Showing 19 results for Dehnavieh
M Mehrolhassani, B Najafi, V Yazdi Feyzabadi , Aa Haghdoost, M Abolhallaje, M Ansari, R Dehnavieh, M Ramezanian, F Kouhi, M Jafari, Lashkari M,
Volume 12, Issue 0 (Special Issue Vol.12 2017)
Abstract
Background and Objectives: Out-of-pocket (OOP) expenditure is one of the main indicators in health financing, indicating risk pooling and risk spreading. This study aimed to calculate the total health expenditure (THE), the THE per capita and share of OOP in each province from 2008 to 2014.
Methods: The present cross-sectional study was done by collecting provincial health expenditure data from public and private organizations during 2008-2014. The data were approved by board of trustees or board of directors in each organization. The relevant data on household health expenditures were collected from the Statistical Centre of Iran, as well.
Results: Even though the absolute monetary value (IRR) of OOP in the study years showed an increase, it decreased from 51.9% in 2008 to 40.6% in 2014 in terms of share. The absolute monetary value (IRR) of THE and THE per capita increased about 3.5 times in all provinces. So, during the study years, Tehran and Sistan and Baluchistan Provinces had the highest and lowest absolute monetary values (IRR) in THE per capita and this difference increased from 2.12 million Rials in 2008 to 10.56 million Rials in 2014.
Conclusion: Although the share of OOP decreased in all provinces in the country during the study years, it is still far from the objective of the national development plans (30% OOP). In order to improve the study indices and reduce the provincial inequity, it is suggested to put more emphasis on prepaid-based mechanisms, insurance system improvement, and equitable distribution of financial resources should be compatible with the deprivation of the area and its infrastructures.
E Ghasemi, M Barooni, R Dehnavieh, M Jafari Sirizi , Mh Mehrolhassani,
Volume 12, Issue 0 (Special Issue Vol.12 2017)
Abstract
Background and Objectives: Health insurance would guarantee people security against disease and health problems. Given the key role of health insurance in achieving the goals of justice and reducing the out-of-pocket payment, this study aimed to evaluate the performance of Iran health insurance using the DEA model in 2014.
Methods: This was a cross sectional study. The study population included all Iran health insurance organizations. DEA input and output criteria were selected by targeted library and documentary review and the data were collected accordingly. The determinants of efficiency were evaluated using liner regression.
Results: The mean technical, management, and scale efficiency of Iran health insurance head offices was 0.593, 0.761, and 0.721, respectively. Considering the findings, the capacity of efficiency promotion at these head offices was approximately 41%. Regarding technical efficiency, 5 head offices had the maximum efficiency (1), 7 head offices had efficiency between 0.5 and 1, and 19 head offices had efficiency less than 0.5. In addition, the variables of population and total number of institutions had a significant impact on efficiency.
Conclusion: Based on defined variables, input oriented AP-DEA model was appropriate. The results showed a great capacity for increasing technical efficiency in the Iranian health insurance organizations which could be increased by benchmarking efficient and reference organizations and also adjusting their input. For this purpose, downsizing and agility of the Iranian health insurance organizations based on the e-government clause are proposed for administrative system reform.
Mh Mehrolhassani, M Emami, Aa Haghdoost, R Dehnavieh, S Amanpour, F Sabbah, M Bazrafshan,
Volume 12, Issue 0 (Special Issue Vol.12 2017)
Abstract
Background and Objectives: Universities of medical sciences play a vital role in promoting population health and without a doubt, their performance should be measured and evaluated.
Methods: The study was a mixed method study (consecutive combination) and the universities were examined by census. In the qualitative phase of the study, by examining the documents and focused group discussions, the basic framework of the performance evaluation model and its associated challenges were elicited. Then, the policies, objectives, and strategies related to each dimension were extracted and finally, key indicators were selected. Finally, by running Analytic Hierarchy Process method, the weight of dimensions and their key aspects were calculated and the model was implemented.
Results: BSC was designed in accordance with the universities. In this model, four main aspects including population health, services, finance, and development were identified. Then, by reviewing the documents, key policies and strategies, key policies and criteria, primary and secondary strategies were extracted. 13 key indicators were chosen as the final indexes. Moreover, 3 main challenges and 11 secondary challenges were identified. The results of the AHP-BSC model indicated that categorizing (ranking) universities had an impact on their functional status.
Conclusion: The main challenge for evaluating the performance of universities was the presence of a logical connection between policies, strategies, and criteria to have comprehensive and concise indexes for evaluation and ranking.
R Goudarzi, Mh Mehrolhassani, R Dehnavieh, A Darvishi,
Volume 12, Issue 0 (Special Issue Vol.12 2017)
Abstract
Background and Objectives: Efficiency measurement can be used for all decision-makers and planners for useful resource allocation. Social Security Organization as a health service provider, provides part of health care services in indirect sector. This study aimed to assess the performance of provincial units of Social Security Organization in the indirect health services sector.
Methods: This descriptive analytical study was conducted based on the available data of Social Security Organization in 2014. To assess efficiency and super-efficiency, the DEA-VRS and Anderson-Peterson rating model were used, respectively. Factors affecting the efficiency was evaluated using multivariate regression.
Results: The primary efficacy analysis showed that 61% of the provincial units of Social Security had maximum efficiency. Average efficiency was 0.94. After super-efficiency analysis, it was found that Markazi and Kerman provincial units were the most efficient and the most inefficient units, respectively. Additionally, none of the variables had a significant impact on the efficiency.
Conclusion: Evaluation of the general performance of provincial units reflected the good state of technical efficiency in the indirect health service sector. On the other hand, the scale efficiency of inefficient units compared with managerial efficiency had a higher share of inefficiency. Optimum performance can be achieved through modification of managerial practices for optimal utilization of resources and factors.
Mh Mehrolhassani, B Najafi, V Yazdi Feyzabadi, M Abolhallaje, M Ramezanian, R Dehnavieh, M Emami,
Volume 12, Issue 0 (Special Issue Vol.12 2017)
Abstract
Background and Objectives: Timely access to required health services without any financial hardship is necessary to achieve public health. Therefore, the aim of present study was to review the policies and plans adopted in the health financing system.
Methods: The qualitative study with a policy research approach reviewed upstream laws, policies, and plans in Iranian health financing. Then, by holding seven focused group discussions with 28 participants who represented various stakeholders, financing policies and programs were identified. Using framework analysis, the data were coded and categorized.
Results: In response to health financial protection indexes improvement, policies and plans in this field were defined in 10 themes and 4 categories: resources collection, resources management and pooling, resources allocation, and strategic purchasing of health services. The most important policies and plans were integration of insurance funds, increasing sustainable financial resources and targeted allocation of subsidies, services priority setting, establishment and improvement of a performance-based payment system with emphasis on integration of the professional element in the public and private sectors.
Conclusion: There is no gap for documented laws and policies in the Iranian health financing system. The main barriers are the method of implementation and adequate commitment to laws that have created major difficulties in relation to financial protection. Resolving these barrierrs requires sufficient political support and a common understanding between stakeholders at different levels of policymaking and implementation and designing programs based on the infrastructures.
Mh Mehrolhassani, Aa Haghdoost, R Dehnavieh, M Abolhallaje, M Emami,
Volume 12, Issue 0 (Special Issue Vol.12 2017)
Abstract
Governance and leadership are seen as the most important function in the realization and promotion of community health. This two components through legislation must identify present situation, determine the desirable situation, provide infrastructures and implementation mechanisms and in accordance with stated policies and planning, they should apply necessary monitoring and control. In this regard, the most important challenge is a comprehensive and evidence-based identification and analysis, which can consider all functions in relation to the objectives at a general and coherent glance and assess the functions of the health system.
Aa Haghdoost, H Hashemi, S Noori Hekmat , M Haji Aghajani , Gh Janbabaee, A Maher, Am Javadi, S Emadi, H Haghighi, Mr Rajabalipour, R Dehnavieh, M Ferdosi, Hr Rashidinejad, F Moeen Samadani , R Rahimisadegh,
Volume 13, Issue 0 (Vol.13, (Special Issue) 2018)
Abstract
Background and Objectives:Among health sector resources, hospital beds are the primary unit of calculation for the capacity of the health service and vital capacity in patient care. Lack of appropriate distribution in different parts of the country leads to transfer of patients and irreparable problems. The aim of this study was to provide accurate information on the number and distribution of hospital beds in the country in 2016 and to estimate the number of beds required by 2026.
Methods:This descriptive-analytic study was conducted in 2016. The population of the study comprised 439 counties covered by 46 medical universities of the country. In this study, the data of 2016 were used and information about the number and ownership of beds and the size of hospitals were obtained from the treatment deputies of medical universities.
Results:The number of active beds in the country was 117580 in 2016, and it is estimated that in order to meet the needs of the community, this number should reach 194471 beds by 2026. There were 1.47 beds for 1,000 people in 2016, which will increase to 2.9 in 2026 by implementing the NEDA project. The coefficient of variation in 2016 was 36%, which will reach 19% by 2026 according to estimates in the Iran's roadmap project.
Conclusion:The distribution of beds was differed in different regions of the country and there are not enough hospital beds in some areas. If the Iran roadmap is implemented, 2026 beds will be distributed more evenly across the country.
M Haji Aghajani , H Hashemi, Aa Haghdoost, S Noori Hekmat, Gh Janbabaee, A Maher, R Rahimisadegh, S Emadi, Mr Rajabalipour, H Haghighi, R Dehnavieh, F Dehnavieh Tijang ,
Volume 13, Issue 0 (Vol.13, (Special Issue) 2018)
Abstract
Background and Objectives: Iran is a large country that is often an importer of major medical equipment. There is no comprehensive databank of the status of the equipment in the country. The present study provides a clear description of the dispersal status of major medical equipment in the country in 2016 and the estimated number of required devices in 2026.
Methods: This study was conducted in 2016 in Iran. The study included 8 MRI, CT scan, gamma camera, linear accelerator, PET scan, cardiac angiography, peripheral angiography, and CT angiography devices. The data of the number of equipment in each city were collected through a census of devices.
Results: At the beginning of the year 2016, 3.5 MRI devices, 6.93 CT scans, 2.18 gamma cameras, 1.23 linear accelerators, 0.04 PET scans, 2.3 cardiac angiography devices, 0.27 peripheral angiography devices, and 0.25 CT angiography devices per million population were active in Iran. CT scan and MRI devices were the most available equipment. It is estimated that the same pattern should be maintained in 2026, but the distribution of devices as well as the total number of devices in the country should improve.
Conclusion: In 2016, for most of the devices, the proportion of the device to the population in the whole country was close to the global average, but there was a large accumulation of devices in large cities. This problem has been identified and interventions have been planned to move towards reducing inequalities In Iran's Health Roadmap.
R Dehnavieh, S Noorihekmat, A Masoud, Ma Moghbeli, H Rahimi, A Poursheikhali , M Hoseinpour, S Salari,
Volume 13, Issue 0 (Vol.13, (Special Issue) 2018)
Abstract
Background and Objectives: One of the decentralized models that has been formed based on universal health coverage is the model of health complexes in Tabriz. This study was conducted to evaluate the model.
Methods: This case study was conducted in 2017. Beside observation, 28 individuals, including informed experts in the field of establishment of health complexes in Tabriz University of Medical Sciences, were purposefully selected and semi-structured interviews were also conducted. To analyze the interviews and the results of observations, the framework analysis was used based on the components of the Primary Care Evaluation Tool (PCET) model.
Results: The strengths of the health complex model are decentralized planning, strengthening the private sector participation, have more appropriate methods for assessing the performance of the health team, creating a sense of delivering effective services in providers, using electronic information registration system, using the prospective payment method, strengthening the referral system, enhancing service continuity, and facilitating financial and geographical access, especially in marginalized areas. However, there are some problems such as lack of some facilities and equipment, lack of some workforces and high workload, financial instability, and lack of insurance organizations cooperation with the plan.
Conclusion: The health complex model has improved organizational, financial, and geographic access to health services. It seems that if the resources are more stable and by cooperation of basic insurances, the results of this project will be better.
M Haji Aghajani , Aa Haghdoost, S Noori Hekmat , Gh Janbabaee, A Maher, Am Javadi, R Rahimisadegh, Mr Rajabalipour, H Haghighi, R Dehnavieh, S Emadi,
Volume 13, Issue 0 (Vol.13, (Special Issue) 2018)
Abstract
Background and Objectives: The imbalance between the existing human resources and future needs of the health system disturb the service delivery process. The present study aimed at determining human resources needs in the health sector for a 10-year planning program. For this purpose, the researchers examined the geographical distribution of different groups of health system staff in 2016 and 2026.
Methods: This descriptive-analytic study was carried out in 2016. The population of this study included 46 universities of medical sciences. Data of the number and distribution of health care staff working in public, private, charity, and semi-public sectors of medical departments of medical universities were collected. The Qlik View software was used for data integration and designing information dashboards.
Results: At the beginning of 2016, the ratio of nurses, nursing groups, midwives, pharmacists, dentistry and general physician per 100,000 individuals was 133, 199, 32, 17, 22, and 53 respectively, which are estimated to reach 223, 272, 37, 26, 27, and 79 in 2025, respectively. The coefficient of dispersion variation of the above was 39%, 32%, 43%, 33%, 43%, and 44% in 2016, respectively, which are estimated to reduce by 2026 if the Iran medical roadmap is implemented.
Conclusion: The high dispersion index of the medical personnel relative to the population in the cities covered by medical universities indicates unbalanced distribution. If the estimates of the Iran's 2026 medical roadmap are implemented, more appropriate distribution of the medical staff is expected.
A Maher, Aa Haghdoost, S Noori Hekmat , M Haji Aghajani , Gh Janbabaee, H Vaezi, Gh Khademi, S Emadi, R Rahimisadegh, H Haghighi, R Dehnavieh, Mr Rajabalipour,
Volume 13, Issue 0 (Vol.13, (Special Issue) 2018)
Abstract
Background and Objectives: The aim of this study was to provide a clear description of the pre-hospital emergency setting and risk management in accidents and disasters in accordance with current Iran’s standards in different regions of the country. This study was part of the national project "Iran Roadmap (Neda 2026)".
Methods: The data of the major medical equipment was gathered from 48 medical universities covering all of the country's 32 provinces. Goal standards were obtained from the “Ministry of Health” and the “Department of Statistics for Medical Accident and Emergency Management Centers” in all universities. Coefficient of dispersion was calculated to evaluate any dispersion in major medical equipment.
Results: The results of this study showed that in 2017, the highest and lowest coefficient in “pre-hospital facilities” was related to the ambulance engine (301%) and the operational base personnel (93%), respectively. Nio national standards were implemented in “Risk Management in accidents and disasters needs” in most provinces of Iran. In 2026 estimates, all of the factors improved and dispersion decreased.
Conclusion: Despite the poor distribution of prehospital indicators in 2017, forecasting showed desirable conditions in distribution of facilities in the pre-hospital emergency and risk management of accidents and disasters.
R Dehnavieh, Aa Haghdoost, Sr Majdzadeh, S Noorihekmat, H Ravaghi, Mh Mehrolhasani, O Barati, H Salari, A Masoud, A Poursheikhali, N Mirshekari , S Ghasemi, A Esfandiary,
Volume 13, Issue 0 (Vol.13, (Special Issue) 2018)
Abstract
Background and Objectives: Universal health coverage will have a problem in achieving it’s goals if it doesn’t consider the quality. This study aimed to Background and Objectives: Universal health coverage cannot achieve it’s goals if it doesn’t consider the quality. This study wants to assess the quality of health services in Iran, identify existing challenges and provide solutions.
Methods: This study was a mixed qualitative and review study. In the first stage, the national main indicators of the quality of services were reviewed. Then, the orientation of the available upstream documents on the quality of services was explained. The most important challenges, trends, and recommendations of health quality improvement were extracted via interviews.
Results: Proper observation of the Iran health care quality requires appropriate framework and indicators. Upstream documents strongly emphasized on the government's responsibility to play a key role as stewardship and that the health system should provide the necessary structural, procedural, and consequential requirements besides determining appropriate model. Quality management programs had obstacles in some aspects like the performance of managers and human resources, structural/communicational requirements, education, payment system, culture, use of quality management indicators and models, financial, information, and equipment resources, laws and regulations, and supervision.
Conclusion: Improving the quality of health services in Iran requires strategies in organizing, resource generation, payment, laws and regulations, and behavior of policy makers and planners. Quality tools should be used without haste and should pay attention changes in the nature of diseases, expectations of stakeholders, and increased global attention to this issue in designing related plans.
S Noori Hekmat, H Hashemi, Aa Haghdoost, M Haji Aghajani , Gh Janbabaee, A Maher, A Javadi, R Rahimisadegh, S Emadi, Mr Rajabalipour, R Dehnavieh, H Haghighi,
Volume 13, Issue 0 (Vol.13, (Special Issue) 2018)
Abstract
Background and Objectives: The distribution of specialists is important in two ways: geographical and specialty. In this study, we provided a description of the distribution of specialists in Iran in 2016 and its estimates in 2026.
Methods: This descriptive-analytical study was conducted in 2016 to estimate the number of specialists in 2026. Data were gathered through a census of specialists working in each of 439 cities in the country, including those in public and private sectors. Coefficient of variation and the number of specialists in 100000 populations were applied as distribution measures.
Results: In the year 2016, there were 46 specialists per 100,000 populations, and it is estimated that considering the full-time equivalent index of 1.2, 63 specialists per 100,000 populations will be required in the year 2026. The highest and lowest ratio of specialists per population in the year 2016 was reported in Tehran (89 per 100,000 populations) and Jiroft (10 per 100,000 populations), respectively. The gynecologist group and geriatric specialists group were the largest (4747 specialists) and smallest group (4 specialists), respectively.
Conclusion: There was a considerable disparity between different regions of the country in terms of access to specialists. Furthermore, the ratio of specialist per population in different specialty groups varied from one province to another. Upon implementation of the Iran Roadmap, according to 2026 estimates, this dispersion will be reduced to some extent; however, part of the dispersion related to the regionalisation pilicy.
V Kohpeima Jahromi , R Dehnavieh, Mh Mehrolhasani,
Volume 13, Issue 0 (Vol.13, (Special Issue) 2018)
Abstract
Background and Objectives: Due to lack of proper health system coverage in cities, the urban family physician program began as pilot in two provinces in Iran. Decision on developing the program to other provinces requires a comprehensive assessment. The study aimed to evaluate the program in Iran.
Methods: This cross-sectional study was conducted in 2015 and 2016 in two provinces (Fars and Mazandaran). The data of 141 family physicians working in health centers and 710 patients were collected using a questionnaire. A multi-stage sampling method was used for the samples. Data analysis was performed using descriptive and inferential statistical methods.
Results: 81% of the workload of family physicians in a week was patient visits. Co-payment in second and third levels was a real obstacle for some patients. The majority of the patients could receive their required healthcare facilities in up to 40 minutes. Software programs were infrequently used. Patients were visited by their physicians 5.5 times in a week. The mean duration of each patient visit was less than 10 minutes in 80% of the cases. Referral rate was reported by 14% (Fars= 21.8%, Mazandaran= 4%). 30 out of 45 medical devices were available to family physicians on average.
Conclusion: Although the program has been successful in areas such as access to health services and comprehensiveness of care, there are some challenges in coordination and continuity of care. Therefore, it is suggested that the root causes of these challenges be resolved prior to extending this program to other provinces.
S Noori Hekmat, Aa Haghdoost, R Dehnavieh, R Ghorbani Nia,
Volume 14, Issue 0 (Special Issue, Vol.14, 2019)
Abstract
Background and Objectives: In 1995, a huge revolution occurred in Iran’s health system when the entire medical-related educa-tion program was integrated into the Ministry of Health. This paper was conducted to provide a review of all studies investigating this integration and to synthesize their results.
Methods: This study was a systematic review and qualitative meta-synthesis of the papers on integration using the Walsh and Downe process. An extensive search of the databases of ScienceDirect, PubMed, EMBASE, ISI, Google Scholar, Scopus, SID, Magiran, and Irandoc revealed 187 articles of which 25 were selected. The content of the studies was analyzed and combined using the Walsh and Downe technique.
Results: The results showed 5 main concepts, including the goals and reasons of the medical education integration, integration achievements, challenges, and barriers to achieving the goals of integration, and the future of integration. The greatest success of the integration program was related to health services, while the least positive effects were related to medical education and research.
Conclusion: A review of available documents shows that not all dimensions of integration have been well analyzed and their economic, social, developmental and scientific effects have not been studied. The majority of the limited studies in this regard were surveys and overview studies and few studies used economic analysis and modeling. Therefore, the effects of the integration cannot be evaluated using the available studies.
R Dehnavieh, Aa Haghdoost, S Noori Hekmat, M Bamir, A Masoud, A Poursheikhali, Mr Cheshmyazdan,
Volume 14, Issue 0 (Special Issue, Vol.14, 2019)
Abstract
Background and Objectives: Before any development in scientific health activities, we have to observe its scope and compare it with health sector. Accordingly, the aim of this study was to determine the quality and quantity of the health-prioritized disciplines mentioned in the comprehensive health plan of Iran.
Methods: This scientometric cross-sectional study was done during 2010-2017. The study population was 26 prioritized areas in three categories of survival, excellence, and infrastructure according to comprehensive health plan of Iran in 2010. The data collection tool was the SCImago database. The number of documents, citation indicators, and h-index were analyzed by Excel.
Results: The findings of the research showed that the highest h-index of Iran in the excellence, survival, and infrastructure category was in Nano (90), infectious diseases (67), and systematic ecology (56), respectively. Moreover, the highest ranked citations in three categories of survival, infrastructure, and excellence were related to traditional medicine, family medicine, and dentistry with a global rank of 8, 9 and 15, respectively. In categories of excellence, survival and infrastructure; public health, bioinformatics, and infectious diseases had the highest number of products with 7045, 5371 and 5135 articles.
Conclusion: There has been a marked improvement in the quality and quantity of all the subject categories over time. The general domains of excellence, survival, and infrastructure categories had the highest mean H-index, and the highest average growth rate of scientific productions was related to excellence, infrastructure and survival categories, respectively.
R Dehnavieh, Aa Haghdoost, H Rahimi, A Poursheikhali, M Hasani, N Mirshekari, F Hoseinabadi, S Radmerikhi, Z Khajeh, N Khajehpour, A Masoud, M Balochi, S Noori Hekmat, K Nouhi,
Volume 14, Issue 0 (Special Issue, Vol.14, 2019)
Abstract
Background and Objectives: Plagiarism is the most prevalent type of scientific misconduct, and various rules and strategies have been proposed to combat it in different countries. A review of other countries' experiences in this area contributes to good policymaking. The present study was conducted to introduce preventive interventions of plagiarism in the leading countries.
Methods: The present study was a qualitative review study of applied practices. In this study, preventive interventions of scientific plagiarism in the 27 European ::::::::union:::::::: countries were studied due to the appropriate coherence and structural similarity at national, organizational, and individual levels. The national-level interventions were analyzed using the content analysis method in mentioned countries.
Results: The results of analyzing the national-level interventions were categorized into eight main themes, including reaching a national agreement on examples of scientific plagiarism and misconduct; policy development; monitoring and supervision; financial support development; development of databanks and software; compiling educational programs for faculty members and students; dissemination and use of successful experiences; and eventually establishment of laws related to scientific misconduct, plagiarism, and punishments activities.
Conclusion: Using preventive interventions at a national level proves the commitment and determination of policymakers to control and prevent plagiarism. Proper use of preventive interventions at a national level strengthens the controlling and preventive infrastructures of this issue at the organizational level, and enhances moral commitment and professional skills among the country's researchers.
Aliakbar Haghdoost, Alireza Alikhani, Mostafa Hosseini Golkar, Reza Dehnavieh, Samira Seifi,
Volume 18, Issue 2 (Vol.18, No.2, Summer 2022 2022)
Abstract
Background and Objectives: The COVID-19 epidemic and its subsequent effects have become a significant global challenge. In addition to being affected by this crisis, Iran is also facing many other problems, including sanctions and economic problems. So, there is a concern that it will suffer more severe consequences.
Methods: Scenario planning is one of the ways to recognize future changes and environmental uncertainties. This study used the so-called global business network (GBN) method, also known as the scenario matrix method. This method is based on two key uncertainties and six steps have been taken to examine variables related to health and socio-economic factors and use the opinions of relevant experts.
Results: To be expected, Iran's health system will be able to manage the epidemic in the face of various conditions with severity and weakness, and only in the pessimistic scenario or in Worst-case scenario with the default assumption of the continuation of sanctions and the spread of the epidemic. It leads to global restrictions, loss of foreign exchange reserves, loss of performance or collapse of the health system, increasing the number of deaths and diminishing the quality of life.
Conclusion: Regarding the COVID-19 epidemic and the existing background factors, scenarios of Iran’s health and economic conditions were narrated. Given the ability of the scenarios to understand the complexity and help in decision-making, it is considered a useful tool for policy makers to have a broader, comprehensive and reasonable look to achieve a correct consensus. This situation leads to the preservation and continuation of society health and conventional economic decisions.
Sahar Najafizadeh, Seyed Vahid Ahmadi Tabatabaei, Fatemeh Dehnavieh Tijang, Somayeh Noori Hekmat,
Volume 19, Issue 1 (Vol.19, No.1, Spring 2023)
Abstract
Background and Objectives: Human resources play a crucial role in delivering optimal healthcare services to the population. Expanding primary healthcare coverage requires a heightened focus on the healthcare workforce due to their pivotal role in service delivery. This study aims to evaluate the current workload and staffing requirements for primary health workers and midwives in Kerman, Iran, employing the Workload Indicators of Staffing Need (WISN) methodology.
Methods: A descriptive cross-sectional study was conducted in four selected health centers in Kerman, Iran, to estimate staffing requirements across two categories. A total of 118 activities for primary health workers and 89 activities for midwives were identified through the collaboration of expert panels and a comprehensive review of the Iran’s integrated health system. Subsequently, all activities were meticulously timed in each of the four health centers using stopwatches, and WISN ratios and proportions were calculated using Microsoft Excel 2010.
Results: The WISN calculations revealed a surplus in the number of primary health workers in three of the centers: B, C, and D. However, in center A, the workforce in this category is deemed sufficient. Conversely, a deficiency of midwives was noted in two centers, A and B, with WISN ratios of 0.67 and 0.50, respectively, while center C demonstrated an excess of the workforce with a WISN ratio of 2.00. Notably, an average of 50% of the staff workload in both categories comprises supportive and additional activities.
Conclusion: Interestingly, despite 75% of the cases indicating an excess or sufficiency of employees, staff members continue to grapple with high work pressures. This anomaly appears to be linked to the substantial volume of support and additional activities. Furthermore, the intense workload during specific days and hours translates into a pervasive sense of pressure throughout the week. As a potential remedy, introducing a queuing system into the primary healthcare sector could alleviate this issue.
