Journal of School of Public Health and

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Background and Aim: Rapid growth of Iran's population attracted attention of the authorities after the 1986 national census. This led to population control and family planning programs to be considered as a priority. Appropriate strategies of the family planning program led to a very fast decrease in population growth and fertility indices: and use of contraceptive techniquies rate increased from 49% in 1989 to 73.8% in 2007. This study aimed at reviewing family planning program in Iran (FPPI) during the last four decades and discussing the reasons for its success, as it can be a guide for future efforts aimed at improving other aspects of reproductive health.

Materials and Methods: The method used was systematic reviewing of articles indexed in Medline and University Jihad Scientific Database, reports of the Demographic and Health Project, the Iranian Statistical Center National Censuses, and the Ministry of Health and Medical Education reports on knowledge, attitude and practice.

Results: FPPI initiated officially in 1966 faced with limited success. Following the 1986 national census, population control was announced as a public policy, supported by the leaders. A supportive environment was created by mass media. Establishment of the Departments of Population and FP in the Ministry of Health made possible reorganizing family planning services: expanding coverage of PHC services, including FP services training skilled personnel providing free contraceptives and vasectomy and tubectomy services. Involvement of volunteers and NGOs helped in strengthening community actions. In order to develop personal skills, in addition to face-to-face FP counseling in the health centers, FP education in schools, colleges, workplaces, army and pre-marriage classes was also imparted. Promotion of men's participation in FPPI, by providing male methods of contraception, such as vasectomy or condom use, was also considered. There was also cooperation and support on the part of nongovernmental and international organizations.

Conclusion: Based on the findings, it may be concluded that the principles of health promotion can explain the FPP achievements in Iran. This model can be used in expanding other reproductive health programs in Iran.

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Background and Aim: Considering the social and cultural characteristics of Iranian adolescents, none of the quantitative instruments designed so far to assess their health needs is quite appropriate. The purpose of this study was to design a valid and reliable questionnaire to assess the health needs of Iranian adolescent females.

Materials and Methods: Both qualitative and quantitative approaches to instrument development were adopted in this study conducted in the District of Sari in the north of Iran. Sampling was objective-based, with an attempt to have female adolescent sample as varied as possible. In the qualitative phase, a content analysis approach was used to explore the concept of health needs as seen by female adolescents. Data were collected using 8 focus group discussions (FGDs) with the presence 6-10 adolescents 12-18 years old in each FGD, as well as 11 semi-structured interviews, each one involving 11 well-informed individuals. In the quantitative phase, the psychometric properties, including content validity, face validity, construct validity, concurrent validity, internal consistency, and test-retest reliability, were determined.

Results: Five themes were identified in the qualitative phase of study, including psycho-emotional health, social health, physical health, and educational needs, as well as spiritual beliefs. The mean scale-level content validity index (S-CVI) was found to be 0.92. The factor structure of the instrument was identified by doing a Principal Component Analysis. Five factors were extracted with a total variance account of 45.37%. The reliability and consistency of the instrument were established with the Cronbach's alpha coefficient (0.90) for the entire scale and test-retest reliability with a 2 week-interval Intraclass Correlation Coefficient (ICC=0.984, p<0.001).There was a concurrent correlation between the instrument and Pediatric Quality of Life Inventory (PedsQL TM 4.0) (r=0.66, p<0.001).

Conclusion: The instrument developed in this study is a valid, reliable and culturally appropriate instrument for assessment of health needs of Iranian adolescent females. 

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Background and Aim: Breast and cervical cancer screening is considered a health promotion behavior, influenced by complex factors. The theory of planned behavior provides a useful framework for predicting and understanding the health behavior and designing appropriate educational interventions. Integrating this theory with self-efficacy will increase its predictive value. The objective of this qualitative research project was to understand the factors influencing the behavior of breast and cervical cancer screening of female-workers as a base for future educational planning.

Materials and Methods: This was a qualitative approach research based on the Integrated Model of Planned Behavior and Self-Efficacy. Seventy 20-45 year-old women working in industrial plants in Abbasabad, Pakdasht, selected by purposeful sampling with maximum diversity participated, in 10 groups of 7 each, in focus-group discussions, in which they discussed their experience regarding factors influencing the behavior of breast and cervical cancer screening. Data were collected and their validity, conformability, transferability and dependability confirmed. For data analysis the conventional method of content analysis was used.

Results: The female workers had a low knowledge and attitude concerning the behavior of breast and cervical cancer screening. Attaching importance to comments given by the family members, especially the husband, and preference of treatment to prevention of disease in the society at large were the subjective norms of the female workers. The most important barriers to participating in screening programs were lack of knowledge, depression, fatigue, embarrassment and fear of examinations, fear of being sick, poor quality of services and lack of attention to privacy in health centers, limited access to health centers, and costs of tests. The female workers had a low self-efficacy for planning and overcoming barriers. Most of them had not had screening tests and had no intention of doing their screening tests in the following three month.

Conclusion: The following measures are recommended: designing and implementing specific educational programs in workplaces for female-workers aiming at increasing their awareness and positive attitudes towards breast and cervical cancer screening designing and implementing educational/training programs for families, employers and planners to increase their knowledge and attitude and facilitating women's access to health centers in industrial estates.

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Background and Aim: Becoming to an adult who is sexually healthy is one of the key developmental activities for adolescents. sexual health is included of sexual development and reproductive health and also the ability to create and maintain good interpersonal relationships, are valued for their body, Respectful engagement with both sexes in correct method and expressed a desire, love and intimacy based on personal and stable social values.
Materials and Methods: In this study, using key words adolescence, sexual behavior, sexual risk behavior and sexual health and peers, related studies from 1370 to 1390 in IranMedex, Irandoc, Medlib, SID and Google scholar were investigated.
Results: Factors and challenges are associated with adolescent sexual health can be categorized into the following 4 themes (12 sub themes): Religious beliefs and spirituality (abstinence) lack of sexual education (false beliefs and knowledge about sexual function adolescents' attitudes toward risky behavior and sexual relations information sources of adolescents skills for "say no") community and youth issues(gender differences relationships with peers monitoring and control by the family communication challenges between teen and parents socioeconomical factors Centers for reproductive health services to adolescents) adolescents sexual relationship outcomes (catching sexually transmitted diseases probability).
Conclusion: In some areas, including relationships between parents with children, gender differences, attitudes and sexual behavior and the influence of peers, Studies conducted in our country is well. But in areas such as spirituality and religious beliefs, self-control, prevalence of sexually transmitted diseases and AIDS, life skills in adolescents and intervention strategies to promote sexual health of adolescents there are a great gap.

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  Background: Sexually transmitted infections are one of the most prevalent infections all over the world that impose significant morbidity on people. There are an increasing number of sexually transmitted infections in Islamic Republic of Iran during recent years. So developing and implementing programs for STIs prevention and control is considered as a health priority. While the role of gender based power in sexual relationships has in recent years been acknowledged, the understanding has largely lacked practical considerations in the STIs/HIV/AIDS prevention fields. This study aims to explore gender sensitive STIs/HIV/AIDS prevention services concepts and dimensions.

  Method : This study employed content analyzes research design. Semi-structured in-depth interviews were conducted with 37 expert reproductive health managers and providers that selected purposively and then continued by snow ball method. Data collected by using semi-structured interview guide. The interviews were transcribed and typed. Data was analyzed according to content analysis.

  Results: 2 categories emerged as the result of data content analysis: 1) gender sensitive structure including employers, facilities and management dimensions 2) gender sensitive process including care and educational processes.

  Conclusion: providing gender sensitive STIs/HIV/AIDS prevention services need gender sensitive management, facilities and providers and gender sensitive care and educational design.

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  Background an d Aim : Several factors can affect the sexual function of women. The aim of this study was to determine the correlation between exercise and sexual function in post-menopausal women.

  Materials and Methods : This was a community-based, descriptive-analytical study including 405 post-menopausal women 40-65 years old selected by multi-stage stratified random sampling . The data were obtained through interviews using the Female Sexual Function Index (FSFI) and a researcher-made questionnaire. The data were analyzed using descriptive and analytical tests such as multiple linear regression and logistic regression models .

  Results : On the whole, 61% of the subjects had sexual dysfunction. The most common type of exercise was “walking” (79.8%). For the women who exercised, the mean score in the domain of pain was significantly lower (worse) (p=0.013). The total FSFI, lubrication and pain domains scores were significantly lower in the women who did exercises other than walking as compared to those who did not exercise or practiced only walking. The weekly exercise frequency had positive correlations with lubrication (r=0.18, p=0.014) and orgasm (r=0.146, p=0.045) domain scores. However, multiple regression analysis to determine predictors of total score of FSFI and the domains scores did not give any statistically significant results. Finally, the logistic regression test showed that one additional exercise session per week would result in reduction of chances of sexual dysfunction by 80.2%.

  Conclusion : Based on the findings, it may be concluded that exercise can be a w ay to compensate for sexual problems and dissatisfactions caused by reduced sex and sexuality in post-menopausal women. Exercising more frequently during the week could have positive effects on the sexual function of post-menopausal women.

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  Background and Aim : Empowering women means enabling them to decide independently on the basic issues of life. The great challenge of fertility and reproductive health of women is indicative of their inability to make decisions . The third objective of the Millennium Development Goals is empowerment of women and the effect of social determinants of health in this regard has been recognized. This study was conducted to assess the relationship between structural social determinants of health and women's empowerment in reproductive health.

  Materials and Methods: This was a descriptive-correlation study including 400 women consulting the Shahid-Beheshti University of Medical Sciences health centers in Tehran, Iran. In the first stage, the health centers were selected by the simple random method, followed by quota sampling the f inal sampling was done by the convenience sampling method. The tools for data collection were demographic and socio-economic questionnaires, as well as a questionnaire to obtain data on women's empowerment in reproductive health . Data were analyzed using SPSS-17.

  

  Results: That data showed that the women’s empowerment in reproductive health was at an intermediate level. Structural social determinants of health were correlated with women’s empowerment in reproductive health the highest correlation was found to be with women’s education level (r= 0.44, P< 0.001).

  Conclusions: Women's general empowerment, as well as their empowerment and in family planning needs special attention. Structural social determinants of health are correlated with women's empowerment in reproductive health . Thus, policies should be adopted and plans executed aiming at strengthening the role of women in the family and the society .

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Background and Aim: Prenatal and neonatal care provides an opportunity for counseling, resulting in reduction of pregnancy-related and neonatal complications. It is expected that such care would result in promoting the health status of these vulnerable groups and improving the relevant indicators.

Materials and Methods: This was a cross-sectional survey including 668 mothers and 2-month-old children. Data were collected using questionnaires and structured interviews.

Results: On the whole, 35.9%, 21.0% and 5.1% of the mothers reported, at least, one pregnancy, one complication, and one neonatal complication, respectively. Results of the logistic regression model showed that the odds ratio of reporting at least one of the pregnancy complications increased by more than double in women who had a medical history or a high-risk pregnancy, increase decreased by 63% in those who had continuous care during pregnancy, decreased by 40% in those who had received thorough prenatal care, and increased by 0.05% for every unit increase in age. The odds ratio of reporting at least one postpartum complication increased by 70% per unit of in the density of health workers. Moreover, the odds ratio of reporting at least one neonatal complication decreased by 48% in women who had received full neonatal care and by 50% per every unit of increase in the density of health workers.

Conclusion: The findings of this study show the important role of behvarzes (community health workers) in detecting postpartum and neonatal complications, as well as the importance of antenatal care and quality of antenatal care as regards detecting at-risk women and neonates and prevention of pregnancy and antenatal complications.