Although hospital preparedness is emphasized in credible references, this study showed that lack of preparedness is a major challenge for hospitals during disasters. Thus, it seems that hospital officials' disaster risk perception and hospital preparedness should be improved. In addition, hospital preparedness assessment indexes should be included in the hospital accreditation process. (Disaster Med Public Health Preparedness. 2017;11:422-430).

Background Imbalance in distribution of Health Care Workers (HCWs) in a country is a global challenge. Almost all of the rural and underdeveloped areas are struggling with the shortage of HCWs, especially physicians. Therefore, this study aimed to identify factors governing the retention of physicians in rural and underdeveloped areas. Methods International databases including Scopus, PubMed, Web of Science, Proquest, and Embase were searched using Mesh terms in order to find peer-reviewed journal articles addressing physicians’ retention factors in rural and underdeveloped areas. The records were screened, and any duplicate results were removed. The quality of the studies was assessed according to the Critical Appraisal Skills Program developed for different types of studies. Then, through content analysis, the related factors were identified from finally selected papers, coded, and categorized. Results The initial search resulted in 2312 relevant articles. On the basis of specific selection criteria, 35 full-text articles were finally reviewed.. The major affecting factors in physicians’ retention in rural and underdeveloped regions were classified into the following six categories: 1) financial; 2) career and professional; 3) working conditions; 4) personal; 5) cultural; and 6) living conditions factors. Conclusion There is a complex interplay of factors governing physicians’ retention in rural and underdeveloped areas. If health organizations are concerned with physicians’ retention in deprived areas, they should take into account these main factors. Moreover, they should develop policies and strategies to attract and retain physicians in rural and underdeveloped areas.

AimTo investigate barriers to patient engagement in the delivery of safe hospital care.DesignQualitative exploratory study.MethodsA qualitative study with 35 Iranian health professionals was conducted from February to April 2019 using semi‐structured interviews to elicit their opinions. MAXQDA 11 software was used for data management, and the data were analysed using framework analysis.ResultsBarriers, which potentially have negative impact on patient engagement in the delivery of safer care, were categorized into four themes. The first category included patient‐related barriers such as low levels of health literacy, ineffective education, patient unwillingness and cultural barriers. The second category included staff‐related barriers such as the existence of negative attitudes towards engaging patients in matters relating to patient safety, ineffective communication, high workload and the reluctance on the part of physicians to engage with patients. Barriers created by limited resources and inadequate training provided by universities and in the workplace formed the third category and community‐related barriers such as the inadequate dissemination of information via the mass media and a lack of community‐based services formed the fourth category.ConclusionResults demonstrate the multilayered nature of the significant barriers to the engagement of patients in the delivery of safe care and reflect the need for a collaborative approach between the recipients of care, researchers, care providers and policy makers if these are to be overcome.

Climate is an effective factor in the ecological structure which plays an important role in control and outbreak of the diseases caused by biological factors like malaria. With regard to the occurring climatic change, this study aimed to review the effects of climate change on malaria in Iran. In this systematic review, Cochrane, PubMed and ScienceDirect (as international databases), SID and Magiran as Persian databases were investigated through MESH keywords including climate change, global warming, malaria, , and Iran. The related articles were screened and finally their results were extracted using data extraction sheets. Totally 41 papers were resulted through databases searching process. Finally 14 papers which met inclusion criteria were included in data extraction stage. The findings indicated that mosquitoes are present at least in 115 places in Iran; they are compatible with climatic zones of Iran. Malaria and it's vectors are affected by climate change. Temperature, precipitation, relative humidity, wind intensity and direction are the most important climatic factors affecting the growth and proliferation of , and the prevalence of malaria. The transmission of malaria in Iran is associated with the climatic factors of temperature, rainfall, and humidity. Therefore, with regard to the occurring climatic change, the incidence of the disease may also change which needs to be taken into consideration while planning of malaria control.

Revisions to Iran's National Public Health Emergency Operation Plan (PHEOP) are currently underway. 1 Lessons learned from the recent twin earthquakes in East Azerbaijan in northeast Iran can be incorporated to enhance the health sector response.On August 11, 2012, two consecutive magnitude 61 earthquakes hit East Azerbaijan (EA) province in Iran at 4:53 PM and 5:04 PM local time. The quakes led to 303 deaths and 2,600 injuries, and affected 60,000 people across 182 villages.The Ministry of Health and Medical Education deployed an assessment team to Tabriz (the capital of province) along with a team of technical advisers. Massive medical and search and rescue operations were undertaken during the first 24 hours, and were followed by public health operations. 2 Here, we would like to address two main challenges that have bearing on revisions to the PHEOP.The health system in three affected districts of East Azerbaijan province was severely damaged. According to the existing emergency plan, the District Public Health Centers (DPHCs) are focal points for management of disaster response. In this event, all three DPHCs in addition to 89 health houses were damaged, and failed in their functions. 2 As a result, mutual assistance was invoked from neighboring districts. While health workers were able to take on some of the functions of the damaged centers, they could not effectively take on the coordinating role for disaster response. To prevent this problem in the future, we propose the development of Disaster Public Health Assistance Teams (DPHATs) to be incorporated into Iran's new emergency plan. Disaster Public Health Assistance Teams must be equipped for two functions: (1) to support the DPHC in terms of command and coordination functions; and (2) to augment the provision of health services in damaged centers for the first 72 hours.A second lesson learned in this disaster was the lack of real-time integration and georeferencing of data collected. This limitation of the health information management system (HIMS) caused delays in assessment and response to this disaster. In addition, it was difficult to adapt instruments to evolving data needs. The current disaster plan underestimated the ability to re-establish telecommunications service in the wake of an earthquake. In fact, we found that coverage was provided quickly to most areas, within 24-72 hours after the event. We propose that the new plan should emphasize the use of crowd-sourced, geo-referenced data using GSM (Global System for Mobile Communications) messaging from a trusted network of health staff.