Showing 159 results for Health
Zahra Validabady, Mozhgan Lotfi,
Volume 20, Issue 1 (6-2022)
Abstract
Background and Aim: Among the valuable developments in the primary health care system has been the special attention paid to the issue of mental health and the addition of a self-care program for community mental health education. However, no integrated measures have been taken in relation to the needs of service recipients, educational priorities and the required facilities. This study was conducted to explain the priorities of this program in primary health care centers affiliated to Iran University of Medical Sciences, Tehran, Iran.
Materials and Methods: This was a qualitative study with a content analysis approach. The sample consisted of 12 stakeholders selected by purposive sampling with maximum diversity. Data were collected through in-depth and semi-structured interviews and a modified checklist of the Community Health Needs Assessment Program and analyzed using the Granheim and Landman approach.
Results: Based on data analysis, the needs were grouped into two main categories, namely, the needs of service providers and the needs of service recipients. The service providers’ needs included continuous coordination with non-health sectors, a virtual education and information system and continuous training and educational supervision, as well as appropriate space, facilities and equipment, while the of needs of service recipients were classified based on services needed for age groups, namely, services for children, adolescents and young people, adult and middle-aged, elderly and others.
Conclusion: Identifying needs can lead to the optimal use of limited resources aiming at imparting applied education and training. The results of this research can be an effective step towards expansion based on the needs for mental health education and a great help in achieving the goals of this program in primary health care centers. Based on the results it is recommended to plan personnel training and revise the services based on the identified needs in order to increase the effectiveness of this program.
Alireza Delavari, Abbas Vosoogh-Moghaddam, Zahra Kazemi Esfa, Zahra Beigom Seyed Aghamiri,
Volume 20, Issue 1 (6-2022)
Abstract
Background and Aim: The District Health Network is based on the principles of equity, appropriate technology, inter-sectoral collaboration and public participation. Measuring patient satisfaction is one of the basic criteria in determining the quality of care services. The purpose of this study was to compare the level of satisfaction of service recipients between government and non-government health posts in the south of Tehran in 2021.
Materials and Methods: This was a cross-sectional, descriptive and analytical study. A two-part researcher-developed questionnaire was used to collect data. The first part included items related to demographic characteristics of the clients, insurance status, geographical location and type of health post, appointment system and frequency of visits, and the second part contained questions on the type and level of satisfaction with the services provided.
Results: In the governmental health posts, the clients were mostly satisfied with, in a decreasing order, vaccination services, post-vaccination education, waiting time and physical space. In the outsourced posts, post-vaccination care education, under-one year old child care, vaccination and a sense of responsibility obtained, in an increasing order, the highest scores of satisfaction. Further analysis of the data showed the clients’ least satisfaction with youth and middle-aged care in governmental posts and youth care in outsourced posts.
Conclusion: Continuous and frequent measurement of satisfaction and developing timely interventions based on the results obtained will help greatly promotion of the quality of health services.
Nader Jahanmehr, Ali Siamiaghdam, Abbas Daneshkohan,
Volume 20, Issue 1 (6-2022)
Abstract
Background and Aim: With the rapid spread of Covid-19 around the world, the exposure of health care workers to the disease has increased. The study aimed to investigate the personal and professional experiences of health care workers during the outbreak of coronavirus in hospitals in Tehran, Iran.
Materials and Methods: This qualitative study included health care workers in the main Covid-19 units in Shahid-Beheshti University of Medical Sciences hospitals in Tehran, Iran conducted using the content analysis method in 2021. The sample was selected by purposeful sampling, using the snowball method. Data were collected through semi-structured interviews and, after extracting the items, analyzed using the MAXQDA 10 software.
Results: After coding a total of 236 main codes were extracted and divided into 10 main categories and 30 subcategories. Four main themes were identified: "Personal experience of health care workers", "Professional experience of health care workers", "Challenges of working in the field of Covid-19" and "Strategies to deal with Covid-19".
Conclusion: Due to the increasing psychological pressure on health care workers, it seems that planning psychological counseling and providing welfare facilities for them can be useful in reducing their mental stress. In addition, it is recommended to hold training and maneuvering courses at times of crisis and provide the necessary equipment, as well as take action for continuous supervision and monitoring to improve the working conditions of health workers.
Ali Mohammad Mosadeghrad, Mahya Abbasi, Mahdieyh Heydari,
Volume 20, Issue 2 (9-2022)
Abstract
Background and Aim: The health financing system is "the process of collecting, pooling and managing financial resources and purchasing healthcare services”. Iran's health financing system is facing challenges. The aim of this study was to evaluate the Iranian health financing system.
Materials and Methods: This descriptive study retrospectively evaluated the health financing system of Iran between 2000 and 2019 using archival data. Data were collected from the World Bank website and analyzed using the Excel software.
Results: Iran's health expenditure per capita increased by 3.7% annually between 2000 and 2019 and reached $868 (purchasing power parity) in 2019. Iran's total health expenditure increased from $32 billion in 2000 to $72 billion (purchasing power parity) in 2019 (5.9% annual increase). Iran accounted for about 0.6% of the world total health expenditure in 2019. In that year about 6.7% of the country's gross domestic product was spent on health, the global average being 9.8%, while the general government health expenditure (% of the then current health expenditure) in Iran and the world were 49.5% and 59.8%, respectively. Out-of-pocket expenditure (% of the then current health expenditure) decreased in the last decade in Iran, reaching 39.5% in 2019, compared to 18% worldwide.
Conclusion: Iran’s health system costs are increasing at a faster rate than the growth of its Gross Domestic Product (GDP). The country’s health expenditure (% of GDP) and, as a result, the general government health expenditure (% of general government expenditures) has decreased and out-of-pocket expenditure (% of current health expenditures) has increased. Therefore, reforms should be implemented to strengthen the country's health financing system.
Farhad Shekari, Hadi Jalilvand, Asghar Mohammadpoorasl,
Volume 20, Issue 2 (9-2022)
Abstract
Background and Aim: The promotion of the health of the members of a society is based on the assessment of the situation of that society. This study was conducted in the Soufian district of Shabestar city with the aim of identifying and prioritizing its problems and needs with the direct participation of the people.
Materials and Methods: This was a cross-sectional study conducted in the Sufian District of Shabestar city in 2019, the methodology used being based the 8-phases model of North Carolina. The community health assessment was performed in 8 phases. The first seven phases included identifying and prioritizing the problems of the District, and the eighth was developing operational plans to solve its priority problems.
Results: A total of 23 different problems were identified. Prioritizing the problems according to the Hanlon method showed the ten main and priority problems to be, in a descending order, as follows: marriage of girls at an early age (21.01), excessive use of chemical fertilizers in farmlands (20.89), lack of social security clinics (20.51), unemployment (20.38), severe air pollution caused by incineration of industrial waste (20.01), accumulation of municipal waste in the city (19.89), high hardness of city water (19.76), lack of property deeds (19.63), lack of a specific unit in the industrial town to separate waste (19.38), and lack of a gas supply to Mehr Housing and lack of asphalted roads (19.28). Marriage of girls at an early age was identified as the main problem and with the first priority, and a general preliminary study was done on it; it was found that in about 43% of all marriages registered between 2014 and the first half of 2021 the ages of girls were under 18 years. Factors causing and increasing marriage of girls at an early age were identified to be as follows: low awareness of girls' families and girls themselves of the consequences of early marriage, social acceptance of early marriage in the area and low parental literacy.
Conclusion: In this study a wide range of social, cultural, economic and health problems were identified in the population studied. Marriage of girls at an early age is an important social problem with serious undesirable consequences. In an attempt to solve this problem it is essential to consider, in addition to legal and legislative strategies and actions, appropriate scientific, social, cultural and economic strategies and applied research.
Somayeh Mokhtari Molaei, Roya Sadeghi, Azar Tol, Maryam Sabouri, Shahrzad Saadat Gharin, Abbas Rahimi Foroushani,
Volume 20, Issue 3 (12-2022)
Abstract
Background and Aim: Food preferences and health literacy ─ key determinants of food choices in childhood and adolescence ─ are determinants of chronic diseases in adulthood. This study aimed to determine associations between food preferences, health literacy and body mass index (BMI) among elementary school students in Malekan city, east Azarbayejan Province, Iran in 2021-2022.
Materials and Methods: This cross-sectional descriptive-analytical study included 582 male and female primary-schoolers in the fourth, fifth and sixth grades in both the public and private schools in Malekan County (Malekan, Lilan, and Mubarakshahr) selected by the two-stage randomized cluster method. A questionnaire including background questions and questions about health literacy and a researcher-made checklist of food preferences was used to collect data online using the Pros-Online Platform. The content validity ratio and index were used to determine validity and Cronbach's alpha index to check for the reliability of the questionnaire (CVI=0.98, CVR=0.91, Cronbach's alpha > 0.7). Data were analyzed using Mann-Whitney, t-test, one-way analysis of variance, Kruskal-Wallis and Chi-square tests at a significance level of 0.05 using SPSS 26.
Results: The average health literacy score of all the students was rather low (52.9±00.33), that of the female students (55.7±36.49) being slightly higher than that of the boys (49. 9±29.79). Further analysis of the data showed that there was a statistically significant relationship between the students' food preferences and health literacy variables (p<0.001). Furthermore, statistically significant relationships were observed between the students' BMI and their food preferences (p˂0.001) and health literacy (p˂0.001).
Conclusion: Considering the low level of health literacy of the adolescents and a positive relationship between health literacy, food preferences and BMI in adolescents, it can be concluded that increasing their health literacy will improve their healthy food choices. Therefore, it seems that interventions based on a theoretical framework aiming at increasing the students’ health literacy and improving their food preferences can be beneficial to them as a potential strategy for improving their healthy eating patterns resulting in preventing overweight and obesity.
Nazar Dahmardeh Ghale No, Atefeh Delgarm,
Volume 20, Issue 3 (12-2022)
Abstract
Background and Aim: Economic complexity indicates the availability of knowledge within a country. Increasing economic complexity indicates an increased capacity of producing a diverse set of complex products. The complexity of the economic structure of a country is the main factor affecting social choices and human abilities, including but not limited to, employment and learning opportunities, and the employment status of an individual is an important determinant of his/her health status. Therefore, the production of advanced products depends to a large extent on the quality of human capital and knowledge. On the other hand, knowledge and education are widely recognized as promoting factors of the health of the population.
Materials and Methods: This research investigated the effect of the economic complexity index (ECI) on the health outcomes in seventeen selected countries in the region using panel data in the period 2001-2019 by using the quantile regression and the OLS ordinary least squares methods.
Results: Based on the findings of this study, ECI, globalization, economic growth and trade openness variables will improve health. However, despite this, the institutional quality variables, politics and urban population have not improved health in the countries studied.
Conclusion: The results of this research are particularly relevant to developing economies that usually suffer from poor health and low levels of economic complexity.
Hamed Yeganeh, Hossein Parvaresh, Mohsen Dehghani Ghanataghestani, Mohammadreza Mohammadi Soleimani,
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: The health, safety and environment (HSE) system is an integrated system that tries to create a healthy, pleasant and lively environment with no accidents, damages and injuries by converging and synergizing human resources, facilities and equipment. The purpose of the present study was to investigate the validation of the revised scale of HSE performance.
Materials and Methods: This was a descriptive and analytical research conducted using the psychometric method. The statistical population included all workers of the steel companies in Kerman Province, Iran in 1400. Using the cluster sampling method based on psychometric criteria a sample of 100 was selected for the convergent validity and a sample of 578 for the construct validity section. Data were collected through two scales of HSE performance and job stress (Cohen et al., 1983). Content validity, convergent validity and factor analysis methods were used to check the validity of the scale. The reliability of the scale was checked using the internal homogeneity and classification reliability (dividing in 2 haves). The SPSS version 22 software was used for data analysis.
Results: Confirmatory factor analysis confirmed the six-factor model. The questionnaire was used along with the 35-item occupational stress questionnaire of Cohen et al. (1983) which had good reliability and validity. The alpha coefficient obtained for the whole scale was 0.79, and for the subscales as follows: resilience 0.93, demand 0.90, role 0.93, control 0.85, support 0.72 and relationships 79.0. In addition, the reliability coefficient of the scale was also calculated using the classification method. The classification coefficient for the first and second halves of the data was 0.87 and 0.62, respectively, the correlation between the two halves being 0.248. These findings indicated a favorable internal consistency coefficient for the HSE performance scale (P<0.001).
Conclusion: According to the findings obtained based on the HSE validation, which showed that the fit of the model is high and also that the evaluation of HSE performance has a great role in the health of employees, more attention should be paid to the establishment and implementation of HSE management in Kerman steel companies.
Ali Mohammad Mosadeghrad, Mahya Abbasi, Mahdi Abbasi, Mahdieh Heidari,
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: Health system financing is the process of collecting, pooling, and allocating financial resources to maintain, restore or promote the health of the people. Developing countries face many challenges in mobilizing, managing and allocating health financial resources. The aim of this study was to identify sustainable financing methods in developing countries.
Materials and Methods: This study was conducted using the scoping review. All the studies related to health system financing methods in developing countries were searched in the English electronic databases (i.e., Pubmed, Scopus, Science Direct, and Web of science), Persian electronic databases (i.e., Magiran, Iranmedex, and SID) and Google Scholar and Google search engines using appropriate keywords. Finally, 94 suitable documents were selected and analyzed using the framework analysis method and MAXQDA software.
Results: Forty-two methods were identified to strengthen the sustainability and resilience of the health financing system in developing countries; these methods were grouped into three categories: collection and management of financial resources, pooling of financial resources and purchasing of health services. The most frequently used solutions to strengthen the sustainability of the health financing system in developing countries were as follows: expanding social health insurance plans, integrating multiple health insurance plans, strengthening public-private partnerships, establishing a robust referral system, imposing taxes on harmful commodities, using perspective fixed payment methods, defining needs-based health service packages, promoting donors’ contributions, and reforming health service tariffs.
Conclusion: The health financing system in developing countries should be strengthened. The financial reforms of the health system should be accompanied by reforms in providing health services to make possible efficient and effective results. Health policymakers and senior managers should strengthen the governance of the health financing system at the macro level. In addition, healthcare managers should increase the efficiency and reduce resource wastage by strengthening budget capacity and financial management at the micro level.
Mohammad Zia Hoseini, Fatemeh Setoodehzadeh, Mehdi Zanganeh Baygi,
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: As a pandemic disease, Covid 19 has taken the lives of many people all over the world and has put a lot of pressure on the health care system and health care personnel. The experiences of managers and employees can help increase the efficiency of the health systems in future crises. This study was carried out in order to use the experiences of the personnel of the Crisis Section of Zahedan Medical University Public Health Deputy (ZMUPHD) in controlling the Covid-19 epidemic.
Materials and Methods: This was a qualitative research conducted in 2021-22 using the content analysis method including 30 employees of the Crisis Staff of the ZMUPHD selected by purposeful sampling. Data were collected based on semi-structured, in-depth interviews and analyzed in eight stages including typing the text of the interviews, determining semantic units, coding the text, revising the codes, classifying and developing the classes, revising the classes, identifying the themes and reporting the data.
Resulte: The experiences of the managers and employees of the ZMUPHD to deal withا the Corona pandemic were identified and extracted in 5 main areas including "Legislative", "Operational", "Manpower", "Supervisory" and "Financial", and 13 sub-areas.
Conclusion: Based on the results of the present study, one of the problems in the administration and management of the Covid crisis was the lack of sufficient supervision and political requirements in order to control and prevent the spread of the disease, as well as the lack of a single decision-making organization. Also, financial problems and problems related to human resources were found to be among the most important issues. On the other hand, from the point of view of the interviewees, the use of the 4030 system was one of the turning points in crisis management.
Atefeh Modabernejhad, Seyed Samad Beheshty, Vahid Ghasemi, Ramin Moradi,
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: Considering the destructive consequences of corruption in Iran’s healthcare system, the present study aimed to explain the roots and causes of corruption prevalence in this system.
Materials and Methods: This was a qualitative study with quantitative content analysis conducted in Iran’s Ministry of Health and Medical Education (MHME). Data were collected based on in-depth interviews with 13 experts in the MHME headquarters selected by theoretical and snowball sampling. The unit of analysis of the interviews was the sentence and the conducted interviews were analyzed through thematic analysis using the Shannon Entropy index.
Results: Data analysis showed that legislative fields with an importance coefficients (IC) of 0.293 ranked first, followed by social and cultural fields (IC 0.26), economic fields (IC 0.175), decision-making fields and organizational factors (IC 0.174), and, finally, individual factors and micro-level fields (IC 0.102).
Conclusion: Considering the importance coefficient of individual factors and micro-level fields,
it can be concluded that the personality and individual characteristics of the experts/relevant persons are less important in the corruption occurrence, while the legal, social and cultural variables paly crucial roles in explaining corruption in the Iran’s healthcare system.
Seyed Samad Beheshty, Hamid Sedaghat, Khirey Hamidpor,
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: The social health of people is a phenomennon that can play an essential role in the development of the society. A question is: to what extent has the Imam Khomeini Relief Committee (IKRC), an organization established at the beginning of the Iranian Islamic revolution to deliver services and help and empower the poor people to get them out of poverty, been successful in affecting the social health of the household female heads? This study aimed to answer this question.
Materials and Methods: This research was conducted with a quantitative and survey approach, including 221 female heads of households under coverage of IKRC in Shiraz, Iran selected by the multi-stage cluster sampling method. The data collection tool was a questionnaire.
Results: The findings showed that the social health of the household female heads under coverage of IKRC and all its components were higher than the average level.
Conclusion: Based on the findings it can be concluded that the educational, health and financial
services provided by the Imam Khomeini Relief Committee could not have influenced significantly the social health of the service-seekers, although they could have affected some aspects of their lives. It is, thus, essential that the Committee revise the contents and the form of services delivered to female heads of households to promote their social health.
Maryam Tajvar, Omolbanin Atashbahar, Firoozeh Dadras, Haniye Sadat Sajadi,
Volume 21, Issue 1 (10-2023)
Abstract
Background and Aim: Performance evaluation is a useful way to obtain information for decision-making and management of healthcare organizations. The purpose of this study was to assess the performance of health houses in rural areas in Kerman City, Iran during the outbreak of Covid-19.
Materials and Methods: This cross-sectional study was conducted in 2021-22 using descriptive and analytical methods. The research population included all the health houses in Kerman City (n=57), Iran. The tool for data collection was the Health House Performance Evaluation Checklist of the Ministry of Health and Medical Education developed to supervise the performance of health houses during the outbreak of Covid-19. Data analysis was done using SPSS 26 software, the statistical tests being descriptive statistics (mean and standard deviation) and analytical statistics including independent t-test, one-way analysis of variance and Pearson and Spearman correlations.
Results: The average performance score of the health houses (n =55) in managing Covid-19 was 96.37 out of 136. Installation of the village map on the wall of the health house (92.3%), screening and following up the positive-test individuals and informing the health care team to track and isolate individuals in close contact (84.6%) were found to have the highest, and injecting the third dose (78.8%) and the second dose (75%) of the Covid vaccine the lowest, scores. From among the characteristics investigated the variable of native Behvarzes (the personnel of health houses) had a statistically significant positive relationship with the performance score (p=0.01). In addition, the health houses with more than one Behvarz were found to perform better than those with only one Behvarz (p=0.05).
Conclusion: Assessing the performance of health care units at times of crisis, including communicable diseases epidemics, will make it possible to identify the bottlenecks that need improvement for better preparedness in the future. Based on the findings of this research, the expansion of the coverage of the covid-19 vaccination, updating the disease incidence, the performance of health care teams at home visits, and the progress of the operational plan were the variables that needed improvement most.
Elham Fatholahi, Mohammad Jafari,
Volume 21, Issue 1 (10-2023)
Abstract
Background and Aim: Products such as tobacco are considered harmful to human life due to the fact that they contribute greatly to mortality around the world. Tobacco use kills more than eight million people worldwide annually. This has necessitated the imposition of taxes on such harmful products with the aim of reducing their demand and, thus, guaranteeing the increase in the health of the population in Iran.
Materials and Methods: Using the tobacco tax as a proxy for the tax on harmful products and the death rate as an indicator of the general health of the population, this study investigated the effect of the tax on harmful products on the health of the population in 30 provinces of Iran between 2007 and 2018. For this purpose, the dynamic panel generalized moment method (GMM) using Eviews 10 and stata17 software was used as an experimental estimation technique.
Results: Analysis of the data collected revealed that the tax on harmful products can help promote the health of the population, since the government can use the additional income thus generated to improve the health of the population. These findings support the World Health Organization's justification that taxes on harmful products, especially on tobacco, not only can reduce their consumption, but also can help to promote health outcomes. In addition, increasing the tax on cigarettes, which is considered the most important and key strategy by the World Health Organization, will lead to spending the resulting income on improving health and educational infrastructure, health centers, emergency services, etc.
Conclusion: In general, the more a government spends on health care, the more the health of the population and, consequently, the higher the life expectancy of the population. Regarding the effects of prices/and taxes on smoking or tobacco consumption on the mortality reduction in Iran, if the taxes imposed on harmful products are increased and the resulting additional funds are used and effectively administered to meet the recommendations of the World Health Organization, better desirable outcomes will result in the health of the population as compared to those observed in this study. In addition, the policymakers should start actions that will help promote economic growth, because this will increase the health of the population. Moreover, actions and efforts aiming to increase the population growth rate should be accompanied by significant investments in the health sector.
Banafsheh Aleyaran, Zahra Delavari, Fatemeh Fayyaz, Hamed Moslehi,
Volume 21, Issue 2 (9-2023)
Abstract
Background and Aim: Social health is one of the most basic criteria of social well-being and an effective factor in improving the quality of life of any society. .In Iran, the Office of Mental Health, Social Health and Addiction (OMSHA) is responsible for planning, implementing, monitoring and evaluating social health programs. The purpose of this research was to criticize and assess the contents of the social health component of the primary health care (PHC) system in an attempt to revise the contents.
Materials and Methods: The method used in this study was the deconstruction method. The research environment was all the contents of the social health component provided by OMSHA, and in order to obtain precise data the entire statistical population was taken as the study sample.
Results: In general, data analysis indicated the following: inappropriate screening, cultural adaptation, unidimensionality, role and responsibility adaptation, the preference of treatment to prevention, updating, comprehensiveness and adequacy of basic contents, and comprehensiveness and adequacy of practical suggestions.
Conclusion: It can be concluded that revision of the contents of the social health component of the Office of Mental health, Social Health and Addiction is a necessity in order to improve the delivery of mental health services..
Hamidreza Atefifar, Hossein Aghajani Marsa, Alireza Mohseni Tabrizi,
Volume 21, Issue 2 (9-2023)
Abstract
Background and Aim: Tobacco use, narcotics, drug abuse, consumption of alcohol, having unsafe sexual relations and other such behaviours are risky behaviors that tend to cause great concerns in families. Parents try to cope with high-risk behaviors through care strategies. The purpose of this research was to determine the typology of strategies for taking care of risky behaviors based on to the family socioeconomic status (SES).
Materials and Methods: This was a quantitative descriptive-correlational research including all the urban families of Tabriz, Iran, from among whom a sample of 384 families was selected by the multi-stage cluster method. Two measurement tools (checklist for high-risk behavior care strategies and a family SES questionnaire) were used to gather data, the one-way analysis of variance (F) test and linear regression being used to determine the relationships between the variables.
Results: The means of strategies for taking care of risky behaviors were significantly different based on the SES of the family, the upper classes adopting a more appropriate (procedural) strategy to take care of children against risky behaviors than the lower classes. Conclusion: Families with a medium and low SES use ineffective care strategies (inefficient and momentary) to cope with risky behaviors. In order to improve the public's health, it is necessary to adopt prevention-based cultural-educational policies to transform ineffective care strategies to procedural strategies.
Ahmad Nejati, Alireza Asgari Golzardi, Farshad Khodakhah, Katayoun Samimi-Rad, Seyedeh Maryam Yousefi, Yaghoub Mollaei-Kandelousi, Maryam Keyvanlou, Mohammad Razaghi, Parastoo Soheili, Delaram Yaghoubzadeh, Nastaran Ghavami, Susan Mahmoudi, Seyed Mohsen Zahraei, Shohreh Shahmahmoodi,
Volume 21, Issue 3 (12-2023)
Abstract
Background and Aim: During the COVID-19 pandemic public health measures and protocols such as regular hand washing and wearing a face mask were recommended at the national level. The implementation of these health protocols reduced the prevalence of respiratory diseases, but no study has been conducted to investigate the impact of the implementation of these protocols on the spread of viruses that are transmitted through fecal-oral route. Considering that non-polio enteroviruses (NPEVs) are mainly transmitted through fecal-oral route, this study was conducted to determine the prevalence of non-polio enteroviruses in patients with acute flaccid paralysis (AFP) in Iran before and during the COVID-19 pandemic.
Materials and Methods: To detect non-polio enteroviruses stool samples of AFP cases received by Iran National Polio Laboratory in 2019 (before the COVID-19 pandemic) and 2021 (during the COVID-19 pandemic) were tested. To isolate NPEVs by cell culture, the WHO standard protocol was used, and the TaqMan One-Step Real Time PCR was used for molecular testing.
Results: In 2019, a sample of 21 out of 1070 patients and a sample of 12 out of 100 patients were found to be positive for non-polio enterovirus by cell culture and the molecular method, respectively; these ratios decreased to10 out of 678 and 3 out of 100 in 2021.
Conclusion: Based on the findings of this study, it can be concluded that the observance of personal hygiene and public health protocols during the COVID-19 epidemic have, in addition to the general reduction of respiratory transmission of viruses, also affected the faecal-oral transmission of viruses.
Hamed Moslehi, Reyhaneh Fayyaz, Zahra Validabadi, Iman Zaghian,
Volume 21, Issue 3 (12-2023)
Abstract
Background and Aim: The objective of this study was to gain a deep understanding of the importance (expected services) and performance (services provided) of mental health services to determine the priority indicators of mental health to help design higher quality and more effective community mental health interventions.
Materials and Methods: This was a mixed-method study including all the mental health executives and practitioners (n=998) in Iran. In the quantitative part, the Importance-Performance Analysis (IPA) model was used to determine the importance and performance of the current mental health programs in the primary health care (PHC) system, and in the qualitative part complementary explanations were analyzed using the thematic analysis method.
Results: The findings show that there were gaps between the expected services and the services provided in the mental health program. Thus, the following points should be taken into account to be able to improve the mental health services: 1. Strengthening the domestic violence prevention program as regards spouse misbehavior and misbehavior towards children; 2. Continuation of lifestyle skills and parenting programs, 3. Self-care in mental health and drug use programs; 4. psychiatric disorders diagnosis and care and a healthy adolescents program is desirable and necessary, but revising and modifying the suicide prevention program (as regards costs and treatment) are essential. 5. In addition, the psycho-social intervention programs in disasters, addiction harm reduction program, strengthening family foundation and the Competent Family Program are of low importance in formulating a strategy.
Conclusion: Corrective actions based on the prioritizations determined can be included in the working agenda of the managers of mental health care systems at the primary levels to improve the quality of mental health services.
Fatemeh Setoodehzadeh, Hossein Ansari, , Fatemeh Nazari, Fatemeh Khabiri, Mohammad Hassan Amiri Moghaddam,
Volume 21, Issue 3 (12-2023)
Abstract
Background and Aim: The health system is trying to prevent unnecessary referrals to higher levels by providing tiered services and thus reduce the cost of health care. Therefore, this study was conducted in Zahedan City, Iran with the aim of finding the causes of referrals from level 1 to higher tiers in rural areas.
Materials and methods: This cross-sectional study was conducted on 458 rural patients referred to the second level in the rural areas of Zahedan City, Iran. Data were collected from the family health files available in the Sib system and analyzed using the SPSS-16 statistical software, the statistical tests being descriptive statistics (percentage, frequency) and Chi-square test.
Results: The highest (57.6%) and lowest (4.1%) proportions of referrals to the second level of service provision were found to have been in 2018 and 2016, respectively. From among the referred patients nearly 50% had been referred due to the need for a higher expertise, thus most referrals (67.2%) were to specialists. Further analysis of the data showed that only in 23.6% of the cases there was a feedback from the higher level to the first level.
Conclusion: The findings show that referrals from family physicians to higher levels in the health system requires higher medical expertise and patient insistence. In addition, feedback to the first level of service provision has not received proper attention. Establishing interactions between physicians and other health service levels, refresher training of physicians, emphasizing the importance of providing feedback and promoting the awareness of patients can reduce to a large extent inappropriate referrals.
Seyedeh Maryam Pourmousavi, Zoha Hajiha, Mohammad Marfat, Iman Zaghian, Hamed Moslehi,
Volume 21, Issue 4 (3-2024)
Abstract
Background and purpose: The purpose of this research was to write a critical review of the available service packages in the Mental and Social Health and Addiction Office (MSHAO) of the Ministry of Health and Medical Education in the areas of drugs, alcohol and tobacco, which are currently used in the primary health care system. The content analysis method was used to extract the specialists’ critiques.
Materials and Methods: Initially the MSHAO sent 1362 pages of information in the form of 47 files to researchers to be reviewed. The files were classified, eliminating/removing additional, unrelated and duplicated items; finally 840 pages in 29 files were studied and carefully examined. Then, seven experts in the field of addiction were asked to criticize the packages, using the content analysis method to extract the experts' critiques.
Results: The findings showed that comprehensive information about drugs, alcohol and tobacco addiction is provided to the clients. However, based on a critical review of the existing packages four main critiques were extracted, namely, sources/references, epidemiology, incompatibility of Iranian-Islamic culture, and technical-specialist issues. In addition, criticisms were also extracted in the following areas/services: the number of files and the variety of interventions, editing and writing problems, interventions and discussions with inappropriate in-text sources/citations, some old sources/references (published in 2013 and 2014), old interventions, lack of appropriate compatibility with the culture of the Islamic society of Iran, and direct translation of some parts of the original texts and documents of international meetings/gatherings.
Conclusion: Despite the efforts of the Mental and Social Health and Addiction Office to cover the needs of the majority of people referring to the primary care system, it seems that the high number of interventions and additional information can cause confusion of/for the physician, mental health care provider, family health care provider, general health care provider and other relevant individuals. It is, therefore, suggested that some packages be merged with each other, duplicate items be removed and specific sections be added, some packages be fundamentally revised based on the suggested items, and updated packages be developed with due consideration of to the culture of the Iranian society.
