Payesh
Year:2020 | Volume:19 | Issue:6|Papers Count:11

Objective (s): Due to the higher life expectancy of women than men, the number of ageing women is significantly higher than ageing men, which is known as the feminization of ageing. The objective of this article is to identify socio-economic status of Iranian ageing women and policy requirements according to official statistics and futuristic scenarios of the population. Methods: In order to understand socio-economic status of ageing women in Iran, the 2016 census data and other official statistics has been used. Also, according to the demographic scenarios, the situation of ageing women in the perspective of 2050 has been analyzed. Results: Based on the processing of official statistics, it can be said that the ageing women make up about 9. 5% of the total female population of the country, which is expected to increase to about 32. 7% by 2050, based on the prediction of a probable future scenario. At present 99. 72% of ageing women live in normal households; 44% of are literate (50% with primary education). The economic participation rate of ageing women is 6% and the unemployment rate is 1. 8%. 43. 3% have lost their husbands and 24% of ageing women live alone. Also, 39. 7% of ageing women are heads of households in which they live. Conclusion: The high and increasing number of ageing women headed households is one of the most important findings of the present study. Demographic and social policy requirements in this regard are discussed.

Objective (s): Since the rapid expansion of Covid 19, a series of precise prevention and control measures have been taken place to reduce the prevalence of this pandemic in China and other countries worldwide. The aim of this study was to compare the policies of selected countries to combat the corona virus disease 2019. Methods: This comparative review study conducted in 2020. Required information (demographic information, statistical information, control policies and their results) extracted from articles from official and valid databases and sites. Results: The selected countries have more and less implemented these policies: quarantining infected patients, the restrictions, health education, disease detection, punishing for defecting Covid-19 laws, and recessing schools and universities. South Korea and China have also implemented quarantine policies for contaminated cities and geographical tracking. Conclusion: A set of comprehensive, coordinated and integrated policies and measures was implemented by successful countries for controlling Covid-19 spread including: quarantine of patients and cities, extensive disease detection, geographical tracking, penalties for violating protocols, health education. Countries in where the policies were implemented more strictly were more successful in controlling this pandemic.

Objective: The aim of this study was to investigate the fertility indicators in Iran. Methods: This was a cross-sectional study and included Iranian women of reproductive-age. The data were collected using a questionnaire and analyzed using SPSS18. Results: In all 10547 women included in the study. The mean live birth was 1. 96 and it was increased as age of both women and husbands were increased; and it was decreased as age at marriage, age at birth of the first child, and education were increased. Live birth was more in low-income women and in rural areas. The frequency of stillbirth was 4. 8% and increased as age of both women and husbands were increased. The stillbirth decreased as age at marriage, the age at birth of the first child, and education were increased. There was no relationship between stillbirth and women’ s occupation, occupation of husbands, and religion. The stillbirth was more in low-income women and in rural areas. The frequency of abortion was 18. 2% and increased with age of women, age of husbands, and age at birth of the first child. Abortion decreased with increased age at marriage and education. Abortion was more common in low-income women. Abortion had no relationship with women’ s occupation, religion, and urban/rural residency. The frequency of the cesarean section was 42. 1%. Cesarean increased with increased age of women and husbands, age at marriage, age at birth of the first child, and education. Delivery by cesarean had no relationship with occupation of husbands. The cesarean decreased with decreased income and was higher in urban areas. Conclusion: Investigating the trend of fertility indicators can play important role in identifying problems, planning for required services, and optimal allocation of resources. The findings from this study will complement the information that is needed by policy-makers.

Objective (s): Health policy-making process in Iran is extremely complex because of the impact of contextual factors and various actors with competing interest. It is not clear how the interaction of these factors bring about changes in policies. We propose a substantive theory to understand how policy changes form, and we provide policy practitioners with practical suggestions to improve the policy outcomes. Methods: A qualitative method based on grounded theory research strategy was applied. For data collection we used in-depth one-on-one interviews with key informants who were involved in three major health policy figures in Iran. We explored the change mechanism by identifying the institutional context, action-interaction patterns and the consequent policy outcomes. For analyzing data, we conducted the three coding stages using Atlas-Ti software. Results: The main motivator of change in health policies is ‘ impression making’ which its owners act in three contextual spheres of agenda-setting, documentation and implementation using certain strategic patterns to make it realized. Impression as the dominant determinant stream in health domain requires aligning four underlying streams of politics, idea, vertical individualism and problem with its requirements to realize the expected impressions of its owners. As long as the impressions are made, the change is in progress. By deviation of any contextual streams or reducing the eagerness to make impression, the change is stopped or downgraded regardless of the problem to be solved or the policy idea to be implemented completely. Conclusion: Understanding the pattern of health policies changes through identifying role of contextual streams and adopted strategic patterns of behavior, reveals the casual mechanism behind the failure or success of polices. The theoretical model of policy change phenomenon provides policy practitioners with important lessons that enable them to control over the changes and improve the policy content and outcomes if they take them into consideration.

Objective (s): National accreditation standards could improve both quality of services and the patient safety. This study aimed to investigate the accreditation status from the perspective of nurses working in hospitals affiliated to Iran University of Medical Sciences. Methods: This was a cross-sectional study conducted in 9 hospitals affiliated to Iran University of Medical Sciences in 2018 and 365 nurses with at least 5-years clinical work experiences were selected by simple random sampling. Data were collected using a 54-item questionnaire that included 9 dimensions of quality, leadership, commitment and support, strategic quality planning, quality management, staff training, reward, use of data, staff involvement and benefits of accreditation. All statistical analysis was performed by SPSS-22 software using descriptive statistics. Results: The overall score of accreditation status in the present study was 3. 0± 0. 7 that among its dimensions, the highest mean score (3. 3± 0. 8) and the lowest mean score (2. 7± 0. 8) was related to the ‘ staff involvement’ and ‘ staff training’ , respectively. Conclusion: In order to better implement accreditation program of healthcare organizations, policies to reduce the number of metrics and making them more transparent seems necessary. In addition, providing desirable training for staff and giving them the financial and non-financial rewards are recommended.

Objective (s): After leaving home, runaway girls face many problems that threaten their physical, mental, and social health. One of the programs implemented by the Welfare Organization is the establishment of separate and special centers for these people throughout the country. This study was conducted to explain the goals, service model, challenges and strategies to improve this program. Methods: A qualitative study was conducted in 2016. Participants in the study included managers and experts from the departments of the Welfare Organization in 31 provinces, 21 members from the public mediators and partner organizations and 6 senior managers and experts in charge of the social deputy of the Welfare Organization. In order to collect data, three methods of document analysis and in-depth interviews and focus group discussion were used and the data were analyzed by content analysis. Results: Health centers for girls exposed to social harms have been set up in all provinces of the country since 1999. The goals of the program are to support and care for girls exposed to social harms, to provide them with education, employment, self-sufficiency and independence, and to recognize their talents and abilities and guide them to use their abilities. The program faces challenges including poor public awareness and attitudes, insufficient cooperation broadcasting information, inadequate distribution, and inadequate allocation of financial budget, and insufficient commitments to implement the memorandums. Recommended solutions to improve the program include increasing the awareness of stakeholders, reviewing relevant guidelines, strengthening and updating training packages, developing an early audience identification protocol, creating opportunities for continuing education and employment for clients, strengthening and expanding places and programs. It is suitable for girls' leisure time, strengthening intersectoral coordination, passing and amending judicial laws in order to protect these girls. Conclusion: Despite the services provided in health homes for runaway girls, it faces the challenges at the government and public levels. In order to improve the current situation, it is necessary to use the proposed solutions along with reviewing and correcting related processes.

Objective (s): Iranian Ministry of Health launched a national campaign to control high blood pressure among adult population in Iran. The campaign was consisted of two phases: raising awareness and filed action. This study was aimed to perform a rapid evaluation of the first phase of the campaign. The campaign was started from 17 May to 8 July 2019. Methods: A cross sectional population study was conducted during the first phase of the campaign in order to find out the extent to which the campaign was successful in reaching the intended target population. A random sample of Iranian adults aged 18 and above were entered into the study and interviewed via telephone survey using a selfdesigned questionnaire including demographic information and items related to the campaign. Results: In total a sample of 1526 Iranian adults were recruited and interviewed. The mean age of participants was 38. 04 (SD = 12. 9) years. Overall the findings showed that only 24. 6% of participants (n = 376) heard about the campaign. Of these, only 167 individuals knew about the aim. However, performing logistic regression analysis the findings showed that higher age, being single, less education, and having a family without high blood pressure history were associated with lack of knowledge about the campaign while gender and living area (Urban vs. rural) were not. Conclusion: The study findings suggest that to promote such campaigns there is need to develop appropriate strategies including formative and process evaluations at earlier stage of the campaign.

Objective (s): Thalassemia is the most common genetic disease can affect the quality of life of patients. The aim of this study was to evaluate the effect of interventions performed to improve quality of life of patients with major thalassemia. Methods: The present study was a systematic review. The following databases were included to identify relevant citations: Magiran, SID, ISC, IranMedex, Pubmed, Scopus, Google scholar, Web of Science, ProQuest and Cochrane using the keywords major thalassemia, quality of life, beta thalassemia, clinical research, Clinical trials based on Mesh were identified during July 2010 to July 2020. Articles were searched and extracted by two researchers independently. All articles that met the eligibility criteria were reviewed. Results: Out of 370 studies, finally 16 articles (5 Persian articles and 11 English articles) were reviewed, which were divided into five categories: psychological interventions (5 articles), health promotion education interventions (5 articles), and care interventions (3 articles), Empowerment interventions (2 articles) and physical activity (1 article). Most studies have confirmed the effectiveness of educational interventions in improving the quality of life of patients with major thalassemia. Conclusion: Educational interventions to improve the quality of life of patients with major thalassemia can have a positive effect and improve the quality of life of these people.

Objective (s): Active Pharmaceutical Ingredients (APIs) are a significant contributing factor to the price, quality, and access of pharmaceutical products. Thus countries often would develop their policy of supplying APIs based on these three factors. This study examined the impact of the supply policies of APIs on the price, quality, and access of medicines in Iran. Methods: This study consisted of qualitative and quantitative phases. In the qualitative phase, semi-structured interviews were carried out with leading experts in the field, and thematic analysis method was used for data analysis. In the quantitative phase, the price of domestic APIs was compared to that from China and India in the case of 50 medicine products, and the ratio of the API price to the final product was determined. In addition, opinion of manufacturers of final products was asked about the quality of domestic and imported APIs. Results: In 45 products, the price of domestic APIs was higher than that of their counterparts imported from China and India. Judging by the opinion of quality control experts in drug manufacturing companies, the quality of domestic APIs was also inferior to that of the imported ones. Conclusion: Economic reasoning and quality of APIs in supply constitute the main business principles of final product manufacturers. To promote market of domestic active pharmaceutical ingredients, their price and quality should be improved.