient health services,
policies and programs. Limited resources for the healthcare sector also means that
health care administrators are continuously being called upon to make choices, ethical
decisions and sound judgment. Evidence from health services research and program
evaluation will assist and inform this important process of making choices and
decisions. Furthermore, just as health services research has helped decision makers
understand and shape the health care system of the past, so too can it continue to
critical decisions by government officials, corporate leaders, clinicians, health plan
managers, and even ordinary people making choices about health problems ranging
from minor to catastrophic. In addition, the importance of implementing program
evaluation in public health was emphasized by many countries .Program evaluation
enables public health programs and interventions to improve upon existing processes,
operations and ultimately health outcomes

In DOHMS there is an inactivation of the health research policy and lack of studies
particularly in health system research. These could be attributed to insufficient
awareness of the importance of health studies, lack of resources for studies of
researches and insufficient qualified staff and trained research teams within the
DOHMS. The continuation of this situation will lead to lack of basic information that
results in duplication, dispersion of efforts and waste of resources. The health studies
will lack strategies and objectives directed to serve the DHA plan with incomplete
community based information that could be used to serve the purpose of planning and
evaluation. There is also difficulty to indicate the health gaps and to determine the
points of weakness in the health system with difficulty to determine the actual
magnitude of problem in relation to administration and technical constrains within the
health system. In addition, there is difficulty in measuring the quality of health

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services within insufficient knowledge about users satisfaction as regards the services
provided.

Proposed Health Research Section in DOHMS

Mission Statement

To contribute to the development of standards for quality health care and to be

recognized as a leader in health policy by coordinating, facilitating, and conducting
health services & health policy research and evaluation of programs run in DHA.

Goal

The Health studies and Research Section goal is to influence health policy, practice,
and equitable access to high quality care through rigorous health services, health
economics, and health policy research, and through education of health care
professionals. The section will also facilitate optimal health care delivery strategies,
which in turn, will improve efficiency, cost-effectiveness, and satisfaction with health
care together with economic evaluation and priority settings and evaluation of projects
run in DHA aimed at increasing the health and wellbeing of the population in Dubai.
The Section reviews health services research studies that include multidisciplinary
investigations of the predictor, processes and outcomes of health services, including
availability, access and acceptability; organization; decision-making; delivery,
utilization and quality of care; and costs, cost-effectiveness and financing of health
care. Health services include inpatient, ambulatory, sub-acute, acute, community-
based, rehabilitative and long-term care.

Objectives

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 • Influence policy through patient-centered, collaborative, interdisciplinary
research that focuses on health situation, health outcomes, health care
economics, cost effectiveness, and medical decision making.
• Inform, analyze, and interpret health care policy to policy makers and to
support optimal health care decisions.
• Identify best practices and influence patient care at DHA
• Contribute to the health of the population in Dubai through research and
evaluation of health programs and a varied program of teaching and training
that advances knowledge about health programs
• Improves DHA ability to evaluate health programs, fosters methodological
development and exemplary practice and addresses relevant issues
productively and flexibly.
• Identify barriers to delivery of high quality care and influence access to care.
• Training in the field of health research and in collaboration with the
Continuing Education Department in DHA.
• Collaboration with the concerned Departments in DHA, Dubai and UAE
Agencies

Specific areas covered by HSRS

• Health situation of the main health problems in Dubai.

• Community, personnel, economic, technological, and management resources

and support, including studies of community resources; health care provider
characteristics; health insurance, care management technology and assessment;
delivery system characteristics.

• Health needs and health services utilization; studies of severity of illness; co

morbidity; health care access and health services utilization and patterns.

• Healthcare organizations, programs, and delivery of services

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 • Healthcare quality, effectiveness, outcomes; studies of application and
evaluation of practice guidelines; quality of health care; patient and provider
satisfaction; health status and outcomes assessment; evidence-based practice;
health-related quality of life.

• Voluntary health and social service organizations and programs

Epidemiological Analysis Unit

As Epidemiology is the study of health and disease in communities. The goal of the
unit is to ensure the availability of high-quality and comprehensive health data on the
population of Dubai and to facilitate its use for public health assessment, policy
development, and program planning and evaluation.

Key activities of the Epidemiology Unit include, but are not limited to:

1. Provide epidemiology support and training in DHA especially toward chronic

disease prevention and where such capacity does not currently exist.
2. Centralize non communicable disease epidemiology and training in DHA
3. Standardize and make available data on health status, hospital discharge
diagnoses, health-related quality of life, and other indicators of community
health.
4. Participate in the conduct of special studies and projects, especially those that
integrate efforts among PHC and hospital in DHA.
5. Participating in developing the information infrastructure for disease
prevention and control in Dubai
6. Developing and validating outcome and risk indicators of population health
status in communicable and non communicable diseases.
7. Developing novel methods to enhance the value of existing health data set
including the electronic database in DHA and the online statistics model for
the private health sector in Dubai.

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 8. Analysis of surveillance data that comes primarily from morbidity, mortality
and risk factor data sets.

Program Evaluation Unit

Program evaluation is an essential organizational practice in public health; however, it

is not practiced consistently across program areas in DHA, nor is it sufficiently
integrated into the day to day management of most programs. Program Evaluation
Unit in the Division of Health Research, Planning and statistics Department in DHA
is responsible for evaluating the effectiveness of programs and other DHA initiatives.

The goals of program evaluation unit are as follows:

1. To present descriptive data related to the specifics programs and provide

decision makers with a clear understanding of the reach and scope of the
programs;
2. To determine the impact of a particular program on key program outcomes
3. To determine which programmatic aspects of a specific program or initiative
had the most influence on improving health and other applicable program
outcomes, to provide program administrators and policymakers with
information about promising practices observed in the programs under review

The primary responsibilities of the Unit are to:

• Measure and evaluate the efficiency and cost-effectiveness of DHA programs;

• Support the Department's commitment to providing the highest quality of
services by continued surveying and monitoring of consumer satisfaction
• Evaluation of projects run in general practice and other primary care settings
• Economic evaluation and priority - settings

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 • Disseminate program evaluation findings to policymakers, to practitioners in
the field, to the public, and to program staff, in order to assist with the
continuous improvement of existing programs, the development of new
programs, and the efficient implementation of the program initiatives.

Health Services Research Unit

Goal

The goal of the Health Services Research Unit in the Health Research section is to
support a program of research which enables the development of an effective Health
Service, one which delivers the best possible health for the population of Dubai.

Responsibilities of the unit

1. Undertake research which is of priority to DHA Health Service.

2. Increases research capacity in DHA. This is achieved by offering research
advice and support, by training and mentoring health professionals who want
to develop research skills, experience and qualifications and by collaborating
with clinicians on intervention studies.
3. Develop, maintain, and make available databases and other data resources to
support health services and health policy research
4. Activate health services research and build capacity in research field by
supporting the DHA with professional staff in health research.
5. Conducting various health research studies indicated within the authorized
plan.

Governing structure and Core operations:

The Department of Planning and Statistics will be the one that govern and set the
overall goals of the section. The section will include three units; Health System
Research, Program Evaluation unit and Epidemiology unit .The section core operation

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organized within three core operations will assist the Department of Planning and
Statistics in successfully accomplishing each phase of the research enterprise, from
proposal development and design to research coordination, including data
management and analysis, presentation and dissemination. The needs of DHA
investigators will vary depending upon their past experience, personal skills and the
nature of the work undertaken through their research studies. The core operations will
be designed to accommodate this variation in individual needs and capacities. The
three-core operations are:

1. Scientific oversight and Section management:

y Head of Health Research Section

2. Study design, plan for implementation and analysis of data:

y Consultant epidemiologist
y Health Planning Specialist
y Health Economic Specialist

3. Statistical support
- Staff members of Statistical Analysis Section.

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 ‫اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻰ‬

‫ﻣﻘﺪﻣﺔ‬

‫ﺗﻠﻌﺐ اﻟﺒﺤﻮث دوراً هﺎﻣﺎً ﻓﻲ ﺗﺤﺴﻴﻦ اﻟﺼﺤﺔ واﻟﺘﻲ ﺗﻌﺘﻤﺪ ﻋﻠﻰ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﻲ ﻳﻤﻜـﻦ اﺳـﺘﻨﺒﺎﻃﻬﺎ ﻣـﻦ ﺗﻠـﻚ اﻟﺒﺤـﻮث‪،‬‬
‫هﺬا وﻳﻌﺘﺒﺮ ﻣﺠﺎل ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﻣﺘﻌﺪد اﻟﺠﻮاﻧﺐ ﻟﺪراﺳﺔ هﻴﻜﻠﺔ وﺗﻨﻔﻴﺬ وأﺛﺮ ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳـﺔ اﻟـﺼﺤﻴﺔ وﺑـﺎﻟﺮﻏﻢ‬
‫ﻣﻦ أﻧﻪ ﻳﺮﺗﻜﺰ ﻋﻠﻰ أﺳﺲ إآﻠﻴﻨﻴﻜﻴﺔ وأآﺎدﻳﻤﻴﺔ إﻻ أﻧـﻪ ﻳـﺪﻣﺞ اﻹﻃـﺎر أﻟﻤﻔـﺎهﻴﻤﻲ واﻟﻄـﺮق ﻟﻜﺜﻴـﺮ ﻣـﻦ اﻟﻌﻠـﻮم ﻓـﻲ إﻃـﺎر‬
‫إﺑﺪاﻋﻲ ﻟﺘﻘﺪﻳﻢ ﺳﺒﻞ ﺟﺪﻳﺪة ﻟﺪراﺳﺔ وﻓﻬﻢ ﻧﻈﺎم اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪.‬‬

‫وﻧﻈﺮاً ﻷن هﻴﻜﻠﺔ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﻏﺎﻟﺒﺎً ﻣﺎ ﺗﺘﻐﻴﺮ آﺄن ﺗﺪﻣﺞ أو ﺗﻮﺳﻊ أو ﺗﻘﻠﺺ أو ﻳﻌـﺎد هﻴﻜﻠﺘﻬـﺎ وأﺣﻴﺎﻧـﺎً ﻣـﺎ ﺗﻜـﻮن ﻣﺤﻴـﺮة‬
‫وﻏﻴﺮ واﺿﺤﺔ ﻓﻲ أﺛﺮهـﺎ ﻋﻠـﻰ اﻟﻜﻠﻔـﺔ واﻟﺠـﻮدة وإﻣﻜﺎﻧﻴـﺔ اﻟﻮﺻـﻮل إﻟـﻰ اﻟﺨﺪﻣـﺔ اﻟـﺼﺤﻴﺔ‪ ،‬آﻤـﺎ أن ﻧﻈـﻢ اﻟﻤﺴﺘـﺸﻔﻴﺎت‬
‫اﻟﺼﺤﻴﺔ ﻣﻌﻘﺪة ﻷﻧﻬﺎ ﺗﻘﺪم ﺧﺪﻣﺎت ﻣﺘﻌﺪدة ﻣﻦ ﺧﻼل ﻣﻮارد آﺜﻴﺮة ﻟﻨﻄﺎق آﺒﻴﺮ ﻣﻦ اﻟﻤﺮﺿﻰ وﻣﻤﺎ ﻳﺰﻳـﺪ اﻟﻤﻮﺿـﻮع ﺗﻌﻘﻴـﺪاً‬
‫أن اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﻤﺪاﺧﻞ واﻟﻤﺨﺎرج واﻟﻤـﻮارد ﺑﺎﻟﻤﺴﺘـﺸﻔﻴﺎت ذات ﺑﻌـﺪ إﻧـﺴﺎﻧﻲ‪ .‬إﺿـﺎﻓﺔ إﻟـﻰ أن وﺿـﻊ اﻟﺨـﺪﻣﺎت اﻟـﺼﺤﻴﺔ‬
‫ﺑﺎﻟﻤﺠﺘﻤﻌﺎت ﻗﺪ ﺗﺪﻓﻊ ﺗﻮﻗﻌﺎﺗﻬﺎ ﻓﻲ آﺜﻴﺮ ﻣﻦ اﻷﺣﻴﺎن ﺑﺪون اﻟﻨﻈـﺎم اﻟـﺼﺤﻲ‪ .‬وﻓـﻲ ﻇـﻞ هـﺬا اﻟﻮﺿـﻊ ﻣـﻦ اﻟﺘﻐﻴـﺮ اﻟـﺴﺮﻳﻊ‬
‫وﻋﺪم وﺿﻮح اﻟﺮؤﻳﺎ ﻓﺈن ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟـﺼﺤﻴﺔ ﺗـﺴﻬﻢ ﺑﺪرﺟـﺔ آﺒﻴـﺮة ﻓـﻲ ﺗﻮﺛﻴـﻖ وﺗﻘﻴـﻴﻢ أﺛـﺮ إﻋـﺎدة هﻴﻜﻠـﺔ اﻟﺨـﺪﻣﺎت‬
‫اﻟﺼﺤﻴﺔ‪ .‬آﻤﺎ أﻧﻪ ﻓﻲ زﻣﻦ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﻤﺮﺗﻜﺰة ﻋﻠﻰ اﻟـﺪﻟﻴﻞ ﻓـﺈن ﻧﺘـﺎﺋﺞ ﺑﺤـﻮث اﻟﺨـﺪﻣﺎت اﻟـﺼﺤﻴﺔ ﺳـﻮف ﺗـﺴﺎهﻢ‬
‫ﺑﺪرﺟﺔ آﺒﻴﺮة ﻓﻲ ﺗﻄﻮﻳﺮ وﺗﻘﺪﻳﻢ ﺧﺪﻣﺎت ﺻﺤﻴﺔ ذات آﻔﺎءة ﻋﺎﻟﻴﺔ وﺳﻴﺎﺳﺎت وﺑﺮاﻣﺞ ﺻـﺤﻴﺔ ﻣـﺆﺛﺮة آﻤـﺎ أن ﻗﻠـﺔ اﻟﻤـﻮارد‬
‫ﻟﻘﻄﺎع اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ واﻟﺬي ﻳﺪﻓﻊ ﻣﺪﻳﺮي اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ إﻟﻰ وﺿﻊ اﻻﺧﺘﺒﺎرات واﺧﺘﻴﺎر ﻟﻘﺮارات اﻟﺴﻠﻴﻤﺔ ﻳﻜـﻮن اﻟـﺪﻟﻴﻞ‬
‫ﻣﻦ ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﺗﻘﻴـﻴﻢ اﻟﺒـﺮاﻣﺞ هﺎﻣـﺎ ﻓـﻲ ﺗـﺸﻜﻴﻞ هـﺬﻩ اﻟﻤﻨﻈﻮﻣـﺔ اﻟﻬﺎﻣـﺔ ﻣـﻦ وﺿـﻊ اﻻﺧﺘﺒـﺎرات واﺗﺨـﺎذ‬
‫اﻟﻘﺮارات‪ .‬إﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ ﻓﻘﺪ ﺳﺎﻋﺪت ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﻣﺘﺨﺬي اﻟﻘﺮار ﻓﻲ اﻟﻤﺎﺿـﻲ ﻓـﻲ ﻓﻬـﻢ وﺗـﺸﻜﻴﻞ ﻧﻈـﺎم‬
‫اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ وﻣﺎ زاﻟﺖ ﻗﺎدرة ﻋﻠـﻰ أن ﺗﻘـﺪم اﻟﻘـﺮارات اﻟﺤﺎﺳـﻤﺔ ﻣـﻦ اﻟﻤـﺴﺌﻮﻟﻴﻦ اﻟﺤﻜـﻮﻣﻴﻴﻦ وﻣﺨﻄﻄـﻲ اﻟﺨـﺪﻣﺎت‬
‫اﻟﺼﺤﻴﺔ واﻷﻃﺒﺎء ﻟﻠﻜﺜﻴﺮ ﻣﻦ اﻟﻤﺸﺎآﻞ اﻟﺼﺤﻴﺔ‪ .‬آﻤﺎ أن أهﻤﻴﺔ ﺗﺤﻘﻴﻖ ﺑﺮاﻣﺞ اﻟﺘﻘﻴﻴﻢ ﺑﺎﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ ﻗﺪ ﺗﻢ اﻟﺘﺄآﻴـﺪ ﻋﻠﻴـﻪ‬
‫ﻣﻦ دول ﻋﺪﻳﺪة ﻧﻈﺮاً ﻷن ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ ﻳﻤﻜﻦ ﺑﺮاﻣﺞ اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ واﻟﺘﺪﺧﻼت ﻣﻦ ﺗﺤـﺴﻴﻦ ﻋﻤﻠﻴﺎﺗﻬـﺎ اﻟﺤﺎﻟﻴـﺔ وﺑﺎﻟﻨﻬﺎﻳـﺔ‬
‫ﺁﺛﺎرهﺎ اﻟﺼﺤﻴﺔ‪.‬‬

‫هﺬا و ﻻ ﻳﻮﺟﺪ ﻧﺸﺎط واﺿﺢ ﻟﺴﻴﺎﺳﺔ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ﻓـﻲ داﺋـﺮة اﻟـﺼﺤﺔ واﻟﺨـﺪﻣﺎت اﻟﻄﺒﻴـﺔ ﺑـﺪﺑﻲ ﻣـﻊ ﻗﻠـﺔ اﻟﺪراﺳـﺎت‬
‫ﺧﺎﺻﺔ ﻓﻲ ﻣﺠﺎل ﺑﺤﻮث اﻟﻨﻈﻢ اﻟﺼﺤﻴﺔ‪ .‬وﻳﻤﻜﻦ إرﺟﺎع ذﻟﻚ إﻟﻰ اﻟـﻮﻋﻲ ﻏﻴـﺮ اﻟﻜـﺎﻓﻲ ﻷهﻤﻴـﺔ اﻟﺪراﺳـﺎت اﻟـﺼﺤﻴﺔ وﻗﻠـﺔ‬
‫اﻟﻤﻮارد ﻟﻠﺪراﺳﺎت وﻗﻠﺔ اﻷﺷﺨﺎص اﻟﻤﺆهﻠﻴﻦ واﻷﻓﺮاد اﻟﻤﺪرﺑﻴﻦ ﻓﻲ إﺟﺮاء اﻟﺒﺤـﻮث ﺑﺎﻟـﺪاﺋﺮة وﺑﺎﺳـﺘﻤﺮار هـﺬا اﻟﻮﺿـﻊ ﻓـﺈن‬
‫ﻧﻘــﺺ اﻟﻤﻌﻠﻮﻣــﺎت ﺳــﻮف ﻳــﺆدي إﻟــﻰ اﻟﺘﻜــﺮار وﺗــﺸﺘﻴﺖ اﻟﺠﻬــﻮد وﺗﺒﺪﻳــﺪ اﻟﻤــﻮارد‪ .‬آﻤــﺎ أن اﻟﺪراﺳــﺎت اﻟــﺼﺤﻴﺔ ﻳﻨﻘــﺼﻬﺎ‬
‫اﻹﺳﺘﺮاﺗﻴﺠﻴﺔ واﻷﻏﺮاض اﻟﻤﻮﺟﻬﺔ ﻟﺨﺪﻣﺔ ﺧﻄﺔ اﻟﺪاﺋﺮة وﺑﻤﻌﻠﻮﻣﺎت ﻏﻴﺮ آﺎﻣﻠﺔ ﻋﻦ اﻟﻤﺠﺘﻤﻊ ﻻﺳﺘﺨﺪاﻣﻬﺎ ﻟﺘﺨﻄﻴﻂ وﺗﻘﻴﻴﻢ‬
‫اﻟﺨﻄﻂ اﻟﺼﺤﻴﺔ‪ .‬آﻤﺎ أن هﻨﺎك ﺻﻌﻮﺑﺔ ﻓﻰ ﺗﺤﺪﻳﺪ اﻟﻔﺠﻮات اﻟﺼﺤﻴﺔ و ﻧﻘﺎط اﻟﻀﻌﻒ ﻓـﻲ اﻟﻨﻈـﺎم اﻟـﺼﺤﻲ وﺻـﻌﻮﺑﺔ ﺗﺤﺪﻳـﺪ‬
‫اﻟﺤﺠﻢ اﻟﺤﻘﻴﻘﻲ ﻟﻠﻤﺸﺎآﻞ ذات اﻟﻌﻼﻗﺔ ﺑﺎﻹدارة واﻟﻤﻌﻮﻗﺎت اﻟﺘﻘﻨﻴﺔ ﻓﻲ اﻟﻨﻈﺎم اﻟﺼﺤﻲ آﻤﺎ أن هﻨﺎك ﺻﻌﻮﺑﺔ ﻓﻲ ﻗﻴﺎس‬
‫ﺟﻮدة اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﻣﻦ ﺧﻼل اﻟﻤﻌﻠﻮﻣﺎت اﻟﻨﺎﻗﺼﺔ ﻋﻦ رﺿﺎ اﻟﻌﻤﻼء ﻋﻦ اﻟﺨﺪﻣﺎت اﻟﻤﻘﺪﻣﺔ ﻟﻬﻢ‪.‬‬

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‫وﻟﻤﺎ آﺎﻧﺖ أﺣﺪ اﻟﻤﺴﺆوﻟﻴﺎت اﻟﺮﺋﻴﺴﻴﺔ ﻹدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء ﺑﺎﻟﺪاﺋﺮة هﻮ ﺗﺤﺪﻳﺪ وﺗﻘﻴﻴﻢ اﻟﺘﻮﺟﻬﺎت اﻟﻤﺘﻌﻠﻘـﺔ ﺑﺎﻟﺮﻋﺎﻳـﺔ‬
‫اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة ﻣﻊ إﻋﺪاد دراﺳﺎت إﺳﺘﺮاﺗﻴﺠﻴﺔ ﺣﻮل اﺣﺘﻴﺎﺟﺎت اﻟﻤﺠﺘﻤﻊ وﻣﺘﻄﻠﺒﺎﺗﻪ ﻣﻦ ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ وﺗﻘـﺪﻳﻢ‬
‫اﻟﻤﻘﺘﺮﺣﺎت ﺑﻨﺎءاً ﺗﻠﻚ اﻟﺪراﺳﺎت ﻓﺈن هﻨﺎك ﺣﺎﺟﺔ إﻟﻰ إﻧﺸﺎء ﻗﺴﻢ ﻟﻠﺒﺤﻮث اﻟﺼﺤﻴﺔ ﺑﺈدارة اﻟﺘﺨﻄﻴﻂ و اﻹﺣﺼﺎء ﻟﻤﺠﺎﺑﻬـﺔ‬
‫ﺗﻠﻚ اﻟﻤﺸﺎآﻞ ﻣﻊ اﻟﺘﺮآﻴﺰ ﻋﻠﻰ دراﺳﺔ اﻟﻮﺿﻊ اﻟﺼﺤﻲ وﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﻣﻦ ﺧﻼل ﺑﺤﻮث ﻣﺘﻌﺪدة اﻟﺘﺨﺼﺼﺎت‬

‫ﻣﻘﱰﺡ ﺑﺈﻧﺸﺎء ﻗﺴﻢ ﲝﻮﺙ ﺻﺤﻴﺔ ﺑﻬﻴﺌﺔ ﺍﻟﺼﺤﺔ ﺑﺪﺑﻲ‬

‫رﺳﺎﻟﺔ اﻟﻘﺴﻢ‬

‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ إﻧـﺸﺎء ﻣﻌﻠﻮﻣـﺎت ﻣﺮﺗﻜـﺰة ﻋﻠـﻰ اﻟـﺪﻟﻴﻞ ﻟﺘﻘـﺪﻳﻤﻬﺎ إﻟـﻰ ﺻـﺎﻧﻌﻲ اﻟـﺴﻴﺎﺳﺎت اﻟـﺼﺤﻴﺔ وﻣﺘﺨـﺬي اﻟﻘـﺮار‬
‫واﻹدارﻳﻴﻦ ﺑﻜﺎﻓﺔ ﻣﺴﺘﻮﻳﺎت اﻟﻨﻈﺎم اﻟﺼﺤﻲ ﻣﻦ ﺧﻼل ﺗﻨﺴﻴﻖ وﺗﺴﻬﻴﻞ وإﺟﺮاء اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ﻟﺘﻘﻮﻳﺔ اﻟﺨﺪﻣﺎت واﻟﻨﻈـﺎم‬
‫اﻟﺼﺤﻲ وﺗﻘﻴﻴﻢ ﺑﺮاﻣﺞ اﻟﺪاﺋﺮة‬

‫اﻟﻬﺪف اﻻﺳﺘﺮاﺗﻴﺠﻲ ﻟﻠﻘﺴﻢ‬

‫ﻳﻬﺪف اﻟﻘﺴﻢ إﻟﻰ اﻟﺘﺄﺛﻴﺮ ﻋﻠﻰ اﺗﺨﺎذ اﻟﻘﺮارات ﻋﻦ إدارة اﻟﺮﻋﺎﻳﺔ اﻟـﺼﺤﻴﺔ واﻟـﺴﻴﺎﺳﺎت واﻟﻤﻤﺎرﺳـﺎت اﻟـﺼﺤﻴﺔ واﻟﻮﺻـﻮل‬
‫اﻟﻌﺎدل إﻟﻰ ﺟﻮدة ﻋﺎﻟﻴﺔ ﻣﻦ اﻟﺨﺪﻣﺎت ﻣﻦ ﺧﻼل إﺟﺮاء دراﺳﺎت ﺗﺘﻌﻠﻖ ﺑﺘﻘﺪﻳﻢ اﻟﺨﺪﻣﺔ واﻟﺘﺤﻠﻴﻞ اﻟﻮﺑﺎﺋﻲ وﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ ‪،‬‬
‫آﻤﺎ ﻳﻬﺪف اﻟﻘﺴﻢ إﻟﻰ دﻋﻢ اﺳﺘﺮاﺗﻴﺠﻴﺎت اﻷداء اﻷﻣﺜﻞ ﻟﻠﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ واﻟﺘﻲ ﺑـﺪورهﺎ ﺗﺤـﺴﻦ ﻓﺎﻋﻠﻴـﺔ وآﻔـﺎءة اﻟﺮﻋﺎﻳـﺔ‬
‫اﻟﺼﺤﻴﺔ ورﺿﺎ اﻟﻤﺘﻌﺎﻣﻠﻴﻦ وﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ‪ ،‬هﺬا وﺳﻴﻘﻮم اﻟﻘـﺴﻢ ﺑﺒﺤـﻮث اﻟﺨـﺪﻣﺎت اﻟـﺼﺤﻴﺔ واﻟﺘـﻲ ﺗـﺸﻤﻞ دراﺳـﺎت‬
‫ﻣﺘﻌﺪدة اﻟﺠﻮاﻧـﺐ ﻋـﻦ ﺗـﻮﻓﺮ واﺳـﺘﺨﺪام وﻗﺒـﻮل وهﻴﻜﻠـﺔ وآﻔـﺎءة اﻟﺨـﺪﻣﺎت اﻟـﺼﺤﻴﺔ وﺗـﺸﻤﻞ اﻟﺨـﺪﻣﺎت اﻟـﺼﺤﻴﺔ اﻹرﻗـﺎد‬
‫واﻟﻤﺘﺮددﻳﻦ ﺑﺎﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ واﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ ودراﺳﺎت اﻟﻤﺠﺘﻤﻊ واﻟﺘﺄهﻴﻞ واﻟﺮﻋﺎﻳﺔ ﻃﻮﻳﻠﺔ اﻷﺟﻞ‪.‬‬

‫اﻷهﺪاف اﻟﺘﻔﺼﻴﻠﻴﺔ‬

‫إﻧﺸﺎء ودﻋﻢ ﻗﺎﻋﺪة اﻟﺒﻴﺎﻧﺎت اﻟﻤﺘﺎﺣﺔ ﺑﺎﻟﺪاﺋﺮة واﻟﻤﺼﺎدر اﻷﺧﺮى ﻟﻠﺒﻴﺎﻧﺎت ﻟﺪﻋﻢ ﺑﺤﻮث اﻟﺨﺪﻣﺎت واﻟـﺴﻴﺎﺳﺔ اﻟـﺼﺤﻴﺔ‬ ‫‪.1‬‬
‫وﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ ‪.‬‬
‫ﺗﻨﺸﻴﻂ ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة وﺑﻨﺎء ﻗﺪرات ﺑﺤﺜﻴﺔ ﻓﻲ اﻟﻤﺠﺎل اﻟﺼﺤﻲ ﻣﻦ ﺧﻼل دﻋﻢ اﻟـﺪاﺋﺮة ﺑـﺎﻟﻤﻬﻨﻴﻴﻦ‬ ‫‪.2‬‬
‫ﻓﻲ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‪.‬‬
‫ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ وﺑﺎﻟﺘﻨﺴﻴﻖ ﻣﻊ اﻷﻗﺴﺎم واﻹدارات ذات اﻟﻌﻼﻗﺔ ﺑﺎﻟﺪاﺋﺮة وﻣﺮآﺰ اﻹﺣﺼﺎء ﺑـﺪﺑﻲ ووزارة‬ ‫‪.3‬‬
‫اﻟﺼﺤﺔ‪.‬‬
‫ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة وﺗﺤﺪﻳﺪ اﻟﺠﻮاﻧﺐ ذات اﻷﺛﺮ اﻟﻔﻌﺎل‬ ‫‪.4‬‬
‫ﺗﻮﺛﻴﻖ اﻟﺒﺤﻮث ﺑﺈدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء و إﺻﺪار اﻟﻨﺸﺮات واﻟﻤﻄﺒﻮﻋﺎت ذات اﻟﻌﻼﻗﺔ ﺑﺎﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.5‬‬
‫اﻟﺘﺪرﻳﺐ ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ وﺑﺎﻟﺘﻨﺴﻴﻖ ﻣﻊ إدارة اﻟﺘﻌﻠﻴﻢ اﻟﻤﺴﺘﻤﺮ ﺑﺎﻟﺪاﺋﺮة‬ ‫‪.6‬‬

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 ‫اﻟﻤﻬﺎم اﻟﻮﻇﻴﻔﻴﺔ )اﻷﻧﺸﻄﺔ(‬

‫ﻗﺴﻢ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‬

‫ﺗﻨﺸﻴﻂ ﺑﺤﻮث ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﺑﻨﺎء ﻗـﺪرة ﺑﺤﺜﻴـﺔ ﺑﺎﻟـﺪاﺋﺮة ﻋـﻦ ﻃﺮﻳـﻖ دﻋـﻢ اﻟـﺪاﺋﺮة ﺑـﺎﻟﺨﺒﺮات ﻓـﻲ ﻣﺠـﺎل‬ ‫‪.1‬‬
‫اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ﻟﻠﺘﻌﺮف ﻋﻠﻰ اﻟﻤﺸﺎآﻞ اﻟﺼﺤﻴﺔ واﻟﺤﻠﻮل اﻟﻤﻤﻜﻨﺔ‪.‬‬
‫اﻟﺘﻌﺎون واﻟﺘﻨﺴﻴﻖ ﻣﻊ اﻷﻗـﺴﺎم ذات اﻟﻌﻼﻗـﺔ ﻓـﻲ ﻣﺠـﺎل اﻟﺒﺤـﻮث اﻟـﺼﺤﻴﺔ ﺑﺎﻟـﺪاﺋﺮة واﻟﻬﻴﺌـﺎت اﻟﺤﻜﻮﻣﻴـﺔ واﻟﺠﻬـﺎت‬ ‫‪.2‬‬
‫اﻟﺨﺪﻣﻴﺔ ذات اﻟﻌﻼﻗﺔ‪.‬‬
‫ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ ﻟﺘﺤﺪﻳﺪ اﻷﺛﺮ واﻟﻔﺎﻋﻠﻴﺔ واﻟﻨﺘﻴﺠﺔ واﻹﻧﺠﺎز اﻟﻤﻼﺋﻢ واﻟﻨﺠﺎح اﻟﻜﻠﻲ ﻟﻠﺒﺮاﻣﺞ إﺿﺎﻓﺔ إﻟﻰ اﻟﺠﻮاﻧﺐ‬ ‫‪.3‬‬
‫اﻟﺘﻲ ﺗﺤﺘﺎج إﻟﻰ ﺗﺤﺴﻴﻨﺎت ﻣﻊ إﻣﺪاد ﻣﺘﺨﺬي اﻟﻘﺮار ﺑﺎﻟﻤﻌﻠﻮﻣﺎت ﻋﻦ ﻣﺪى ﻓﺎﻋﻠﻴﺔ ﺗﻠﻚ اﻟﺒﺮاﻣﺞ‪.‬‬
‫ﺗﺤﻠﻴﻞ اﻟﻮﺿﻊ اﻟﺼﺤﻲ وﺗﺤﺪﻳﺪ اﻟﻤﺸﺎآﻞ اﻟﺼﺤﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ ﺑﺪﺑﻲ‪.‬‬ ‫‪.4‬‬
‫اﻟﺘﺪرﻳﺐ ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ وﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﺑﺎﻟﺘﻨﺴﻴﻖ ﻣﻊ إدارة اﻟﺘﻌﻠﻴﻢ اﻟﻤﺴﺘﻤﺮ‪.‬‬ ‫‪.5‬‬
‫إﺟﺮاء اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ﻃﺒﻘﺎً ﻟﻠﺨﻄﻂ اﻟﻤﻮﺿﻮﻋﺔ وﺑﺎﻟﺘﻨﺴﻴﻖ ﻣﻊ اﻷﻗﺴﺎم ذات اﻟﻌﻼﻗﺔ‪.‬‬ ‫‪.6‬‬
‫إﻧﺸﺎء وﺗﺤﺪﻳﺚ ﻗﺎﻋﺪة ﺑﻴﺎﻧﺎت ﻟﻠﺒﺤﻮث اﻟﺼﺤﻴﺔ ﺗﺪﻋﻢ اﻟﺨﺪﻣﺎت واﻟﺴﻴﺎﺳﺔ اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.7‬‬
‫إﺻﺪار اﻟﻨﺸﺮات واﻟﻤﻄﺒﻮﻋﺎت ذات اﻟﻌﻼﻗﺔ ﺑﺎﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.8‬‬
‫ﺗﺤﺪﻳﺪ اﻻﺣﺘﻴﺎﺟﺎت اﻟـﺼﺤﻴﺔ واﺳـﺘﺨﺪام اﻟﺨـﺪﻣﺎت اﻟـﺼﺤﻴﺔ ﻣـﻊ دراﺳـﺔ ﺧﻄـﻮرة اﻷﻣـﺮاض واﻟﺪراﺳـﺎت اﻟﻮﺑﺎﺋﻴـﺔ ذات‬ ‫‪.9‬‬
‫اﻟﻌﻼﻗﺔ ﻋﻦ اﻟﻤﺮض واﻟﻮﻓﺎة‪.‬‬
‫‪ .10‬دراﺳﺔ هﻴﻜﻠﻴﺔ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ واﻟﺒﺮاﻣﺞ وﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬
‫‪ .11‬دراﺳﺔ آﻔﺎءة اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻟﻤﻘﺪﻣﺔ ورﺿﺎ اﻟﻌﻤﻼء وﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ وآﻔﺎءة اﻟﺤﻴﺎة اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺼﺤﺔ‪.‬‬
‫‪ .12‬ﺗﺤﺪﻳﺪ اﻟﺨﺪﻣﺎت اﻟﺘﻄﻮﻋﻴﺔ واﻻﺟﺘﻤﺎﻋﻴﺔ واﻟﺒﺮاﻣﺞ ﻓﻲ اﻟﻤﺠﺎل اﻟﺼﺤﻲ‪.‬‬

‫ﺷﻌﺒﺔ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‬

‫دﺑـﻲ ﻣـﻦ ﺧـﻼل ﺑﺤـﻮث‬ ‫ﺳﻴﻜﻮن هﺪف وﺣﺪة اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ هﻮ دﻋﻢ اﻟﺪاﺋﺮة ﻟﺘﻘﺪﻳﻢ ﺧﺪﻣﺎت ﺻﺤﻴﺔ ﻓﻌﺎﻟﺔ ﻟـﺴﻜﺎن‬
‫ذات آﻔﺎءة ﻋﺎﻟﻴﺔ ﻣﺮﺗﻜﺰة ﻋﻠﻰ اﻟﺪﻟﻴﻞ وﻧﺸﺮ ﻧﺘﺎﺋﺞ ﺗﻠﻚ اﻟﺒﺤﻮث إﻟﻰ إدارات اﻟﺪاﺋﺮة واﻟﺠﻬﺎت ذات اﻟﻌﻼﻗﺔ ﺑﺈﻣﺎرة دﺑـﻲ ﻣـﻊ‬
‫ﺗﻌﺰﻳﺰ ﺗﻀﻤﻴﻦ ﺗﻠﻚ اﻟﻨﺘﺎﺋﺞ ﻓﻲ رﺳﻢ اﻟﺴﻴﺎﺳﺎت واﺗﺨﺎذ اﻟﻘﺮارات‪.‬‬

‫وﺳﺘﻜﻮن ﻣﺴﺆوﻟﻴﺎت اﻟﺸﻌﺒﺔ هﻲ‬

‫إﺟﺮاء اﻟﺒﺤﻮث ذات اﻷوﻟﻮﻳﺔ و اﻟﻌﻼﻗﺔ ﺑﺎﺣﺘﻴﺎﺟﺎت وهﻴﻜﻠﺔ واﺳﺘﺨﺪام اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.1‬‬
‫اﻟﺮﻳﺎدة ﻓﻲ ﻣﺠﺎل ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة واﻟﻤﺠﺘﻤﻊ ﺑﺪﺑﻲ ﻣﻊ زﻳـﺎدة اﻟﻤﻘـﺪرة اﻟﺒﺤﺜﻴـﺔ ﻟﻠـﺪاﺋﺮة ﻣـﻦ ﺧـﻼل‬ ‫‪.2‬‬
‫ﺗﻘﺪﻳﻢ اﻟﺪﻋﻢ واﻟﻤﺸﻮرة وﺗﺪرﻳﺐ اﻟﻜﻮادر اﻟﺼﺤﻴﺔ واﻟﺘﻨﺴﻴﻖ ﻣﻊ اﻹدارات اﻟﻤﻌﻨﻴﺔ ﻓﻲ هﺬا اﻟﻤﺠﺎل‪.‬‬
‫اﻟﺘﻨﺴﻴﻖ ﻣﻊ ﻗﺴﻢ اﻹﺣﺼﺎء ﺑﺎﻹدارة ﻟﺘﺤﺪﻳﺚ ﻗﺎﻋﺪة اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺘﺎﺣـﺔ ﺑﺎﻟـﺪاﺋﺮة وﻣـﺼﺎدر اﻟﺒﻴﺎﻧـﺎت اﻷﺧـﺮى ﻟـﺪﻋﻢ‬ ‫‪.3‬‬
‫ﺑﺤﻮث اﻟﺨﺪﻣﺎت واﻟﺴﻴﺎﺳﺎت اﻟﺼﺤﻴﺔ‪.‬‬
‫دراﺳﺔ أداء وآﻔﺎءة اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ وﻓﺎﻋﻠﻴﺔ وأﺛﺮ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.4‬‬
‫ﺗﺤﺪﻳﺪ رﺿﺎ اﻟﻤﺘﻌﺎﻣﻠﻴﻦ وﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﺑﺎﻟﺘﻨﺴﻴﻖ ﻣﻊ اﻷﻗﺴﺎم ذات اﻟﻌﻼﻗﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.5‬‬
‫اﻟﺘﻌﺮف ﻋﻠﻰ ﻣﻌﻮﻗﺎت أداء اﻟﺨﺪﻣﺔ ﺑﻜﻔﺎءة و اﻟﻮﺻﻮل إﻟﻴﻬﺎ‪.‬‬ ‫‪.6‬‬

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‫اﻟﻤﺸﺎرآﺔ ﻓﻲ اﻟﺒﺤﻮث اﻟﺘﻲ ﻳﻨﻔﺬهﺎ اﻟﻘﺴﻢ ﻓﻲ ﻣﺠﺎل ﺑﺤﻮث اﻟﺨﺪﻣﺎت واﻟـﻨﻈﻢ اﻟـﺼﺤﻴﺔ وﻓﻘـﺎً ﻟﻠﺨﻄـﺔ اﻟﻤﻮﺿـﻮﻋﺔ‬ ‫‪.7‬‬
‫واﻟﻤﺴﺘﺠﺪات‪.‬‬
‫اﻟﻤﺸﺎرآﺔ ﻓﻲ اﻟﻤﻄﺒﻮﻋﺎت اﻟﺘﻲ ﻳﺼﺪرهﺎ اﻟﻘﺴﻢ آﻨﺸﺮة اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ واﻟﻮﺿﻊ اﻟﺼﺤﻲ ﻹﻣﺎرة دﺑﻲ‪.‬‬ ‫‪.8‬‬
‫إﺟﺮاء اﻟﺪراﺳﺎت ﻣﺘﻌﺪدة اﻟﺘﺨﺼﺼﺎت ﻓﻲ ﻣﺠﺎل اﻷﺛﺮ اﻟﺼﺤﻲ واﻗﺘﺼﺎدﻳﺎت اﻟﺮﻋﺎﻳـﺔ اﻟـﺼﺤﻴﺔ وآﻠﻔـﺔ اﻟﻘﻄـﺎع اﻟـﺼﺤﻲ‬ ‫‪.9‬‬
‫واﺗﺨﺎذ اﻟﻘﺮارات اﻟﺼﺤﻴﺔ‪.‬‬
‫‪ .10‬إﺟﺮاء اﻟﺪورات اﻟﺘﺪرﻳﺒﻴﺔ ﻓﻲ ﻣﺠﺎل اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ واﻻﻗﺘﺼﺎد اﻟﺼﺤﻲ‪.‬‬

‫ﺷﻌﺒﺔ اﻟﺘﺤﻠﻴﻞ اﻟﻮﺑﺎﺋﻲ‬

‫ﺳﻮف ﺗﻜﻮن اﻟﺸﻌﺒﺔ ﻣﺴﺆوﻟﺔ ﻋـﻦ إﺟـﺮاء اﻟﺪراﺳـﺎت اﻟﻮﺑﺎﺋﻴـﺔ اﻟﻤـﺴﺘﻤﺮة ﺑﺎﺳـﺘﺨﺪام اﻟﺒﻴﺎﻧـﺎت اﻷوﻟﻴـﺔ واﻟﺜﺎﻧﻮﻳـﺔ ﻟﺘﺤﺪﻳـﺪ‬
‫اﻟﻤﺸﺎآﻞ اﻟﺼﺤﻴﺔ واﺗﺠﺎهﺎت اﻟﻤﺮض واﻟﻮﻓﺎة ﻣﻊ وﺿﻊ اﻟﺤﻠﻮل اﻟﻤﻼﺋﻤﺔ‪.‬‬

‫وﺳﺘﻜﻮن اﻷﻧﺸﻄﺔ اﻷﺳﺎﺳﻴﺔ ﻟﺸﻌﺒﺔ اﻟﺘﺤﻠﻴﻞ اﻟﻮﺑﺎﺋﻲ هﻲ‬

‫ﺗﻘﺪﻳﻢ دﻋﻢ وﺗﺪرﻳﺐ ﻟﺪاﺋﺮة اﻟـﺼﺤﺔ واﻟﺨـﺪﻣﺎت اﻟـﺼﺤﻴﺔ ﺑـﺪﺑﻲ ﻓـﻲ ﻣﺠـﺎل اﻟﻮﺑﺎﺋﻴـﺎت وﻣﻜﺎﻓﺤـﺔ اﻷﻣـﺮاض و ﺧﺎﺻـﺔ‬ ‫‪.1‬‬
‫اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ واﻟﺘﻲ ﻻ ﺗﺘﻮﻓﺮ ﻓﻲ اﻟﻮﻗﺖ اﻟﺤﺎﻟﻲ‪.‬‬
‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ ﺗﺼﻤﻴﻢ ﺷﻜﻞ ﻣﻌﻠﻮﻣﺎﺗﻲ ﻟﻤﻜﺎﻓﺤـﺔ اﻷﻣـﺮاض ﻏﻴـﺮ اﻟﻤﻌﺪﻳـﺔ ﺑـﺪﺑﻲ وﺗﺜﺒﻴـﺖ ﻣﻌـﺎﻳﻴﺮ اﻷﺛـﺮ واﻟﺨﻄـﻮرة‬ ‫‪.2‬‬
‫ﻟﻸﻣﺮاض اﻟﻤﻌﺪﻳﺔ وﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻋﻠﻰ اﻟﻮﺿﻊ اﻟﺼﺤﻲ ﻟﻠﺴﻜﺎن ﺑﺪﺑﻲ‪.‬‬
‫ﺗﻘﺪﻳﻢ اﻻﺳﺘﺸﺎرة واﻟﻨﺼﺢ ﻋﻦ ﺗﺤﻠﻴﻞ وﺗﻔﺴﻴﺮ اﻟﺒﻴﺎﻧﺎت اﻟﻮﺑﺎﺋﻴﺔ ﻹدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء واﻹدارات اﻷﺧﺮى ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.3‬‬
‫ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ اﻟﻤﺴﻮﺣﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﺑﺎﻟﺪاﺋﺮة آﺄﻣﺮاض اﻟﻘﻠﺐ واﻟﺴﻜﺮي‪.‬‬ ‫‪.4‬‬
‫إﻧﺸﺎء وﺗﺪﻋﻴﻢ ﻧﻈﺎم ﻣﺮاﻗﺒﺔ ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ واﻟﻌﻮاﻣﻞ ذات اﻟﺨﻄﻮرة ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.5‬‬
‫اﺳﺘﺨﺪام ﻗﺎﻋﺪة اﻟﺒﻴﺎﻧﺎت اﻹﻟﻜﺘﺮوﻧﻴﺔ ﺑﺎﻟﺪاﺋﺮة وﺑﻴﺎﻧﺎت اﻟﻘﻄﺎع اﻟﺼﺤﻲ اﻟﺨﺎص ﺑﺪﺑﻲ ﻓﻲ إﺟﺮاء ﺑﻌﺾ اﻟﺒﺤﻮث‪.‬‬ ‫‪.6‬‬
‫إﺻﺪار اﻟﻤﻄﺒﻮﻋﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ووﺑﺎﺋﻴﺔ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ وﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬ ‫‪.7‬‬
‫اﻟﺘﺪرﻳﺐ ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ووﺑﺎﺋﻴﺔ اﻷﻣﺮاض اﻟﻤﻌﺪﻳﺔ وﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬ ‫‪.8‬‬
‫اﻟﺘﻌﺎون واﻟﺘﻨﺴﻴﻖ ﻣﻊ اﻷﻗﺴﺎم ذات اﻟﻌﻼﻗﺔ ﺑﺎﻟﺪاﺋﺮة ﻓﻲ ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.9‬‬

‫وﺣﺪة ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ‬

‫ﺑﺎﻟﺮﻏﻢ ﻣﻦ أن ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ ﻳﻌﺘﺒﺮ أﺣﺪ اﻟﻤﻤﺎرﺳﺎت اﻹدارﻳﺔ اﻟﺮﺋﻴـﺴﻴﺔ ﻓـﻲ اﻟـﺼﺤﺔ اﻟﻌﺎﻣـﺔ إﻻ أﻧـﻪ ﻻ ﻳﻤـﺎرس ﺑﺎﺳـﺘﻤﺮار‬
‫ﺑﺎﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة آﻤﺎ أﻧﻪ ﻏﻴﺮ ﻣﺪﻣﻮج ﺑﺪرﺟﺔ آﺎﻓﻴﺔ ﻓﻲ اﻹدارة اﻟﻴﻮﻣﻴﺔ ﻟﻤﻌﻈﻢ اﻟﺒﺮاﻣﺞ‪ ،‬هﺬا وﺳﻮف ﺗﻜﻮن وﺣـﺪة‬
‫ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ ﻣﺴﺌﻮﻟﺔ ﻋﻦ ﺗﻘﻴﻴﻢ أﺛﺮ وﻓﺎﻋﻠﻴﺔ اﻟﺒﺮاﻣﺞ واﻟﻤﺒﺎدرات ﺑﺪاﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ واﻟﺮﻳﺎدة‬
‫ﻓﻲ ﻣﺠﺎل ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ ﺑﺎﻟﺪاﺋﺮة‬

‫وﺗﺮﺗﻜﺰ أهﺪاف اﻟﻮﺣﺪة ﻓﻴﻤﺎ ﻳﻠﻲ‬

‫ﻋﺮض اﻟﺒﻴﺎﻧﺎت اﻟﻮﺻﻔﻴﺔ ﻋﻦ اﻟﺒﺮاﻣﺞ اﻟﻤﺤﺪدة وإﻣﺪاد ﻣﺘﺨﺬي اﻟﻘﺮار ﺑﻔﻬﻢ واﺿﺢ ﻋﻦ ﻣﺪى ﻓﺎﻋﻠﻴﺔ ﺗﻠﻚ اﻟﺒﺮاﻣﺞ‬ ‫‪.1‬‬
‫واﻻﺳﺘﻔﺎدة ﻣﻨﻬﺎ‪.‬‬

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‫ﺗﺤﺪﻳﺪ ﺟﻮاﻧﺐ اﻟﺒﺮاﻣﺞ ذات اﻷﺛﺮ اﻟﻔﻌﺎل ﻓﻲ ﺗﺤﺴﻴﻦ اﻟﺼﺤﺔ وﺗﺄﺛﻴﺮ اﻟﺠﻮاﻧﺐ اﻷﺧـﺮى اﻟﻤﻄﺒﻘـﺔ ﻹﻣـﺪاد ﻣـﺪﻳﺮي‬ ‫‪.2‬‬
‫اﻟﺒﺮاﻣﺞ وﺻﺎﻧﻌﻲ اﻟﺴﻴﺎﺳﺎت ﺑﺎﻟﻤﻌﻠﻮﻣﺎت ﻋﻦ اﻟﻤﻤﺎرﺳﺎت ﻟﻠﺒﺮاﻣﺞ اﻟﻤﻘﻴﻤﺔ‪.‬‬
‫اﺳﺘﺨﺪام اﻟﻄﺮق اﻟﺤﺎﻟﻴﺔ واﻟﺴﺒﻞ ﻟﻤﺒﺎﺷﺮة أﻧﻮاع ﻣﺘﻌﺪدة ﻣﻦ ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ ﻣﺘﻀﻤﻨﺔ اﻷﺛﺮ واﻟﻔﺎﻋﻠﻴـﺔ واﻟﺘﻨﻔﻴـﺬ‬ ‫‪.3‬‬
‫واﻟﺘﻘﻮﻳﻢ واﻟﺘﻘﻴﻴﻢ اﻟﻜﻠﻲ‪.‬‬
‫ﺗﻘﺪﻳﻢ اﻟﻤﺸﻮرة ﻋﻦ ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ آﻠﻤﺎ ﻃﻠﺐ ذﻟﻚ‪.‬‬ ‫‪.4‬‬
‫اﻟﺘﻌﺮف ﻋﻠﻰ ﻣﻀﺎﻣﻴﻦ ﻧﺘﺎﺋﺞ اﻟﺘﻘﻴﻴﻢ ﻟﺘﻄﻮﻳﺮ اﻟﺒﺮاﻣﺞ ﻣﻊ ﺗﻘﺪﻳﻢ اﻟﺘﻐﺬﻳﺔ اﻟﺮاﺟﻌﺔ إﻟﻰ ﻣﻘﺪﻣﻲ اﻟﺒﺮاﻣﺞ‪.‬‬ ‫‪.5‬‬

‫وﺳﺘﻜﻮن اﻟﻤﺴﺆوﻟﻴﺎت اﻷﺳﺎﺳﻴﺔ ﻟﻠﻮﺣﺪة هﻲ‬

‫ﻗﻴﺎس وﺗﻘﻴﻴﻢ ﻓﺎﻋﻠﻴﺔ وآﻔﺎءة ﺑﺮاﻣﺞ داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﺑﻜﻠﻔﺘﻬﺎ‪.‬‬ ‫‪.1‬‬
‫دﻋﻢ اﻟﺘﺰام إدارات اﻟﺪاﺋﺮة ﺑﺘﻘﺪﻳﻢ ﺧﺪﻣﺎت ذات آﻔﺎءة ﻋﺎﻟﻴﺔ ﺑﺎﻟﻤﺴﻮﺣﺎت اﻟﻤﺴﺘﻤﺮة ورﺻﺪ رﺿﺎ اﻟﻌﻤﻼء‪.‬‬ ‫‪.2‬‬
‫ﺗﻘﻴﻴﻢ اﻟﻤﺸﺎرﻳﻊ اﻟﻤﻘﺪﻣﺔ ﺑﺎﻟﻤﻤﺎرﺳﺎت اﻟﻌﺎﻣﺔ واﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.3‬‬
‫اﻟﺘﻘﻴﻴﻢ اﻻﻗﺘﺼﺎدي ووﺿﻊ اﻟﺴﻴﺎﺳﺎت‪.‬‬ ‫‪.4‬‬
‫ﺗﻘﺪﻳﻢ ﻧﺘﺎﺋﺞ ﺗﻘﻴﻴﻢ اﻟﺒـﺮاﻣﺞ إﻟـﻰ واﺿـﻌﻲ اﻟـﺴﻴﺎﺳﺎت وﻣـﺴﺌﻮﻟﻲ اﻟﺒـﺮاﻣﺞ ﻟﻠﺘﺤـﺴﻴﻦ اﻟﻤـﺴﺘﻤﺮ ﻟﻠﺒـﺮاﻣﺞ اﻟﻘﺎﺋﻤـﺔ‬ ‫‪.5‬‬
‫وإﻧﺸﺎء ﺑﺮاﻣﺞ ﺟﺪﻳﺪة ذات ﻓﺎﻋﻠﻴﺔ‪.‬‬

‫اﻷوﺻﺎف اﻟﻮﻇﻴﻔﻴﺔ‬

‫اﻟﻮﺻﻒ اﻟﻮﻇﻴﻔﻲ ﻟﺮﺋﻴﺲ ﻗﺴﻢ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‬

‫اﻹﺷﺮاف اﻹداري واﻟﻔﻨﻲ ﻟﻠﻘﺴﻢ‪.‬‬ ‫‪.1‬‬

‫ﺗﻘﺪﻳﻢ اﻟﻤﺸﻮرة اﻟﻔﻨﻴﺔ واﻟﺪﻋﻢ ﻹدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء وﻟﻠﺪاﺋﺮة ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.2‬‬
‫اﻟﺘﻨﺴﻴﻖ واﻟﺘﻌﺎون ﻣﻊ أﻗﺴﺎم إدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء وإدارات اﻟﺪاﺋﺮة ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ وﺑﺤﻮث اﻟﺨـﺪﻣﺎت‬ ‫‪.3‬‬
‫اﻟﺼﺤﻴﺔ واﻟﻨﻈﺎم اﻟﺼﺤﻲ و ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ‪.‬‬
‫إﻋﺪاد وﺗﻨﻔﻴﺬ اﻟﺪورات اﻟﺘﺪرﻳﺒﻴﺔ ﻓﻲ ﻣﺠﺎل ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ واﻟﺪراﺳﺎت اﻟﺼﺤﻴﺔ ﺗﻘﻴـﻴﻢ اﻟﺒـﺮاﻣﺞ وﺑﺎﻟﺘﻨـﺴﻴﻖ‬ ‫‪.4‬‬
‫ﻣﻊ إدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء وإدارة اﻟﺘﻌﻠﻴﻢ اﻟﻤﺴﺘﻤﺮ ﺑﺎﻟﺪاﺋﺮة‪.‬‬
‫اﻟﻤﺸﺎرآﺔ ﻓﻲ ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ﺑﺎﻟﺪاﺋﺮة وﺑﺎﻟﺘﻨﺴﻴﻖ ﻣـﻊ اﻷﻗـﺴﺎم واﻹدارات داﺧـﻞ اﻟـﺪاﺋﺮة واﻟﻬﻴﺌـﺎت‬ ‫‪.5‬‬
‫اﻟﺤﻜﻮﻣﻴﺔ ﺑﺈﻣﺎرة دﺑﻲ‪.‬‬
‫إﺻﺪار اﻟﻤﻄﺒﻮﻋﺎت ذات اﻟﻌﻼﻗﺔ ﺑﺎﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.6‬‬

‫اﻟﻤﺴﺘﻮى اﻟﺘﻌﻠﻴﻤﻲ‬

‫ﻃﺒﻴﺐ اﺧﺘﺼﺎﺻﻲ ﻓﻲ اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ وﻟﻪ ﺧﺒﺮة ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث‬ ‫•‬

‫اﻟﻮﺻﻒ اﻟﻮﻇﻴﻔﻲ ﻟﺮﺋﻴﺲ ﺷﻌﺒﺔ اﻟﺘﺤﻠﻴﻞ اﻟﻮﺑﺎﺋﻲ‬

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‫ﺗﻘﺪﻳﻢ اﻟﻤﺸﻮرة واﻟﺪﻋﻢ ﻹدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣـﺼﺎء ﺑﺎﻟـﺪاﺋﺮة ﻓـﻲ اﺳـﺘﺤﺪاث واﺳـﺘﺨﺪام اﻟﺒﻴﺎﻧـﺎت اﻟـﺼﺤﻴﺔ ﻟﺘـﺼﻤﻴﻢ‬ ‫‪.1‬‬
‫وﺗﻘﻴﻴﻢ ﺳﻴﺎﺳﺎت اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ واﻟﺘﺪﺧﻼت اﻟﺼﺤﻴﺔ واﻟﺨﻄﻂ واﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ‪.‬‬
‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ ﺗﺼﻤﻴﻢ ﺷﻜﻞ ﻣﻌﻠﻮﻣﺎﺗﻲ ﻟﻤﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﺑﺪﺑﻲ وﺗﺜﺒﻴﺖ ﻣﻌﺎﻳﻴﺮ اﻷﺛﺮ واﻟﺨﻄﻮرة ﻟﻸﻣﺮاض اﻟﻤﻌﺪﻳـﺔ‬ ‫‪.2‬‬
‫وﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻋﻠﻰ اﻟﻮﺿﻊ اﻟﺼﺤﻲ ﻟﻠﺴﻜﺎن ﺑﺪﺑﻲ‪.‬‬
‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ ﺗﻄﻮﻳﺮ اﻟﻤﺆﺷﺮات اﻟﺼﺤﻴﺔ وﺗﻘﺪﻳﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻼزﻣﺔ ﻟﺤﺴﺎب وﺗﻔﺴﻴﺮ ﺗﻠﻚ اﻟﻤﺆﺷﺮات‪.‬‬ ‫‪.3‬‬
‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ واﻟﺘﺤﻠﻴﻞ اﻟﻮﺑـﺎﺋﻲ ﺑﺎﻟـﺪاﺋﺮة وﺑﺎﻟﺘﻨـﺴﻴﻖ ﻣـﻊ اﻟﻮﺣـﺪات ذات اﻟﻌﻼﻗـﺔ‬ ‫‪.4‬‬
‫ﺑﺎﻹدارة واﻟﺪاﺋﺮة‪.‬‬
‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ اﻟﺘﺪرﻳﺐ ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ واﻟﻮﺑﺎﺋﻴﺎت‪.‬‬ ‫‪.5‬‬
‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ إﺻﺪار اﻟﻤﻄﺒﻮﻋﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‪.‬‬ ‫‪.6‬‬

‫اﻟﻤﺴﺘﻮى اﻟﺘﻌﻠﻴﻤﻲ‬

‫ﻃﺒﻴﺐ ﺣﺎﺻﻞ ﻋﻠﻰ ﻣﺎﺟﺴﺘﻴﺮ ﻋﻠﻰ اﻷﻗﻞ ﻓﻲ اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ )وﺑﺎﺋﻴﺎت( وﻟﻪ ﺧﺒﺮة ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‪.‬‬ ‫•‬
‫اﻟﻮﺻﻒ اﻟﻮﻇﻴﻔﻲ ﻟﺮﺋﻴﺲ ﺷﻌﺒﺔ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‬

‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ ﺗﺼﻤﻴﻢ اﻟﺒﺤﻮث اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ و اﻟﻨﻈﺎم اﻟﺼﺤﻲ‪.‬‬ ‫‪.1‬‬

‫ﺗﻘﺪﻳﻢ اﻟﺪﻋﻢ اﻟﻔﻨﻲ و اﻟﻤﻌﻠﻮﻣﺎت ﻹدارة اﻟﺘﺨﻄﻴﻂ و اﻹﺣﺼﺎء‪.‬‬ ‫‪.2‬‬
‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ ﺗﺼﻤﻴﻢ و ﺗﻨﻔﻴﺬ اﻟﺪورات اﻟﺘﺪرﻳﺒﻴﺔ ﻓﻲ ﻣﺠﺎل ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ واﻟﻨﻈﺎم و اﻻﻗﺘﺼﺎد اﻟﺼﺤﻲ ‪.‬‬ ‫‪.3‬‬
‫اﻟﻤﺸﺎرآﺔ ﻓﻲ إﻋﺪاد اﻟﻤﻄﺒﻮﻋﺎت اﻟﺨﺎﺻﺔ ﺑﺒﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﺑﺎﻟﻘﺴﻢ‪.‬‬ ‫‪.4‬‬

‫اﻟﻤﺴﺘﻮى اﻟﺘﻌﻠﻴﻤﻲ‬
‫ﻣﺎﺟﺴﺘﻴﺮ ﻓﻲ اﻹدارة اﻟﺼﺤﻴﺔ أو اﻻﻗﺘﺼﺎد اﻟﺼﺤﻲ وﻟﻪ ﺧﺒﺮة ﻓﻲ ﻣﺠﺎل ﺑﺤﻮث اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ‪.‬‬ ‫•‬

‫اﻟﻮﺻﻒ اﻟﻮﻇﻴﻔﻲ ﻟﺮﺋﻴﺲ ﺷﻌﺒﺔ ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ‬

‫ﺗﻘﺪﻳﻢ اﻟﺪﻋﻢ اﻟﻔﻨﻲ و اﻟﻤﻌﻠﻮﻣﺎت ﻹدارة اﻟﺘﺨﻄﻴﻂ و اﻹﺣﺼﺎء‬ ‫‪.1‬‬

‫ﻗﻴﺎس وﺗﻘﻴﻴﻢ ﻓﺎﻋﻠﻴﺔ وآﻔﺎءة ﺑﺮاﻣﺞ داﺋﺮة اﻟﺼﺤﺔ واﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﺑﺪﺑﻲ ﺑﻜﻠﻔﺘﻬﺎ‪.‬‬ ‫‪.2‬‬
‫ﺗﻘﻴﻴﻢ اﻟﻤﺸﺎرﻳﻊ اﻟﻤﻘﺪﻣﺔ ﺑﺎﻟﻤﻤﺎرﺳﺎت اﻟﻌﺎﻣﺔ واﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.3‬‬
‫ﺗﻘﺪﻳﻢ ﻧﺘﺎﺋﺞ ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ إﻟﻰ ﻣﺘﺨﺬي اﻟﻘﺮار ﺑﺎﻟﺪاﺋﺮة‪.‬‬ ‫‪.4‬‬
‫اﻟﻤﺴﺎهﻤﺔ ﻓﻲ ﺗﺼﻤﻴﻢ و ﺗﻨﻔﻴﺬ اﻟﺪورات اﻟﺘﺪرﻳﺒﻴﺔ ﻓﻲ ﻣﺠﺎل اﻟﺒﺮاﻣﺞ وﺗﻘﻴﻴﻤﻬﺎ‪.‬‬ ‫‪.5‬‬
‫اﻟﻤﺸﺎرآﺔ ﻓﻲ إﻋﺪاد اﻟﻤﻄﺒﻮﻋﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﻘﺴﻢ‪.‬‬ ‫‪.6‬‬

‫اﻟﻤﺴﺘﻮى اﻟﺘﻌﻠﻴﻤﻲ‬
‫ﻣﺎﺟﺴﺘﻴﺮ ﻓﻲ اﻹدارة اﻟﺼﺤﻴﺔ )ﺗﻘﻴﻴﻢ ﺑﺮاﻣﺞ( وﻟﻪ ﺧﺒﺮة ﻓﻲ ﻣﺠﺎل ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ‪.‬‬ ‫•‬

‫اﻟﻬﻴﻜﻞ اﻟﺘﻨﻈﻴﻤﻲ اﻟﻤﻘﺘﺮح‬

‫ﺳﻴﻜﻮن ﻗﺴﻢ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ ﺗﺎﺑﻌﺎً ﻹدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء ﺑﺎﻟﺪاﺋﺮة‪ ،‬هﺬا وﺳﻴﻀﻢ اﻟﻘﺴﻢ ﺛﻼث ﺷﻌﺐ‪:‬‬

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 ‫ﺷﻌﺒﺔ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‬ ‫‪.1‬‬
‫ﺷﻌﺒﺔ اﻟﺘﺤﻠﻴﻞ اﻟﻮﺑﺎﺋﻲ‬ ‫‪.2‬‬
‫ﺷﻌﺒﺔ ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ‬ ‫‪.3‬‬

‫آﻤﺎ ﺳﻴﻜﻮن هﻨﺎك ﻟﺠﻨﺔ اﺳﺘـﺸﺎرﻳﺔ ﻋﻠﻤﻴـﺔ ﺗﻘـﺪم اﻹدارة اﻟﻔﻜﺮﻳـﺔ واﻟﺨﻄـﻂ اﻹﺳـﺘﺮاﺗﻴﺠﻴﺔ وﺣﻠﻘـﺔ اﻟﻮﺻـﻞ ﺑـﻴﻦ اﻟﻘـﺴﻢ‬
‫وإدارات اﻟﺪاﺋﺮة‪.‬‬

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 ‫وهﻨﺎك ﺛﻼث ﻋﻤﻠﻴﺎت ﺟﻮهﺮﻳﺔ ﺑﺎﻟﻘﺴﻢ ﺗﺴﺎﻋﺪ ﻓﻲ إﻧﺠﺎز آﻞ ﻣﺮﺣﻠﺔ ﻣﻦ ﻣﺸﺮوع اﻟﺒﺤـﻮث ﺑﻨﺠـﺎح ﺑـﺪءاً ﺑﺈﻋـﺪاد ﺑﺮوﺗﻮآـﻮل‬
‫اﻟﺒﺤﺚ وإﻗﺮارﻩ ﺑﺎﻟﻠﺠﻨﺔ اﻻﺳﺘﺸﺎرﻳﺔ وﺗﻨﻔﻴﺬﻩ وإدارة اﻟﺒﻴﺎﻧﺎت وﺗﺤﻠﻴﻠﻬﺎ وﻋﺮﺿﻬﺎ وﻧـﺸﺮهﺎ‪ .‬واﻟﻌﻤﻠﻴـﺎت اﻟﺠﻮهﺮﻳـﺔ ﺑﺎﻟﻘـﺴﻢ‬
‫هﻲ‪:‬‬

‫رﺋﻴﺲ ﻗﺴﻢ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ‬ ‫إدارة اﻟﻘﺴﻢ واﻹﺷﺮاف‬ ‫‪.1‬‬

‫اﻟﻜﺎدر اﻟﻔﻨﻲ ﻟﻠﻘﺴﻢ‬ ‫ﺗﺼﻤﻴﻢ اﻟﺪراﺳﺎت وﺧﻄﻂ ﺗﻨﻔﻴﺬهﺎ وآﻴﻔﻴﺔ ﺗﺤﻠﻴﻞ اﻟﺒﻴﺎﻧﺎت‬ ‫‪.2‬‬
‫و ﺗﻘﻴﻴﻢ اﻟﺒﺮاﻣﺞ‬
‫ﻗﺴﻢ اﻟﺘﺤﻠﻴﻞ اﻹﺣﺼﺎﺋﻲ ﺑﺈدارة اﻟﺘﺨﻄﻴﻂ واﻹﺣﺼﺎء‬ ‫اﻟﺪﻋﻢ اﻹﺣﺼﺎﺋﻲ‬ ‫‪.3‬‬

‫اﺣﺘﻴﺎﺟﺎت اﻟﻘﻮى اﻟﺒﺸﺮﻳﺔ‬

‫ﺳﻴﻌﺘﻤﺪ اﺣﺘﻴﺎج اﻟﺪاﺋﺮة إﻟﻰ اﻟﺒﺎﺣﺜﻴﻦ ﻋﻠﻰ ﺧﺒﺮاﺗﻬﻢ اﻟﺴﺎﺑﻘﺔ وﻣﻬﺎراﺗﻬﻢ اﻟﺸﺨﺼﻴﺔ وﻃﺒﻴﻌﺔ اﻟﻌﻤﻞ اﻟﻤﻮآﻠﺔ إﻟﻴﻬﻢ‪.‬‬

‫ﻋﺪد ‪1‬‬ ‫أﺧﺼﺎﺋﻲ وﺑﺎﺋﻴﺎت )ﻳﻮﺟﺪ اﺳﺘﺸﺎري وﺑﺎﺋﻴﺎت(‬

‫ﻋﺪد ‪1‬‬ ‫أﺧﺼﺎﺋﻲ ﺗﺨﻄﻴﻂ ﺻﺤﻲ‬
‫ﻋﺪد ‪1‬‬ ‫أﺧﺼﺎﺋﻲ اﻗﺘﺼﺎد ﺻﺤﻲ‬
‫ﻋﺪد ‪1‬‬ ‫أﺧﺼﺎﺋﻲ ﺗﻘﻴﻴﻢ ﺑﺮاﻣﺞ ﺻﺤﻴﺔ‬
‫ﻋﺪد ‪1‬‬ ‫ﺿﺎﺑﻂ إداري‬

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 Vital Statistics and Medical Indicators

Vital Statistics

• Crude Death Rate.

• Neonatal Mortality Rate.

• Child Mortality Rate under five years of age.

• Crude Birth Rate.

Accessibility of Health Services

• Population per PHC Center.

• Average time to see a doctor in the clinic.

• Population per full time equivalent specialist (to be discussed by the Work Group)

• Average waiting time to see specialist.

• Average waiting time for surgeries

• Bed population Index.

Utilization of Health Services

• Daily encounter visit rate.

• Average length of stay.

Productivity and Efficiency of Health Services

• Average daily number of visits per PHC physician.

307
• Average daily number of patients per Specialist.

• Average occupancy rate.

Quality of Health Services

• Nosocomical Infection rate.

• Crude hospital death rate.

Improving Health Indicators

• Deaths from cardiovascular Diseases under 75 years.

• Death rates from cancer under 75 years (change in rate).

Leading Health Indicators

• Immunization.

• Proportion of pregnant women who begin prenatal care in the first trimester of
pregnancy.

Human Resources for Health

• Physicians per 1000 population.

• Nurses per 1000 population.

• Dentists per 10000 population.

308
 Demography Sub-Sector Situation Analysis
SWOT Workshop

Mortality

Strengths

y Mortality rate in Dubai is low 1.4 per thousand.

y Life expectancy is high is Dubai 72 years.
y Reduction of deaths from preventable diseases as diarrhea and respiratory diseases
by, immunizations and environmental satiation.
y Infant mortality rate is very low (7 per 1000).

Weakness

y All the progression life expectancy, has after all postponed death.
y Deaths form non-communicable diseases constitutes more than 85% of deaths in
Dubai.
y Injuries cause the most death in the age group 15-24 years.

Threads:

309
• Population and epidemiologic transition increase the occurrence of non
communicable diseases.

• Prevention of deaths for non communicable diseases is costly and needs lot of
resources.

• Waxing and warning of diseases may affect the mortality of the population.

Opportunities:

• Control of chronic diseases by implementation of non communicable diseases

control program, weight control, notational education, physical activity and
cessation of smoking.
• Availability of medical services could help in reducing mortality

Fertility

Strengths:

• Policies that directly or indirectly influence childbearing by incoming couples to

marry and have more children.

• Family friendly employment policies as flexible working assistance.

• Maternity leave.

310
• Family support policies as cash payments to families on birth of every child and
low income housing loans.
• Son preference. Couples may continue to have children until they have a son.
There by pushing up overall fertility.

Weakness:

• High income and education (Development is the best contraceptive).

• Employment of women.

• Parental leave.

• Availability of contraceptive methods.

• Low rates of marriage and high rates of divorce especially among Emirates (73%
increase 2000-2004).

Immigration

Strengths:

• Immigration of working age people lead to higher productivity gains and higher
economic growth.

• Reduce health costs, insurance and national health budgets.

311
• Fill the labor gap for the growing economic in Dubai.
• Many businesses rely on immigrant labor.

• Policy option for regulating population size.

Weakness

• Social cohesion may be threatened.

• Weaken national identity.

• Locals may consider expatriates as a threat to their jobs and ethnic dominance.

• Sensitive issue especially for the large groups of ethnic minorities.

Population Growth and Composition

Strengths

y Provision of highly Technical Group.

y Dependency ratio is low

312
y Population hypothetical doubling time in Dubai for natural increase is 45 years.
Actual increases hypothetical doubling time will be in 11 years. (By 2017,
population of Dubai will be 2122)
y Death is low.
y Fertility is high

Weakness

y Single and non-family households in Dubai are high.

y The effect of extremely unbalanced immigration pattern is evident in the
population pyramid in Dubai. The sex ratio was estimated to be 2.82:1 in
2004.
y Host government did not want immigrants to settle permanently. In addition
highly educated foreigners are less likely to stay if they had families waiting for
them back home.
y Sex ratio in Dubai affects the availability of marriage – means that there may not
be enough men or women for everyone to find a spouse. The scarcity potential
marriage partners are not merely a personal disappointment for individuals who
really want to get married. It also affects the social and economic structure of the
society this also affects the marriage rate, childbearing practices and family
stability .
y Different ethnic groups with differences in fertility, cultural and social values.
y Population distribution in Dubai about two thirds are Asians. This needs
population redistribution.

313
 ‫ﺗﺤﻠﻴــﻞ اﻟﻮﺿــﻊ اﻟﺴﻜﺎﻧـﻲ ﺑﺈﻣــﺎرة دﺑﻲ‬

‫اﻟﻮﻓﻴﺎت‬

‫اﻟﻘﻮة‬

‫ﻣﻌﺪل اﻟﻮﻓﻴﺎت ﻣﻨﺨﻔﺾ ﺑﺪﺑﻲ )‪ 1.3‬ﻓﻲ اﻷﻟﻒ(‪.‬‬ ‫‪.1‬‬

‫ﻣﻌﺪل اﻟﻌﻤﺮ ﻋﻨﺪ اﻟﻮﻻدة ﻣﺮﺗﻔﻊ )‪ 74‬ﻋﺎﻣﺎً(‪.‬‬ ‫‪.2‬‬

‫ﺗﻘﻠﻴﻞ اﻟﻮﻓﻴﺎت ﻣﻦ اﻷﻣﺮاض اﻟﺘﻲ ﻳﻤﻜﻦ اﻟﻮﻗﺎﻳﺔ ﻣﻨﻬـﺎ آﺎﻹﺳـﻬﺎل وأﻣـﺮاض اﻟﺠﻬـﺎز اﻟﺘﻨﻔـﺴﻲ ﺑـﺎﻟﺘﻄﻌﻴﻢ واﻟﺘﺤـﺴﻦ‬ ‫‪.3‬‬
‫اﻟﺒﻴﺌﻲ‪.‬‬

‫اﻟﻀﻌﻒ‬

‫آﻞ اﻟﺘﻘﺪم ﻓﻲ ﻣﻌﺪل اﻟﻌﻤﺮ ﻋﻨﺪ اﻟﻮﻻدة هﻮ ﺗﺄﺟﻴﻞ ﻟﻠﻮﻓﺎة‪.‬‬ ‫•‬

‫ﺗﺸﻜﻴﻞ اﻟﻮﻓﻴﺎت ﻣﻦ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ‪ %85‬ﻣﻦ اﻟﻮﻓﻴﺎت ﺑﺪﺑﻲ‪.‬‬ ‫•‬

‫ﺗﺸﻜﻴﻞ اﻟﺤﻮادث ﻣﻌﻈﻢ اﻟﻮﻓﻴﺎت ﻓﻲ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻌﻤﺮﻳﺔ ‪ 24-15‬ﻋﺎﻣﺎً‪.‬‬ ‫•‬

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 ‫اﻟﺘﻬﺪﻳﺪات‬

‫ﺳﺒﺐ اﻟﺘﺤﻮل اﻟﺴﻜﺎﻧﻲ واﻟﻮﺑﺎﺋﻲ ارﺗﻔﺎﻋﺎً ﻓﻲ ﺣﺪوث اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬ ‫•‬

‫ﺗﻘﻠﻴﻞ اﻟﻮﻓﻴﺎت ﻣﻦ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ ﻣﻜﻠﻔﺎ وﻳﺤﺘﺎج اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﻤﻮاد‪.‬‬ ‫•‬

‫ﻗﺪ ﻳﺆﺛﺮ ارﺗﻔﺎع واﻧﺨﻔﺎض ﻣﻌﺪﻻت اﻷﻣﺮاض ﻋﻠﻰ اﻟﻮﻓﻴﺎت ﺑﺎﻟﺴﻜﺎن‪.‬‬ ‫•‬

‫اﻟﻔﺮص‬

‫ﺑﺘﻄﺒﻴﻖ ﺑﺮاﻣﺞ ﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳـﺔ وﺗﻘﻠﻴـﻞ اﻟـﻮزن واﻟﺘﻌﻠـﻴﻢ واﻟﻨـﺸﺎط اﻟﺒـﺪﻧﻲ واﻟﺘﻮﻗـﻒ ﻋـﻦ اﻟﺘـﺪﺧﻴﻦ ﻳﻤﻜـﻦ‬
‫ﻣﻜﺎﻓﺤﺔ اﻷﻣﺮاض ﻏﻴﺮ اﻟﻤﻌﺪﻳﺔ‪.‬‬
‫ﺗﻮﻓﺮ اﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ ﻗﺪ ﻳﺴﺎﻋﺪ ﻓﻲ ﺧﻔﺾ اﻟﻮﻓﻴﺎت‪.‬‬

‫اﻟﺨﺼــــــــــــﻮﺑﺔ‬

‫ﻣﻮاﻃﻦ اﻟﻘﻮة‬
‫اﻟﺴﻴﺎﺳﺎت اﻟﺘﻲ ﺗﺆﺛﺮ ﺑﻄﺮﻳﻘﺔ ﻣﺒﺎﺷﺮة أو ﻏﻴﺮ ﻣﺒﺎﺷﺮة ﻋﻠﻰ إﻧﺠﺎب اﻷﻃﻔﺎل ﻟﻠﻤﻘﺒﻠﻴﻦ ﻋﻠﻰ اﻟﺰواج وﻹﻧﺠﺎب‬ ‫‪-‬‬
‫أﻃﻔﺎل أآﺜﺮ‬
‫ﺳﻴﺎﺳﺎت اﻟﻌﻤﻞ ﺻﺪﻳﻘﺔ اﻷﺳﺮة آﻤﺴﺎﻋﺪات اﻟﻌﻤﻞ اﻟﻤﺮﻧﺔ‬ ‫‪-‬‬
‫إﺟﺎزة اﻟﻮﺿﻊ‬ ‫‪-‬‬
‫ﺳﻴﺎﺳﺎت دﻋﻢ اﻷﺳﺮة آﺎﻟﺪﻓﻊ اﻟﻨﻘﺪي ﻟﻸﺳﺮ ﻋﻨﺪ وﻻدة آﻞ ﻃﻔﻞ وﻗﺮوض اﻹﺳﻜﺎن ﻟﺬوي اﻟﺪﺧﻞ اﻟﻤﻨﺨﻔﺾ‬ ‫‪-‬‬
‫ﺗﻔﻀﻴﻞ اﻟﺬآﻮر آﺎﻹﻧﺠﺎب اﻟﻤﺴﺘﻤﺮ وﺣﺘﻰ إﻧﺠﺎب اﻟﺬآﺮ واﻟﺬي ﻳﺰﻳﺪ اﻟﺨﺼﻮﺑﺔ اﻟﻜﻠﻴﺔ‬ ‫‪-‬‬

‫ﻣﻮاﻃﻦ اﻟﻀﻌﻒ‬
‫اﻟﺪﺧﻞ اﻟﻤﺮﺗﻔﻊ واﻟﺘﻌﻠﻴﻢ )اﻟﺘﻘﺪم هﻮ أﻓﻀﻞ ﻣﻮاﻧﻊ اﻟﺤﻤﻞ(‬ ‫‪-‬‬
‫ﻋﻤﻞ اﻟﻤﺮأة‬ ‫‪-‬‬

‫‪315‬‬
 ‫ﺗﻮﻓﺮ وﺳﺎﺋﻞ ﻣﻨﻊ اﻟﺤﻤﻞ‬ ‫‪-‬‬
‫إﺟﺎزة رﻋﺎﻳﺔ اﻷﻃﻔﺎل‬ ‫‪-‬‬
‫اﻧﺨﻔﺎض ﻣﻌﺪﻻت اﻟﺰواج وزﻳﺎدة اﻟﻄﻼق ﺧﺎﺻﺔ ﺑﻴﻦ اﻟﻤﻮاﻃﻨﺎت‬ ‫‪-‬‬

‫اﻟﻌﻤﺎﻟﺔ اﻟﻮاﻓﺪة‬

‫اﻟﻘﻮة‬

‫ﺗﻮﻓﺮ اﻟﻌﻤﺎﻟﺔ ﻓﻲ ﺳﻦ اﻟﻌﻤﻞ ﻳﺴﺎﻋﺪ ﻋﻠﻰ زﻳﺎدة اﻹﻧﺘﺎج وﺳﺮﻋﺔ اﻟﻨﻤﻮ اﻻﻗﺘﺼﺎدي‪.‬‬ ‫•‬

‫ﺗﻘﻠﻴﻞ اﻟﺘﻜﻠﻔﺔ اﻟﺼﺤﻴﺔ واﻟﺘﺄﻣﻴﻨﺎت وﻣﻴﺰاﻧﻴﺔ اﻟﺼﺤﺔ‪.‬‬ ‫•‬

‫ﺳﺪ ﻓﺠﻮة اﻟﻌﻤﻞ ﻟﻠﻨﻤﻮ اﻻﻗﺘﺼﺎدي ﺑﺪﺑﻲ‪.‬‬ ‫•‬

‫ﺗﻌﺘﻤﺪ اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﻤﻬﻦ ﻋﻠﻰ اﻟﻌﻤﺎﻟﺔ اﻟﻮاﻓﺪة‪.‬‬ ‫•‬

‫ﺧﻴﺎر ﺳﻴﺎﺳﻲ ﻟﺘﻨﻈﻴﻢ ﺣﺠﻢ اﻟﺴﻜﺎن ﺑﺪﺑﻲ‪.‬‬ ‫•‬

‫اﻟﻀﻌﻒ‬

‫ﻗﺪ ﺗﻬﺪد اﻟﺘﻤﺎﺳﻚ اﻻﺟﺘﻤﺎﻋﻲ‪.‬‬ ‫•‬

‫ﺗﻀﻌﻒ اﻟﻬﻮﻳﺔ اﻟﻘﻮﻣﻴﺔ‪.‬‬ ‫•‬

‫ﻗﺪ ﻳﻌﺘﺒﺮ اﻟﻤﻮاﻃﻨﻮن اﻷﺟﺎﻧﺐ ﺗﻬﺪﻳﺪاً ﻟﻮﻇﺎﺋﻔﻬﻢ واﻟﻬﻴﻤﻨﺔ اﻟﻌﺮﻗﻴﺔ‪.‬‬ ‫•‬

‫اﻟﺤﺴﺎﺳﻴﺔ ﻟﻤﺠﻤﻮﻋﺎت آﺒﻴﺮة ﻣﻦ اﻷﻗﻠﻴﺎت اﻟﻌﺮﻗﻴﺔ‪.‬‬ ‫•‬

‫اﻟﻨﻤﻮ واﻟﺘﺮآﻴﺒﺔ اﻟﺴﻜﺎﻧﻴﺔ‬

‫اﻟﻘﻮة‬

‫اﻷﻋﺪاد آﻤﺠﻤﻮﻋﺎت ﺗﻘﻨﻴﺔ ﻋﺎﻟﻴﺔ‪.‬‬ ‫•‬

‫اﻧﺨﻔﺎض ﻣﻌﺪل اﻻﻋﺘﻤﺎد‪.‬‬ ‫•‬

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‫اﻟﻮﻗﺖ اﻟﻔﺮﺿﻲ ﻟﻤﻀﺎﻋﻔﺔ اﻟﺴﻜﺎن ﺑﺪﺑﻲ ﺑﺎﻟﺰﻳـﺎدة اﻟﻄﺒﻴﻌﻴـﺔ هـﻮ ‪ 45‬ﻋﺎﻣـﺎً وﺑﺎﻟﺰﻳـﺎدة اﻟﺤﺎﻟﻴـﺔ ‪ 11‬ﻋﺎﻣـﺎً )ﺑﻌـﺎم ‪2017‬‬ ‫•‬
‫ﺳﻮف ﻳﻜﻮن ﻋﺪد اﻟﺴﻜﺎن ﺑﺪﺑﻲ ‪ 2.122‬ﻣﻠﻴﻮن‪.‬‬

‫اﻧﺨﻔﺎض اﻟﻮﻓﻴﺎت‪.‬‬ ‫•‬

‫زﻳﺎدة ﻧﺴﺒﺔ اﻟﻤﻮاﻟﻴﺪ‪.‬‬ ‫•‬

‫اﻟﻀﻌﻒ‬

‫اﻟﻌﺰاب واﻷﺳﺮ ﻏﻴﺮ اﻟﻌﺎﺋﻠﻴﺔ ﻋﺎﻟﻴﺔ ﺑﺪﺑﻲ‪.‬‬ ‫•‬

‫ﻣﻌﺪل اﻟﻨﻮع ﺑﺪﺑﻲ ‪ 1:2.76‬ﻓﻲ ‪.2005‬‬ ‫•‬

‫ﻋﺪم اﻻﺳﺘﻤﺮار اﻟﺪاﺋﻢ ﻟﻐﻴﺮ اﻟﻤﻮاﻃﻨﻴﻦ‪.‬‬ ‫•‬

‫ﺗﻘﻠﻴﻞ ﻓﺮص اﻟﺰواج ورﻋﺎﻳﺔ اﻷﻃﻔﺎل واﻻﺳﺘﻘﺮار اﻷﺳﺮي‪.‬‬ ‫•‬

‫ﻣﺠﻤﻮﻋﺎت ﻋﺮﻗﻴﺔ ﻣﺨﺘﻠﻔﺔ ﺑﻤﻔﺎهﻴﻢ ﺛﻘﺎﻓﻴﺔ واﺟﺘﻤﺎﻋﻴﺔ ﻣﺨﺘﻠﻔﺔ‪.‬‬ ‫•‬

‫ﻳﺸﻜﻞ اﻵﺳﻴﻮﻳﻮن ﺛﻠﺜﻲ اﻟﺴﻜﺎن ﻣﻤﺎ ﻳﺴﺘﺪﻋﻲ إﻋﺎدة ﺗﻮزﻳﻊ اﻟﺴﻜﺎن‪.‬‬ ‫•‬

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