maryam zaboli

In school age children, a healthy nutritional behavior can prevent double burden of malnutrition and chronic diseases. Nutritional education has a key role in adopting a healthy lifestyle. This study aims to evaluate the effectiveness of an educational package on the nutritional knowledge and practices, physical activity (PA), and body mass index (BMI) of elementary school children in Zahedan, southeast Iran.

In this quasi-experimental before-after study, a total of 734 elementary school children‎, aged 10–14 years, recruited by census sampling method completed the survey. Each student received 8 hours of training and they were provided with a booklet that included a weekly chart for recording intake of food groups and PA by students for 3 months. A semi-structured questionnaire that included questions on the students' nutritional knowledge, eating behavior, PA performance, and BMI before and after the intervention was used for data collection. Paired t-test, McNemar's, and Friedman tests were used for data analysis.

Before the intervention, the mean score of nutritional knowledge was 7.5 and the prevalence of underweight and overweight/obesity was 17.4% and 0.4%, respectively. After the intervention, the results showed a significant increase in the nutritional knowledge scores, the number of days with 30 min PA per week, and the frequency of consumption of dairy products, animal protein, and fruits. Also, in comparison with before intervention, a significant decrease was found in the prevalence of underweight and overweight/obesity of school children after the intervention.

This multifaceted nutritional education intervention was associated with improved nutritional knowledge score, PA, and being underweight in elementary school children.

It is a fact that coronavirus disease of 2019 (COVID-19) infection mortality rate is high, but the question is "what is the role of other factors in maternal death with COVID-19?" The present study aimed to understand the factors that prevent women from timely use of healthcare services and also the potential weaknesses of the healthcare system that cause the lack of quality healthcare services for women.

This case-series study was performed in the southeast of Iran. In total, 12 cases of maternal deaths attributed to COVID-19 were identified through the Iranian Maternal Mortality Surveillance System. The required information was collected through existing verbal autopsy data sets. In some cases, the family members had to be re-contacted and healthcare workers were asked to supply the missing information. The root cause analysis method was employed for data analysis.

From March 2020 to March 2021, the deaths of 12 women were attributed to COVID-19. The majority of these women lived in rural areas (58%) and had a secondary school education level or less (83.3%). The contributing factors were divided into three categories: barriers at the community level (no prenatal care, lack of trust, lack of recognition of the severity of disease, and attribution of symptoms to something else), at the primary health system level, and at the hospital level (fear of staff of being infected, non-compliance with guidelines, lack of team working, and problem with telehealth).

The socio-cultural context and unmet healthcare needs hinder the utilization of available services. Moreover, factors at the level of the healthcare system prevent the timely detection and referral of women with COVID-19 to receive quality healthcare services. Using telehealth also did not help to appropriately triage pregnant women.

The data on the prevalence of substance abuse in Iranian pregnant women is scarce in the current literature. This study investigated the prevalence of and the factors associated with substance abuse among pregnant women, and compared self-reported use with urine test results. This cross-sectional study included data for 2000 pregnant women admitted to a tertiary care hospital in the southeast of Iran. Data were collected on socio-demographic characteristics and the patterns of substance use. Multivariate logistic regression analysis was used to identify factors associated with opiate use. A subsample (200 women) was randomly selected to provide urine samples for toxicological screening. The lifetime prevalence of substance abuse and tobacco smoking was 15% and 31%, respectively. Overall, 3.3% of the participants reported using at least one substance during the previous month. One third of pregnant women reported using substances as a home remedy for treatment of pregnancy related health problems. Overall, 23% of the urine screening tests were positive. The agreement between self-reported substance abuse and the results of the urine tests was poor. Factors associated with opiates use in pregnant women were age at the first pregnancy of less than 20 years, living in rural areas, unwanted pregnancy, lack of healthcare during pregnancy, and having a spouse and/or first-degree family member with substance abuse. This study showed a high prevalence of substance abuse among the studied women. Thus, a multidisciplinary approach to provide preventive educational programs during pregnancy, and interviews and urinary screening of all pregnant women is recommended.

Providing high-quality maternity services is crucial to increase utilization of these services and reduce maternal mortality. The quality of the maternity services provided to pregnant women in rural areas of Iran is poorly understood.. This study aimed to investigate the quality gap in the maternity care services provided by Rural Delivery Facilities and Safe Delivery Posts in Sistan and Balouchestan Province, southeast of Iran, as expressed by the difference in women’s perceptions and experiences of services..Patients and In this cross-sectional study a total of 438 pregnant women who gave birth in rural maternity unit were recruited between February and May 2013. The SERVQUAL questionnaire was used for data collection. The Wilcoxon Signed-Rank test was used to compare the quality gap as expressed in the mean of differences in the expectation and perception scores. The quality gap was compared between demographic groups using Kruskal-Wallis tests.. There was a negative gap in all dimensions of the quality of services provided. The highest quality gap was found for the reliability dimension followed by tangibles, empathy, assurance and responsiveness. The participants’ age, levels of education, and the type of maternity unit were found to be associated with the clients’ perceived quality of services.. The quality gap in the services provided by maternity units showed that these units are not able to meet pregnant women’s expectations completely. The negative quality gaps can be used as a guideline to improve the maternal health care quality and reduce maternal mortality, particularly in high-risk women such as those living in rural areas..