Payesh
Year:2022 | Volume:21 | Issue:1|Papers Count:9

Objective (s): Health policy is course of actions developed by policy makers and senior managers in the areas of financing, resource generation and health service delivery to promote, restore, and maintain health of the community. It is a guide to low-level managers’ decision-making and planning. This study aimed to develop a practical model for health policy making and analysis. Methods: This research was conducted using scoping review method. All policy making and policy analysis models published and indexed in the Web Of Science, Scopus, Embase and PubMed databases and two search engines (e. g., Google and Google scholar) were searched using appropriate keywords. Finally, 43 policy making and policy analysis models were selected and analysed using framework synthesis method. Results: Policy making is a complex, dynamic, evolving and rarely linear process. An integrated model of health policy and analysis consisting of four phases (policy preparation, policy formulation, policy implementation and policy evaluation) and 10 steps (policy secretariat formation, problem definition, consensus building, agenda setting, policy content writing, policy advocacy, policy planning, policy execution, policy monitoring and policy evaluation) was developed. The garbage can and bounded rationality approaches are used in this model for health policy making. Conclusion: An integrated model of health policy-making and analysis was developed according to the historical, political, economic, social, cultural and technological conditions of Iran. This model can be used for health policy making and health policy analysis (retrospectively and prospectively).

Objective (s): One of the important factors for the implementation of primary health care is the referral system. The aim of this study was to analyze of electronic referral system agenda setting based on Kingdon's multiple streams framework in Golestan province. Methods: A qualitative study was conducted in 2020 based on Kingdan (2003) model in Golestan province. Data were collected using two methods of document review and in-depth individual interviews with 26 individual interviews. Purposeful sampling and analysis of documents were performed by content analysis and interviews were analyzed by framework analysis. Results: The Problem stream was the weakening of the general practitioner and the non-referral of patients, the increase in the payment of people and insurance organizations, and the absence of some specialist physicians. The Policy stream included the obligation to implement the family physician program and referral system in upstream laws and documents, the implementation of the rural family physician program and referral system in 2005, and the urban family physician program in Fars and Mazandaran provinces. The Politic stream included launching a lean system at Golestan University of Medical Sciences, passing a law allocating one percent of value-added resources to the prevention and treatment of villagers within the referral system, and charismatic policymakers and committed executives. Conclusion: Despite the problems caused by the non-implementation of the referral system and the enforcement of laws due to conflicts of interest and insufficient funding for policy implementation in this area, the intersection of three currents of problem, policy, and political determination led to the opening of the window of e-referral policy and system in Golestan province.

Objective (s): Responsiveness is considered as a strategic tool through which organizational performance is evaluated, customer satisfaction is promoted, and operational efficiency and improvement of business operations are achieved. Since the study of the dimensions of accountability of any organization requires the determination of specific indicators for that organization, recognizing the indicators and determining the degree of reliability becomes an important issue. Methods: This qualitative study was conducted in 1399 with content analysis method. Participants were purposefully selected. The data collection tool was a semi-structured interview. After conducting 30 interviews with managers, experts and experts, the data were saturated. And was analyzed using Granheim-llandman's qualitative content analysis method. Results: By reviewing and analyzing the interviews, 6 main themes and 84 sub-themes were extracted. The main themes include designing an appropriate structure for accountability, considering trustees for accountability of the health system, defined and independent management for accountability, predicting units outside the health system for accountability, designing an appropriate model for customer-centered accountability, use indicators and checklists to assess the accountability of the health system. Conclusion: This study identified six strategies for evaluating health system accountability to be suggested to managers and policymakers, and to consider these strategies when planning to evaluate health system accountability.

Objective(s): The purpose of this study was to predict hhappiness among members an academic center in Tehran, Iran. Based on Self-efficacy and Quality of Life by mediating of Psychological Well-being. Methods: This was a cross sectional study among a sample of members of an academic center in Tehran in 2019. To collect data we used Oxford Happiness Inventory, SF-36, Sherer self-efficacy beliefs questionnaire and Ryff’ s Psychological well-being questionnaire. To explore the relationship between happiness, quality of life and psychological wellbeing path analysis was performed. Results: In all 382 respondents (213 men and 169 women) completed the questionnaires. The results showed that self-efficacy and quality of life had a positive and significant causal direct effect on happiness with a standard coefficient of 0. 09 and 0. 44, respectively. The higher self-efficacy and quality of life, predicted higher happiness. Also, the path of self-efficacy toward happiness by mediating role of psychological well-being with standard coefficient of 0. 045 and the path of quality of life toward happiness by mediating role of psychological well-being with standard coefficient of 0. 289 were significant. Conclusion: According to the findings of the present study, self-efficacy and quality of life can be predictive of happiness by mediating role of psychological well-being.

Objective (s): Sexual assertiveness is defined as one of the most important components of sexual life and as a psychosocial feeling towards one's personal interpretation of how to express oneself in a marital relationship. The aim of this study was to investigate the relationship between sexual health literacy levels and Sexual assertiveness in married women of reproductive age. Methods: This study was performed with a sample size of 200 married women in reproductive age who were referred to Banaruyeh health center in the south of Fars province, Iran through available sampling method. The instruments used in the study included a researcher-made demographic_ reproductive questionnaire, sexual health literacy for adults (SHELA) questionnaire, and the Sexual Assertiveness Hulbert Index (HISA). The data obtained from this study were analyzed through descriptive and inferential statistics using SPSS software version 21. Results: The mean age of participants was 31. 65 ± 5. 95 years. The mean score sexual assertiveness was 58. 9 ± 6. 95. A quarter of women had excellent sexual health literacy. The results of analysis of covariance showed that people with inadequate, not enough and sufficient sexual health literacy levels had lower mean sexual assertiveness scores than those with excellent sexual health literacy levels (p˂ 0. 05). There was a statistically significant relationship between sexual fulfillment score and occupation, spouse occupation, economic status and delivery history and between sexual assertiveness score with age, age of spouse, number of pregnancies, number of abortions, inverse and statistically significant relationship (p ˂ 0/05). Conclusion: The results showed that higher levels of sexual health literacy were associated with higher scores of sexual assertiveness. Necessary educational and counseling interventions for women of reproductive age need to be designed and implemented to improve sexual health literacy.

Objective (s): Awareness of people's childbearing intentions, which play a key role in predicting future fertility behaviors, is one of the most crucial topics in low-fertility societies. This study aimed to investigate the fertility intentions of recently married couples in Iran. Methods: The data of the National Marriage Survey in Iran (2016-2017) were analyzed using secondary analyses technique. The sample consisted of 8, 977 people in provincial capitals. Results: The results revealed that 2. 1% of people intend to remain childless and 16. 9% want to have one-child. The most important reasons for childlessness intention were the financial costs of the children and the lack of interest in having a child. Ethnicity was one of the main determinants. The Baluchs and the Arabs tend to have more children than the other ethnic groups, and the Gilakis were most inclined to be childless or have one-child. Furthermore, education, participation in religious rites, employment status and religion have a significant effect on fertility intentions. Conclusion: Although the childlessness intention was low, one-fifth of people tend to have less than two children. This could affect future fertility rates negatively given the expansion of higher education and the economic challenges. Thus, policymakers should prioritize reconciliation policies and child care programs.

Objective(s): The outbreak of COVID-19 disease has led to a dramatic increase in hand hygiene and use of masks and gloves which cause skin problems, including eczema. The aim of this study was to investigate the prevalence of eczema and its associated risk factors among different members of society during the Covid 19 epidemic and also to provide appropriate strategies to prevent and treat eczema. Methods: In this systematic review, relevant studies were searched in scientific databases fusing keywords associated with eczema, Covid-19 and disinfectant from 2019 to 2021. Articles were evaluated with the STROBE checklist. Results: Finally, 10 articles including 6 articles on medical staff, 3 studies on children and 1 study on the general public were reviewed. These studies investigated the prevalence of eczema before and after the pandemic, the symptoms of eczema and its associated risk factors, as well as strategies to prevent and treat eczema. Conclusion: The findings indicate a nearly two-fold increase in the prevalence of eczema in society during this pandemic. Most important risk factors associated with this finding were the frequency of hand washing, the use of gloves, and exposure to chemicals. Proper hand hygiene education and the use of emollients are the most important ways to prevent eczema.

Objective (s): Acceptance of COVID-19 vaccination could be influenced by attitude towards the vaccine. The aim of this study was to develop and evaluate the validity and reliability of adult attitudes towards COVID-19 vaccination. Methods: First, an item pool was generated by reviewing existing resources. Then content and face validity was examined. In the next stage, the structural validity (exploratory and confirmatory factor analysis) of the questionnaire was examined in two distinct samples among 505 Iranian adults. Finally, the attitude was assessed among two samples. The internal consistency of the instrument was estimated by calculating Cronbach's alpha. Results: The initial questionnaire consisted of 38 items that after examining the content and face validity, a number of items was removed and corrections were applied to the remaining items. The results of exploratory factor analysis showed a three factor solution (emphasis on the need for corona vaccine, no need for corona vaccine and emphasis on the side effects of corona vaccine) including 13 items that jointly explained about 52% of variance observed. Similarly, the results obtained from confirmatory factor analysis indicate a good fit for the data. The fit indexes were as follows: (X2/df =2. 15, GFI=0. 91, CFI=0. 95, NFI=0. 91, NNFI=0. 94, SRMR=0. 068, RMSEA=0. 076). The reliability of the questionnaire as assessed by the Cronbach’ s alpha was 0. 853 for the scale and ranged from 0. 68-0. 74 for its dimensions. Finally, the mean attitude score of the participants was 64. 1 out of 100 points. Conclusion: Considering the validity and reliability of the attitude assessment questionnaire regarding the COVID-19 vaccination in adults, this questionnaire could be used for measuring attitude towards COVID-19 vaccination.