Journal of School of Public Health and

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

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

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

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

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Background and Aim: Recently the use of heterotrophic plate count (HPC) has received much attention as a supplementary indicator of the MPN test in water quality control. The US Environmental Protection Agency (USEPA) has declared 500 cfu/mL as the maximum acceptable level for heterotrophic bacteria in distribution networks. Currently the HPC determination is not among the routine control items in Tabriz city and there is no published information on the presence of heterotrophic bacteria in that city's potable water. In this study the presence of HPC in potable water main was determined in Tabriz city, Iran.
Materials and Methods: A total of 50 water samples, representing drinking water of the whole city of Tabriz, were taken randomly from different districts of Tabriz city and their HPC, coliform, residual chlorine, turbidity, temperature, and pH were measured. For the heterotrophic bacteria the R2A and Nutrients Agar culture media were used, while the spread plate count method was used for the HPC test. The statistical tests used for data analysis were the t-test and regression.
Results: In 50% of the samples heterotrophic bacteria were present. In 6 districts the HPC was higher than 500 cfu/mL. Based on Nutrient Agar and R2A, the HPC indicator in Tabriz drinking water was 184±340 and 154±315 cfu/mL, respectively, the growth rate being higher in the former medium. There was a significant correlation between the HPC and residual chlorine in both media (for Nutrients Agar, p<0.05 R= -0.347, and for R2A, p<0.05 R= -0.312). Also, there was a significant positive correlation between the HPC and pH (p<0.05). Further analysis of the data showed that the correlation between HPC values in both media was also significant (p<0.95, R= 0.95).
Conclusion: The presence of heterotrophic bacteria in 50% of the water samples tested indicates that drinking water contamination with these bacteria is a public health problem in Tabriz city. As a result, monitoring of HPC at least once every 6 or, at least, 12 months, together with coliform bacteria, and the comparison of the results over time can help to better determine water quality in the distribution system, as well as boost the system operation and ensure drinking water with a high quality.

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  Background and Aim: A ssociations between air pollution and morbidity have been reported in several studies. Due to limited publications in the literature for Iran, this study aimed to determine the association between air pollution and hospital admissions of respiratory disease patients in Tabriz, Iran.

  Materials and Methods: The methodology used in this study was case -crossover and the artificial neural network model. The variables of the model included air quality, hospital admission and air pollutants. Daily hospital admission data were collected from five hospitals in Tabriz, Iran based on the International Classification of Diseases (ICD-10) , air quality data including NO₂, SO₂, CO, PM₁₀ and O₃ from the six fixed online air quality monitoring stations, and the daily mean temperature and relative humidity data for the same period from the East Azerbaijan Meteorological Bureau.

  Results : P articulate matter with a median aerometric diameter <10 μm (PM₁₀) was found to be the most important pollutant affecting respiratory hospital admissions. The ANNs data showed that the most important causes of hospital admissions were for COPD NO₂, NO and CO, for respiratory infections PM_10, and for asthma PM₁₀, O₃ and CO. The highest associations were observed between hospital admissions due to COPD and asthma in females and those due to respiratory infections in males. The elderly (individuals over 65 years old) were at the highest risk.

  Conclusion: The results show a significant relation between air pollutants and respiratory hospital admissions in Tabriz, Iran. The importance and necessity of enforcement of existing regulations and enacting laws to prevent and control the adverse health effects of air pollution are confirmed.