Showing 20 results for Health Care
M Farahbakhsh, A Zakeri, N Khodaee,
Volume 6, Issue 3 (2-2009)
Abstract
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.
M Farahbakhsh,
Volume 8, Issue 1 (6-2010)
Abstract
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.
Mehdi Mohebali, Gholamhossein Edrissian, Mohammad Reza Shirzadi, Yavar Hosseingholizadeh, Mohammad Hossein Pashaei, Akbar Ganji, Zabihallah Zarei, Ahmad Kousha, Behnaz Akhoundi, Homa Hajjaran, Hossein Malekafzali,
Volume 9, Issue 2 (11-2011)
Abstract
Background and Aim: Visceral leishmaniasis is a systemic parasitic disease with a high fatality rate in under-5-year-old children. The disease is endemic in some parts of Iran, particularly in the north-west region. In 2001 a visceral leishmaniasis (VL) surveillance system was established for children aged ≤ 12 years in the primary health system in Meshkin-Shahr District, Ardebil Province, situated in the north-west of Islamic Republic of Iran.
Materials and Methods: All cases with clinical signs and symptoms of VL and confirmed positive by the direct agglutination test (DAT) were referred for physical examination and treatment.
Results: The mean annual incidence of VL decreased significantly from 1.88 per 1000 children before (1985-2000), to 0.77 per 1000 child population after (2001-07), the intervention. In the control area with no surveillance, it increased from 0.11 to 0.23 per 1000.
Conclusion: Early detection of VL using serological tests and timely treatment of cases can decrease the mortality and morbidity rates of VL in endemic areas.
Saeed Karimi, Marzieh Javadi, Mina Iravani, Elham Chavoshi,
Volume 11, Issue 1 (8-2013)
Abstract
Background and Aim: Global growth in the elderly population for both health care providers and families and also the community is an important challenge . Elders are the largest and fast factor for increasing hospital admissions in Society . Increasing costs of aging is the most concern to elders and their families. This study aimed to investigate the health team s approach about cost–effective alternatives for aging health services.
This study is a qualitative research which was done through content analysis.
18 people consisting of five faculty members , 6doctors , 3 nurses and 4health public health expert were participated. Samples were selected based on purposive sampling . Data were collected through interviews .
Results: Four core themes derived from this study which included: 1- Emphasis on training for aging care ( including training doctors, nurses , health professionals , public health experts, elder sand their family caregivers). 2- Emphasis on proper implementation of primary health care for the elderly. 3- Emphasis on home care for elderly.4-attntion to mental health of elderly.
Conclusion: It seems effectiveness of tree alternatives emphasis to training, home care and mental health for elderly are obvious and evident, so implementing and applying these suggestions would be helpful.
But the second alternative emphasis on proper implementation of primary health care for the elderly must be performed based on a comprehensive needs assessment in elders population. Finally it is stressed that calculating and comparing actual costs of each alternative in elders caring must be measured through quantitative researches.
Hossein Malekafzali,
Volume 12, Issue 2 (10-2014)
Abstract
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.
Shirin Rezaei, Abbas Rahimi Foroushani, Mohammad Arab, Ebrahim Jaafaripooyan,
Volume 14, Issue 2 (9-2016)
Abstract
Background and Aim: A New Health Reform Plan consisting of seven programs was initiated in Iran in mid-May 2015 aiming to reduce the out-of-pocket payments, improve the public’s health, and promote the public health indicators. This study was conducted to determine the effect of the Plan on the performance indicators of Hamedan university hospitals.
Materials and Methods: In this longitudinal descriptive-analytical study, based on the interrupted time series design, data related to hospital performance indicators were collected from all (15) Hamedan University hospitals for a period of 15 months (7 months before, and 7 months after, the implementation of the Plan, with a one-month interval in between). The SPSS software was used for data analysis.
Results: The data indicated changes in all the performance indicators after the implementation of the Plan. The largest changes were in the number of emergency and selective surgeries and the smallest in the ratio of active to total beds. Further analysis of the data showed that, as compared to the same months in the previous year, only a small number of these changes (number of emergency surgical operations and the ratio of active to total beds) were statistically significant.
Conclusion: Based on the findings it can be concluded that changes have occurred in all the selected indicators as a result of implementation of the New Reform Plan, indicating that the Plan has affected favorably performance of the hospitals. However, the effects observed should be judged cautiously, considering the possible negative consequences such as induced demand and hospital workload increase in the long run.
Mehdi Memarpour, Ashkan Hafezalkotob, Seyed Khalil Allah Sajjadi, Mahnaz Mayel Afshar,
Volume 14, Issue 2 (9-2016)
Abstract
Background and Aim: Nowadays selecting an appropriate technology for storing and disposal of health care wastes is a difficult task. For example, selecting an optimum technology for storing and disposal of hospital wastes is a complex multi-criteria decision-making process, which requires consideration of qualitative and quantitative factors and criteria. This paper presents a new decision-making model for selecting a better method in the management of health care wastes in the City of Tehran.
Materials and Methods: So far selection of technologies for health care wastes storing has been based on inaccurate information or uncertain data, and linguistic variables have been used by decision-makers (experts) to assess the ranks, criteria and options described.In this study a combinational multi-criteria decision-making model has been used which includes the fuzzy analytic network process technique and the fuzzy MULTIMOORA method. This model uses the fuzzy analytic network process to get the related with criteria and sub-criteria of better health care wastes storage technology and uses MULTI MOORA method for evaluation of five available technologies based on the above-mentioned criteria.
Results: Analysis of the data showed that the "environmental" and "technical" criteria were the most important criteria for selection of the best technology, while for storing health care wastes "hydroclave" is the most appropriate technology in the City of Tehran.
Conclusion: The proposed framework for assessing health care wastes technologies for storing hospital wastes is effective, and the hydroclave technology is to be considered as the best solution and the most suitable option from the environmental, public health and technical perspectives in the City of Tehran.
Maryam Yaghoubi, Marzieh Javadi, Saeid Karimi, Vahid Pirasteh,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: Iran's Health Sector Evolution Plan (HSEP) is one of the most important national health reform plans. HSEP has attracted many criticisms. An important criticism is about its service costs. This article reports the results of a project conducted to compare the costs of normal and caesarian section delivery before and after implementation of the HSEP.
Materials and Methods: This was an applied research project using hospital accounting records as data. A total of 120 delivery files (60 normal delivery and 60 caesarian section) were selected randomly from the accounting software of a large hospital in Isfahan before and after May, 2014.The data in each subject’s file ─ paid shares of the hospital, patient and insurance ─ but not hoteling, inpatient and other costs was extracted. The health service providers’ incomes based on the annual tariffs of the services and changes in payments for each service for gynecologist and anesthesiologists were calculated. Data were analyzed using the excel software.
Results: The costs of normal delivery and caesarian section after implementation of the National HSEP had increased by 193% and 226%, respectively. In addition, of the treating physicians (gynecologists and anesthesiologists) had also increased by 257% for the normal and by 130% for caesarian section. Changes in the sums of money involved in service delivery indicates shifting of parts of the costs from the patients to the health subsidy and insurance systems.
Conclusion: The health System Evolution has not lead to real reductions in the out-of-pocket money paid by the patients. Higher cost of services will imply the need for better cost management. Increased costs of services will be to the benefit of neither patients nor the health system. This would mean that in designing and implementation of the Health Sector Evolution Plan economic aspects should be taken into consideration more carefully.
Azar Tol, Bahram Mohebbi, Elham Shakibazadeh, Mehdi Yaseri, Maryam Sabouri,
Volume 16, Issue 2 (9-2018)
Abstract
Background and Aim: In health promotion, empowerment is a process through which people gain greater control over decisions and actions affecting their health. This study aimed to assess the predictive factors of health care empowerment among women in reproductive age in 2016.
Materials and Methods: This cross-sectional study was conducted on 549women in reproductive age referring to health centers in South Tehran. The participants were recruited through cluster and multi-stratified sampling. Data were collected using the Health Care Empowerment Questionnaire (HCEQ), which has three subscales, namely, degree of control, involvement in interactions and involvement in decision-making. The data were analyzed using the descriptive and analytical tests and multi-regression analysis.
Results: Husbands' education level, women's employment, family size, ethnicity, history of chronic diseases and economic status were predictors of degree of control. Husbands' education level (under high school diploma and high school diploma), family size (2-3, 3-4) and moderate economic status (sufficient income) predicted involvement in interactions. In addition, husbands' education (incomplete high school diploma and high school diploma), family size (2-3, 3-4), women's employment and history of chronic diseases predicted involvement in decision-making.
Conclusion: The findings indicate that various individual, family and socio-economic conditions of reproductive-age women influence their potential empowerment for receiving health care services. A family-based approach to facilitate receiving reproductive health care seems to be essential.
Sajjad Dorri Kafrani, Atefeh Zolfagharnasab, Fatemeh Torabi,
Volume 17, Issue 2 (9-2019)
Abstract
Background and Aim: Along with the expansion of health systems, the importance of primary health care as the basis of an efficient health system is more evident and the quality of the provided services at this level becomes more important. In this way, the present study attempts to collect patterns used to improve the quality of primary health care.
Materials and Methods: The present study is a systematic review. The advanced search was done in the Web of Science, Scopus, Embase, PubMed, Cochrane, SID, MagIran, IranDoc, and Google Scholar databases in title, abstracts and keywords fields. Inclusion criteria include a comprehensive attitude, focus on primary health services, English or Persian language, published between 2006 and 2018. Exclusion criteria include studies that focus outside of primary health care. The quality of the studies was evaluated using the JBI checklist. Two independent researchers conducted the task of selecting studies, extracting data and evaluating the quality of studies, and disagreement cases were resolved by the third researcher.
Results: After screening and reviewing the criteria for the entry of 10095 studies, 11 studies were finally included. The quality of the four studies was evaluated average and the rest of the quality was high. Two studies have provided patterns for improving the quality of primary health care, three evaluated the effectiveness of quality improvement tools, and five presented conceptual frameworks.
Conclusion: A total of eight types of systems extracted to assess and improve the quality of primary health services. Studies on primary health care have been used at various levels of personal, professional, practical and national policy, and have developed models, tools and frameworks that each of them can be used separately or combined for different situations with regard to the limitations and facilities mentioned and improve health outcomes.
Mohammad Mehdi Kiani, Khatereh Khanjankhani, Maryam Shirvani, Batoul Ahmadi,
Volume 18, Issue 2 (9-2020)
Abstract
Background and Aim: It is essential to take action to strengthen the national primary health care (PHC) system. The purpose of this study was to conduct a comprehensive review to find ways to strengthen the PHC system in Iran based on the experiences of different countries.
Materials and Methods: This was a comprehensive review study. The relevant studies were retrieved using Science Direct, PubMed, Google Scholar, Scopus, Web of Science, Magiran, Iranmedex and SID databases. Inclusion criteria included all the studies that specifically focused on the factors enhancing the PHC system between 1998 and 2017. Finally, 30 articles were selected.
Results: Strategies for strengthening the PHC system were examined from two different angles: factors that facilitate the performance of the health care team, and ways to improve the implementation of PHC. In addition, strategies have been recommended for the following in order to strengthen the PHC system in Iran: trust-based relationships; widespread implementation of the National PHC Program with a focus on personnel training; teaching healthy lifestyle behaviors and drug side-effects; investing in information technology in the health sector in areas such as immunization, child care and prevention of chronic diseases.
Conclusion: Strengthening primary health care requires coordination and inter-sectoral collaboration; involvement and will of a wide range of health and non-health organizations; government support; strengthening of the referral system and the family physician; strengthening the health team; self-care and community participation; a public health-oriented and preventive approach in macro-policies; and, finally, allocating more resources to the health sector.
Ali Mohammad Mosadeghrad, Mahdiyeh Heydari, Parvaneh Esfahani,
Volume 19, Issue 3 (3-2022)
Abstract
Background and Aim: The Primary Health Care (PHC) system is the most comprehensive, equitable and efficient way to promote people's health and social welfare by providing preventive, curative, rehabilitative and palliatvie services in a place close to where people live and work. Iran's PHC system faces challenges that limit its effectiveness and efficiency. The aim of this study was to identify strategies to strengthen Iran's PHC system.
Materials and Methods: A realistic review method was used in this research. Published articles on strategies to strengthen the PHC system between 1978 and 2019 were searched in eight databases and Google scholar search engine. Finally, 29 articles were found to be eligible for inclusion in this study; framework analysis was done using the MAXQDA-10 software.
Results: Twenty-nine strategies were identified for strengthening the PHC system. A well designed PHC system is one with the following characteristics: realistic goals and appropriate strategies equipped with necessary resources, organized in multidisciplinary teams that provide comprehensive and quality health services (intervention program), with strong governance and leadership, financing, work force, equipment and medicines, information systems and robust health services delivery processes and well adpated to the external environment (context). Such a PHC system will increase healthcare providers’ satisfaction and commitment, as well as the patients’ trust, participation and satisfaction (the mechanism) and, finally, promotes, restores, and maintains the people health (result).
Conclusion: A strong PHC system is a pre-requisite for strengthening a health system. Various strategies such as strengthening management and leadership, improving organizational structure and culture, improving the information system, empowering human resources and increasing population coverage can lead to an improved PHC system. Historical, social, cultural and economic factors affecting the health system should be considered in redesigning and stregtening a PHC system.
Farahnaz Mohammadi-Shahboulaghi, Tahereh Ramezani, Dariush Panahizadeh, Sholeh Hazarian, Reza Fadayevatan,
Volume 19, Issue 4 (3-2022)
Abstract
Background and Aim: Delivering health services to the elderly is one of the most important responsibilities of the health care system of any country. In order to improve the provision of health services to the elderly population under its coverage, the National Social Security Organization conducted this study with the aim of designing, implementing and evaluating a model for providing outpatient health care services to the elderly population under the coverage of its Tehran Province Office.
Materials and Methods: This was a sequential-exploratory mixed-method study. The initial model was developed and validated using the integrated review method and the final model using the Delphi technique and group discussions with experts. Then the educational program was developed and implemented for the health team. Assessment of the effectiveness of the program was done using a researcher-made knowledge and attitude questionnaire (pre- and post-test). The model was then implemented in the Khandan-e-Hakim Clinic. The effectiveness of the model implementation was determined based on the qualitative content analysis of the interviews with the elderly and qualitative content analysis of the health team comments.
Results: The outpatient care model of the elderly included an organized clinical process consisting of 6 phases. The mean age of the health team members was 45.7±15.11 years. The difference between the health team satisfaction total scores before and after participating in the educational program was statistically significant (P≤0.05). Further analysis of the data showed, based on the interviews with the elderly, the main categories to be "assessment of cognitive function, mood and behavior", "physical assessment", "appreciation of the health and dignity of the elderly" and "satisfaction of the elderly and their companions". Analysis of the comments of the health team revealed their satisfaction with the implementation of the model.
Conclusion: The introduced model can make possible rapid identification of health problems and timely intervention in the elderly population. This implementation model will help disease prevention and complications at different levels. The findings of this study can help service providers to provide better care and health services for the elderly.
Ali Mohammad Mosadeghrad, Tina Taherkhani, Shayan Shojaei, Matin Jafari, Sara Mohammadi, Alireza Emamzadeh, Shahrzad Akhavan,
Volume 20, Issue 1 (6-2022)
Abstract
Background and Aim: Primary health care is a holistic approach that aims to maximize people's health and well-being as quickly as possible in their immediate living environment. The primary health care system is the first point of contact of the people with the health system. Therefore, increasing its resilience will play a significant role in controlling and managing pandemics. This research aimed to identify strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic.
Materials and Methods: This study was conducted using the scoping review method. Using appropriate keywords search was done on the subject of the study in PubMed, Web of Science, Scopus, SID, Iranmedex and Magiran databases and Google and Google Scholar search engines. Finally, after screening and reviewing the titles, abstracts and texts of the retrieved documents, 36 articles were selected and strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic were extracted from them.
Results: A total of 48 strategies/solutions were extracted to strengthen the resilience of the primary health care system, categorized into 6 groups, namely, governance and leadership, financing, human resources, medicines and equipment, health information systems, and health service delivery. Among the most frequently solutions mentioned were the following: Dynamic and accountable leadership, using valid research evidence in policy-making, contingency planning, increasing inter-sectoral cooperation, advocacy for health policies, community involvement, sustainable financing, recruiting additional staff and training and supporting them, providing sufficient stocks of medicines and diagnostic kits, developing and modernizing public health information systems, facilitating people's access to health centers, continuing to provide health services, and increasing the community’s health literacy.
Conclusion: The structural and process components of the primary health care system including "governance and leadership", "financing", "staff", "equipment, vaccines and medicines", "information" and "health care delivery" should be strengthened in a coordinated manner in the primary health care system to be prepared for future epidemics.
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.
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.
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.
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..
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.
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.
