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1.  Women’s perspectives of female genital cutting: Q-methodology 
BMC Women's Health  2014;14:11.
Background
Understanding women’s perspectives of female genital cutting is particularly critical for understanding the roots of the problem and enhancing effectiveness of any prevention program. Very limited research has examined how people in Iraqi Kurdistan Region think about this practice. This study aimed to explore the perspectives of women of female genital cutting with the aim of uncovering discrepancies and commonalities between women of different socio-educational groups.
Methods
An explorative study using Q-methodology was conducted with 29 women from different educational and socio-economic statuses in Erbil, the main city of the Iraqi Kurdistan Region. Participants were asked to rank-order a set of 39 statements about different aspects of female genital cutting into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis was performed with factors or latent viewpoints extracted through centroid method and varimax rotation.
Results
A four-factor solution and one consensus perspective provided the best conceptual fit for the women’s perspectives about female genital cutting. Factor 1, entitled “positive cultural tradition”, centers on recognizing female genital cutting as a positive cultural aspect and an essential part of the Kurdish culture. Factor 2, “active opponents”, positions around actively opposing the practice of female genital cutting and considering the practice a violation of human rights. Factor 3, “role of law”, stresses the importance of developing and enforcing law for combating female genital cutting. Factor 4, “health concerns and passive opposition”, represents the perspectives of recognizing the importance of health concerns resulting from female genital cutting and opposition of the practice but not in an active manner. A consensus perspective, “marital role”, centers primarily on lack of effect of female genital cutting on women’s marital role.
Conclusions
Female genital cutting is still a contentious issue among women in Iraqi Kurdistan Region. By identifying disagreement and consensus among women, four different perspectives on female genital cutting were uncovered with having perspectives at both extremes of accepting the practice and actively opposing it. The study highlighted the typical characterizations that are associated with each perspective.
doi:10.1186/1472-6874-14-11
PMCID: PMC3898223  PMID: 24433509
2.  A Qualitative Assessment of The Small Group Teaching at Hawler College of Medicine 
Context: Although the medical schools in Iraq recently started to increasingly use the small group teaching approach, only little is known about the students’ perceptions toward this approach. Therefore, the aim of this study was to assess small group teaching as a method of teaching at Hawler College of Medicine, from the students’ perspectives.
Setting: This study was a qualitative study which was based on six focus group discussions which involved a sample of students from the three last years at the Hawler College of Medicine. A topic guide was used to lead the discussions and it covered questions on the positive aspects and the problems of small group teaching in the college, in addition to recommendations for its improvement. The qualitative data analysis involved a content analysis, followed by a thematic analysis.
Results: The participants were generally happy with the application of the small group teaching approach and they recognized many positive aspects which were related to this experience, which included, increasing the focus on the study subjects, enhancing the student-teacher interaction, building a better student-teacher relationship, encouraging the students’ attendance, providing a better opportunity to apply a student-centered learning, enhancing a more efficient use of time and assisting in a better understanding of the subjects. The main problems which were faced, included a poor infrastructure and teaching facilities, problems which were related to examinations and the mark distribution, an improper syllabus preparation and problems which were related to the teachers’ commitments and performances. The main suggestions which were put forth to improve this system, included, changing the assessment system with the focus more on the end of the course assessment, the students’ involvement in the curriculum design, improving the infrastructure and teaching facilities and a better organization and management of the system.
Conclusions: The concept of the small group teaching approach was well received by the students and many positive aspects of this approach have been highlighted. However, this experience witnessed many problems and faced different challenges that need better preparation, organization of the resources and the orientation of students and teachers, for insuring its success.
doi:10.7860/JCDR/2013/5455.2966
PMCID: PMC3681061  PMID: 23814734
Medical education; Small group teaching
3.  Birth defects in Iraq and the plausibility of environmental exposure: A review 
An increased prevalence of birth defects was allegedly reported in Iraq in the post 1991 Gulf War period, which was largely attributed to exposure to depleted uranium used in the war. This has encouraged further research on this particular topic. This paper reviews the published literature and provided evidence concerning birth defects in Iraq to elucidate possible environmental exposure. In addition to published research, this review used some direct observation of birth defects data from Al-Ramadi Maternity and Paediatric Hospital in Al-Anbar Governorate in Iraq from1st July 2000 through 30th June 2002. In addition to depleted uranium other war-related environmental factors have been studied and linked directly or indirectly with the increasing prevalence of birth defects. However, the reviewed studies and the available research evidence do not provide a clear increase in birth defects and a clear indication of a possible environmental exposure including depleted uranium although the country has been facing several environmental challenges since 1980.
doi:10.1186/1752-1505-6-3
PMCID: PMC3492088  PMID: 22839108
4.  Teaching methods in Hawler College of Medicine in Iraq: A qualitative assessment from teachers' perspectives 
BMC Medical Education  2012;12:59.
Background
Medical education in Iraq is poorly assessed and there is a general lack of documented knowledge about the challenges facing this field and the needs for its development. This study aimed to assess the existing teaching methods in the Hawler College of Medicine, Iraq from teaching staff perspectives and assess the knowledge of the teaching staff about student-centred learning.
Methods
A qualitative study based on a self-administered questionnaire survey of a purposive sample of 83 teaching staff in Hawler Medical University was conducted. The questionnaire addressed the participants’ view on the positive aspects and problems of the current teaching methods and priorities to change it. The qualitative data analysis comprised thematic analysis.
Results
The study revealed significant problems facing the existing teaching methods including having large number of students in the lecture hall (45.0 %), having focus on teacher-centred teaching (45.0 %) and lack of infrastructures and facilities suitable for proper teaching (26.7 %). The priorities for improving the quality of teaching methods included adoption of small group teaching strategy in all study years (34.6 %), improving the infrastructure and facilities for teaching in the college (34.6 %) and provision of continuous academic development programs for the teaching staff (24.3 %).
Conclusions
The existing medical education system face significant problems and it needs important and comprehensive improvements in different areas. There is a need for further research in this field to explore the identified problems in a more in-depth manner in order to better understand of the problems and needs of this important area of education.
doi:10.1186/1472-6920-12-59
PMCID: PMC3444947  PMID: 22840193
5.  Iraqi health system in kurdistan region: medical professionals' perspectives on challenges and priorities for improvement 
Conflict and Health  2010;4:19.
Background
The views of medical professionals on efficiency of health system and needs for any changes are very critical and constitute a cornerstone for any health system improvement. This is particularly relevant to Iraqi Kurdistan case as the events of the last few decades have significantly devastated the national Iraqi health system while the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims to examine the regional health system in Iraqi Kurdistan from medical professionals' perspectives and try to define its problems and priorities for improvement.
Methods
A survey questionnaire was developed and administered to a convenience sample of 250 medical professionals in Erbil governorate. The questionnaire included four items; rating of the quality of services and availability of resources in the health institutions, view on different aspects of the health system, the perceived priority needs for health system improvement and gender and professional characteristics of the respondents.
Results
The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspects of services and resources in the health institutions as weak or very weak including the availability of the required quantity and quality of medicines (68.7%), the availability of sufficient medical equipment and investigation tools (68.7%), and the quality of offered services (65.3%). Around 72% of respondents had a rather negative view on the overall health system. The weak role of medical research, the weak role of professional associations in controlling the system and the inefficient health education were identified as important problems in the current health system (87.9%, 87.1% and 84.9%, respectively). The priority needs of health system improvement included adoption of social insurance for medical care of the poor (82%), enhancing the role of family medicine (77.2%), adopting health insurance system (76.1%) and periodic scientific evaluation of physicians and other health staff (69.8%).
Conclusion
Medical professionals were generally unsatisfied with the different aspects of the health system in Iraqi Kurdistan region. A number of problems and different priority needs for health system improvement have been recognized that require to be studied in more details.
doi:10.1186/1752-1505-4-19
PMCID: PMC3003630  PMID: 21118537

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