ObjectiveThe socioeconomic status (SES) is as a symbol of social determinants of health which has a dominant influence on population health. The purpose of this study was collecting, weighing, and determining the most relevant SES measurement items in Iran.ResultsThe SES health studies conducted in Iran was searched from 2007 to 2017. First, the SES items were categorized. Then, each item was weighed based on its reliability and generalizability. Finally, the necessity of items was determined, weighed, and ranked. This is the two-round Delphi technique. After weighing 57 SES items, 37 items were selected with ≥ 1 weight and classified in 7 categories. According to the Delphi evaluation, 15 items were identified ≥ 3.5 for measuring SES of Iranian households: household size, head of household education, head of household job, household monthly income, type of school that children attend, house ownership, local value of residence, number of rooms in the house, house area, personal computer/laptop, smart cell phone, 3D TV, dishwasher, microwave, and car ownership. The SES items for the present society are categorized in 7 domains. The items collected in this study have the most comprehension of all studies related to income, life facilities, and assets.
The recent increase of 'Health Technology Assessment' (HTA)-related activities in Iran has necessitated the clarification of policy-making process based on the HTA reports. This study aimed to develop a Decision Support System (DSS) in order to adopt evidence-informed policies regarding health technologies in Iran. The study can be classified as Health Policy and Systems Research. A core panel of seven experts conducted two separate reviews of relevant literature for: 1- Determining the potential technology-related policies. 2- Listing the criteria influencing those policy decisions. The policies and criteria were separately discussed and subsequently rated for appropriateness and necessity during two expert meetings in 2013. In the next step, The 'Discrete Choice Experiment' (DCE) method was employed to develop the DSS for the final technology-related policies. Accordingly, the core panel members independently rated the appropriateness of each policy for 30 virtual technologies based on the random values assigned to all the criteria for each technology. The obtained data for each policy were separately analysed using stepwise regression model, resulting in a minimal set of independent and statistically significant criteria contributing in the experts' judgments about the appropriateness of that policy. The obtained regression coefficients were used as the relative weights of the different levels of the final criteria of any policy statement, shaping the decision support scoring tool for each policy. The study has outlined 64 policy decisions under 7 macro policy areas concerning a health technology. Also, 34 criteria used for making those policy decisions have been organized within a portfolio. DCE, using stepwise regression, resulted in 64 scoring tools shaping the DSS for all HTA-related policies. Both the results and methodology of the study may serve as a guide for policy makers (researchers), particularly in low and middle income countries, in developing decision aids for their own context-specific HTA-related policies.
Objective Migration of healthcare workers could result in shortage of human resources and rising inequalities in service provision in resource poor countries. The aim of this review was to determine the factors influencing the migration decisions of medical and dental graduates migrating from low- and middle-income countries as well as introducing a practical model for health professional’s migration. Methods Google Scholar and PubMed were searched together with relevant journals for English studies from January 2005 to January 2020. The original studies which evaluated the motivational factors of dental and medical graduates migrating from low or middle income countries were included. The migration model was developed by investigating the factors and frameworks of selected studies. Results Twenty-five articles were met the inclusion criteria. Push and pull theory was the most popular way to describe the driving factors of migration. These factors were classified into three macro-, meso- and micro-level with eight key domains. Poor income, unfavorable socio-economic situation, political instability, lack of professional and educational opportunities together with family and personal concerns found as strong common reasons perpetuating migration. Conclusion Despite the fact that health workers migrate for different reasons, they follow a same route for decision to stay or leave their home countries. Un-fulfillment of expectations in mother land in addition to media reconstructed reality of life in foreign land can develop a positive attitude for better quality of life improvement after migration. Once individuals could overpass their national identity and barriers of migration, the final decision toward migration would be more feasible.
With the knowledge we have today about the concept of health and its complexities and determinants, the separation between medical and dental education (DE) does not seem reasonable anymore. Dentistry has mainly developed based on a mechanical approach to treat the related problems. This makes the efforts for reorientation of dental care (DC) toward a preventive approach, relying upon dentists as the chief oral health (OH)-related workforce, inefficient. This is while effective strategies have been identified for prevention, as the key to simultaneously control the burden and costs of the ubiquitous oral diseases, at both individual and population levels without dentists. We think that approaching OH as an integral part of the general well-being requires fundamental changes in the structure of OH system including a substantial revision in the current situation of dentistry as an autonomous health profession with a separate education from the main body of the medicine. In this short article, we briefly discuss the necessity of blending DE into the mainstream of medical education and actual consideration of dentistry as a medical specialty area. After discussing the subject at two levels (health-care system and national levels), the next sections draw attention to some complementary issues.
Background: Increasing social welfare and reducing poverty are to ensure the well-being of all classes of a society. Cities and villages are distinguished by cultural and economic disparities. The purpose of this study was to develop and present a comprehensive model on welfare and wealth components and their relationship with each other, as well as determining the contributing factors and variables affecting them by presenting a comprehensive model. Methods: The components of wealth and welfare were determined based on the national data comprising 19261 rural and 18701 urban household participants. Initially, the conceptual model was drawn. Later, observed and latent variables of the model were analyzed and tested using AMOS software, in two exploratory and confirmatory factor analyses. Finally, the Structural Equation Modeling was used to analyze the data and investigate the causal relationship of latent variables.Results: The findings showed that the factors generating wealth in the urban initiate from education and lead to employment and then into income and ultimately provide wealth and welfare. Plus, there is no separation between the concept of welfare and wealth in urban society. However, land ownership is the prerequisite for wealth and welfare issues in a rural community. Moreover, wealth and welfare are two distinct phenomena in rural areas. Conclusions: The results of this study would provide the clear hints for effective policy making to resolve deprivation and poverty in Iranian rural and urban populations, prioritizing education for urban and land ownership for rural areas.
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