The present study is an initiative to explore the performance of various hospitals relating to various environmental sustainability practices in the health care sector in the study area. Seven broad factors considered for the study were sustainable management -8 sub-variables, environmental communication-6 sub-variables, managing hospital pollution -3 sub-variables, resource conservation-7 sub-variables, water recycling -5 sub-variables, energy conservation-7 sub-variables, and patient room sustainability-8 sub-variables. Totally, 316 responses were considered for the study including lower level, middle level, and senior level employees of the hospitals under study. The results found that all the health care service providers are following the environmental sustainability practices as per norms, but still certain areas which need to be addressed by the health care providers in the study area.

Background: The health system is recognized as one of the most fundamental pillars of societal development. Therefore, ensuring its resilience against sanctions, within the framework of resistance economy policies based on the capacities of Iranian medicine, is of great importance for the country. Hence, this study aims to explain the potential of Iranian medicine in achieving a resistance economy by strengthening and empowering the health system. Methods: This study is qualitative in approach and applied in purpose. Data were collected using library studies and semi-structured interviews. The statistical population consists of 12 experts in the field of health. The sampling method is purposive sampling. Two methods have been used for data analysis: qualitative content analysis and thematic analysis Results: The qualitative content analysis revealed that ensuring the resilience of the health system occurs through three main axes: food and drug security, reducing dependency on imports of health-related goods, and modifying consumption patterns. Furthermore, thematic analysis identified the following as key capacities of Iranian medicine in strengthening the health system: utilization of indigenous medical knowledge and local pharmaceutical production chains, designing a native nutrition model based on domestic raw materials and products, and implementing comprehensive preventive principles and simple, home-based treatments. Conclusion: The application and scientific development of Iranian medicine can play a key and effective role in reducing the vulnerability of the health system and enhancing its resilience within the framework of resistance economy policies.

There is an increasing policy emphasis on the integration of care, both within the healthcare sector and also between the health and social care sectors, with the simple aim of ensuring that individuals get the right care, in the right place, at the right time. However, implementing this simple aim is rather more complex. In this editorial, we seek to make sense of this complexity and ask: what does integrated care mean in practice? What are the mechanisms by which it is expected to achieve its aim? And what is the nature of the evidence base around the outcomes delivered.

Background and Objective: Fear of childbirth is a common problem during pregnancy. Previous studies have shown that pregnancy outcomes and experiences can significantly vary across various ethnic groups. This study aimed to determine the prevalence of fear of childbirth among pregnant mothers of various ethnicities referring to comprehensive health service centers in Gorgan, Iran. Methods: This descriptive-analytical study was conducted on 341 pregnant women of Fars, Turkmen, and Sistani/Baluch ethnicities using a random sampling method at comprehensive health service centers in Gorgan during 2023. Data collection instruments consisted of a demographic and pregnancy characteristics form and the Childbirth Fear Questionnaire (CFQ; Zar and Wijma). Results: The mean fear of childbirth score in pregnant women was determined to be 69.88±20.19 (severe fear). Among all studied groups, mild fear (21 individuals), moderate fear (100 individuals), severe fear (147 individuals), and clinical fear (73 individuals) were identified in 6.2%, 29.3%, 43.1%, and 21.4% of the pregnant women, respectively. The combined prevalence of severe and clinical fear of childbirth among pregnant women of Sistani/Baluch, Turkmen, and Fars ethnicities was determined to be 73%, 73.3%, and 52.2%, respectively, and this difference was statistically significant (P<0.05). A statistically significant relationship was observed among the variables of age, gestational period, and the level of satisfaction with prenatal care received at comprehensive health service centers (P<0.05). Conclusion: Severe and clinical fear of childbirth is more prevalent among pregnant women of Sistani/Baluch and Turkmen ethnicities compared to the Fars ethnicity.

In the past two decades, powerful international trends in "market-oriented" health sector reforms have been sweeping around the world for meeting new health needs and requirements. Major elements of these reforms are: - Health sector restructuring- Privatization- User fees for public servicesIn recent years, for many reasons, Iran health sector has confronted with many challenges, for examples; inequity of access to care, unequal share of limited resources, high cost of treatments and rehabilitations, demographic, epidemiologic and economic transition, poor quality of care and so on. Therefore, Iran health sector needs reform, but the report acknowledges that many of societies health problems, especially in developing countries, are not solved by this reforms.Mixing the mean of "reform content" with "reform process" is one of the most important causes of this problem. However, the reform is not an economical or a political issue. On the contrary, it is a management topic and needs a management philosophy. Organizational change for meeting new health needs must be followed by this philosophy.Total Quality Management (TQM) is being adopted as a management philosophy that can be used in dealing with these challenges.

Background and Objective: People act differently in choosing their health care providers. This study was conducted to identify the effective factors on choosing health care providers in public, private, and charity in Shiraz University of Medical Sciences’ staff.Materials and Methods: This research was a cross-sectional applied study that was conducted in 2016. The study sample consisted of 330 of the staff affiliated to Shiraz University of Medical Sciences centers that entered the study through stratified and simple random sampling methods. The study tool was a reliable and valid Persian draft of questionnaire designed by Ferreira. Data were analyzed applying SPSS23.Results: Findings showed that intention, attitude, and perceived behavioral control constructs were higher in public sector than the private and charity. The male, married, older and low educated staff, who engaged in research centers and hospitals’ staff with higher work years and those with contract and corporate the types of employment have higher intention to choose public sector than the private and charity.Conclusion: The present findings indicate the more intention of the participants to use the services in public sector than those of private and charity. In order to better use of services and resources in each of the three health care providers these recommendations are presented: increasing the atmosphere of trust, respect, and empathy along with simplifying the application of services in public sector and using different methods of social marketing accompanied with balancing the tariff and identifying the payable tariff for all the people in private and charity sector.

Background and aims: The difficult tasks of firefighters' operational personnel, can determine the risk of hypertension and other acute cardiovascular and cerebrovascular diseases. Objective: This study aimed to determine the relationship between health literacy and self-care of hypertension among firefighters in Tehran. Methods: This cross-sectional descriptive-analytical study, which conducted in among 360 male firefighters, age of 18-60 years, working in the Tehran Fire Department in year 2019 was performed by two-stage sampling method in cluster and simple random. Data collection instruments were a demographic questionnaire together with the Standard Iranian Health Literacy in Adult questionnaire and the self-care checklist for hypertension. Data were analyzed in SPSS (version 22) using descriptive methods and, analytical tests. Results: 57.5% of people were in the age group of 30-40. The mean score of health literacy was 73.96 with a standard deviation of 3.8. The highest mean score of health literacy was related to information perception and the lowest average score was related to reading skills. Among study sample, 44.2% had “good” and 26.7% had” very good” health literacy. Also, the mean score of self-care behaviors was 19.23 with a standard deviation of 3.4. About 14.4% of employees had a mean score of good self-care. There was a direct and significant correlation between health literacy and self-care of 0/360 (p <0.0001 Conclusion: Health literacy and self-care behaviors were found to be not satisfactory. There was a significant positive correlation between health literacy and self-care. Therefore, it is necessary to design an appropriate intervention.

Dear Editor-in-ChiefOne of the most effective and valuable principles to promote health in all countries has been adoption of Primary Health Care (PHC) as a fundamental strategy. In Sept. 1978, an interna-tional conference was held in Alma-Ata, whose great achievement was declaring PHC as a roadmap for “ Health for All” by the year 2000 (HFA 2000). Indeed, as a new approach beyond the traditional system of health care, PHC insist-ed on justice in the delivery and distribution of services in the health sector (1)...

Despite all the problems caused by the imposed war, sanctions and accidents after the Islamic Revolution, materializing primary health care (PHC) in Iran through establishing the National Health Network (NHN) has had substantial gains. Many health indicators in Iran have undergone significant changes. As an example, the change in death of children under the age of 5 years has been studied by adjusting the economic status, and it is estimated that about 2 million deaths in this age group were avoided within 30 years after the Islamic Revolution. Nevertheless, the global experience implies that the PHC has its limitations. By changing the social, economic, and epidemiological patterns of diseases, demands and expectations of community has changed. With the emergence of chronic conditions and new technologies, health expenditures have become a major concern. Meanwhile, in the 2000s, the revision at PHC was aimed at strengthening through the universal health coverage (UHC). Therefore, UHC is along the PHC and not against it.