Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Community Medicine

Introduction: Operational research (OR) is managerially oriented research that provides evidence-based solutionsfor executive problems and help in decision making. Objectives: Improve performance of service providers in Primary Health Centers (FHC) through hands-on training in OR.Methods: The study was conducted in Talbia Family Health Center (TFHC)-Giza Governorate. An "exploratory {u2013} intervention- outcome" design was used. Exploratory phase included assessment of work climate using self {u2013}administered questionnaire form ( 100 staff members), using quality checklist for resources and process of care (252 items), client satisfaction (n=200), and service statistics for year 2014 for three FHCs in Omraneia district. Intervention (1): Focus group discussion (FGDs) and review findings of exploratory phase with physicians and nurses and identification of three major operational problems. Intervention (2): Hands'-on training in three OR studies. Outcome: Completing 3 OR studies and 3 policy briefs. conclusions: Family health centers FHC have the potentials and critical mass to conduct OR studies. The first study was conducted on 1053family folders (4160 individuals).Out of Individuals whose age 25 years and above (n=1913) 5.8% were diagnosed as having diabetes, 4.9% had hypertension, and 4.1% had Cardiovascular diseases. The study concluded that: FHC could be used as reporting centers for surveillance of non-communicable diseases. The second study: included 3659 FP clients. Out of 10 teen-age nine had 2 children and more. Out of each 10 women 35 and moreyears old, 8 women had4 children and more. The study concluded children-marriage could bereduced through facility-community communication. Counseling should include guidance for limiting and/or spacing. The third study: was an intervention study conducted by 12 nurses involved in teambuilding on-daily basis to respond to conversion from vertical to integrated comprehensive services of Family medicine (FM). The study concluded that: teambuilding by nurses raised demands for capacity building and having action planperformance for identifyingand solving operational problems.

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