فهرست مطالب بختیار پیروزی

A comprehensive understanding of the current state of geriatric care in Iran is necessary in order to strengthen and align it for responding to the current and future needs of the elderly in the country. The purpose of this study was to identify the challenges and barriers in the elderly care system in Iran.

This was a qualitative study. Forty semi-structured interviews were carried out with various participants involved in providing care to the elderly across the country in 2019. Participants were selected using maximum variation sampling. Using MAXQDA10 software, data were analyzed by the qualitative content analysis method based on six building blocks of health systems developed by the world health organization.

Challenges and barriers in the elderly care system were categorized into six groups: service delivery, health workforce, health information system, access to essential medicine, financing, and governance/leadership. Also, some of the most important challenges of the elderly care system included: absence of a single organization with sufficient power as the steward for providing the elderly services, lack of integration of services for the elderly from primary care to specialized care; shortage or inadequate distribution of skilled manpower; lack of insurance coverage for home care services for the elderly; lack of registry system or database for the elderly; lack of or weakness in elderly-friendly activities in the service centers.

The current elderly care system in Iran faces many challenges in all six building blocks of the World Health Organization. Reforming and redesigning the elderly care system based on the findings of this study is necessary and urgent in order to meet the needs of the elderly in the country.

The growing trend of elderly population makes it necessary to consider their physical, social, mental health and life quality. Therefore, this study was conducted to investigate their life quality and its relationship with socio-economic situation in Sanandaj.

This descriptive cross-sectional study was done on 400 the elderly in Sanandaj in 2020. The stratified random sampling method was used and the data collection tool was the SF-36 Quality of Life Assessment Questionnaire. Data were analyzed by SPSS 20 software using independent T-test and analysis of variance.

The highest and lowest average quality of life was in the dimensions of mental health and in the subscales of social functioning (89.53 ± 14.68) and emotional functioning (28.39 ± 43.36), respectively. The socio-economic status of the elderly had a relationship with the life quality subscales such as physical function (p ˂ 0.001), dysfunction due to physical health (p < 0.001), physical pain (p = 0.04), emotional function (p ˂ 0.001), and vitality (p <0.001). Also, marital status (p ˂ 0.001), employment (p ˂ 0.001) and income (p = 0.004) of the elderly had a significant relationship with the life quality subscales

Improving the life quality of the elderly requires financial and spiritual support of public and private organizations and institutions. By allocating subsidized support, improving the quality of housing, the inclusion of social security insurance and retirement of the elderly, as well as creating various recreational and sports programs, steps can be taken to improve the socio-economic status of the elderly and their quality of life.

On 12 November 2017, an earthquake with a magnitude of 7.3 on the Richter scale occurred in Kermanshah Province. Explaining the challenges and needs of the victims in such circumstances can be an important source of information for future planning and better management of such conditions. Thus, the purpose of this study was to explain the challenges and needs of the earthquake victims.

This study was a qualitative study. Twenty-nine semi-structured interviews were conducted with managers, policymakers, and health and emergency relief providers in earthquake areas, and 10 focused group discussions were held with earthquake victims from December to February 2016. The data were analyzed using conventional content analysis.

The needs and challenges in Kermanshah earthquake were classified into three periods after the earthquake: 1. Challenges and needs in the first few days with three sub-categories including management, rescue services, and urgent care, 2- Challenges and needs in the first few weeks  after the earthquake with three sub-categories including housing and emergency assistance, public health services, and access to health care; and 3. Needs and challenges in several months after the earthquake with four sub-categories including economic, social, infrastructural and health service needs.

Lack of unity of command was the main challenge in this earthquake. Another point was the health needs of victim earthquakes over time. Therefore, dispatching of aid forces to the affected areas during natural disasters should be based on planning and needs.

The main objective of this paper is to descriptive status of nutritional Habitus examine the impact of economic capital on it as a social / cultural phenomenon. To achieve this goal, the theoretical framework of research is on social capital theory of Pierre Bourdieu, and its according Research hypotheses were raised.

The population of this research was residents of Sanandaj that using Multi-stage cluster sampling 576 of them were selected. The method used in this study was a survey and questionnaire, after collecting data, descriptive and inferential statistical methods were used to analyze the data.

The results of this study indicate that level of nutritional habitus of citizens is moderate and medium to high. Explainable results also showed that the level of correlation is reported 0/559 between nutritional Habitus and the economic capital. Independent variable “economic capital” alone accounts for about 31 percent of the changes in the purchase of nutritional Habitus of residents of Sanandaj. The results of the analysis of the relationship between nutritional Habitus and demographic variables also show that the nutritional Habitus has a significant relationship with the variables of age and marital status and has no relation with other variables (religion, education, and gender).

Thus the results showed a significant positive correlation between nutritional Habitus and the economic capital there. And economic capital is one of the effective factors that plays an important role in nutritional Habitus.

This study aimed to determine the perceived need, seeking, and utilization of health services among eight-year-old or younger children with disabilities in Iran.

This descriptive cross-sectional study was conducted on a sample of 2,000 children with disabilities aged eight years or lower selected through multistage sampling from five provinces of Iran. Data were collected using a researcher-made electronic questionnaire. Descriptive statistical methods were used to analyze the data by Stata 13.

The highest percentages of perceived needs for outpatient services in the last three months belonged to specialist physician visits (65.80%), medication (66.05%), speech therapy (57.58%), and occupational therapy (54.89%). The lowest percentages of seeking for perceived needs belonged to dental services (45.80%), psychiatry services (51.30%), and physiotherapy services (60.69%). The lowest percentages of utilization after seeking for perceived needs belonged to dental services (61.00%), physiotherapy services (82.38%), and outpatient surgery services (86.40%). The percentages of perceived need, seeking, and utilization of inpatient services over the past 12 months were reported to be 22.08%, 88.73%, and 87.89%, respectively.

There was a significant difference between perceived need, seeking, and utilization of health services in children with disabilities in Iran. Health system policymakers should consider the factors affecting the seeking and utilization of health services by children with disabilities in designing appropriate interventions.
 

Cesarean rate has had a rising trend in Iran during the last two decades. Natural childbirth promotion plan has been implemented in the form of health sector evolution plan (HSEP) in order to increase natural childbirth. Present study aimed to evaluate the effect of health sector evolution plan on cesarean rate and the average costs paid by mothers hospitalized in Kurdistan province.
Methods & Materials: This descriptive study was conducted as longitudinal and retrospective study. Cesarean rate in all hospitals of Kurdistan province was assessed in 2013 and one year after the implementation of HSEP. Furthermore, data related to the percentage of out of pocket expenditures by pregnant mothers in one of the hospitals of Kurdistan University of Medical Sciences, which was randomly selected, was also studied. Data were analyzed using SPSS v.20.
There was a 14.02% reduction in the rate of cesarean in Kurdistan province one year after the implementation of HSEP compared to its basal rate in 2013 (P Natural childbirth promotion plan has reached its predetermined goal, which was a 10% decrease in cesarean rate one year after the implementation of HSEP compared to its rate in 2013. In addition, there was a significant reduction in the percentage of out of pocket expenditures.

Promoting Natural Childbirth Package has been the most serious action of Ministry of Health in recent decades to reduce cesarean section. This study was conducted to evaluate the stakeholders’ opinion about this package.
This is a descriptive-analytic study which was conducted in hospitals of Kurdistan University of medical science. The samples consisted of 73 health care providers, and 104 service recipients. The researcher-made questionnaire was used to collect data. The descriptive statistics, t-test and ANOVA were used to analyze the data using SPSS16.
The results showed that %60. 6 (CI= 54-73) of service recipients believed that "free vaginal delivery", affected their choice to have vaginal delivery. The mean score of "incentive to encourage mothers to give normal vaginal delivery» (p= 0/019) and the «satisfaction of tariff changes» (p= 0/001) in Obstetricians and Gynecologists was significantly higher than midwives. The mean score of "overall satisfaction with the implementation of the package" was different significantly among three groups of health care providers (obstetricians and gynecologists, midwives, and anesthetists, and Obstetricians’ and Gynecologists’ satisfaction was higher than other groups significantly (p= 0/006).
This package has made Obstetricians and Gynecologists to be satisfied largely; also has encouraged pregnant women for normal vaginal delivery. There is room to pay more attention to health workers (as the first contact point of pregnant mothers with service providers), especially midwives and health professionals. This could increase the effectiveness of this package.

Responsiveness is a response to the reasonable expectations of people about non-clinical aspects of the health system. The purpose of this paper was to assess the responsiveness of the health system after the first year of the health system reform in Sanandaj in 2015.
This descriptive-analytic and cross-sectional study was conducted on 646 households in Sanandaj. The World Health Survey (WHS) questionnaire was used to collect the data. The data was analyzed with SPSS 16 as well as descriptive statistics and ANOVA.
All dimensions of responsiveness, except for choice, were 100% important according to the respondents. In inpatient services, social support (100%) and confidentiality (96%) had the best performance while communication had the worst performance (49%). In outpatient services, confidentiality (100%) and autonomy (42%) had the best and worst performance, respectively. In inpatient wards, a significant difference only in “quick attention” dimension was observed among responsiveness dimensions with regards to proprietorship of the health care center (P-value=0.03). On the contrary, this difference was not significant in outpatient wards.
In this study, communication (time to ask questions about health problem/treatment, clarity of providers explanations), autonomy (participation in treatment decision-making, possibility of obtaining information on other types of treatment) and quality of basic amenities (cleanliness inside the health facility, available space in waiting and examination rooms) were identified as priority areas for actions to improve the responsiveness of the health care services.