Medicine Program

M3-PHC (MED-461) 2021 - 2022

Field Report

Written By: Mohammed Mahsoub Helmi Soliman

Group: B1
Date: 15th December 2021
I.D: 130200
Supervised By: Dr. Ehab A. Abo Ali

1. Abstract:
Studying medicine does not only mean obtaining scientific information, but actually means making the student
a person who is able to employ that information in a practical and applied manner, so that he can apply it to
patients in a way that ensures the provision of comprehensive health care in the required form. This was what
we did from a visit to the health care center to see and apply what we learned during this block of information
about the services provided by these health centers and assessing their quality. These services are among the
most important basics that should be present in the health system. That visit was to Al-Sheraa (505) primary
health care center located in Al-Sheraa district in Jeddah, KSA. Through that visit, it became clear to us that Al-
Sheraa Center is providing primary health services in an appropriate and correct manner, and each of the work
members is doing what they should do perfectly. This included the appropriate way to deal with vaccinations
and how to preserve them, as well as providing distinguished care for mother and child, but there were some
observations as there are no activities for health offices.
2. Introduction and Objectives:
Primary health care (PHC) is the essential health care responded to almost 80% of the community needs and
provided at the first contact between the community and the health care provider based on methods and
technology that are socially acceptable, scientifically sound, and accessible universally to individuals and their
families at a cost that the community and country can stand. Health services are provided by newly graduated
general practitioners and qualified physicians through health facilities. The octagon elements of (PHC) include
Promotive, Preventive, and Curative elements. Health education, proper nutrition and food supply, and
provision of a complete maternal and child health care, are the main promotive elements. Immunization of
children against main infectious diseases, prevention and control of locally prevalent diseases, adequate safe
water supply, and basic sanitation, are the main preventive elements. Appropriate treatment of common
illnesses and wounds, and providing of necessary drugs, are the main curative elements. PHCCs decrease the
load of individuals at secondary and tertiary health facilities.
The main objectives of our visit include; Watching the activities and services provided by the Primary Health
Care Center and linking them to what we have learned in the scientific material and comparing them with the
internationally established specifications that should characterize those services, and evaluating them
accordingly. These services include a healthy baby clinic for children under the age of five years, immunization
room, maternity clinic and birth control, health offices, and outpatient clinics.
3. Methodology:
As mentioned previously, the aim of these visits that we have undertaken is
to link and compare what we have learned during this block (M-3_3d block -
PHC) of the importance of services and activities provided by health care
centers and the way they are properly provided, with what is realistically
provided in these centers, and seeking to improve them in the future. We
made two visits to Al-Sheraa Health Center (505) located in Al-Sheraa
district in the city of Jeddah [Figure 1, 2]. The duration of each of them was
three hours (from 9 A.M to 12 P.M); the first visit was on Wednesday,
December8, 2021, and the second On Wednesday, December15, 2021.
Figure 1: Al-Sheraa main building

When we went on the first visit as a group of 13 students (Group B1) we

were very excited as it is our first time to visit a health center and it is an
activity outside the college. When we entered the center, our group leader
spoke with the administrator of the center and confirmed to him the
formality of our attendance as students from Batterjee medical College with
their prior approval. After that we asked the administrator to direct us to the clinics we were asked to visit, he

was very cooperative with us as he was with us step by step introducing us to doctors and guiding us. We
visited all clinics, but Al-Sheraa Center does not have a health office. In each clinic, the working members of
the doctors and nurses were very cooperative and gave their best in order for us to benefit. However, due to the
presence of a large number of patients, we could not enter the clinics while the patients were inside, which was
also due to the precautionary measures taken due to the pandemic, so we were also divided into three groups,
five students, four students, and other four students. On the second visit, we learned more details about
vaccinations in the vaccination clinic, how to store them and their cold chain.
Figure 2: location by Google maps.

We took a quick tour of the rest of the clinics, but due to the presence of a large number of patients, we could
not take many details about the rest of the clinics. We took a look at the safety procedures and the emergency
exit.
4. Results:
At the end of these visits, it became clear to me the importance and role of primary health care in covering the
greater part of the community's health needs. It was one of the best that I saw that the service providers there are
doing their best to provide care and services to the fullest. Indeed, it was one of the most beautiful activities we
did, as we benefited a lot and learned more, and this was only possible with the cooperation and effort of the
workers there. Below are the details of my visits:
At the vaccination room:
This was the first clinic we entered, accompanied by the
manager, where he asked the nurse who was there to cooperate
with us and answer our inquiries and he introduced us to her.
Our main questions in this station were about how to store
vaccinations and the appropriate way to store them in the cold
chain, as well as about the application of different types of
compulsory vaccinations.
At the beginning, the nurse mentioned to us the way to put the
refrigerator in the room and the measures taken to preserve the Figure 3: 2 refrigerators.
vaccinations in the correct manner, as there were two
refrigerators to preserve the vaccinations [Figure 3] with a
good distance between them and the walls (10cm) and between
them and each other (15cm). She also mentioned that the
vaccinations are kept in the refrigerator at a temperature of 8-
2°C. There is a device at the top of the refrigerator body to
measure the temperature and it is checked twice a day, at the
beginning of work in the morning and in the afternoon, and the
temperature is recorded when inspected daily. One of the
refrigerators has a recording tool and one of them does not, and
the temperature is recorded on a paper, [Figure 4]. The nurse,
when asked about the way to organize the vaccinations inside
the refrigerator, she mentioned that they put each vaccination
according to its need for cold. Vaccines that need high cold, Figure 4: Sheet indicating order of
such as the triple bacterial vaccination and the triple viral vaccine arrangement, above is a device
recording the temperatures.
vaccination, are placed in the upper shelves. There is a small
distance between the vaccinations to ensure proper access to the
cold. The frequently used vaccinations are located at the front of the shelves. Some vaccinations are very
sensitive to light, so the refrigerator light is closed. Some vaccinations have an indicator that changes
color depending on the change in temperature.[Figure 5] The vaccinations required for use are taken out
daily at the beginning of the day from the refrigerator and placed in the ice pack in a way that ensures
the arrival of the required cold,[Figure 6]. Children under five years of age are obligated to be
vaccinated according to Immunization schedule approved by the Ministry of Health, [Figure 7].

At the Child Health Clinic:

This clinic is located next to the vaccination clinic in the same

Figure 7: MOH-Approved immunization Figure 6: Vaccine vials cold

boxes.

room. The doctor told us the reason for this, which is that the
Figure 8: Tools used to measure growth
child must pass the clinic of the healthy child to ensure his parameters with related growth charts
health condition before giving him the vaccination. The
focus of our questions to the doctor present there was about
methods and tools for monitoring and following up on the
child, and about the most important diseases or problems that
occur to children at this age (under five years old) and how
to control and deal with them. The doctor mentioned to us
that it is necessary to determine the growth rate of the
children every time they come for periodic follow-up, by
measuring the mass, height, head circumference and other
parameters, and then placing them on the growth chart.
Figure 9: Denver’s chart
[Figure 8]. There is also a test called the Denver test, which
measures the stages of a child's development in the first five
years to ensure the continuation of healthy growth so that they ask the parents some questions and the
child does some things and then compare them with the Denver chart [Figure 9]. The doctor indicated
that they do not deal with major problems and diseases in children, but on the contrary, this is a clinic to
follow up on a healthy child, but when there is a problem with the child, he is referred directly to King
Abdullah Hospital. However, some minor or chronic diseases are followed up and dealt with in the
clinic, such as children who have nutritional problems or suffer from diabetes
or hypertension.
In the Clinic for Maternal Care:
In this clinic, our inquiries were about the services they provide to the mother
in the antenatal period, as well as about methods of birth control. The doctor
who was there told us that the first thing they offer to the mother on the first
visit is to make a record book [Figure 10] of her and take a history from her,
 as well as measuring the vital signs with the mobile composite device [Figure 11], then the pregnancy,
fetus, and the expected birth day, are examined through the ultrasound device [Figure 12]. And then the
heart sounds of the fetus are measured using a Doppler device [Figure 13] to check his health. None of
the methods of birth control are available at this center.
At the Outpatient
Clinic:
Because it is the most
busy clinic with patients,
we were unable to meet a
doctor inside the clinic,
but there was an empty
clinic that did not have a
[Figure14]: inside the clinic.

doctor, so we asked the director to take a look at it [Figure14], and he told us that the most important
thing offered in this clinic is the treatment of simple diseases present in the local region that can be
controlled in the center such as minor wounds, diabetes,
hypertension, general cold, etc.
When we asked about the activities of the health office:
The administrator replied that the activities of the health office,
such as registration of births and deaths, and environmental
sanitation, are not done in this center.

5. Quality of Provided Services (in relation to the expected):

Technical Performance:
Starting from receiving people in the center and providing the appropriate services, through the
professional storage of vaccines and medicines, and through the provision of maternal and child care,
and general care for the local community; All of this was provided according to the basic rules stipulated
by international health organizations.
Effectiveness of Care:
During our exit from the center, I spoke with two patients about their level of satisfaction with the
services provided by the center. Their response was impressive about the quality of service and follow-
up at the center. They mentioned that one of the most important factors that helped in this is that the
center's employees are doing their best to provide health care, this was in support of what we saw as an
effective care for the community.
Efficiency of Service Delivery:
What we have seen of the quality of the services provided and the keenness to provide a high level of
care, indicates the good management of the exploitation of the cost set for providing those services. This
can only be continued by permanent evaluation and comparison between the cost and the desired
outputs.
Safety:
Taking appropriate measures for safety is one of the most important
features that distinguishes and enhances the healthy environment for
both workers and those coming to the center, including what we have
seen of the measures taken to reduce infection, starting from
continuous sterilization and keenness to wear a mask, especially in the
circumstances of the pandemic, and even taking caution when
throwing medical waste so that It is placed in the designated place
 [Figure 14]. As well as the procedures in place to reduce the injury of fires and wounds - the presence
of fire extinguishers with regulations and instructions on preparing for emergency situations [Figure
15].
Access to Services:
Among the factors that help make the services provided by Al-Sheraa
Center (505) for primary health care - accessible to the community are
as follows: The geographical location of the center as it is located
close to a large number of residents, which enhances its ease of access,
Also, the organization within the center of making appointments,
organizing visits, and coordinating between the number of available
doctors and patients is one of the most important things that help
facilitate the access of services to the largest number of patients.
Noting that it is a governmental center that provides services to all

economic groups of society without large costs. Since the staff there [Figure 15]: extinguishers and
emergency evacuation plan.
are of different nationalities, there are no barriers in understanding
languages between staff and patients.
Interpersonal Relations:
Interpersonal relations are among the most important features of the employees of this center, as they
take into account the rights of patients in terms of safety and privacy, as well as give sympathy to
patients in an optimal way. The trust is very great between them and the ease of communication also,
where respect is given in a distinctive way.

Physical Infrastructure:
The good shape and cleanliness of the place is one of the most important things that give the recipient of

the service an initial impression about the extent to which they can receive adequate health care. This is
one of the most important characteristics of Al-Sheraa Health Center building, where the workers

constantly keep the place clean and well-groomed. Also a lot of privacy tools can be seen easily in this
center as it provides a great deal of convenience to clients.

6- Summary and Conclusion:

In this visit, I benefited from a lot of information about the appropriate ways to provide primary health care, not
only about the mechanism of its provision, but also about how to deal with work personnel, patients, and
followers, and the appropriateness of what I should say to the person in front of me. Indeed, it was a beautiful
experience as we witnessed how the primary care service can be received optimally in Al-Sheraa Health Center,
starting with keeping vaccinations in an appropriate manner, passing through periodic follow-up of the child,
and ending with providing care to the mother in the antenatal stage, as well as managing minor diseases in

outpatient clinics. As a conclusion, in order to provide a high level of services, it is necessary to work hard
behind achieving the characteristics leading to reaching that level. At the end, I would like to express my
sincere thanks and gratitude to everyone who contributed to giving us the opportunity to practice this
experience.