Iraq Healthcare System During the First Year of Covid-19 Pandemic

Abstract

Background: The year 2020 witnessed the rapid spread of covid-19 pandemic in Iraq and in almost all the countries in the world. This spread has created a serious health crises and a public health emergency in Iraq and throughout the world. Throughout the world, healthcare systems have been negatively influenced by the pandemic and experienced unexpected changes. We have previously provided several descriptions of the Iraq health care system from its evolution. However, little is known about the health care system in Iraq during the first year of the coves pandemic. The aim of this paper is provide a description of the healthcare system in Iraq during the year 2020, the first year of covid-19 global pandemic. Materials and Methods: The available unpublished and published data about the Iraqi healthcare system during the first year of covid-19 pandemic, the year 2020 were examined. The data included more than 100 relevant unpublished and published information documents including journal articles, books, official reports of the Iraqi Ministry of Planning and Iraqi Ministry of Health. In addition, relevant useful data available at internet web sites were also reviewed. The available relevant data were classified into categories including; demographic data relevant to healthcare, Data related to covid-19 disease in Iraq, data related to the organizational structure of the healthcare system, data related to national healthcare policies including national healthcare mission, vision, strategic goals and plans, data related to healthcare system financing, data about healthcare services delivery, data about the workforce in the Iraq healthcare system, data related to child health and maternal, data about notifiable infectious disease, data about chronic disorders and the main causes of morbidity and mortality, and data about medical education and healthcare education. Many relevant healthcare data for three provinces (The Kurdish provinces in the north of Iraq) of the eighteen provinces in Iraq were not available in English or Arabic. Results: The population of Iraq in 2020 was estimated at 40.150.174 (20.284.823 males and 19.865.351 females). During the year 2020, 595291 cases of covid-19 disease were registered by the Iraqi Ministry of Health. 12813 (2.15%) patients died and 537841 (90.3%) patients experienced recovery. The organizational structure of the Iraq health system, the backbone of the Iraq healthcare system witnessed no important change from the description before covid-19 global pandemic in 2019. The declared mission and vision of the Iraqi Ministry of Health for the year 2020 were the same mission and vision of the Iraqi Ministry of Health that were declared in 2018. In 2020, the Iraqi Ministry of Health declared a strategic plan which included a vision and mission statements for the health information system. The first year of covid-19 pandemic in Iraq was not associated with an important increase in the number of primary healthcare centers. However, there was little increase in the number of governmental hospitals. Surprisingly, the bed occupancy rate of governmental hospitals during the first year of the pandemic was lower than the bed occupancy rate during the two years before the pandemic. The total number of hospitalized patients in 2020 was lower than the previous four years, but the mortality rate per 1000 hospitalized patients was significantly higher in 2020 than the previous four years. Conclusion: Covid-19 disease in Iraq was associated with a significant mortality during the year 2020. It actually changed the previously reported national mortality pattern as covid-19 has become the second most common cause of death in Iraq. Contradictory, to the general belief that mortality associated with covid-19 disease was generally restricted to the older age groups, 117 children under the age of ten years died because of covid-19 disease in 2020. This number of childhood deaths suggests the need to consider vaccination of the younger age groups and to perform the relevant research. Covid-19 disease has emerged as a new notifiable infectious disease in Iraq and throughout the world; therefore, it changed the pattern of notifiable infectious diseases in Iraq.