Background. Congenital anomalies are responsible for a remarkable proportion of mortality and morbidity in newborns. The aim of this study was to document the epidemiological features of congenital anomalies in rural areas, northwest of Iran. Method. The study population included live births born between 2004 and 2012 in rural areas of Tabriz district. All health records of the children under 8 years were assessed retrospectively. Results. Of 22500 live births, 254 cases were identified with a primary diagnosis of congenital anomalies giving a prevalence rate of 112.89 per 10 000 births (95% CI: 99.08 to 126.69). Anomalies of the nervous system were the most common defects, accounting for 24% of birth defects followed by the heart diseases anomalies. The highest prevalence rate for birth defects was observed in the south-western region with 386 per 10 000 births (95% CI: 215 to 556) compared to the similar rate in the north-western region with 15 per 10 000 births (95% CI: −14 to 45). Conclusion. The considerable geographic disparities in the prevalence of congenital anomalies in the region might be attributed to the highly polluted industrial zone in the area (including air and water pollution, etc.). This needs further etiological investigations in the region.

Background: Providing comprehensive and high-quality services is one of the most important goals of the health systems and a basic principle for Universal Health Coverage (UHC). Fulfilling this important task would be feasible through continuous evaluation and improvement of the health services quality. The aim of this study was to develop a framework for quality assessment of Primary Health Care (PHC) in Iran's health system. Methods: This study is a literature review which continued by a qualitative research. The extracted quality dimensions and indicators for initial screening were reviewed and discussed in two panel meetings attended by the experts with regard to the current package of health system in Iran. Using Delphi method, the dimensions and Quality Indicators(QIs) were evaluated and approved by 39 national health professionals in two rounds. Finally, after 4 panel sessions at ministerial level, the selected QIs were categorized in form of the final dimensions of the quality of care. Results: The literature review emerged 13 Primary Health Care Quality Assessment Frameworks (PHCQAF) including 20 and 698 QIs. Delphi study resulted in developing Iranian PHCQAF comprising 7 dimensions and 40 QIs. Among these, 8 QIs of the dimension of access and equity, 5 QIs of safety dimension, 2 QIs of efficiency dimension, 13 QIs of effectiveness dimension, 2 QIs of patient-centeredness dimension, 3 QIs of governance dimension and 7 QIs of appropriateness dimension were presented. Conclusions: The presented PHCQAF can be used as a comprehensive and practical tool for continuous improvement of the quality of PHC services at local, national and regional levels. Moreover, it can give some useful information to the health managers and policy makers on how the services are provided.

Objective:This study investigated the health effects of Lake Urmia’s drought on adjacent urban and rural areas and people.Methods:The data for sociodemographic status, physical activity, dietary pattern, smoking, and angina of the subjects living in areas adjacent to and far from Lake Urmia were collected through validated questionnaires. Physical examinations, including blood pressure, anthropometrics, and biochemical measurements, were performed.Results:There were no significant differences between 2 areas in the case of age, sex, educational, and physical activity and smoking status (P > 0.05). The mean systolic and diastolic blood pressures and the prevalence of hypertension, prehypertension, and anemia in cases living in the adjacent areas were significantly higher than those in the control group (P < 0.05). No significant differences were observed between 2 districts in the prevalence of hyperlipidemia, overweight/obesity, asthma, angina, infraction, diabetes, and vitamin D insufficiency/deficiency.Conclusions:Our data showed that Lake Urmia’s drought has serious effects on hypertension and anemia. More longitudinal and well-designed studies are needed to confirm these results.

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