The Status of Health Services in Iraq; A Case Study of Pediatric Diabetes

Aims: Diabetes mellitus type 1 as a chronic disease represents a heavy burden on its patients and families. In the absence of health insurance in Iraq, the public sector should provide these patients with standard care to not compel them to get it from the costly, private one. This study aimed to overview the provided public service for children and young people living with diabetes in Iraq and compare it with international standards. Instrument Methods: In this descriptive study in 2019, the opinions of physicians running public PDU in 18 provinces of Iraq were collected via an online questionnaire. The collected data were analyzed using the Survey Monkey built-in analyzing tools. Findings: The number of patients in each center ranged between 98-3000. Before transferring patients to adult services, the mean age was 16 years, ranging between 14-19 years. 78% of health care providers had no transition policy in their centers. Team composition was variable; 44% of the units had no pediatric diabetologists or trained physicians in pediatric diabetes, half had no diabetes specialist nurses or diabetes educators, 78% had no dietitians, and 94% functioned without psychologists. Basic facilities and medical supplies were limited, and not all investigations were available. The annual screening was performed in 56% of centers. Educational activities were organized only in 39% of units. Conclusion: There is a significant shortage of essential requirements for running a reasonable pediatric diabetes service with a wide variation in the provided services between the pediatric diabetes units.