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Mh Fallah Mehrabadi , Ar Bahonar, F Tehrani, M Vasfi Marandi , A Sadrzadeh, M Shabani ,
Volume 12, Issue 1 (6-2016)
Abstract

Background and Objectives: Influenza is an acute, highly contagious disease of a variety of both domestic and wild bird species. The aim of this study was to estimate subclinical infections or previous exposure to H5 and H7 subtypes and to discover potentially important determinants of the prevalence of this disease in industrial and backyard poultry in Iran.

Methods: A survey was conducted from September to December 2014 in Iran using a cross-sectional design throughout the entire country. The Enzyme-Linked Immunosorbent Assay (ELISA) was used as the screening test and all ELISA-positive samples were examined with the HI test to differentiate H5 and H7. A total of 1378 places and 31547 birds were sampled.

Results: One place (bird garden) out of 1378 was positive for the H7 subtype and six places (2 bird gardens, 3 villages, and 1 ostrich farm) out of 1378 were positive for the H5 subtype on HI test. The results of this study showed that the presence of a lake (OR=12.20, CI 95% 2.19-68.09) and live bird marketing (11.73, CI 95% 1.32-104.42) were risk factors for the H5 subtype.

Conclusion: Sampling migratory waterfowl birds is recommended for early detection of probable infections and preventing the spread of infection to the backyard and industrial poultry because of their role in the transmission of the disease and probability of circulation of the virus.


Mr Aflatoonian, I Sharifi, Mr Shirzadi, B Aflatoonian,
Volume 12, Issue 1 (6-2016)
Abstract

Background and Objectives: Anthroponotic cutaneous leishmaniasis (ACL) is restricted to humans; thus, prompt diagnosis and early treatment are significant measures to control the disease. This study was conducted to determine the effect of direct active case- detection and early treatment on the control of ACL in Bam District.

Methods: This retrospective cohort study was performed based on intervention and nonintervention. After the 2003 earthquake, an equipped treatment center was established to actively detect CL cases following the CL epidemic. This intervention was carried out in 2007 and the suspected cases were referred to the center for diagnosis and treatment Another comparable CL treatment center was selected as the control in Kerman. The recorded data of the patients were analyzed with statistical tests at p<0.05.

Results: The incidence rate steadily increased to 30% from 2003 to 2007 whereas the incidence gradually decreased to 1% after the intervention. However, by contrast, the incidence rate increased significantly in the control area. The treatment failure and relapse rate of ACL showed no significant difference with the control group before and after the intervention. The effectiveness of the intervention was calculated to be 85%.

Conclusion: Active case-detection and early treatment of ACL could be an effective measure in controlling ACL, particularly during epidemics. Lessons learned from the 2003 Bam earthquake could be used as a suitable model for ACL endemic areas, nationally and globally.


F Bagheri Amiri , Ar Bahonar, E Mostafavi, Ma Mansournia, N Rasouli , Mh Fallah Mehrabadi, D Abdollahi, Sholepash,
Volume 12, Issue 1 (6-2016)
Abstract

Background and Objectives: Foot-and-mouth disease (FMD) is one of major contagious animal. The purpose of this study was to evaluate the determinants associated with FMD occurrence in farms.

Methods: A case- control study was carried out in cattle farms.  The cases were farms with new reports of FMD and controls were units without any report of FMD in last 6 month. For assessing the risk factors, a researcher- made questionnaire was used. Statistical analyses were done with SPSS version 16 using the logistic regression test.

Results: Purchase of new livestock [OR: 14.69 (CI95%: 4.29, 50.36)] and passing migratory livestock [OR: 13.32 (CI 95%: 1.74, 101.87) were identified as the risk factors of the disease. Visiting the farm by the vaccinator in last 2 weeks [OR: 0.17 (CI 95%: 0.05, 0.63)] and buying new livestock from the same village/ city where the farm is located [OR: 0.16 (CI 95%: 0.04, 0.58)] were considered as protective factors.

Conclusion: Considering the role of infected livestock in the country, the most important steps for effective preventation are: areadherence to biosecurity as well as quarantining new purchased animals, and informing and training farmers to not purchase new animals from farms that are located in the infected areas and around the times of outbreak.


R Safari Faramani, H Akbarin, Aa Haghdoost, A Beigzadeh, Ah Takian, R Malekzadeh, E Mostafavi, H Sharifi,
Volume 12, Issue 1 (6-2016)
Abstract

Background and Objectives: Taking into account the roles and positions of WHO Collaborating Centers (WHOCCs) in the furtherance of national goals and the great impact of their interaction as well as cooperative relations between these centres, this study was conducted to assess the current status of WHOCCs, identify opportunities and threats, and provide practical solutions to solve WHOCCs problems.

Methods: This cross-sectional study was conducted using an open-ended questionnaire in 2014. The questionnaire revolved around the WHOCCs' status in terms of goal achievement, manpower problems, financial resources, communications, as well as suggestions to solve problems in these domains. These findings were approved in the second convention of the heads of WHOCCs in Kerman in 2014 and the questionnaires of the second phase were distributed and completed by participants. Data were analyzed using the content analysis method.

Results: The majority of the centres assessed their performance regarding the national goals (11.59) in comparison with international goals (14.20), and self-regulated goal setting (14.7o) in an unfavorable condition. Financial problems and lack of recruitment were the most important problems for WHOCCs. The support of the Ministry of Health, WHO, supporting universities, and establishing research networks at national and international levels to foster communication, contracts to share experiences and resources, considering the authors' rights as well as introducing the competencies of centres at national and international levels, were some of the suggestions proposed.

Conclusion: It seems that more support of the WHO, Ministry of Health, and supporting universities is needed to increase financial resources and recruit staff.


Mr Aflatoonian, I Sharifi, M Zeinali, M Bamorovat, B Aflatoonian,
Volume 12, Issue 2 (8-2016)
Abstract

Background and Objectives: Cutaneous leishmaniasis (CL) is a public health problem in Iran and Kerman Province which is expanding to new foci. This study was conducted to estimate the incidence of CL by a simple and cost – effective method in a major focus of CL in the city of Kerman, southeastern Iran.

Methods: A combination of two longitudinal and cross – sectional studies was performed. First, the frequency of referred patients to the CL treatment clinic in 2009-2014 was assessed. Then, four highly infected zones consisting of 800 households in the city were selected. In addition, the relative proportions of referred and non – referred subjects were assessed. Eventually, the incidence of CL was calculated by dividing the number of CL cases over the total at risk population for the corresponding period (2009-2014).

Results: The mean annual incidence was 175 per 100000 (943 patients) in the city of Kerman, while it was 500 per 100000 people (0.5%) in the new foci. The highest CL infection was observed among the <25-year-old individuals but there was no significant difference between the sexes.

Conclusion:The incidence rate probably increased significantly following the 2003 Bam earthquake because of the migration of CL patients to southern, eastern, and northeastern areas of the city of Kerman. Since only 50% of the cases were passively referred to the CL treatment clinic, health authorities should actively detect CL cases by house – to – house visit for effective treatment strategies.


N Bahrami, A Yaghoobzadeh, H Sharif Nia , Ma Soliemani, Aa Haghdoost,
Volume 12, Issue 2 (8-2016)
Abstract

Background and Objectives: Infertility is one of the most important crises in the lives of couples, which create psychological consequences beside the economic, social and individual problems,. Decreased sexual satisfaction is one of the consequences of infertility. Given the importance of this concept in the life of infertile couples, a tool to measure the sexual satisfaction of this group of people is necessary. Thus, the study aimed to assess the psychometric properties of the Persian version of the LSSQ in Iranian infertile couples in 2013.

Methods: In this methodological study, 150 Iranian infertile couples completed the 25-item Larson's sexual satisfaction questionnaire in Qazvin. Its reliability was determined by the calculation of Cronbach's alpha coefficient. Exploratory and confirmatory factor analyses were done by SPSS-AMOS22.

Results: The internal consistency of the sexual satisfaction questions estimated with Cronbach's alpha was more than 0.7. Exploratory factor analysis was used to evaluate the construct validity of the questionnaire which showed 4 factors (desire to have sexual relations, sexual attitude, quality of sex life, and sexual compatibility) with Eigen values greater than one. Four latent factors explained 53.21% of the total variance. Confirmatory factor analysis confirmed the final model of the construct of the questionnaire.

Conclusion: The results of study showed that the Persian version of LSSQ has a suitable validity and reliability in the Iranian infertile couples. Factor analysis confirmed that the LSSQ had a multi-dimensional structure.


Z Cheraghi, S Nejat, L Haghjoo, F Salehi,
Volume 12, Issue 3 (10-2016)
Abstract

Background and Objectives: The main question that arises in ‘Quality of Life’ (QOL) studies is how people assess this phenomenon and what factors affect it. Using these answers, we can better analyze the findings of QOL studies in our country.

Methods: In this content analysis, we carried out semi-structured interviews, and applied maximum variation opportunistic sampling in terms of gender, age, education, ethnicity, and economic status. First, we asked the participants to answer the question on QOL by thinking aloud. Then, they were asked to discuss the factors that affected their choice a posteriori. Finally, the inductive qualitative analysis was done and the mental model of the participants was extracted.

Results: We extracted five main categories and 33 themes. These categories included physical factors, psychological factors, socioeconomic factors, family issues, and environmental factors. Physical health, expectations, satisfaction, community engagement, financial problems, environmental pollution, leisure and recreation, family environment, family relationships and the role of the wife were the most important factors affecting the QOL in the participants’ opinions.

Conclusion: In addition to the health status, family issues such as the family environment and financial problems affected the QOL. Moreover, the participants believed environmental health was an integral part of QOL.


S Aghamohammadi , E Kazemi, A Khosravi, H Kazemeini ,
Volume 12, Issue 4 (2-2017)
Abstract

Background and Objectives: By identifying the causes of death, interventions can be designed and implemented to reduce the risk factors of different diseases. The aim of this study is to determine the trend of ten leading causes of death in the Islamic Republic of Iran in 2011.

Methods: The study population comprised all deaths recorded in the death registration system of the Ministry of Health and Medical Education (MOHME) from 2006 to 2011. The data related to causes of death reviewed and modified in terms of quality, underreporting of deaths, and garbage codes using the Global Burden of Disease study methods. Finally, the data were analyzed by sex and age groups.

Results: The leading causes of death were cardiovascular diseases (46.12%), cancers and tumors (13.63%) and unintentional injuries (11.55%) in 2011. The 10 leading causes of death in the general population were myocardial infarction, stroke, transportation-related accidents; blood pressure induced heart disease, other cardiovascular diseases, diabetes, chronic pulmonary and bronchial diseases, gastric cancer, other heart diseases and renal failure.

Conclusion: Deaths from non-communicable diseases still account for a large proportion of total deaths. According to the Heath System Reform Plan in Iran and the need for new interventions, it is very important to register the exact causes of death to design service packages and also evaluate the success rate of ongoing interventions.


A Salahi Moghaddam , A Heydari Hengami , M Heydari Hengami ,
Volume 12, Issue 4 (2-2017)
Abstract

Background and Objectives: Iran is classically located in the Palearctic zoogeographic zone, but southern pasts of Iran are drastically different from other parts in terms of fauna and flora. Nowadays, considering the technological advances and the ability to locate the zone border using aerial photos, and the need for comparing the prevalence of the diseases in different locations, it is necessary to identify the border of tropical-like zones as detailed as possible.

Methods: The shapefile of the political classification of Iran was used as the base map and metrological and terrestrial data were obtained from Iran Climatologic Research Center and literature review. Data were arranged in the Geospatial Information System and after geostatistical analysis, a raster map was generated and a probability map for all tropical conditions was calculated and generated as a raster map. Tropical areas were proposed in two layers.

Results: According to our study, between 113 to 125 districts from 8 provinces were located in tropical-like zones. Three of these districts had typical criteria of the Indo-Malayan zone and others resembled the Afrotropical zone. The table of the districts located in the tropical-like zones and the shapefile of these areas are available on the website of Iran Epidemiology Society.

Conclusion: Although Iran in located in the Palearctic zoogeographic area, there are some southern areas which resemble tropical regions and accurate definition of borders is a basic essential need for geo-referenced epidemiology and determining the disease pattern. This study provided a preliminary map for this field of study.


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 (3-2018)
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.
V Yazdi Feyzabadi , Mh Mehrolhasani, Mr Baneshi, S Mirzaei, N Oroomiei,
Volume 13, Issue 0 (3-2018)
Abstract

Background and Objectives: Urban family physician program(UFPP), a program for improving equity in access to, financing, and quality of health services, is piloting in two provinces of Fars and Mazandaran, Iran since 2012. This study aimed to examine the association between the implementation of program and financial protection measures.
 
Methods: This cross-sectional, ecological study was performed on aggregated data of financial protection measures and some independent variables in the above provinces from 2008 to 2015. At first, the Lasso regression model was used for selecting independent variables affecting financial protection indexes. After adjusting the selected independent variables, in separate models, the association between the UFPP and financial protection measures, as outcome variables, was examined using a backward linear regression model.
 
Results: The percentage of households facing catastrophic health expenditure(CHE) in the years of UFPP implementation was 1.82% higher than the years before implementation(P<0.05). This increase was 1.37% in rural areas. the percentage of medical impoverishment in the two provinces increased by 0.83% during the implementation years than the years before(P<0.05). Finally, no significant relationship was observed between UFPP implementation and the Kakwani index and out of pocket payment(as % of total health expenditure) in the two provinces(P>0.05).
 
Conclusion: Despite the achievements attained by UFPP in improving physical access to health services, it seems that this program has had no success in improving financial protection measures and equitable health care financing. However, further research is warranted in this regard.
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 (3-2018)
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.
F Heydarpour, A Akbari Sari, M Mohebali, S Bokaie,
Volume 13, Issue 1 (6-2017)
Abstract

Background and Objectives: Leishmaniasis encompasses a wide range of clinical complaints from skin injury to fatal visceral infections. Detailed information about the economic burden of the disease can help health care decision makers to estimate the magnitude of the problem, economic advantages obtained from the prevention of this disease, resource allocation, and disease management. The study was conducted to determine the economic burden of leishmaniasis in humans and animals in Iran in 2013.

Methods: The cost unit was determined through public service tariffs determined by the Ministry of Health and Medical Education and interviews with experts, and service costs were calculated by multiplying the cost unit for one person by all infected cases. The course of the disease and the services provided to patients were obtained from the review of the literature and records and interview with experts.

Results: The economic burden of leishmaniasis was estimated more than IRR 213 billion ($6,700,000). Moreover, 39%, 27%, 18%, and 16% of the costs were related to indirect costs, direct medical costs, indirect medical costs, and dogs, respectively. The average direct medical cost of cutaneous and visceral leishmaniasis was IRR 3381186 ($106) and IRR 9392832 ($295) per person, respectively.

Conclusion: The economic burden  of leishmaniasis compared to some diseases such as hydatid cyst showed a smaller number( 232.3 million$). It is recommended that IIranian health politicians consider the economic burden of other diseases.


A Doosti Irani , F Bagheri Amiri , R Khajehkazemi, E Mostafavi,
Volume 13, Issue 1 (6-2017)
Abstract

Background and Objectives: Internet addiction is a social-physiological event with emotional disturbance, depression, and disruption of social relationships. In addition, Internet addiction has a negative effect on the efficacy of the affected people. The aim of this study was to determine the prevalence of Internet addiction in students and graduates of medical sciences.

Methods: This cross-sectional study was conducted on the sideline of epidemiology, microbiology and pediatric diseases congresses from May to October 2013. The participants included the students and graduates of epidemiology, clinical sciences, and other basic sciences from all medical universities of throughout Iran. The Young’s addiction questionnaire was used to assess Internet addiction.

Results: One hundred and thirty one students and graduates with a mean age 36.1 (±8.4) years participated in this study. The prevalence of mild and moderate Internet addiction was 61.83% (95% CI: 40.53, 70.26) and 26.95% (95% CI: 26.95, 33.56), respectively. None of the participants suffered from severe Internet addiction.

Conclusion: Severe Internet addiction was not observed in our study. However, a high proportion of the participants had mild and moderate Internet addiction. Therefore, many participants may be at risk of severe addiction. It seems that planning for preventive measures, especially in academic groups, is necessary.


H Soori, J Hasani, N Entezami, Sm Hosseini, E Rafiei,
Volume 13, Issue 1 (6-2017)
Abstract

Background and Objectives: The Millennium Development Goals (MDGs) are common goals that were established by the United Nations in 2000. The aim of this study was to compare some of these indicators in Iran, the Eastern Mediterranean Region (EMR), and the world.

Methods: The existing data from the World Health Status in 2014 and some other available sources in Iran, EMR, and across the world were addressed. The most relevant health indicators included decreased childhood mortality, maternal well-being, prevention of AIDS, tuberculosis and other diseases, and environment quality assurance.

Results: The proportion of neonatal mortality to total mortality among those less than 5 years increased from 37 to 44 in the world compared to 39 to 46 in EMRO and 46 to 61 in Iran. About 14.5% (71000 out of 490000) of the AIDS/HIV cases reported in the EMRO belonged to Iran in 2002. The maternal mortality rate (MMR) showed a decline of 72.2%, 50% and 44% in Iran, EMRO and the World respectively. The proportion of delivery by skilled persons and the proportion of pre-delivery care had a positive trend in Iran and were higher as compared to EMRO and the world average.

Conclusion: Iran achieved many MDGs, however, despite a decline in the AIDS/HIV incidence rate, its prevalence rate has increased in Iran, EMRO and the world from 2001 to 2013. The proportion of neonatal mortality rate to under 5-year mortality rate has had an increasing trend. Decision-makers should give priority to indicators that have not achieved MDGs.


Gh Moradi, M Sehat, Aa Haghdoost, M Karami, R Chaman, Z Khazaei, E Goudarzi, M Asadi Lari, E Mostafavi, K Holakouie Naieni,
Volume 13, Issue 2 (9-2017)
Abstract

Background and objective: Epidemiology is a tool and a field of Medical sciences  which provides evidences necessary to make scientific decisions.  This study aimed to identify strategies for the promotion of the epidemiology by Iranian Epidemiological Association (IrEA) so that people graduated in this field would become able to play an effective and positive role in different parts of the country.

Methods: This study was conducted in 2015. The views and opinions of the members of IrEA were collected by email. The views of the members  were classified using qualitative methods.

Results: The results of this study helped to identify some of the strategies for the promotion of the position of epidemiology in Iran health system by the members of IrEA.

Conclusion: IrEA can play a more effective role in the promotion of this field of study in the health system. Effective communication with the members, holding group meetings, advocacy and negotiation, reporting the activities of the association continuously, identifying national problems and seeking solutions are some of the strategies that can help to enhance the role of the community and promote the position of epidemiologists in Iran.


M Parvareh, Gh Moradi, B Nouri, F Farzadfar, N Rezaei,
Volume 13, Issue 3 (12-2017)
Abstract

Background and Objectives:In order to determine the workload of health workers(Behvarz), this research was conducted for work measurement and time assessment in rural health centers(health house).
Methods: This cross sectional study was conducted in 30 health centers during a routine working day in Saghez in 2015 using the “stop watch method”. The time and frequency of the processes were recorded in a checklist. We estimated and compared spent, standard, expected and pessimistic time, and also the mean repetition for each process per day and month as the unit of time.
Results: The mean real working time was about 157.5 minutes (33%) per day, which was mostly (35.5 minutes) spent on the affairs of health volunteers. Care for non-communicable diseases was the most frequent task with an average of 2.4 times per day. In a month, family planning was undertaken more than other processes. The time of most activities like mother care, elderly care, care for communicable and non-communicable disease was significantly lower than the expected and pessimistic times (P<0.05).
Conclusion: The time spent by health workers was low and unscheduled, particularly for important activities of primary health care. It seems that it is necessary to revise the models and methods of service provision in health centers. Efficient use of existing personnel, reducing unnecessary activities and adding more service packages according to the health system priority seem to be important requirements in the first level of health system.
M Enayatrad, K Etemad, S Khodakarim, P Yavari,
Volume 13, Issue 3 (12-2017)
Abstract

Background and Objectives: Colorectal cancer is the fourth most common cancer and the fifth cause of cancer-related mortality in Iran. This study aimed to determine the incidence of colorectal cancer in men and women and to investigate its relationship with the human development index (HDI) and its components in Iranian provinces.
Methods: This ecological study was conducted to assess the correlation between age-specific incidence of colorectal cancer in men and women and the Human Development Index. We used the data of the Iranian Cancer Registry and Statistical Centre of Iran. We used a bivariate correlation method to assess the correlation of ASR and HDI. P values less than 0.05 were considered significant. All reported P-values are two-sided. Statistical analyses were performed using the SPSS software version 23.
Results: The highest incidence of colorectal cancer in men was seen in Tehran (78.16), Eastern Azerbaijan (41.14), and Semnan (62.13), and the highest incidence of colorectal cancer in women was seen in Tehran (47.18), Semnan (80.14), and Eastern Azerbaijan (82.12), respectively. The results showed that the incidence of colorectal cancer in men (r = 0.605) and women (r = 0.661) had a positive significant correlation with the Human Development Index (P<0.001).
Conclusion: The incidence of colorectal cancer was high in provinces with a higher human development index. Therefore, evaluation of the incidence of cancer by the Human Development Index and its components can be used to show a clearer picture of the distribution of cancer in each country and may be useful for cancer prevention plans.
Me Motlagh, F Torkastani, H Ashrafian Amiri , Sm Rabiee, L Radpooyan, Sd Nasrollahpour Shirvani , Z Hassanzadeh Rostami ,
Volume 13, Issue 4 (3-2018)
Abstract

Background and Objectives: Satisfaction of health care recipients is always considered by policy makers and implementers as an indicator of measuring the quality and determining the effectiveness of services. This study aimed to determine the satisfaction of mothers from first level of Iranian network system.
Methods: This cross-sectional study was conducted to assess the incidence of maternal mortality in six provinces of Iran in 2015. Twenty-four public health centers were randomly stratified and selected. In each center, 15 to 20 mothers who were covered by prenatal care were examined. The data were collected through a researcher-made questionnaire whose validity and reliability were confirmed, interviews with mothers, and their medical records. SPSS version 17 was used for analysis. P values less than 0.05 were considered significant.
Results: Of 2722 mothers participating in the study, 2187 (80.3%) were satisfied with the condition and facilities of health units and service providers and 535 (19.7%) were dissatisfied. The highest level of satisfaction in mothers was observed in the areas of behavior, complete services, training of health professionals, and adequacy of pharmaceutical products while the lowest level of satisfaction was related to the adequacy of the medical education and the distance between the health unit and home. There was a significant relationship between 16 demographic variables and maternal satisfaction (P<0.05).
Conclusion: This study showed that about one fifth of pregnant mothers are still not satisfied with the first level of network systems in Iran and many factors have an impact on their satisfaction. It is recommended to design and implement interventional programs to increase their satisfaction.
V Yazdi Feyzabadi , Mh Mehrolhassani, Ss Pourhosseini,
Volume 14, Issue 0 (1-2019)
Abstract

Background and Objectives: Research plays an important role in solving health problems in the community. One main mission of higher education institutions is developing research tailored to the needs of the community by providing equal and fair opportunities for research sectors. The present study aimed to measure inequality in the rea of research in Iranian medical sciences universities.
Methods: In this descriptive study, the Gini Coefficient (GC) was used to measure inequality from 2010 to 2016. The indexes included the number of published papers, citations, citation per paper, self-citation, Scimago Journal Rank (SJR), Source Normalized Impact per Paper (SNIP), Citescore, Hirsch
(h-index), number of faculty members, number of students, and educational and research budget. Stata 14 software was used for data analysis.
Results: During the study years, the GC of SJR, SNIP, and Citescore varied from 0.65 to 0.73, 0.62 to 0.73, and 0.61 to 0.72, respectively. In addition, The GC of international papers, total articles, self-citation, citation per article, Hirsch index, and total citations varied from 0.62 to 0.70, 0.56 to 0.66, 0.22 to 0.27, 0.12 to 0.28, 0.33 to 0.39, and 0.57 to 0.72, respectively. The GC of the number of faculty members and budget ranged from 0.26-0.40 and 0.34-0.67, respectively.
Conclusion: Inequality in self-citation and citation per article was relatively fair, while Hirsh and the number of faculty members had intermediate inequality. Other indicators had a high and very high inequality. To reduce inequality, developing of the balanced research infrastructures in medical universities is recommended.

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