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Showing 5 results for Equity

Reza Khadivi,
Volume 17, Issue 0 (12-2024)
Abstract

Over the past few decades, various models have been employed to assess health needs and allocate resources within the health sector. These models include economic approaches based on cost-effectiveness, epidemiological methods using indicators such as disease burden or disparities in health outcomes between socioeconomic groups, and comparative studies between societies or countries. Efficiency and equity are often seen as competing goals in the resource allocation process, making it challenging for health systems to achieve both simultaneously.  Traditional approaches primarily focus on deficiencies and adopt an individualistic perspective. When individuals experience limitations due to disease or disability, the relationship between their health status and social functioning is not always directly linear. Disease and disability inherently tend to widen the gap between individuals and their ability to fulfill normal roles, responsibilities, primary social dependencies, and desired capabilities. The capability approach advocates for respecting the life contexts of individuals and collaborating with them to enhance their skills, assets, and capabilities. Instead of focusing solely on deficiencies and addressing them through resource redistribution, this approach emphasizes empowering individuals to manage their lives with minimal external interference. These capabilities encompass skills that allow individuals to navigate their social, economic, and personal environments effectively. They include:
  • Interpersonal skills for fostering meaningful relationships.
  • Technical skills for managing routine aspects of life.
  • Emotional and psychological resilience to cope with challenges.
  • Purpose-building abilities to find meaning and direction in life.
Such capabilities equip individuals to manage both the normal struggles of everyday life and significant life events. As capabilities are enhanced, individuals gain greater control over their life circumstances, thereby becoming more resilient. The ability to control one’s life world is a fundamental capability. The unequal distribution of this ability forms the foundation of health inequities, as not everyone has the same capacity to exercise such control. Health needs assessments based on the capabilities theory align more closely with the goals of achieving and sustaining equity in healthcare. By focusing on empowering individuals and addressing their life contexts, this approach provides a more holistic and equitable framework for health resource allocation.

Heshmatolah Heydari,
Volume 17, Issue 0 (12-2024)
Abstract

Acquired Immunodeficiency Syndrome (AIDS) is a disease that occurs in the final stage of infection with the Human Immunodeficiency Virus (HIV). According to the World Health Organization (WHO), approximately 39.9 million people were living with HIV worldwide in 2024, with an incidence rate of 1.3 million and a mortality rate of 630,000 globally. In Iran, the prevalence and incidence rates of HIV were reported as 54,000 and 2,400 people, respectively, with a mortality rate of 3,200 annually. Access to healthcare is considered one of the key goals of a health system. The Universal Declaration of Human Rights recognizes the right to health services as a common standard. People living with HIV, as a vulnerable group, may face barriers to accessing healthcare services. This study aims to explore the challenges faced by people living with HIV in accessing equitable healthcare. This qualitative study was conducted using a conventional content analysis approach between April and September 2024 in Iran. Participants included people living with HIV and healthcare providers, who were recruited through purposive sampling. Data were collected through 10 face-to-face interviews and analyzed using the method proposed by Lundman and Graneheim. From the data analysis, 406 initial codes were extracted. These codes were then grouped based on similarities and differences into three main categories:
1.Factors related to clients (with subcategories: fear of transmitting the disease to others, poverty, physical problems, unfamiliarity with their rights, and non-adherence to treatment regimens)
2.Factors related to the healthcare system (with subcategories: discrimination in accessing healthcare services, contemptuous attitudes of healthcare providers, incompetency of healthcare providers, fear of infection by the virus, disclosure of patient information, negligence by medical centers in identifying infected individuals, and failure to conduct premarital testing)
3.Cultural factors (with subcategories: non-acceptance of infected individuals in society, stigma, and discrimination in marriage and childbearing).
The right to access healthcare services, confidentiality of information, the right to marry, financial protection, and active participation in society should be prioritized for people living with HIV.

Peyman Parvizrad,
Volume 17, Issue 0 (12-2024)
Abstract

Healthcare policy-making and national planning are complex processes that require the integration of ethical principles to ensure fairness, effectiveness, and public trust. This qualitative study explores the key ethical considerations that should guide the development and implementation of healthcare policies and plans. A qualitative research design was utilized, incorporating semi-structured interviews with key stakeholders in the healthcare sector, including policymakers, healthcare providers, and patient representatives. A total of 15 interviews were conducted until data saturation was achieved. The interviews were transcribed verbatim and analyzed using thematic analysis. Thematic analysis identified seven key ethical considerations in healthcare policy-making and planning: (1) Equity and Justice – ensuring equitable access to healthcare regardless of socioeconomic status, race, or other demographic factors; (2) Autonomy and Informed Consent – respecting individual autonomy and ensuring informed decision-making in healthcare interventions; (3) Beneficence – prioritizing actions that maximize benefits and minimize harm; (4) Non-Maleficence – preventing harm to patients and communities; (5) Confidentiality and Privacy – safeguarding patient information and ensuring data protection; (6) Resource Allocation – making fair and justifiable decisions regarding the distribution of limited healthcare resources; and (7) Transparency and Accountability – promoting openness in policy decisions and ensuring accountability for outcomes. Ethical considerations play a critical role in shaping healthcare policies and national planning efforts. By integrating ethical principles into decision-making, policymakers and healthcare providers can foster policies that enhance public well-being, equity, and trust in the healthcare system. A structured ethical framework can help ensure that healthcare policies align with societal values and promote justice in health service delivery.

Heshmatolah Heydari,
Volume 17, Issue 0 (12-2024)
Abstract

Acquired Immune Deficiency Syndrome (AIDS) occurs in the final stage of infection with the Human Immunodeficiency Virus (HIV). According to the World Health Organization (WHO), approximately 39.9 million people were living with HIV worldwide as of 2024, with reported global incidence and mortality rates of 1.3 million and 630,000, respectively. In Iran, the prevalence and incidence rates of HIV are reported at 54,000 and 2,400 cases, with an annual mortality rate of 3,200. Access to healthcare is considered a primary goal of the health system, and the Universal Declaration of Human Rights recognizes the right to access health services as a common standard. However, people living with HIV, as a vulnerable group, may face barriers to accessing healthcare services. This study aims to explore the challenges faced by people living with HIV in accessing equitable healthcare. This qualitative study utilized a conventional content analysis approach, conducted between April and September 2024 in Iran. Participants included people living with HIV and healthcare providers, recruited through purposive sampling. Data were collected via 10 face-to-face interviews and analyzed using the method proposed by Lundman and Graneheim. Data analysis revealed 406 initial codes, which were then categorized based on similarities and differences into three main categories: 1) Factors related to clients (with subcategories: fear of transmitting the disease to others, poverty, physical problems, unfamiliarity with self-rights, and non-adherence to treatment regimens). 2) Factors related to the healthcare system (with subcategories: discrimination in access to health services, contemptuous attitudes from healthcare providers, incompetency of healthcare providers, fear of virus transmission, disclosure of patient information, negligence of medical centers in identifying infected people, and failure to conduct premarital tests). 3) Cultural factors (with subcategories: non-acceptance of infected people in the general culture, stigma, and discrimination in marriage and childbearing). The rights to access health services, confidentiality of information, marriage, financial protection, and participation in society should be considered essential for people living with HIV. Addressing these issues is crucial for ensuring that individuals with HIV can live with dignity and equal access to healthcare.

Hakimeh Mostafavi, Efat Mohamadi, Amirhossein Takian, Pr Alireza Olyaeemanesh,
Volume 17, Issue 1 (3-2024)
Abstract

Health inequalities in different populations continue to be the main challenge of health systems; Therefore, it is necessary to address health equity in the developed policies. The study aims to review the studies related to tools and models for assessing the impact of policies on equity in health. This study was conducted as a systematic review to identify the tools and models of assessing the impact of policies on equity in health and the process of assessing health outcomes from 2005 to 09/30/2022 in English and Farsi. National and international databases such as Scopus, PubMed/Medline, and Google Scholar were searched. First, 16901 studies were obtained. After the initial screening, 243 articles entered the abstract review phase. Then, 99 studies entered the phase of studying the text. Finally, 53 studies entered the final phase of analysis. Screening steps, identification of decision-making assessment scope, evaluation, and follow-up were the four dominant steps in most of the developed tools. The study showed that to choose the appropriate tool to assess the impact of policies on equity in health, it is necessary to pay attention to various factors such as assessment time, policy level, available resources, and the population affected by the desired policy.


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