Journal of School of Public Health and

Background and Aim: Public-private partnership is a type of privatization in which the public sector continues to participate in the provision of services. Based on an agreement between the Ministry of Health and the Ministry of Cooperatives, Tabriz University of Medical Sciences started the process of creating health cooperatives in the Eastern Azerbaijan Province. In this study we compare the function of various health service processes between public health centers and health cooperatives.

Material and Methods: This study looks at coverage, quality and continuity of primary health care in 9 health centers handed over to cooperatives as compared to 18 current public health centers. Data were collected over a period of three months and analyzed by the SPSS-10 statistical package. Chi-Square and t tests were used for data analysis.

Results: Family planning coverage rates, infant health care, 1- to 6-year-old health care, prenatal care and the number of households covered by volunteers were all higher in cooperatives compared to public health centers. The mean care delivery volume was smaller in health cooperatives. The mean numbers of screening visits, outpatient visits, control visits, consultations, injections and dressings as well as follow-ups were higher in health cooperatives. Despite the greater numbers of family planning visits, vaccinations, health certificates issued and water chlorimetry tests in the public sector, the differences were not statistically significant. Concordance of data between forms and registers was higher in health cooperatives in the case of child health care, periodic visits and vaccination forms.

Conclusion: Compared to the public sector, health service delivery through cooperatives not only functions well but also yields better indices in many health domains. This is an example that a private institutions functioning under the supervision of the public sector can implement nationwide health care programs better than the public sector itself.

Background and Aim: The district health information system (DHIS) converts raw data into useful manegerial information. The main purpose of DHIS is to improve quality of health services in service delivery points. This study was conducted to investigate the DHIS performance.

Materials and Methods: A total of 200 health service-delivery units were selected by systematic random sampling, and the calculation of 47 primary health care indicators was assessed by the provincial health center statistics supervisor.

Results: On the average, 41.9% of the indicators had been calculated in each unit. In the district health center, the proportions of outcome measures and process performance indicators calculated were 50% and 5.6%, respectively. On the basis of the indicators obtainable from the vital horoscope, 79% of the indicators in the district health center and 66% of those in the health service-delivery units had been calculated. Finally, there were 97 disease-surveillance forms, 35 environment-health forms, 21 family-health forms, and 23 other forms at the district level.

Conclusion: Re-designing the structure of the health information management process and determining indicator packages at the district and service-delivery level are vital steps for improving the health information system at the district level.

Background and Aim: Monitoring and evaluation are basic components of any health program. Control charts show clearly the process performance trend longitudinally and help managers and staff to detect general and specific variations and evaluate the process performance correctly. This study was conducted to design and utilize control charts in the primary health care (PHC) system.

Materials and Methods: This study was conducted in two stages. In the first stage, the average weekly, monthly and seasonal delays in receiving health services were compared retrospectively. In the second stage, appropriate control charts were introduced with due consideration of the PHC system.

Results: More than 95% of the weekly average delays were below the upper control limit, while in 100% of the cases the monthly and seasonal averages were under the upper control limit.

Conclusion:  Desirable health outcomes result from appropriate services. It is necessary to monitor health processes coverage and performance with simple and specific indicators. With regard to the health process outputs in the PHC system, it is suggested that the R-X, np and C charts be used in monitoring processes.

The control charts help the service providers to determine and manage process performance by gathering simple, applicable data. Some of the advantages of using these charts are the possibility of longitudinal surveys, simplicity of the calculation methods, and their high applicability.