Cultura

The Interdependent Role of Health Workers in Improving Population Health

VOLUME 23, 2026

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Mohammad Yaqoub Al-Thani, Osama Saleh Alsheikh, Omar Saeed Alghamdi, Taraq Hassan Alshehri, Abdullah Aysh Alharthi, Abrar Jamal Kamal, Abdulrahman Ahmed Alhamed
Reman Omar Soilmani, Daliyah Abdullatif Alrajhi, Sultan Nahar Suliman Alanazi, Mohammad Faisal Mulla, Malek Mohammed Mathkur, Abdullah Fahad Alqifari

Abstract

Consider a rapidly developing city in the Middle East, such as Doha, where urban and economic growth has led to a surge in population and a corresponding increase in medical demand. For instance, at the Al Wakra Health Center, a model of workforce integration has been implemented to cope with these challenges. In this clinic, integrated teams of health workers, including physicians, nurses, and community health practitioners, collaborate to manage chronic diseases and advocate for preventive care. This scenario not only highlights the complexities and opportunities faced by the health system but also underscores how these systems are seen as complex, adaptive networks formed by interactions among health workers, institutions, populations, and governance structures. The role of health workers extends beyond individual clinical encounters to include health system resilience, improvement of population health outcomes, and cultivation of social trust. The purpose of this article is to argue that the effectiveness of health systems depends fundamentally on the interdependent roles of health workers, whose organization and integration into adaptable teams directly influence public health outcomes. Specifically, the thesis advanced here is that advancing general health requires moving from isolated, profession-specific approaches to integrated workforce ecosystems that intentionally coordinate human capital, institutional design, and population needs. By drawing on international evidence, with a focus on health systems in fast-developing, centrally governed Middle Eastern settings, the discussion will illustrate how workforce dynamics shape preventive care, chronic disease management, and health equity.

Keywords : General health, health workforce, population health, health systems, multidisciplinary care, workforce integration.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty