Preliminary study of morbidity recording in primary health care (PHC), a tool for improving quality of primary health care services

The aim of this study is to improve the curative services at The Primary Health Care (PHC) level and to highlight the requirements for reforming the medical education curriculum to suit our community needs and. Specific Objectives: To set the foundation of morbidity recording (manual and/or computer-based) as part of the reforming process, training PHC team as regard recording methods, simple analysis and utilizing the results in determining pattern of morbidity among their target population, their drug needs, equipment, and training needs for every member of the PHC health team. Study Design: intervention-operational research for one year (January-December 2003). Materials: Six PHC units were assigned, in three districts representing three Governorates in Lower Egypt, namely El Zarka-Damitta, El Manzala-Dakahlia and Kantara Gharb- Ismaelia. Methods: A pre-designed, field tested morbidity record form was provided to each PHC team both as hard and soft copies (excel-based). The attendant physician and two or more health team members (usually nurses) were trained to record in either form. Results: Out of the total recorded visits to the PHC unit (6296), infectious diseases constituted the majority 74% [common cold - Influenza - tonsillitis - bronchitis - gastro-enteritis - otitis media - infective skin diseases and parasitic infections]. The second major category was the non-infectious problems 25% [allergic conditions - chronic diseases such as diabetes or hypertension and rheumatic fever or rheumatic pains] and surgical problems was found the least, constituted about 1% of all PHC visits The overall referred cases (586) represents only 9.3% of the total visits. Conclusion: Morbidity recording in PHC sittings is vital. Together with mortality recording, morbidity data can give accurate picture of our health problems. Medical education, training needs at different levels at Ministry of Health can be greatly improved.