Articles: community-health-services.
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Background: Primary healthcare (PHC) is essential for equitable access and cost-effective healthcare. This makes PHC a key factor in the global strategy for universal health coverage (UHC). Implementing PHC requires an understanding of the health system under prevailing circumstances, but for most countries, no data are available. ⋯ Primary concerns were the absence of a family practice model, brain drain and immigration of FPs. Countries differed in building a coherent policy. Conclusion: Priorities should be focused on: developing PHC model in Eastern Mediterranean region with advocacy for community-based PHC to policymakers; capacity building for strengthening PHC-oriented health systems with FP specialty training and restrict practising to fully trained FPs; engage communities to improve understanding of PHC; adopt quality and accreditation policies for better services; validation of the referral and follow-up process; and, develop public-private partnership mechanisms to enhance PHC for UHC.
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Background: Physical inactivity implies a significant individual and society health burden. Objectives: To assess the feasibility of implementing a preventive physical exercise (PE) programme for the general population and to analyse changes in fitness-related variables and quality of life. Methods: Pre-post comparison study in which general practitioners and nurses recommended PE to participants with sedentary behaviour and hypertension or dyslipidaemia attending in primary care for primary prevention of ischaemic cardiovascular disease. ⋯ Results: The PE programme was offered to 6,140 eligible subjects; 5,077 (82.7%) accepted to participate and received a recommendation; 3,656 (69.6% women) started the programme and 2,962 subjects (80.9% women) finished the programme. After 10 weeks, there were significant improvements (mean difference, 95% CI) in aerobic fitness (2.55 ml/min/kg, 2.32-2.79), muscle strength (0.62 m, 0.57 to 0.67), flexibility (2.34 cm, 2.06 to 2.63) and balance (-0.46 falls, -0.60 to -0.33) as well as significant decreases in body weight (-0.41 kg, -0.64 to -0.17) and BMI (-0.27 kg/m2, -0.34 to -0.20). Conclusion: Implementation of a government-supported PE programme for the general population recruited in the primary care setting and recommended by healthcare professionals is feasible, and was associated with health benefits, mainly improvements in physical fitness.