Hajj health examination for pilgrims with asthma in Malaysia: An ethnographic study.

Autor:	Ramli R; Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Hanafi NS; Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Hussein N; Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Lee PY; UMeHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia., Ghazali SS; Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia., Cheong AT; Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia., Abu Bakar AI; Hospital Pusrawi Pvt Ltd, Kuala Lumpur, Malaysia., Samad AA; Ministry of Health, Putrajaya, Malaysia., Abdullah S; Ministry of Health, Putrajaya, Malaysia., Pinnock H; Usher Institute, University of Edinburgh, Edinburgh, UK., Sheikh A; Usher Institute, University of Edinburgh, Edinburgh, UK., Khoo EM; Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Jazyk:	angličtina
Zdroj:	Journal of global health [J Glob Health] 2022 Mar 26; Vol. 12, pp. 04023. Date of Electronic Publication: 2022 Mar 26 (Print Publication: 2022).
DOI:	10.7189/jogh.12.04023
Abstrakt:	Background: Asthma was one of the top causes of hospitalization and unscheduled medical attendances due to acute exacerbations and its complications. In Malaysia, all pilgrims must undergo a mandatory health examination and certified fit to perform pilgrimage. We studied the current organisational and clinical routines of Hajj health examination in Malaysia with a focus on the delivery of care for pilgrims with asthma. Methods: We conducted non-participant observation to obtain ethnographic understanding of Hajj health examination activities for 2019. Observations were guided by a checklist and recorded as notes that were analysed thematically. The study was conducted at 11 public (from each region in Malaysia, namely, North, South, East, West of Peninsular Malaysia, and Sabah and Sarawak of East Malaysia) and two private primary care clinics. Results: We observed considerable variation in the implementation and practice of Hajj health examinations among the 11 public clinics but no marked variation among the private clinics. The short time span of between three to four months was inadequate for disease control measures and had put pressure on health care providers. They mostly viewed the Hajj health examination as merely a certification of fitness to perform the pilgrimage, though respiratory health assessment was often inadequate. The opportunity to optimise the health of pilgrims with asthma by providing the appropriate medications, asthma action plan and asthma education including the preventive measures was disregarded. The preliminary health screening, which aimed to optimise pilgrims' health before the actual Hajj health examination was not appreciated by either pilgrims or health care providers. Conclusions: There is great potential to reform the current system of Hajj health certification in order to optimise its potential benefits for pilgrims with asthma. A systematic approach to restructuring the delivery of Hajj health examination could address the time constraints, clinical competency of primary health care providers and resources limitations. Competing Interests: Competing interests: This study is written on behalf of the RESPIRE collaborators. E.M.K. reports grant from the National Institute for Health Research Global Health Research Unit on Respiratory Health (RESPIRE) and Seqirus UK; personal fees from AstraZeneca and GlaxoSmithKline; and is board director of the International Primary Care Respiratory Group. The other authors have completed the ICJME Declaration of Interest Form (available upon request from the corresponding author) and declare no further conflicts of interest. (Copyright © 2022 by the Journal of Global Health. All rights reserved.)
Databáze:	MEDLINE
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