Journal of School of Public Health and Institute of Public Health Research

Primary Health case in Islamic Republic of Iran

Hossein Malekafzali

In this article 40 years of Iranian experience in primary health care in west Azarbaijan and behvarzs is presented. In this regard quantitative development of PHC during this period will be discussed, moreover challenges and opportunities of this program will be analysed. Finally family physician program should be considered as an appropriate tool to achieve universal coverago of PHC in iran.

The view of point and perspective of policy makers about HIV/AIDS control policies in Iran-a qualitative study

Hossein Malekafzali

Background and Aim: The aim of the present study was to investigate the views of policy makers and key persons about national AIDS control politics.

Materials and Methods : This qualitative study used purposive sampling. To collect data, the perspectives of six experts about AIDS were inspected. Framework analysis was used to analyze the data.

Results: The results of this study showed that beside the strengths there are also significant weaknesses in making the policies, administering the existing policies, executing the programs in organizations, and planning new policies to control AIDS hence these problems and weaknesses must be identified to achieve the main goals of AIDS control program.

Conclusion: AIDS is not only a health problem but a social, economical and cultural problem, which requires more attention from authorities and related organizations for developing and implementing policies in accordance with international guidelines. To achieve Millennium development goals (MDGs) in the context of AIDS it is essential for policy makers and key figures to consider more effective activities and measures in their agenda.

Barriers of condom use among female sex workers in Tehran, a qualitative study

Afarin Rahimi movaghar

Background and aim: In Iran, HIV prevalence in sex workers is reaching to an epidemic, but still consistent use of condoms is low. This qualitative study aimed to assess barriers to condom use in female sex workers (FSWs).

Materials and Methods: We conducted individual in-depth interviews with 40 FSWs and 12 partners in the year 2010 in Tehran. The FSWs were purposefully selected from four different groups based on the level of socioeconomic status and history of using substance. Findings were extracted and coded manually and the responses of the groups were categorized and compared.

Results: Almost all FSWs had not used condoms regularly in the past six months. The main barriers of condom use were: lack of awareness of the modes of transmission of HIV and prognosis of the disease, doubt on the role of condoms in preventing sexually transmitted diseases and HIV, fear of violence or rejection by male customers, reluctance of sexual partners to use condoms due to diminution of sexual pleasure, and believing in health of some customers.

Conclusions: Increasing awareness of the FSWs through education about HIV, ways to prevent the disease and empowering them on negotiating skills to use condoms as part of harm reduction programs are recommended .

Assessment of factors affecting the persistence of diarrhoeal cases after the explosive epidemic phase of diarrheal disease in Yazd province - summer 2013: an incidence base case-control study

Kourosh Holakoie naieni

Background and Aim: Water and food born diseases are one of the important causes of morbidity and mortality in through the world. The objective of this study was to investigate factors affecting the persistence of diarrheal cases after the explosive epidemic phase of diarrheal disease in Yazd province.

Materials and Methods: We designed a match case control study that was performed on base of incidence cases of diarrhea since 24 Aug, 2013 to 03 Sept, 2013.Characteristics of cases and control were obtained by interviewers using a pre-determined questionnaire. Logistic regression was used at 0.05 significant level.

Results: Totally 69 incidences cases of diarrhea were compared with 138 controls. Incidence rate of diarrhea in Yazd province was 13.79 per thousand. The adjusted odds ratio estimate for presence a patient stricken with gastroenteritis in the household was 3.63 [95% CI: 1.43, 9.20]. The adjusted odds ratio for low education, history of the trip, history of contact with patient and eating outside the home were 1.75, 1.55, 1.93 and 1.37 respectively, that increase odds of disease but their effects was not statistically significant.

Conclusion: In this study the most important risk factor for diarrhea was history of contact with the person with the disease in the household. This result may indicate the lack of personal hygiene by patients and their relatives and thus transmission of disease to others peoples. Therefore the role of health education and informing about transmission and preventive ways is very important in prevention and control of outbreaks of diarrhea diseases.

Life Insurance Demand and Economic Factors Effect on Health Indicators

Hamid Sepehrdoost

Background and Aim: Economic factors, including life insurance in financial sector may have a significant effect on health sector and consequently on the life expectancy of the society. The life insurance effects on health index indirectly through economic growth and directly through bringing mental relaxation and social welfare for the person applying for life insurance. The main purpose of this study was to investigate how life insurance demand and other economic factors effect on life expectancy index of the society.

Materials and Methods: In this study, the relevant data with respect to life expectancy as dependant variable and economic factors including life insurance demand have been collected from Organization of Islamic Conference ( OIC) countries for the years 2011 to 1998 using panel data analysis .

Results: The results of the study indicate a significant and statistically positive effect of life insurance demand on life expectancy index of the selected OIC countries. On the other hand, the variables such as financial development and per capita income also have significant positive effect, while the variables such as unemployment and inflation have significant negative effect on life expectancy index of health.

Conclusion: The results suggest that economic conditions improvement through lowering rate of unemployment, lowering rate of inflation, increase in per capita income and the financial market development could probably improve the condition of life expectancy in a society. Therefore, that is recommended for the planners to take into account the fundamental economic indicators specially life insurance consumption while planning for health and welfare betterment of the society.

Nutritional status of elderly people

Farhad Lashkar boloki

Background an Aim: Aging trend especially in developing country is increasing. This study aimed to assess the nutritional status of the elderly and its associated factors in Gorgan .

Materials and Methods: This is a cross sectional study that two-stage cluster sampling method was used for considering participant. The data were collected using Mini Nutritional Assessment and anthropometric questionnaire which was referred to the elderly inhabitant in urban area. 541 elder were interviewed and data were analyzed by chi square, independent T test and one way ANOVA tests.

Results : The prevalence of malnutrition was %4/8 and nearly %44/7 of the elderly were at the risk of malnutrition. %51/9 of the elderly were on a special diet due to a disease or specific condition. Malnutrition frequency and the risk of it were higher in woman than men and the difference between sexes was statistically significant. BMI, mid arm circumference and calf circumference measures in elderly with malnutrition were less than elderly with good nutrition, and the difference was statistically significant

Conclusion: The risk of malnutrition in elderly who exposed to socio-economic, mental and also dental difficulties, living alone and female old age was higher than others groups. The implementation of supportive and nutritional programs is more important in this group.

Priorities of health risk behaviors among high school students in the public schools in 5th restrict of Tehran: A qualitative study

Shahnaz Rimaz

Background and Aim: Health-risk behaviors are socially constructed and influenced by the given culture. Therefore, the health-risk behaviors are prioritized differently in diverse cultures. In this study, we aimed to explore the priority of health risk behaviors among high school students in Tehran.

Materials and Methods : In this qualitative study using rapid assessment approach, we interviewed 130 individuals who voluntarily participated in the focus group discussions (FGDs, n=17). They were students (n=9 FGDs), the parents (n=5 FGDs), and the teachers (n=3 FGDs). Four of the principals were individually interviewed. Interviews focused on (1) perceptions about and description of healthy or unhealthy behaviors (2) priority of health risk behaviors in adolescents (3) perceptions and beliefs about the formation of the risk behaviors among adolescents. All sessions were embarked on the public schools located in the area five in West Tehran. After obtaining a written consent form from the participants, primary investigators and three of the trained facilitators (male and female) conducted the sessions. We employed content analysis to extract the major themes and sub-themes. The rigor of the data was obtained.

Results : Addiction, risky sexual behavior, and social misconduct ion (aggression) were identified as the main concerns for the boys. Risky sexual behavior, early marriage, eating unhealthy habits, physical motionless, and fear of the future (job, education, marriage) were identified as the main health-risk behaviors for the girls.

Conclusion : According to our findings, health risk behaviors are classified differently for boys and girls. However, sexual risk behaviors are common findings for both groups. The adolescents' risky behaviors are formed throughout their socialization and seriously influenced by the given culture. Understanding of gender schema was identified as an important factor in the way participants do priority health-risk behaviors of young people. Comprehensive and holistic health education and promotion programs targeting adolescents as well as training programs for parents are suggested.

Efficiency of ortho-chlorophenol removal from aqueous solutions using activated Fly Ash of Zarand Fossil Fuel Power Plant

Mohammad Malakoutian

Background and Aim: Chlorophenols are acidic Organic compounds and priority Pollutants. One of the best ways to removal chlorophenols was using different absorbents . In this study, removal efficiency of ortho- chlorophenol as one of the most common organic contaminants in aquatic environments was investigated with absorption method using activated Fly Ash.

Materials and methods: In this experimental study, Fly ash of collected from Zarand Power plant was activated by sulfuric acid. Factors affecting in sorbent activation process including temperature, time, amount and concentration of the acid and also factors influencing in the adsorption process were adjusted for optimum conditions. Experiments was followed on real wastewater samples from coal washing plant of zarand . Data was analyzed by SPSS software.

Results : The sorbent activation was performed in optimized condition acid concentration 1.8 mM, time 5h, temperature 29±2˚C and acid/fly ash ratio 7. Removal efficiency of zarand coal washing plant Effluent at the optimal conditions (pH: 2, adsorbent doze: 1g, time: 3h) was 84.4%.

Conclusion: In addition to the high efficiency of ortho-chlorophenol absorption because of sorbent activation does not require complex and expensive technology, the adsorbents can be used to remove these contaminants from industry effluent.

Effect of educational interventions on sexual high risk behavior between drug addicts ex-users based on the Health Belief Model

Sedighe sadat Tavafian

Background and Aim: Addiction behaviors have been established among high risk behaviors among different age groups in Iran. This study aimed to investigate the effects of a designed educational program on high risk behaviors of a sample of addicts in Qom, Iran.

Materials and Methods: Totally, 128 men with addiction history in self help groups referred to health centers in Qom were studied. The instruments used to collect data were a self administered demographic questionnaire and the designed scale high risk behavior based on Health Belief Model (HBM).

Results: The mean age of participants was 32.4 years. There were no significant difference between two groups at baseline in terms of all demographic data and all HBM constructs. The mean scores of HBM constructs, improved significantly in comparison with baseline. (p < 0.05).

Conclusions: This study indicated that designed educational program could improve all HBM constructs after intervention. Additionally, behavior intention might be changed after intervention significantly.