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Background: Different studies have identified the prognostic factors of COVID-19 infection. These studies have revealed that COVID-19 infection is more severe in males than in females. The aim of our study was to compare the severity of COVID-19 infection between males and females in terms of clinical, biological, radiological, and evolutionary aspects. Methodology: This is a cross-sectional observational study conducted in patients hospitalized with COVID-19 infection over a 6-month period from 1 August 2021 to 1 February 2022. Results: The comparison of clinical, biological, radiological, and evolutionary severity factors of covid-19 infection between the two sexes revealed that this infection was more severe in males. Statistically significant differences were noted for the rate of high dimers (p =0.01) and for lung involvement greater than 25% on chest CT (Computed tomography) (p =0.008). Conclusion: The severity of covid-19 infection in men is due to biological differences between men and women in the renin-angiotensin system, the immune system, genetics, and sex hormones. Further research into the pathophysiological mechanisms behind this finding is needed.

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BACKGROUND: Health promotion (HP) is one of the key skills that every general practitioner (GP) should have, according to The World Organization of Family Doctors, but for several reasons, his practice remains insufficient. However, a gap would exist between the GPs' knowledge and their practices about HP. The aims of our study were to explore GPs' perceptions, knowledge, and practices in Morocco about HP and identify their barriers and needs to best practice HP actions. MATERIALS AND METHODS: A qualitative case study was conducted among GPs, via semi-structured interviews following an interview guide. Purposive and snowball sampling were used to select our sample. It contained four themes, perceptions, practices, barriers and needs, and proposals for improvement. The interviews were recorded and then transcribed. Thematic content data analysis was done manually. Favorable ethical approval was obtained from the local ethics committee. RESULTS: Fourteen GPs participated in this study. The sex ratio was at one. GPs' practices were focused on the biomedical model with wide confusion of HP with prevention and therapeutic education. Their roles in HP were considered paramount. The number of patients during consultations, structures' care, and knowledge were the main barriers. The main cited needs were material resources and HP training. CONCLUSION: Our study has made it possible to make an inventory of the practice of HP in Morocco. Participants' practices were based on the curative aspect. There is a crucial need to implement continuing and contextualized training for general practitioners to strengthen their skills in HP. This training will help to succeed in the health-promoting hospital's strategy.

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BACKGROUND: The series of population-based studies conducted by the Global Campaign against Headache has, so far, included Pakistan and Saudi Arabia from the Eastern Mediterranean Region. The Maghreb countries of North Africa, also part of this Region, are geographically apart and culturally very different from these countries. Here we report a study in Morocco. METHODS: We applied the standardised methodology of Global Campaign studies, with cluster-randomized sampling in regions of Morocco selected to be representative of its diversities. In three of these regions, in accordance with this methodology, we made unannounced visits to randomly selected households and, from each, interviewed one randomly selected adult member (aged 18-65 years) using the HARDSHIP structured questionnaire translated into Moroccan Arabic and French. In a fourth region (Fès), because permission for such sampling was not given by the administrative authority, people were randomly stopped in streets and markets and, when willing, interviewed using the same questionnaire. This was a major protocol violation. RESULTS: We included 3,474 participants, 1,074 (41.7%) from Agadir, 1,079 (41.9%) from Marrakech, 422 (16.4%) from Tétouan and 899 from Fès. In a second protocol violation, interviewers failed to record the non-participating proportion. In the main analysis, excluding Fès, observed 1-year prevalence of any headache was 80.1% among females, 68.2% among males. Observed 1-day prevalence (headache yesterday) was 17.8%. After adjustment for age and gender, migraine prevalence was 30.8% (higher among females [aOR = 1.6]) and TTH prevalence 32.1% (lower among females [aOR = 0.8]). Headache on ≥ 15 days/month (H15+) was very common (10.5%), and in more than half of cases (5.9%) associated with acute medication overuse (on ≥ 15 days/month) and accordingly diagnosed as probable medication-overuse headache (pMOH). Both pMOH (aOR = 2.6) and other H15+ (aOR = 1.9) were more common among females. In the Fès sample, adjusted prevalences were similar, numerically but not significantly higher except for other H15+. CONCLUSIONS: While the 1-year prevalence of headache among adults in Morocco is similar to that of many other countries, migraine on the evidence here is at the upper end of the global range, but not outside it. H15 + and pMOH are very prevalent, contributing to the high one-day prevalence of headache.

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Introduction: Clinical supervision is crucial to establish a learning climate in which the supervisor guides the supervised. Clinical supervisors might have numerous barriers and motivations. Our study aimed to explore the clinical supervision practices among general practitioners and to describe their motivations, barriers, and needs. Methods: A qualitative study was conducted using purposive sampling which is a non-probabilistic sampling method. The population was the general practitioners who were working at the primary health care centers either in the public or the private sectors (N=16). Individual semi-structured interviews were conducted by two authors, using an interview guide. All interviews were recorded, transcribed, and coded. A thematic content analysis was done manually based on an inductive approach. Results: Sixteen general practitioners participated. Three main themes emerged from the study: 1) General practitioners' practices in clinical supervision, 2) the enablers to adequate clinical supervision in general practice, and 3) the general practitioners' fundamental barriers and needs in clinical supervision. Despite their lack of clinical supervision training, they could describe the different clinical supervision steps without giving their exact names. We found that their teaching skills must be reinforced. General practitioners were mainly motivated by personal and professional interests as well as moral obligations. Numerous barriers and needs were identified at the organizational, relational, and financial levels. The principles barriers and needs were the lack of clinical supervision training, lack of equipment, and remuneration. Conclusion: The current study highlighted the motivations and challenges of general practitioners concerning clinical supervision. These results are helpful for all responsible institutions involved in clinical supervision and upcoming programs in Morocco.

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Background: The recent expansion of genomic biobank research in the Arab region in the Middle East North Africa has raised complex ethical and regulatory issues. However, there is a lack of studies regarding the views of Arab researchers involved in such research. We aimed to assess the perceptions and attitudes of Arab researchers regarding these issues in biobank research. Methods: We developed a questionnaire to assess the perceptions and attitudes regarding genetic research of researchers from Egypt, Sudan, Morocco, and Jordan. The questionnaire requested demographic data, perceptions, and attitudes regarding the collection, storage, and use of biospecimens and data, the use of broad consent, data security, data sharing, and community engagement. We used multiple linear regressions to identify predictors of perceptions and attitudes. Results: We recruited 383 researchers. Researchers favored equally the use of broad and tiered consent (44.1% and 39.1%, respectively). Most respondents agreed with the importance of confidentiality protections to ensure data security (91.8%). However, lower percentages were seen regarding the importance of community engagement (64.5%), data sharing with national colleagues and international partners (60.9% and 41.1%, respectively), and biospecimen sharing with national colleagues and international partners (59.9% and 36.2%, respectively). Investigators were evenly split on whether the return of individual research results should depend on the availability or not of a medical intervention that can be offered to address the genetic anomaly (47.5% and 46.4%, respectively). Predictors of attitudes toward biospecimen research included serving on Research Ethics Committees, prior research ethics training, and affiliation with nonacademic institutions. Conclusions: We recommend further exploratory research with researchers regarding the importance of community engagement and to address their concerns about data sharing, with researchers within and outside their countries.

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OBJECTIVE: To adapt the Primary Primary Care Assessment Tool-Adult Edition into the Moroccan Arabic dialect and to assess its reliability and validity from the perspective of Moroccan adult patients. METHOD: A committee of experts carried out the cross-cultural adaptation of the Primary Care Assessment Tool. The adapted questionnaire was subject to forward and backward translation and a pilot study. Exploratory factor analysis assessed the internal consistency, reliability, and construct validity of items and scales. Finally, descriptive statistics were performed on the final factor structure. RESULTS: A 43-item Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition was developed. It consisted of six multi-item scales that represented the four main dimensions of primary care: first contact, continuity, comprehensiveness, and coordination. Four derived dimensions were included: cultural competence, communication, advice, and community orientation. All six scales demonstrated robust internal consistency, item-total solid correlations, and construct validity. The calculated Cronbach's alpha coefficients ranged from 0.78 to 0.90. CONCLUSIONS: Comprehensive metric analyses supported the reliability and validity of the Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition in assessing core primary care domains from the patients' experience. This tool could be used for future research on primary care in Morocco.

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Healthcare professionals (HCPs) are indispensable for improving the availability and quality of healthcare services. Therefore, the present cross-sectional study aimed to measure the job satisfaction of HCPs working in primary care (PC) centers in Marrakech, according to the job satisfaction scale. Using census sampling, this study involved HCPs working in PC centers. Data were collected using an electronic questionnaire and analyzes were performed using Jamovi (version 1.6). The Warr-Cook-Wall scale was used to assess the satisfaction of these professionals. Student's t-test, Kruskal-Wallis test and Mann-Whitney non-parametric tests were used for group comparisons (p < 0.05). The lowest satisfaction scores were recorded for general practitioners (GPs) and nurses. These were work safety (1.54 ± 0.85 vs. 1.51 ± 0.82), salary (1.58 ± 0.79 vs. 1.72 ± 0.87), chance of promotion (1.68 ± 0.87 vs. 1.80 ± 0.93), possibility of using its capacities (1.90 ± 1.04 vs. 2.01 ± 1.08), and workload (1.88 ± 1.10 vs. 2.05 ± 1.06). A statistically significant difference was observed between different professional statuses regarding facility management (p = 0.049). The overall job satisfaction of HCPs was low, especially among GPs and nurses: the scores for intrinsic job satisfaction with respect to sociodemographic characteristics were low, whereas they were medium for extrinsic job satisfaction. Further research is warranted to clarify the intrinsic and extrinsic factors of job satisfaction in Morocco's healthcare sector.

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Background: Health promotion (HP) is a part of the general practitioners' (GPs) competencies defined by the World Organization of Family Doctors. The implementation of HP in their practice is unsatisfactory. Aims: The aim of this study was to explore GPs knowledge, attitudes and practices in Morocco about HP at the primary healthcare services. Methods: A cross-sectional study was conducted using an online self-administrated questionnaire including, knowledge, attitudes and practices of GPs toward HP. Descriptive and bivariate analyses were conducted. Results: Two hundred and forty GPs responded to our questionnaires, the sex ratio was 1.12 with an average age of 40.46 ± 9.05 years. More than half of our participants perceived HP as a concept indistinct from prevention, 70.4% believed that HP refers to the biomedical model. On a Likert scale of 1-5, the level of HP knowledge was 2.71 ± 1.13. The most discussed topics with the population were tobacco, alcohol, overweight and obesity. Statistically significant association was found between the competencies of GPs in lifestyle behaviours and the practice of this competence. Conclusion: The knowledge of GPs remains insufficient, and their practices focus more on the areas in which they feel competent, which requires the implementation of specific training for the development of GPs skills in HP.

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INTRODUCTION: Improving access to sexual and reproductive health remains a public health challenge, especially for women, whose access is affected by several determinants, such as gender inequality, which is the underlying barrier to all other determinants. Many actions have been carried out, but much remains to be done before all women and girls can exercise their rights. This study aimed to explore how gender norms influence access to sexual and reproductive health services. METHOD: A qualitative study was conducted from November 2021 to July 2022. The inclusion criteria were women and men aged over 18 years old, living in the urban and rural areas of the Marrakech-Safi region in Morocco. A purposive sampling method was used to select participants. Data were obtained through semi-structured interviews and focus groups with selected participants. The data were coded and classified using thematic content analysis. RESULTS: The study highlighted inequitable, restrictive gender norms that lead to stigmatization and affect the sexual and reproductive healthcare-seeking behavior and access of girls and women in the Marrakech-Safi region. These most common gender norms for women include parental refusal, stigmatization, and social exclusion of girls from sexual and reproductive health education services; strong decision-making power of family members over contraceptive use and women's adherence to pregnancy monitoring and access to supervised delivery; and culturally constructed role allocation, assigning a reproductive role to women and making them responsible for the health of new-borns. CONCLUSION: Sexual and reproductive health projects must strive to be gender sensitive. Gender-blind projects are missed opportunities to improve health outcomes and advance gender equality.

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Objective: To adapt the Primary Primary Care Assessment Tool-Adult Edition into the Moroccan Arabic dialect and to assess its reliability and validity from the perspective of Moroccan adult patients. Method: A committee of experts carried out the cross-cultural adaptation of the Primary Care Assessment Tool. The adapted questionnaire was subject to forward and backward translation and a pilot study. Exploratory factor analysis assessed the internal consistency, reliability, and construct validity of items and scales. Finally, descriptive statistics were performed on the final factor structure. Results: A 43-item Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition was developed. It consisted of six multi-item scales that represented the four main dimensions of primary care: first contact, continuity, comprehensiveness, and coordination. Four derived dimensions were included: cultural competence, communication, advice, and community orientation. All six scales demonstrated robust internal consistency, item-total solid correlations, and construct validity. The calculated Cronbach's alpha coefficients ranged from 0.78 to 0.90. Conclusions: Comprehensive metric analyses supported the reliability and validity of the Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition in assessing core primary care domains from the patients’ experience. This tool could be used for future research on primary care in Morocco.(AU)

Objetivo: Adaptar la Herramienta de Evaluación de Atención Primaria para Adultos al dialecto árabe marroquí y evaluar su fiabilidad y validez desde la perspectiva de pacientes adultos marroquíes. Método: Un comité de expertos realizó la adaptación transcultural de la Herramienta de Evaluación de Atención Primaria. El cuestionario adaptado fue sometido a traducción directa e inversa y a un estudio piloto. El análisis factorial exploratorio evaluó la consistencia interna, la fiabilidad y la validez de constructo de los ítems y escalas. Finalmente, se realizaron estadísticas descriptivas sobre la estructura factorial final. Resultados: Se elaboró una versión en dialecto árabe marroquí de 43 ítems de la Herramienta de Evaluación de Atención Primaria para Adultos. Consiste en seis escalas de múltiples ítems que representan las cuatro dimensiones principales de la atención primaria: primer contacto, continuidad, integralidad y coordinación. Se incluyeron cuatro dimensiones derivadas: competencia cultural, comunicación, consejo y orientación comunitaria. Las seis escalas demuestran una sólida consistencia interna, correlaciones totales sólidas de ítems y validez de constructo. Los coeficientes alfa de Cronbach calculados variaron de 0,78 a 0,90. Conclusiones: Los análisis métricos exhaustivos respaldan la confiabilidad y la validez de la versión en dialecto árabe marroquí del Instrumento de Evaluación de Atención Primaria Edición para Adultos al evaluar los dominios centrales de la atención primaria desde la experiencia de los pacientes. Esta herramienta podría ser utilizada para investigaciones futuras sobre la atención primaria en Marruecos.(AU)

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Background: Tuberculosis is a major public health problem worldwide, and in Morocco, it is the leading cause of hospitalization in the Pneumology department. Hospitalized patients are often accompanied by family members who primarily act as caregivers. This study aimed to describe the knowledge related to the disease among the companions of tuberculosis patients hospitalized in the pneumology department of Hassan II Hospital in Agadir, Morocco. Methodology: We conducted a cross-sectional observational study with the objective of evaluating the knowledge of the companions of tuberculosis patients. Results: One hundred companions participated in this study, with an average age of 33.8 +/- 10.1. The male-to-female sex ratio was 1.5. More than half of our participants had a low socio-economic level, and over a third were illiterate. Knowledge was assessed through questions related to the disease. Results showed that 82.0% of participants declared that they were aware of the disease called "tuberculosis," and 46.0% knew about its infectious origin. Almost all of them were aware of the contagious nature of the disease and its airborne transmission. Schooling was found to be associated with knowledge of the disease, its infectious nature, contagiousness, and free treatment. The associations were statistically significant with p-values of <0.001, 0.004, <0.001, and 0.002, respectively. Conclusion: The low level of schooling appears to be a hindrance to TB education. This observation could explain the very poor level of knowledge found in our study, despite the efforts made by various programs.

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Background: This study aims to describe the knowledge, attitudes, and practices of cancer patients and their relatives regarding the COVID-19 pandemic in Morocco. Methods: A self-administered online questionnaire was administrated to 133 adults aged 19 to 70 years old, including 32 cancer patients and 101 people from the relatives of cancer patients. Results: The participants showed a very good level of knowledge (cancer patients (84.6%), relatives (82.7%)) and practice (cancer patients (96.0%), relatives (85%)) regarding covid-19. . A very large proportion of cancer patients (84.4%) were very worried about the virus, compared with only 52.5% of relatives. They were concerned about the potential risk of infection and felt personally exposed (93.8%) to serious complications from COVID-19. The knowledge, attitudes and practices score were significantly associated with age (p=0,018), sex (p=0.002), professional activity (p=0,036), medical insurance (p=0,009), place of residence (p= 0,017), presence or absence of cancer (p=0,000), and perception of the danger of catching COVID-19 (p=0,041). Conclusions: Although the level of knowledge and practices of cancer patients and relatives was very satisfying, disparities between the two groups were still to be noted. Cancer patients go out less and practice more, despite the impact of confinement on their health.

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BACKGROUND: The COVID-19 pandemic has highlighted the pivotal role of public health. The aim of this study was to explore the perception of public health among medical students and faculty members (teachers). METHODS: A cross-sectional study was conducted at the medical school of Marrakech (FMPM) in May 2020. Data collection regarding the place of public health (during the training and in the practice) was done by electronic questionnaire. The analysis was descriptive and bivariate. RESULTS: 259 responses were received (78.4% were students). The female / male sex ratio = 1.27. Almost 98.5% believed that public health knowledge and experiences were relevant for clinical practice. The main activities that reflect public health were prevention and health promotion (81%), epidemiological surveillance and epidemic management (89.6%) (98.2% among teachers versus 87.2% among students, p = 0.009). During the pandemic, 85.7% of teachers and 77% of students developed an interest in public health (p = 0.196). Only 6.6% were interested in a career in public health. Compared to teachers, students had a positive perception during the pandemic (p = 0.001). CONCLUSION: The results highlight the lack of knowledge about the fields of application despite heightened sensitivity at the onset of the pandemic. Lessons can be learned in terms of improving public health training, raising awareness of the choice of this specialty and actions in favor of better visibility.

Introduction: La pandémie COVID-19 a remis en lumière le rôle pivot de la santé publique. L'objectif de cette étude était d'explorer la perception de la santé publique auprès des étudiants et des enseignants en médecine. Méthodologie: Nous avons mené une étude transversale à la faculté de médecine de Marrakech (FMPM) en Mai 2020. La collecte des données sur la place de la santé publique (dans la formation et sur le terrain) a été par questionnaire électronique. L'analyse était descriptive et bivariée. Résultats: Nous avons reçu 259 réponses (78,4 % étaient des étudiants). Le sexe ratio Femme/homme=1,27. Près de 98,5 % pensaient que les connaissances et les expériences en santé publique sont pertinentes pour la pratique clinique. Les principales activités qui reflètent la santé publique étaient la prévention et la promotion de la santé (81 %), la surveillance épidémiologique et la gestion des épidémies (89,6 %) (98,2 % chez les enseignants contre 87,2 % chez les étudiants, p=0,009). Au cours de la pandémie, 85,7 % des enseignants et 77 % des étudiants ont développé un intérêt pour la santé publique (p=0,196). Seulement 6,6 % étaient intéressés par une carrière en santé publique. Comparés aux enseignants, les étudiants avaient une perception différente positive au cours de la pandémie (p=0,001). Conclusion: Les résultats mettent en exergue la méconnaissance des champs d'application de la santé publique malgré un intérêt à l'avènement de la pandémie. Des enseignements sont à tirer en termes d'amélioration de la formation de la santé publique, la sensibilisation au choix de cette spécialité et d'actions en faveur d'une meilleure visibilité.

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Population-based genomics studies have proven successful in identifying genetic variants associated with diseases. High-quality biospecimens linked with informative health data from diverse segments of the population have made such research possible. However, the success of biobank research depends on the willingness of the public to participate in this type of research. We aimed to explore the factors associated with the willingness of the public to participate in biobank research from four low- and middle-income countries in the Arab region (Egypt, Jordan, Morocco, and Sudan). We used a previously validated questionnaire to assess several constructs that included the public's perceptions, attitudes, and willingness to participate in biobank research. We recruited 967 participants. More than half did not have prior awareness of biobanks. Participants' willingness to donate biospecimens and health data was less than 10%. Our results also showed that participants harbored concerns with trust, privacy, and with data-sharing involving international researchers. Predictors of willingness to participate in biobank research included no previous involvement in research and positive attitudes toward biobanks. Finally, our study showed several differences between the four countries regarding several of the investigated constructs. We conclude there should be additional efforts to raise public awareness and enhance perceptions of the public in biobanking research to enhance trust. We further recommend qualitative research to explore the underlying factors that contribute to the public's concerns with international data sharing that would enhance global health.

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Introduction: Since the COVID-19, changes have occurred for the Moroccan medical students, which represent a vulnerable population. Coping with this situation could be difficult. Our objective was to estimate and understand the psychosocial barriers to the medical students' well-being at the Faculty of Medicine and Pharmacy of Marrakesh (FMPM) by evaluating their coping strategies, difficulties and needs. Methods: We conducted a mixed method study among pre-graduate medical students. For the quantitative part, we did a cross-sectional study using an online four-part self-administered questionnaire. We compared Likert scales of perceived well-being before and one year after the lockdown. The scales ranged from 0 (very low state of well-being) to 10 (complete state of well-being). Coping strategies were assessed by the Brief-COPE questionnaire. The qualitative perspective was a case-study with semi-structured interviews using an interview guide based on the literature review. Finally, a one-phase triangulation analysis, underlined by a convergence model, was done. Results: We had 355 participants for the quantitative part (participation rate of 16.6%). The mean age was 19.2±1.6. The female/male sex ratio was 1.8. The first cycle students represented 76%. The well-being mean state was better before than after the pandemic (7.8 vs 5.4; p<0.001). The main coping strategy was the acceptance of the situation (5.8±1.7). According to the students, their principal need for promoting their well-being at the faculty was having courses about technologies for studies (89.3%). For the qualitative part, we interviewed 16 students. Thirteen had a decline of their well-being after the lockdown. Isolation and adaptation to e-learning were the principal difficulties. However, mainly, they adopted engaging in coping strategies. Conclusion: The medical students' well-being decreased since the COVID-19 pandemic. Students adopting coping strategies were in the best well-being state. Psychosocial and solution-based measures should be put in place at the FMPM to foster the students' well-being.

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Introduction: COVID-19 pandemic has put unprecedented pressures on obstetrics and gynecology care services. Maternity hospitals have needed to rapidly prepare to provide quality care while preventing the transmission of the infection. The purpose of this study is to describe the key elements of the response to COVID-19 within the maternity ward of the Mohammed VI University Hospital in Marrakech. Methods: a case study was conducted. Data were collected using various administrative documents related to activities in the maternity ward of the Mohammed VI University Hospital during the COVID-19 pandemic. We also conducted semi-structured interviews with professionals at the maternity ward. Qualitative thematic analysis approach was used for the analysis of transcribed data and triangulation, with the analysis of documentary data. Results: the study highlighted phases of design and organization of two maternity ward access circuits. A new circuit for suspicious or confirmed cases of COVID-19 ensured access to quality care for patients, by guaranteeing isolation measures. The access circuit that was commonly used remained functional to consolidate the right of access to tertiary obstetrics and gynecology care while applying protective measures against COVID-19. Conclusion: this study highlights the necessity to draw on the experience of other health facilities, to contextualize local activities and to anticipate work organization in the face of health crises.

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Context: On 30 January, 2020, WHO stated that the global COVID-19 epidemic is a public health emergency. Facing this critical situation, health-care workers were at risk of developing psychological distress and other mental health problems. Aims: This study seeks to explore the feelings, attitudes and perceptions of the COVID-19 pandemic among physicians in pre-graduate and post-graduate training from Marrakesh University Hospital Centre. Methods and Material:We conducted a cross-sectional study with internal and resident-physicians in May 2020. Data collection was based on a self-administered electronic questionnaire. The sociodemographic informations, pandemic impact on the occupational and social fields and stress factors were evaluated. Statistical significance was set at p < 0.05. Results: The number of participants was 74. The sex ratio was 1.4 with an average age of 26.1 ± 3.6 years. Two-thirds were directly involved in the management of patients with SARS-CoV2. The majority reported that their work puts them at high-risk of exposure to SARS-CoV2 and 66% felt stressed at work, female physicians were more stressed than men (p = 0.028). Not knowing when the pandemic will be under control and the risk of developing an infection with SARS-CoV2 were the main sources of stress. About motivators for similar situations, respondents emphasized family support (91.9%) and recognition by management and supervisors for the additional efforts they provide (83.8%). Conclusions: The protection of health-care workers is an important component of public health measures to combat this pandemic. Special interventions to promote health-care workers mental well-being must be implemented immediately.

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INTRODUCTION: The social accountability (SA) challenges health professional training institutes to reorient their missions to train the graduates aligned with the society's priority needs and produce quality, population centered care. The objective was to assess the knowledge, perceptions, and implementation of SA by nursing education institutions. METHOD: The cross-sectional observational survey was conducted at the Higher Institute of Health Professions and Techniques of Marrakech (ISPITS-M) and its annexes between May 17 and June 4, 2020, using a mixed methodology. The data were collected through an online questionnaire, which was tested with 11 students and teachers. It was completed by 50 teachers and 213 students, recruited on a voluntary basis and was developed based on the literature review, aspects and principles of social accountability. In addition, eight semi-structured interviews were performed with administrative staff recruited by purposive sampling. RESULTS: Out of a total of 924 students and 75 teachers, 213 students and 50 teachers participated in the survey, with a response rate of 23% and 67% simultaneously. The average age was 40.2±8.9 years for the teachers and 19.7±1.3 years for the students. 36% of the students had no knowledge of SA; teachers and leaders had different perceptions and the concreteness of the aspects of SA was low. The students felt they were less prepared in social determinants of health (85%), community lifestyles to be served (85%), outreach care, and frontline work (83%). CONCLUSION: The knowledge of SA is average; there is a need to raise awareness of SA in addition to strengthening training programs and the concretization of actions in this direction.

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Background: Assessing the public perspectives regarding donation of biospecimens to biobanks would be helpful with the establishment of biobanks in the Arab region. Objective: To develop a biobanking questionnaire in Arabic and assess its psychometric properties. Design: Multicenter cross-sectional study. Methods: We used a two-step process for questionnaire development. First, we decided on the important constructs for a questionnaire followed by development of an item pool through review of the scientific literature and published questionnaires. The questionnaire was refined through cognitive interviews and translation. An expert panel assessed content validity. The final questionnaire included five domains: perceptions; aspects important to participation in biobank research; preferences for type of biobank; attitudes toward biobanking; and willingness to participate in biobank research. Second, we distributed the questionnaire to 250 members of the public from Egypt, Jordan, Sudan, and Morocco to assess the questionnaire's psychometric properties, including reliability (internal consistency and Cronbach's alpha) and construct validity (convergent and divergent validity and exploratory factor analysis [EFA]). Results: Internal consistency yielded a range of Cronbach's alpha for the five domains from 0.62 to 0.80. EFA showed a 12-factorial solution. Kaiser-Meyer-Olkin measure of sampling adequacy was 0.907 and Bartlett's test of sphericity was significant (p < 0.005). Attitudes were positively correlated with willingness to donate (r = 0.30; p < 0.001). Conclusions: The final biobank Arabic language questionnaire showed excellent reliability and acceptable validity parameters. The newly developed Arabic questionnaire is the first psychometrically tested tool that can be used in the Arab region to assess the public perspectives on participation in biobanking research.

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In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the "patient journey") with perplexing obstacles.High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary.The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded.It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.

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