جستجوی مقالات مرتبط با کلیدواژه « عدالت در سلامت » در نشریات گروه « پزشکی »

The covid-19 disease changed the existing order systems and structures, including the lifestyle of people, by affecting the social and economic components. This disease, due to its infection and transmission process, can be greatly influenced by individual behaviors and socioeconomic characteristics of people. In this paper, the socioeconomic characteristics of people with a history of this disease in Mazandaran province have been investigated.

To collect data, a standard questionnaire was used, which is almost the most comprehensive tool designed in this field. The activity of data collection was a combination of interview and study and document collection and content analysis of documents. Then, the data was extracted with SPSS 16 statistical software in accordance with the solutions in the introduced tool and analyzed and interpreted using descriptive and analytical statistics.

253 people (56.2%) who had a history of corona infection stated that the people of the society used masks to some extent appropriately and on time. Among these people, the tiredness of using a mask was 27.1% in men and 38.5% in women, which could be due to more and more serious use of masks by women. There was a significant relationship between men and women regarding the impact of living and working conditions on compliance with health protocols (p=0.001).

The need to pay attention to the vulnerable group in order to provide the necessities of life and make available the means to prevent corona, including masks, disinfectants, should be placed on the agenda of government and public bodies. Also, care of corona patients and people at risk and compliance with health instructions should be seriously monitored by health inspectors. Training on compliance with health standards in the prevention and care of corona patients should be prioritized.

The Constitution of the Islamic Republic of Iran emphasizes the importance of equal access to basic health care, including oral and dental health care and services. Despite advances in other areas of health care, the oral and dental health care system has faced challenges to meet the needs of the Iranian population. These problems occur due to the imbalance of technical and managerial information between the officials of the Ministry of Health, mostly doctors, and the managers of the dental field. Providing incorrect information to officials leads to decisions without scientific support. Inefficient allocation of resources and monopolization of treatments in the dental profession has caused a lack of fair access to basic oral and dental health services. To improve the situation, it is recommended to take measures such as creating a transparent governance structure, developing a plan to integrate oral and dental health into the primary care system, increasing health and treatment forces in villages, and improving welfare in deprived areas. These recommendations are presented based on a detailed analysis of the challenges ahead and with the aim of improving the oral and dental health situation in the Islamic Republic of Iran.

A part of the expenses of every household in all societies of the world is health expenditures, which can sometimes be disastrous for families. This study was conducted to investigate the change in the share of health expenditure from the total Household costs in Mazandaran province and the possible impact of health system reforms on it in Iran during the recent two decades, especially the Health Transformation Plan.

This is a retrospective descriptive-analytical study, based on quantitative and secondary data. The data required for this study was taken from the Statistics Center including household income and expenditure for a period of 18 years from 2001 to 2018. Descriptive statistics indicators and trend charts were used to describe the quantitative data, and to analyze household health expenditures, the t-test was applied in SPSS software.

The results of the study showed that on average, the share of health expenditures in the total household expenses was 12.04% for urban households and 11.36% for rural households that is more than the stated and expected limit of 10%. The trend of changes in the percentage of health expenditures from the total household expenses at the time of the research compared to the base year has been variable and in some years it has decreased and in some years it has increased.

The health system reforms have not ultimately led to the reduction of household health expenditure to less than the expected level and its increasing trend in Mazandaran province.This means the risk of catastrophc health expenditure among households still exist. Even with the implementation of subsequent plans, the achievement of the previous plan has been neutralized. Considering the importance of financial issues in universal health coverage and also the limited resources of the health sector, more detailed policies and plans should be designed and implemented to target vulnerable groups so that families' financial hardship is prevented as well as the possibility of universal coverage is increased to the maximum.

Health equity is a complex and multidimensional concept that refers to the fair distribution of health resources and opportunities. In developing countries, where resources are limited, ensuring health equity is a major challenge. This study aimed to evaluate the level of attention given to health equity in the development plans of Iran.

The full text of Iran's first to sixth development plans was qualitatively analyzed using a directed content analysis approach. The dimensions of health equity (availability, accessibility, adequacy, affordability, and appropriateness) were identified, and the frequency of each dimension was calculated using a cross-tabulation in SPSS software. The validity of the study was ensured through expert opinions and the agreement between evaluators using Cohen's kappa coefficient.

The results showed that the most attention was given to the dimension of accessibility (17.7%), followed by adequacy (12.4%), appropriateness (7.7%), affordability (4.3%), and availability (1.9 %).

Given the intricate and multifaceted nature of health equity, achieving equity in this domain necessitates a comprehensive and well-rounded approach. It is imperative to delve deeper into this matter within the framework of development programs, with program objectives and implementations aligned accordingly.

One of the important goals in health policy is to ensure equity in health. Equity in health means absence of systematic and potentially remediable differences in one or more aspects of health in a population and economic, social, demographic and geographic subgroups.

This study was conducted by reviewing available scientific literature and texts and examining articles, theses, reports and resources available in internal and external databases and the conference held by the Academy of Medical Sciences by using relevant

  Analysis of the studies showed that the progress of the index of the policies of the health sector has not been able to create a significant change in the direction of improving equity. Discrimination in service coverage, gender discrimination, access to services in remote areas and lack of health services in low-income groups still exist despite the 40-year achievements of the revolution and emphasis on this issue in the first to fifth development programs. Although the transformation plan was able to reduce costs of inpatient services, the costs of justice in financial participation and the index of health costs of the poor is high.

Recurring budget deficit in the health sector shows the instability of the financial resources of this sector. The inconsistencies between the Ministry of Health and Medical Education and the Ministry of Economy and Welfare are effective in not achieving justice in health.One of the approaches to improve indicators and control costs in all societies, whether rich or poor, is management of limited health resources. According to the law of the fifth development plan, full implementation of the family physician program, the referral system, and expansion of insurance coverage can help improve equity in health and reduce costs for the public.

Aim of the family medicine program was achieving comprehensive and equitable health care and services for all individuals in the community. This statement outlines the requirements and strategies required by the program.

According to the WHO Commission on social determinants of health, identification of social determinants of health and collection of scientific evidence in this domain is essential for reducing health inequity. This is considered one of the main missions of social determinants of health research centers. The aim of this study was to evaluate the status of knowledge production in the county SDH research centers in Iran.

In this 5-year cross-sectional study (2014 – 2018) 33 SDH research centers were assessed in regard to knowledge production indicators such as published articles, citation, H index, the high-quality publication (Q1), and international collaborations.

We found 4229 indexed articles which have been published by 334 faculty members/researchers of these research centers from 2014 to 2018. 11.9 percent of these articles have been published in high-quality research journals and 488 articles were produced with international collaboration. In 2018, the total number of citations to these articles published by these research centers from 2014 to 2018, was 4427 and the highest five-year H index was 26. According to the results of the research rankings, social determinants of health research centers of Kermanshah, Kurdistan, and Qazvin were ranked first to third, respectively.

The trend of knowledge production in Iranian social determinants of health research centers has paralleled the trend of their citations and it is necessary to pay more attention to high-quality journals for publication of articles and expansion of international collaboration. Obviously, producing scientific documentation can be an effective source in health promotion policies and reduction of access gradients

Achieving universal health is not possible without achieving equity. Equity in health means reducing or eliminating those factors that are the cause of health inequalities. Inequalities that can be avoided, and are actually unfairly distributed among different sections of society. In this article, the most important factors related to equity in health and its related indicators are presented.

This article describes 69 indicators developed in collaboration with related institutions and approved by the honorable office of the President of the Islamic Republic.

Thirty eight of these indicators are related to health, 12 are related to physical environment and infrastructure, 10 are related to social and human development, 4 are related to economic development and 5 are related to proper governance. The most important of these indicators are: poverty, discrimination, lack of jobs, inadequate income, low literacy, illiteracy, inadequate housing and employment, lack of clean and safe environment, lack of efficient affordable services, low professional ethics in the health system, lack of security and food safety, lack of social support and inadequate to proper transportation.

. In assessing equity in health and, more importantly, developing and execution of strategies to reduce or eliminate inequities, it is necessary to define indicators specifically for monitoring and measuring various aspects of health equity in the areas of social, cultural, economic and political determinants in addition to the common measures in the field of health and safety. Such “health equity indicators” must be measured and expressed with regard to common demographic variables (such as gender, place of residence, economic and social groups, etc”) to be an effective tool to reduce or eliminate inequalities. It requires effective participation and close collaboration of people, governmental institutions, and non-governmental organizations.
It is expected that by using these indicators and evaluating their effectiveness, one can begin to reduce  inequalities

Justice in its ancient meaning is the equivalent of giving everything to someone who deserves it, and in the more modern sense, justice is based on equal recognition of members of society in certain rights, and this view is more compatible with social justice. The main concern of health systems is to ensure the health of society, but this is not only achieved through the control of pathogens, diagnosis and treatment. Rather, social, economic, and environmental factors such as education, economic status, insurance, living conditions, etc play a major role in people's health, and addressing health determinants is a step towards achieving justice. In other words, individuals in society, regardless of gender, race, beliefs, social and economic status, do not have a structural difference in health and its determinants and enjoy the care needed at the right time and place.

This study was conducted with the approach of “qualitative content analysis” and “elite opinion”.

The basis of justice is the realization of social justice and justice in health is a subset of social justice. In the field of health justice, "social factors of health" and "social determinants of health" have the greatest role. Poverty and health inequalities are the most important causes of death and disability in society. The correlation between justice and social health, as well as the social determinants of health, has been proven, and responsibilities have been defined for governments in this area.

For achieving justice in health; the political commitment of the officials, the national determination and will, using all the capacities of the country, recognizing the creating conditions, trying to reduce health inequalities, improving the components of social capital, improving the indicators related to the social determinant of health, reducing social disorders and harms is needed.

Nowadays, health inequalities are emerging at short geographic distances, even among the districts of a city in developed and developing countries. In response to these conditions, it is important to study the role of socioeconomic structures and factors in the incidence and distribution of health outcomes. In a five-level framework, the knowledge network of the Commission on Social Determinants of Health clarifies the mechanism of the effect of social determinants on the creation of differences and inequalities in the health of different population groups. The present paper examines the evidence of health inequalities at international and regional levels and explains its reasons.

Policy change is one of the most popular areas in public policy, and the establishment of justice in the health sector is one of the most important goals of government - oriented governments in this field. Accordingly, the present study aimed to explain the effective factors in promoting justice in health with centrality of Iran health insurance organization.

the present study is applied in terms of the practical purpose and the method is implemented in two qualitative and quantitative sectors in 1397. in the qualitative section after reviewing the literature, the delphi method and expert panel were used with the help of six experts who participated in the mixed sampling method and the snowball sampling in this study, the objective was evaluated and the conceptual model structure was constructed with four constructs and 20 variables. After examining the formal validity and content validity, 16 questions were finalised with a five - point Likert scale to examine in the quantitative section. in the quantitative part, structural validity was evaluated by cronbach's alpha by factor analysis and reliability. at this stage of the research, 190 members of the target community who had
sufficient information on the subject of research were conducted. SPSS and excel software were used for data analysis.

In this study, 65.7 percrent of male participants were male and 43.3 percent female. 57.3 percent of them are official employment and 57 percent have more than 20 years of work experience. More than 56 percent of the participants have master degrees and doctorate degrees. Reliability of the questionnaire proved to be 83 percent in this study. Validity was assessed and confirmed (Face validity, Content validity and Construct validity). All four constructs in this study were the reliability of over 70 percent. Confirmatory factor analysis also showed that construct validity was approved by the whole questionnaire.

The results of this study indicate that the Iranian health insurance organization has a key role in health with the support provided by the government and the adoption of reason Influence in the study to satisfy the people of the society and ultimately in health.

One of the most important parts of the health system ispre-hospital emergency services that provide immediate services to patients. This study investigates the relationship between selected indicators of justice and performance of Iranian pre-hospital emergency services.

The research was done quantitatively and analytically. The society included pre-hospital emergency and the sample consisted six study variables. Using data combination method, the data were entered in the eviews and statasoftware;Flimer and Hausman tests were performed, and data regression of the data panel with fixed effects was obtained and estimated by ordinary least squares method.

Traffic incident prevalence index has a positive effect on three functional indicators. The index, the number of emergency medical missions, Provinces of Tehran, Qom, Khorasan Razavi, Mazandaran, Alborz, Yazd and Fars had the highest average for each medical emergency base.The incidence of traffic accidents in the provinces of Tehran, Khorasan Razavi, East Azarbaijan, Isfahan, Khuzestan, Mazandaran and Fars were the most prevalent.

The most important indicator of the Emergency organization of the country was the prevalence rate of traffic accidents which was effective in all three functional variables and consideredan important factor in distribution of pre-hospital emergency bases. Tehran and Qom provinces need to pay close attention to the number of medical emergencies.

The distribution and productivity of human resources in the health sector have a significant role to play in providing health-care services and services to the population covered. The purpose of this study was to determine the distribution of nursing staff in hospitals affiliated to the Ministry of Health and Medical Education before and after the implementation of the Health System Evolution Plan. This study is a descriptive study carried out in 2014. In this study, the study population consisted of all hospitals affiliated to the Ministry of Health and Medical Education (621 hospitals) from 54 medical universities of Iran that were studied by census method. The data collection was carried out using the "Hospital Information Form". The contents of the form were approved by five management and health professionals. Data analysis was done with Dasp2.1, STATA and SPSS.19. The Gini coefficient varied from 0.05 to 0.09 before the Health System Evolution Plan, and after the between 0.05 and 0.09. There was a significant correlation between the number of beds and the distribution of nursing staff. Distribution of nursing staff after the implementation of the Health System Evolution Plan was more equitable. It is suggested that these indicators be taken into account in the development of medical and non-medical manpower standards at the level of medical universities of the country.

This research was conducted to investigate the socioeconomic and geographical inequality in mortality from road traffic accidents in Iran in 2016.
  In this descriptive cross-sectional study, the data of 16,584 people that died from road traffic accidents in 2016 were received from the Legal Medicine Organization. Theil entropy index was used to determine inequality in geographic areas. Moreover, relative and absolute concentration indices were used to measure inequality in mortality from RTAs across educational levels.
  The mortality rate from road traffic accident was 21.5 per 100,000 people. Theil index was 0.66 for traffic-related deaths among the provinces, indicating an unequal distribution of traffic injuries caused by traffic accidents among the provinces. When inequality was measured at smaller geographical levels, i.e., among cities in each province, the results indicated a fair distribution across smaller geographic levels. The focus index also indicated a fair distribution of traffic accidents among the deceased sub-classes (concentration index & 95% CI: -0.13 (-0.41; 0.16).
  Our findings showed that the distribution of mortality from road traffic accidents was unequal at provincial positions. According to our findings, mortality from traffic accidents was distributed equally among the socioeconomic and urban levels. Therefore, health managers can use the findings of this study to develop interventions to reduce inequalities. In addition to targeting factors contributing to known social inequalities in the health and social status, other factors should be considered and applied to evaluate their interventions in the future.

The Islamic Revolution sought the implementation of justice, eradication of  poverty, and provision of the healthcare needs of the community and this led to the establishment of the "National Health Network System". The goals of  health equity and equitable access to basic and universal healthcare services, for all people, materialized relatively quickly. The main goal was to provide healthcare to all regardless of  socio-economic status and locale, so that basic healthcare services may be rendered without difficulty.

The relevant publications on  healthcare equity and social determinants of health were identified through a literature review of major local and international databases assessed and documented.

The important policies rendered  in the line of healthcare equity included the establishment of the  primary national healthcare network, the integration of medical education into the healthcare delivery system, the generic drug project. and  the health insurance system. Further strengthening and development of these projects ensured equitable, accessible and essential healthcare services for all, especially those in remote areas of the country.

Maintaining, promoting and restoring health, establishing equity in healthcare and minimizing avoidable differences in rendering healthcare are among the most important goals of the healthcare system of Iran. The achievements now four decades  onward , were in line with the most fundamental goals of the healthcare system. Attaining ideal goals and seeking justice in all aspects of the healthcare system, is in line with  future efforts to be pursued in this regard.

Tackling inequity in health is one of the main objectives of health systems. The aim of this study was to assess the achievements and challenges, as well as solutions, in reaching the equity in health in Iran. This study was conducted using a qualitative approach. Data were gathered by reviewing documents and conducting focused group discussions with the stakeholders. The analyzed data were categorized into three groups including achievements, challenges, and solutions. The Iranian health system has achieved many successes in the past 10 years including expanding the primary healthcare networks to city outskirts, implementing the family physician program (urban and rural), implementing the Health Transformation Plan (HTP) and subsequent decrease in catastrophic and impoverishing health expenditures, and increasing the public access to health information and subsequent responsiveness of policymakers. However, some factors hindered further achievements, including the absent or incomplete implementation of laws and practical policies, insufficient attention to the social determinants of health, and poor designing and implementation of the health annex for the policies. It seems that there are little problems in legislation and policymaking in the country and the laws are almost compatible with the recommendations of the World Health Organization, aiming at the inequity reduction in health. However, there is a gap between the policymaking/legislation and the practice. In other words, legislation is poorly practicable and the principles of good governance, including attracting the participation and cooperation of stakeholders, are not fully respected.

Spending great part of financial resources for health care may lead to financial problems for households and threat the life standards. Therefore, protection of families from catastrophic expenditures is a desirable objective for health systems. The aims of this study were to investigate affecting factors on probability of households facing to catastrophic expenditures, estimate FFCI and Gini indices in deprived states of Iran.
Bayesian econometrics model was applied to estimate probability of households facing to the catastrophic expenditures in 2012. Data were extracted from Households Income and Expenditure Survey in Statistical Center of Iran. The sample included 22057 households from deprived provinces.
In 2012, about 6.25% of people in deprived states faced catastrophic expenditures. FFCI and Gini indices were estimated 0.82 and 0.45, respectively. The most important factores for catastrophic expenditues were dentistry and hospital services. Increased number of family members with >65 year old, low literacy and unemployed parent, female guardian and without insurance coverage increase probability of catastrophic expenditures.
Based on the result, protection of health financing system against catastrophic expenditures is not sufficient; therefore, reform of the financing system is necessary. In addition, policy makers should increase fields of insurance services to protect households from facing to catastrophic expenditures by prepayment mechanisms.

Background and Several indices are involved in determining the levels of development in a country or a region. Among them, the most important is believed to be the health equity. The purpose of this study was to assess the level of health equity in selected cities in Mazandaran province, Iran, 2014.
A descriptive-analytic research was carried out in five cities in Mazandaran province including Babolsar, Sari, Tonekabon, Amol, and Noshahr. Relevant information was obtained from the management and planning organization database and health networks in these cities. Taxonomy was used for ranking the cities.
The level of development in different indices ranged as follows: mortality and birth: 0.57 in Noshahr to 0.86 in Sari, disease and accidents: 0.50 in Amol to 0.88 in Tonekanon, environmental health and work: 0.69 in Sari to 0.89 in Babolsar, family health and education: 0.26 in Sari to 0.82 in Amol, and social welfare: 0.82 in Sari to 0.96 in Tonekabon.
In this study none of the cities studied had an appropriate level in mortality and birth, and health and social welfare indices. Therefore, efforts should be made to facilitate services that could enhance these developing indices.