Iran in transition

Danaei, Goodarz; Farzadfar, Farshad; Kelishadi, Roya; Rashidian, Arash; Rouhani, Omid M.; Ahmadnia, Shirin; Ahmadvand, Alireza; Arabi, Mandana; Ardalan, Ali; Arhami, Mohammad; Azizi, Mohammad Hossein; Bahadori, Moslem; Baumgartner, Jill; Beheshtian, Arash; Djalalinia, Shirin; Doshmangir, Leila; Haghdoost, Ali Akbar; Haghshenas, Rosa; Hosseinpoor, Ahmad Reza; Islami, Farhad; Kamangar, Farin; Khalili, Davood; Madani, Kaveh; Masoumi-Asl, Hossein; Mazyaki, Ali; Mirchi, Ali; Moradi, Ehsan; Nayernouri, Touraj; Niemeier, Deb; Omidvari, Amir‐Houshang; Peykari, Niloofar; Pishgar, Farhad; Qorbani, Mostafa; Rahimi, Kazem; Rahimi-Movaghar, Afarin; Tehrani, Fahimeh Ramezani; Rezaei, Nazila; Shahraz, Saeid; Takian, Amirhossein; Tootee, Ali; Ezzati, Majid; Jamshidi, Hamid Reza; Larijani, Bagher; Majdzadeh, Reza; Malekzadeh, Reza

doi:10.1016/s0140-6736(18)33197-0

Cited by 175 publications

(178 citation statements)

References 86 publications

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“…Iran is currently facing extreme water and environmental management challenges [1][2][3][4][5][6][7][8]. The country's technological approach to address water shortages through a large network of dams, inter-basin water transfer projects, and groundwater withdrawal has proven inadequate as water demands keep growing in the face of dwindling natural water supply and newly developed surface water and groundwater resources [1,2].…”

Section: Introductionmentioning

confidence: 99%

The Groundwater‒Energy‒Food Nexus in Iran’s Agricultural Sector: Implications for Water Security

Mirzaei

Saghafian

Mirchi

et al. 2019

Water

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104

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This paper presents the first groundwater‒energy‒food (GEF) nexus study of Iran’s agronomic crops based on national and provincial datasets and firsthand estimates of agricultural groundwater withdrawal. We use agronomic crop production, water withdrawal, and energy consumption data to estimate groundwater withdrawal from electric-powered irrigation wells and examine agronomic productivity in Iran’s 31 provinces through the lens of GEF nexus. The ex-post GEF analysis sheds light on some of the root causes of the nation’s worsening water shortage problems. Access to highly subsidized water (surface water and groundwater) and energy has been the backbone of agricultural expansion policies in Iran, supporting employment in agrarian communities. Consequently, water use for agronomic crop production has greatly overshot the renewable water supply capacity of the country, making water bankruptcy a serious national security threat. Significant groundwater table decline across the country and increasing energy consumption underscore dysfunctional feedback relations between agricultural water and energy price and groundwater withdrawal in an inefficient agronomic sector. Thus, it is essential to implement holistic policy reforms aimed at reducing agricultural water consumption to alleviate the looming water bankruptcy threats, which can lead to the loss of numerous agricultural jobs in the years to come.

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Section: Introductionmentioning

confidence: 99%

The Groundwater‒Energy‒Food Nexus in Iran’s Agricultural Sector: Implications for Water Security

Mirzaei

Saghafian

Mirchi

et al. 2019

Water

Self Cite

104

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“…They are usually quite difficult, although not impossible. Implementation of major reforms, such as merging health insurance schemes structurally, in a fragmented pathdependent system with quite numerous veto-ridden opposed actors is more difficult [40,41].…”

Section: Resultsmentioning

confidence: 99%

“…As a result hospitals and medical health centers running by SSO were extended to provide free of charge health services for the beneficiaries. Now this historical path has become a strong legislative obstacle for consolidation of the existing schemes in Iran "which inhibits the introduction of 'better' or perhaps more rational policies or new organizational forms" [37,40]. Despite increasing health care expenditures in SSO' health centers resulting from moral hazard due to free health services, it is politically and legally difficult to introduce some kinds of cost sharing for the workers in these centers to restrain expenditures.…”

Section: Merging Health Insurance Funds In Iran and Path Dependency Amentioning

confidence: 99%

Combining health insurance funds in a fragmented context: what kind of challenges should be considered?

Bazyar

Rashidian

Sakha

et al. 2020

BMC Health Serv Res

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Background: Iran's Parliament passed a Law in 2010 to merge the existing health insurance schemes to boost risk pooling. Merging can be challenging as there are differences among health insurance schemes in various aspects. This qualitative prospective policy analysis aims to reveal key challenges and implementation barriers of the policy as introduced in Iran. Methods: A qualitative study of key informants and documentary review was conducted. Sixty-seven semi-structured face-to-face interviews were conducted, with key informants from relevant stakeholders. Purposive and snowball sampling techniques were used for selecting the interviewees. The related policy documents were also reviewed and analyzed to supplement interviews. Data analysis was conducted through an existing health financing World Bank framework. Results: This study demonstrated that for combining health insurance funds, operational challenges in the following areas should be taken into account: financing mechanisms, population coverage, benefits package, provider engagement, organizational structure, health service delivery and operational processes. It is also important to have adequate cogent reasons to "the justification of the consolidation process" in the given context. When moving towards combining health insurance funds, especially in countries with a purchaser-provider split, it is critical for policy makers to make sure that the health insurance system is aligned with the policies and Stewardship of the broader health care system. Conclusions: Implementation of major reforms in a health system with fragmented insurance schemes with different target populations, prepayment structures, benefit packages and history of development is inherently difficult, especially when different stakeholders have vetoing powers over the proposed reforms. Solving the differences and operational challenges in the main areas of health insurance system generated in this study may provide a platform for the designing and implementing merging process of social health insurance schemes in Iran and other countries with similar situations.

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“…Compared to countries in the same geographical area, Iran has witnessed several natural disasters and the history of eight years forced war, which appeared to have increased the prevalence of mental disorders. As described by Danaei et al [22], the infrastructure for primary health care and education has improved dramatically within the last two decades. Psychosocial, psychological and psychiatric interventions increased to help survivors of natural disasters or veterans with post-traumatic stress disorder (PTSD); to prevent unfavorable behavior such as suicidal ideation, domestic violence, and substance abuse; or to prevent unfavorable behavior related to traffic accidents [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

A Mixed-Method Modified Delphi Study toward Identifying Key Elements of Psychotherapy in Iran

Rezaie

Heydari

Paschall

et al. 2020

IJERPH

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Purpose: In Iran, psychotherapy is regarded as an effective treatment for psychiatric disorders. However, no previous research has identified the key elements of psychotherapy that may be specific to Iranian society. The current study was conducted in an attempt to identify these elements. Methods: A mixed-method modified Delphi approach was used, taking place over several stages during 2017-2018. The first stage involved interviewing 12 experts in psychotherapy to identify key elements of psychotherapy in Iran by thematic analysis. Then, successive Delphi rounds were conducted to obtain consensus (75% agreement) from 70 psychotherapy experts on these key elements. Results: Key elements of psychotherapy were grouped into the following themes: (1) systematic education/training; (2) psychotherapist competency; (3) psychotherapy reflective of Iranian societal needs; and (4) the substrate (scientific/ethical principles) of psychotherapy. Consensus was reached during two Delphi rounds. In Delphi round 1, 52.8% of the statements reached consensus, and all remaining statements reached consensus in round 2. Conclusions: The key elements of psychotherapy in Iran are a set of conditions for the education and training of competent psychotherapists who can perform psychiatric interventions appropriate to Iranian society under supervised rules. These should serve as a framework for improving the current delivery of psychotherapy in Iran.

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Iran in transition

Cited by 175 publications

References 86 publications

The Groundwater‒Energy‒Food Nexus in Iran’s Agricultural Sector: Implications for Water Security

The Groundwater‒Energy‒Food Nexus in Iran’s Agricultural Sector: Implications for Water Security

Combining health insurance funds in a fragmented context: what kind of challenges should be considered?

A Mixed-Method Modified Delphi Study toward Identifying Key Elements of Psychotherapy in Iran

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