Ebrahim Jafari Pouyan, Maryam Babaei Aghbolagh, Farnoosh Azizi, Aida Asghari,
Volume 21, Issue 3 (12-2022)
Abstract
Management is a key pillar in order to achieve the goals of health systems. An efficient structure for identifying, recruiting, training, promoting, monitoring and evaluating the performance of managers is highly likely to help the specialization of management, prevent non-specialized selection processes and possible deviations. Given the managerial level in which they play a role, health managers ought to have the required competencies and characteristics. The leading countries generally thrive to have structures where proper candidates are systematically placed in the position of management and promoted to the higher positions. Therefore, the experiences of these countries should be solicited in line with the local social, political, economic and cultural factors in order to achieve the health system goals.
Mahnaz Mayel Afshar, Maryam Goodarzi,
Volume 22, Issue 1 (5-2023)
Abstract
Background: Corona virus is a phenomenon that has faced the world with a crisis due to its rapid spread and uncontrollable nature. Although this crisis is only related to the medicine and health system, it is a multidimensional phenomenon whose effects and consequences can be observed and tracked in various economic, social, and political fields. The purpose of this article is to investigate the results of the Corona Virus on the environment.
Materials & Methods: The current study is a scoping review article that was performed based on the collection of information from articles published in the databases ScienceDirect, Web of Science, Google Scholar, and PubMed in the period from 2019 to 2022 with the aim of investigating the consequences of the Corona crisis on the environment.
Results: The findings of this research illustrate that the corona virus crisis and the quarantine conditions have brought many consequences for the environment. On the one hand, as a result of the cessation of many human activities, there is a significant reduction in the emission of pollutants, including greenhouse gases, and on the other hand, waste, especially medical and plastic waste, has increased.
Conclusion: Despite the positive effects of Covid-19 on environmental factors, its short-term and long-term negative effects are obvious. In addition, it seems that the economic activity of country will intensify after Corona, and therefore, with a comprehensive analysis of the effects of Covid-19 on several sectors, significant proceedings should be taken in this field.
Atefeh Tasht Zar, Malike Beheshtifar, Reza Zare, Amin Nik Pour,
Volume 22, Issue 2 (9-2023)
Abstract
Background and Purpose: The purpose of this study is to validate the model of organizational evolution in hospitals affiliated with the Bushehr University of Medical Sciences.
Materials and Methods: This study was applied in terms of its purpose and quantitative in terms of its implementation method, employing a structural modeling approach. The statistical population in this part of the research included all managers, deputies, and experts in the field of the subject studied in Bushehr hospitals, totaling 130 individuals. A sample size of 100 was determined using Morgan's table and was selected via simple stratified random sampling. The research tool was a researcher-developed questionnaire. The questions and items of the questionnaire were compiled using research literature, theoretical foundations, and the results of a qualitative study. The face and content validity was confirmed by experts, and its reliability was obtained with a Cronbach's alpha method result of 0.976. Data were analyzed using the structural equation modeling method in SMART PLS software. Results: The findings of this research demonstrated that the structural model of organizational evolution has 43 sub-components across six components: causal conditions, background, mediating, central phenomenon, strategies, and outcomes. All variables obtained can be considered in the design of the final model. In conclusion, the effectiveness of each variable was discussed and analyzed from an existential perspective. The results indicated that the causal conditions, background conditions, intervening factors, and outcomes in the model of organizational evolution in hospitals affiliated with Bushehr University of Medical Sciences were significant.
Conclusion: The results showed that the model of organizational evolution in hospitals affiliated with Bushehr University of Medical Sciences is valid.
Ebrahim Hasanzadeh, Hasan Aboulghasem Gorji, Aziz Rezapour, Mani Yousef Vand,
Volume 22, Issue 2 (9-2023)
Abstract
Background and purpose: Supplementary health insurance plays a pivotal role in the health economy and individual payments, enhancing access to health services and improving individual quality of life. This study aims to explore the challenges and strategies for developing supplementary health insurance.
Methods: This systematic review examined research related to the challenges and strategies for the development of supplementary health insurance in various countries, focusing on articles published in the last five years in both domestic and international databases. For each article, a data extraction form was completed, and the data were subsequently classified, summarized, and analyzed.
Results: Seventeen articles met the study's inclusion and exclusion criteria and were analyzed. The main challenges and strategies for developing supplementary health insurance were identified across seven primary themes: premium and financing, electronic infrastructure, quality improvement, moral hazards and adverse selection, cost-effectiveness and efficiency, evidence-based decision-making, and effective awareness and advertising.
Conclusion: Considering the numerous identified challenges and barriers in the development of supplementary health insurance, it is recommended to focus on creating electronic infrastructures and necessary platforms to enhance and develop policies in supplementary health insurance, particularly in the dimensions of service packages, cost-effectiveness, and efficiency
Fatemeh Daei Bidgoli, Leila Nazarimanesh, Kamran Hajinabi,
Volume 22, Issue 3 (12-2023)
Abstract
Background and Purpose: Experiential marketing is a type of marketing strategy that attracts and engages customers by creating real-life experiences, allowing them to form lasting positive memories. Creating an excellent customer experience in the healthcare sector is challenging. Therefore, the aim of this study is to investigate the effect of experiential marketing on the intention to revisit social security clinics in Qom province.
Methods: This quantitative and applied research utilized a survey approach for data collection. The statistical population comprised clients of the social security clinics in Qom province. A total of 522 individuals were invited to participate in the study using stratified random sampling. Data analysis was conducted using covariance-oriented structural equation modeling with the help of Amos V24 software.
Results: The effect of experiential marketing (with dimensions of sensory experience, physical experience, emotional experience, cognitive experience, and relational experience) on the intention to return to the clinic was confirmed, with a path coefficient value of +0.540. Additionally, the structural indicators of the model and the validity of the constructs demonstrated a good fit for the model.
Conclusion: Experiential marketing, along with the enhancement of patient-doctor relationships, is crucial. Patient-centered facilities can increase the likelihood of patients returning to clinics by focusing on experiential marketing, providing amenities, and utilizing technologies to improve service delivery.
Mohammadreza Shahraki, Hamidreza Esmaeili,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Artificial intelligence (AI) plays a crucial role in the optimal management of hospital waste, particularly in predicting the volume and type of waste generated. This study aims to identify and rank the risks associated with the use of AI systems in hospital waste management by employing a multi-criteria decision-making approach.
Methods: This descriptive, cross-sectional study was conducted in 2023 (1402 in the Iranian calendar) at two hospitals, Ali Ibn Abitaleb and Khatam al-Anbiah, in Zahedan. Ten hospital staff members were selected as expert participants for the Delphi panel. The Shannon entropy method was utilized for risk weighting, and the TOPSIS method was applied to rank the identified risks.
Results: Kendall's coordination coefficient was used to assess the level of consensus among the Delphi panel members, with the coefficient values for the first, second, and third Delphi rounds being 6.3, 7.1, and 7.3, respectively. The indicators were weighted using the Shannon entropy method, based on three criteria: impact intensity (0.3), probability of occurrence (0.4), and detection probability (0.32). The TOPSIS method was then employed to rank the identified risks, with the most significant risks being the need for necessary infrastructure (0.847), the requirement for accurate and complete data (0.751), and budget constraints (0.749).
Conclusion: By applying multi-criteria decision-making methods, healthcare managers can effectively identify and prioritize the risks associated with using AI systems in hospital waste management, enabling them to focus on strengthening waste management practices based on these priorities.
Seyed Rahim Safavi Mirmahalleh, Mohammad Rahim Ramazanian, Mahmoud Moradi, Mostafa Ebrahimpour Azbari,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Health status is undeniably one of the most critical indicators of social development and progress. Providing healthcare poses a significant challenge for human life, and managing the healthcare supply chain is of strategic importance. The aim of this research is to analyze and compare the results of meta-synthesis with thematic analysis in identifying the risks of the pharmaceutical industry's supply chain.
Methods: This research follows a qualitative approach, utilizing both meta-synthesis and thematic analysis to identify supply chain risks in the pharmaceutical industry. In the first step, a meta-synthesis and systematic review of related studies over the past twenty-three years were conducted, identifying one hundred articles, which were refined to twenty-six key articles for the research. In the next step, risks specific to Iran's pharmaceutical supply chain were identified through thematic analysis and semi-structured interviews with experts, using targeted sampling. Finally, the results from these two approaches were compared and analyzed.
Results: The meta-synthesis approach identified ten general supply chain risks in the global pharmaceutical industry. Similarly, the thematic analysis approach identified ten specific supply chain risks in Iran's pharmaceutical industry. Six risks were common to both approaches: low quality of raw materials, complexity and incompatibility of information systems, supply of foreign currency and financial payments, transportation and insurance issues, increase in the price of raw materials, and unavailability of medicines. These common risks are critical for both the global and Iranian pharmaceutical supply chains.
Conclusion: Stakeholders in Iran's pharmaceutical supply chain (including hospitals) should prioritize managing these six common risks to improve supply chain performance. Additionally, they should focus on the four unique risks identified through thematic analysis specific to Iran's pharmaceutical supply chain, applying appropriate control measures and activities.
Leila Vali, Hojat Farehmandnia, Ahmadreza Mohammadpour,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose:
As people age, physical dysfunction often increases, leading to various challenges and a heightened need for urgent medical services. Elderly individuals are among the primary users of healthcare and pre-hospital emergency services. Their subjective experiences during emergencies are influenced by their need for timely and relevant information regarding emergency procedures and their clinical condition—a need that is also shared by their caregivers. This study aims to elucidate the experiences of elderly individuals who have used pre-hospital emergency services in Shiraz.
Methods:
This qualitative study was conducted in two phases. In Phase 1, semi-structured interviews were conducted with 21 elderly participants using purposeful and snowball sampling until data saturation was achieved. The interview transcripts were analyzed using Colaizzi’s method to extract key themes. In Phase 2, a panel of experts was convened to further discuss the findings and provide recommendations.
Results:
Analysis of the interviews revealed several themes related to the elderly’s experiences with pre-hospital emergency services. These themes were categorized into sub-themes including ambulance condition, performance of technicians, timeliness of emergency response, and issues related to emergency rules and regulations. In Phase 2, the expert panel offered practical solutions to address the identified challenges.
Conclusion:
The findings indicate that elderly patients face significant challenges when accessing pre-hospital emergency services, such as poor ambulance conditions, suboptimal technician performance, delayed emergency response times, and restrictive emergency protocols. The recommendations provided by the expert panel could inform policy development and lead to improvements in the quality of pre-hospital care for the elderly.
Hasan Jafari, Mohammad Kazem Rahimi, Farnoosh Ghomi, Atiye Dehghan Niri ,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Political intelligence is critical for enhancing managerial performance and organizational productivity, while effective communication skills are essential for successful leadership. This study aims to examine the relationship between political intelligence and communication skills among managers and officials in teaching hospitals in Yazd City.
Methods: This descriptive, cross-sectional, and applied study was conducted on 65 hospital managers, selected via census. Two standardized questionnaires were employed to measure political intelligence and communication skills. Data were analyzed using descriptive statistics and analytical tests in SPSS version 26.
Results: The mean (±SD) score for political intelligence was (107.15±11.96), and for communication skills, it was (59.46±7.46)—both above average. No significant relationship was found between political intelligence scores and any demographic variables. However, a significant association was observed between overall communication skills and the gender variable (p=0.029). Spearman’s correlation analysis revealed a positive correlation between political intelligence and communication skills (r=0.527).
Conclusion: The findings underscore the importance of enhancing both political intelligence and communication skills among hospital managers. In particular, the lower scores in the sub-dimensions of social games (within political intelligence) and feedback skills (within communication skills) indicate a need for targeted improvement programs. These enhancements could contribute to better managerial performance and overall organizational effectiveness.
, , ,
Volume 23, Issue 2 (8-2024)
Abstract
Hasan Varmazyar, Ali Akbar Fazaeli, Taghi Torabi, Farhad Ghaffari,
Volume 23, Issue 3 (11-2024)
Abstract
Maryam Goodarzi, Mashallah Torabi, Maryam Ahmadi, Hamideh Hamidi, Samira Elmi, Reyhaneh Sadat Karimi, Fatemeh Golmahi, Samira Mortezaie, Parisa Nezari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: In the current decade, the development of intellectual capital has emerged as a key driver for enhancing both individual and organizational performance. The deployment of electronic service desks can contribute significantly to this development, particularly in strengthening structural capital. This study aimed to examine the impact of implementing an electronic service desk on the structural capital of Tehran University of Medical Sciences during the COVID-19 pandemic.
Methods: This qualitative study employed a multi-case research approach. Data were collected through semi-structured interviews with managers and experts in the domains of service desk operations and university education. Additional data were gathered by reviewing institutional documents and client feedback reports. Identified factors were subsequently validated through focus group discussions. Content analysis was used to analyze the data.
Results: The most prominent impact of the electronic service desk was improved management of client-related statistics and enhanced reporting capabilities to relevant authorities. Other significant effects included easier user access, the ability to refer documents to other departments or organizations, improved resolution of requests during initial user contact, and enhanced interactions with clients.
Conclusion: The electronic service desk played a vital role in sustaining and enhancing the quality of educational services during the pandemic, while aligning with public health protocols. Furthermore, it laid the foundation for managerial innovation within the university’s educational service delivery system.
Leila Bornaye Agah, Amin Qasem Beglou, Abasat Mirzaei,
Volume 23, Issue 4 (2-2025)
Abstract
Background and purpose: Developing countries strive for solutions to attract medical tourists. Digital marketing is explored here. The aim is to assess digital medical marketing criteria and their relation to health tourist acceptance in selected Tehran hospitals in 2022.
Methods: A descriptive-analytical approach using mixed methods. Qualitatively, through text review, digital medical marketing criteria were identified using fuzzy Delphi, resulting in 5 factors and 61 concepts. Quantitatively, after distributing questionnaires among 30 experts, 25 valid questions were retained. The sample included 125 experts from health tourism units and hospital staff. Kendall's correlation and Chi-square tests were run via SPSS 18.
Results: Identified criteria encompassed multilingual websites, content, digital systems, human resources, and health tourist attraction. Kendall's correlation indicated significant relations with human resource performance (r=0.413), website content (r=0.247), and digital systems (r=0.235) significantly influencing tourist attraction (p<0.01). Chi-square tests revealed significant differences in multilingual websites, website content, digital systems, and human resource performance impacting health tourist attraction (p<0.01).
Conclusion: Iran's medical tourism benefits from enhancing service quality, website content, human resource performance, and digital systems, leading to increased health tourist attraction.
Majid Safaei Lari, Ali Akbar Mohammadi, Hamid Raeisi, Zakiyeh Raeisi,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: The Student Welfare Fund of Iran's Ministry of Health is a public institution tasked with providing financial aid to medical students. Amid growing demand for these services and constrained government resources, a comprehensive analysis of the full cost of loan disbursement is crucial for ensuring operational efficiency and financial sustainability.
Methods: This applied, descriptive study conducted a retrospective cost analysis from the perspective of the Student Welfare Fund. The study population comprised all student loan records processed during the 2024 fiscal year. A hybrid top-down and bottom-up costing methodology was employed to determine the full cost of the loan disbursement process. Data were extracted from the Fund's internal financial records, annual reports, and publicly available price lists for equipment and consumables, and subsequently analyzed using Microsoft Excel.
Results: The full cost per loan processed was lowest for single-student academic and essential-needs loans, at IRR 33,538,137, and highest for housing deposit loans, at IRR 56,743,475. The total cost for all student loans disbursed during the 2024 fiscal year amounted to IRR 124,222,283,295.
Conclusion: Processing times were shortest for academic loans and longest for housing deposit loans. Human resources constituted the largest cost component in the disbursement process. Despite the significant personnel costs, a comparison between the full costs and the service fees collected suggests that the Fund's operational processes and staff performance are acceptably efficient.
Fateme Tavallaei, Fattah Sharifzade, Reza Vaezi, Seyed Jalalodin Faraji,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: Non-communicable diseases (NCDs) account for 76% of mortality in Iran, where effective management hinges on community empowerment and integrated service delivery. Co-production, an innovative strategy involving shared power between service users and providers, is a promising approach for addressing the multifaceted needs of patients with chronic conditions. This study aimed to develop a context-sensitive framework for implementing and evaluating co-produced NCD management programs. We achieved this by integrating the core principles of co-production with a realist evaluation lens, drawing on the perspectives of senior healthcare managers.
Methods: Employing a qualitative methodology, this study conducted a thematic analysis of data derived from a comprehensive literature review and semi-structured interviews. A cohort of 17 senior healthcare managers, selected via purposive sampling in 2025, participated as key informants.
Results: The analysis yielded a hierarchical thematic structure comprising 71 basic themes, 20 organizing themes, and 6 overarching global themes. These global themes, which form the core of the proposed framework, are: (1) Developing Participatory Clinical Processes, (2) Establishing Equity-Oriented Support Services, (3) Recognizing Diverse User Groups, (4) Enhancing Provider Capabilities, (5) Understanding User Responses, and (6) Fostering Mutual Benefits among Stakeholders. The dynamic interplay of these themes is crucial for operationalizing effective NCD co-production.
Conclusion: By innovatively integrating co-production principles with a realist evaluation framework, this study offers a context-sensitive model that clarifies theoretical concepts for practical application in NCD management. A key implication is the necessity for monitoring systems that track both clinical and well-being outcomes, supported by multi-level incentive structures. This research provides a foundational model for policymakers to develop, implement, and evaluate more effective and equitable co-produced healthcare programs. Further longitudinal research is recommended to assess long-term outcomes and incorporate patient perspectives.
Karen Fatahi,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: Nurse's thermal comfort in a clinical setting directly impacts their performance and the quality of patient care. This study investigates how two key environmental factors—ambient light intensity and Correlated Color Temperature (CCT)—influence this perception of thermal comfort.
Methods: This experimental study was conducted in a controlled laboratory setting with 60 healthy female nurses over four months (December 2024–March 2025). We assessed the effects of light intensity (at two levels: 300 and 750 lux) and CCT (at three levels: 2700 K, 4000 K, and 7800 K) on perceived thermal comfort. Data were analyzed using a two-way Analysis of Variance (ANOVA).
Results: Light intensity, CCT, and their interaction all had a statistically significant effect on nurses' perceived thermal comfort (p < .05). Optimal thermal comfort was reported at a CCT of 4000 K under both 300 and 750 lux intensities. At a warm CCT (2700 K), comfort was maintained at 300 lux but not at 750 lux. Conversely, at a cool CCT (7800 K), the 300 lux condition was perceived as uncomfortable, while the 750 lux condition was reported as comfortable.
Conclusion: This study demonstrates a significant interaction between light intensity and CCT in shaping thermal perception in a clinical context. The findings suggest that lighting design in healthcare facilities must consider both metrics simultaneously to optimize the work environment. A neutral CCT of 4000 K appears to be the most robust for maintaining thermal comfort across different light levels, highlighting its potential as a design standard for healthcare settings.
Forough Saraee, Fatemeh Zahra Ahmadi, Mahboube Gholami,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: The prevalence of mental health disorders among children and adolescents is on the rise, exerting profound effects on individual development, academic performance, and social well-being. This study aims to map the current landscape of mental health services for this demographic in Iran, identify existing challenges, and propose strategies to enhance service accessibility and quality.
Methods: This scoping review was conducted in 2025 using the six-stage framework developed by Arksey and O’Malley. A comprehensive search was performed across international databases (Scopus, Web of Science, PubMed) and national databases (MagIran, SID), as well as Google Scholar and relevant organizational websites (e.g., WHO, Ministry of Health and Medical Education). Data were extracted using a narrative approach and analyzed thematically.
Results: Nineteen studies met the inclusion criteria. The review identified a multi-level service delivery system encompassing primary care, specialized care, school-based, community-based, family-based, and national-level interventions. These services utilized diverse modalities, including education, screening, and therapeutic interventions. Key barriers to effective service delivery included structural constraints (e.g., inefficient referral systems, resource scarcity), socio-cultural challenges (e.g., stigma, low public awareness), and human resource shortages (e.g., lack of specialists).
Conclusion: Leveraging the capacities of the primary healthcare network and the educational system, alongside workforce capacity building and public awareness initiatives, is essential for expanding access to and improving the quality of mental health services in Iran.
Taher Malaki, Dr Abasat Mirzaei, Sanaz Zeydabadi, Akbar Rasouli,
Volume 24, Issue 1 (5-2025)
Abstract
Background and purpose: One of the health system reform programs is the Family Physician and Referral System Program. Therefore, the purpose of this study is to review how family physicians and referral systems are financed in selected countries and Iran.
Methods: This study was conducted as a comparative review in 1403. Information was extracted using related keywords and their English equivalents based on specific subject headings (Mesh) in various databases. In addition, data from the World Health Organization and health system reports of selected countries were also reviewed. Information was extracted based on a data extraction form (researcher-made). Finally, the information was categorized and analyzed by subject.
Results: The study results showed that the main source of financial resources was through the budget and public taxes, and the payment system in the family physician program in the majority of the countries studied was based on performance-based per capita payments. Finally, in addition to the weaknesses and challenges of the countries studied in implementing The family physician program, in Iran, lack of public awareness, poor supervision and management, incorrect policymaking, and challenges in implementing electronic health records were also identified as weaknesses of the family physician program.
Conclusion: Despite the many similarities in the implementation of the family physician program among the selected countries, there are differences in terms of policymaking, implementation methods, and funding methods. Based on the research findings, it is suggested that in order to successfully implement the family physician program, the successful experiences of other countries at the international level, as well as evidence and information in implementing this program, be used.
Ali Modabber, Habib Jalilian, Behnam Gholizadeh, Esmaeil Mousavi Asl, Farzad Faraji-Khiavi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Ensuring continuous access to healthcare services is critical for patients with hypertension, particularly during pandemics and public health crises. This study aimed to evaluate the resilience of service delivery by Primary Healthcare Centers (PHCs) to hypertensive patients during such emergencies.
Methods: This descriptive cross-sectional study was conducted in 2023 across 10 PHCs in Markazi Province, Iran. A total of 250 patients with hypertension were recruited using a systematic random sampling method. Data were collected using a researcher-designed questionnaire assessing four dimensions of resilience: quality, accessibility, continuity, and coordination. Data were analyzed using descriptive statistics and multiple linear regression in SPSS software (version 24).
Results: The overall service resilience score was 2.95 (±0.32), indicating a "relatively weak" level of resilience. The mean scores for the dimensions were: Accessibility 3.08 (±0.28), Coordination 3.03 (±0.76), Quality 2.93 (±0.41), and Continuity 2.88 (±0.35). Multiple regression analysis revealed that these four dimensions collectively explained 96.1% of the variance in service resilience. Accessibility (β = 0.478) was the strongest predictor, followed by Quality (β = 0.379), Continuity (β = 0.352), and Coordination (β = 0.178).
Conclusion: The resilience of services provided by PHCs to hypertensive patients during pandemics was assessed as suboptimal. These findings highlight an urgent need for strategic operational planning by health policymakers. Developing protocols to ensure service continuity and expanding infrastructure for remote care (telemedicine) are recommended as key priorities to enhance system resilience.
Alireza Rahimi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Pre-hospital Emergency Medical Services (EMS) play a pivotal role in managing life-threatening conditions. However, evidence suggests that the Iranian EMS system faces multifaceted challenges across human, managerial, and infrastructural dimensions. This study aimed to conduct a comprehensive meta-synthesis to identify and analyze the challenges characterizing pre-hospital EMS in Iran, based on research evidence published between 2014 and 2025.
Methods: This study employed a meta-synthesis approach utilizing the seven-step framework by Sandelowski and Barroso (2006). A systematic search of major domestic and international databases using relevant keywords yielded 414 initial records. Following a rigorous screening process based on inclusion/exclusion criteria and quality appraisal, 25 articles were selected for the final analysis. Data were synthesized and categorized using thematic analysis.
Results: The findings revealed that the challenges facing the Iranian pre-hospital EMS can be categorized into six main themes: human resources, logistics and infrastructure, organizational and managerial barriers, socio-cultural issues, and educational deficits. A deeper analysis highlighted the multifaceted and intertwined nature of these obstacles. The results indicate that these challenges do not exist in isolation but are interconnected within a complex network of cause-and-effect relationships.
Conclusion: The findings confirm that the challenges within Iran's emergency system mirror global trends and overlap significantly with issues reported in other low- and middle-income countries (LMICs). Addressing these problems requires a holistic and systemic approach that simultaneously targets human, logistical, organizational, and socio-cultural dimensions, while ensuring system preparedness for potential accidents and disasters.
