Perceived Barriers to Implementing Sexual Health Programs from the Viewpoint of Health Policymakers in Iran: A Qualitative Study

Motamedi, Mahnaz; Shahbazi, Mohammad; Khoei, Effat Merghati; Salehi, Mehrdad; Hajebi, Ahmad; Rahimi-Naghani, Shahrzad; Shah, Safieh; Kamali, Koorosh; Khalajabadi-Farahani, Farideh

doi:10.1007/s13178-021-00540-7

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…55 Given the Islamic ideological approach of Iran's government in health policy making, many of these restrictions target issues such as HIV/AIDS, sexually transmitted diseases, unwanted pregnancy, and abortions. In this regard, some recent studies confirmed our findings and described traditional and religious beliefs, stigma, and non-scientific views of sexual health as challenges to policymaking for sexual health, 52 HIV/AIDS, 56 and reproductive health 57 in Iran.…”

Section: Discussionsupporting

confidence: 88%

“…We also recognized the primary social causes of the current situation as the lack of a thorough strategy, inadequate knowledge of policymakers, insufficient funding, and extensive government intervention in health policy making. Likewise, Motamedi and colleagues 52 demonstrated a “lack of knowledge for policymakers” as a personal barrier to health policy making for sexual health programs in Iran. Interestingly, they also found “lack of a strategic goal,” “financial challenges,” and “uncoordinated and unstable management” as the structural barriers.…”

Section: Discussionmentioning

confidence: 99%

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Government-Controlled Mass Media as an Obstacle to Health Policy Making: The Case of Iran

Aghaei

Mowlaei

2022

International Journal of Social Determinants of Health and Heal

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In government-controlled media, serving governments’ economic, political, or ideological interests often diverts media health policies from their primary target of promoting public health, making them ineffective. Understanding the growth of this diversion in countries’ political and social contexts over a long period demands a multi-layer historical analysis. Thus, to explore the roots of this diversion in government-controlled media, we examined the development process of health policy making in Iranian mass media. We conducted and analyzed interviews with 21 media experts and health policy makers through causal layered analysis, including litany, system, discourse, and metaphor layers. Results indicate that the “absence of stable management” and “health programs’ low quality” undermined achievements of health policy making, including establishing the Health Policy Council and two health channels. We identified “lack of comprehensive strategy,” “policymakers’ inadequate knowledge,” “insufficient financing,” and “extensive government intervention” as underlying social causes of ineffective health programs. In addition, the Islamic ideological approach to health issues has been revealed as the dominant discourse. Interview data imply that conflicts between modern medicine and Iran's traditional medical knowledge make it difficult for media health policy makers to achieve their strategic aims. This study provides insights into the challenges of health policy making in government-controlled mass media.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Government-Controlled Mass Media as an Obstacle to Health Policy Making: The Case of Iran

Aghaei

Mowlaei

2022

International Journal of Social Determinants of Health and Heal

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“…The highest exposure to a general disaster in our study is consistent with the WMH survey’s top three exposures. Nevertheless, the lower prevalence of exposure to sexual harassment in our study can be explained by the shame and taboo associated with sexual issues in Iranian culture that make people uncomfortable talking about these issues ( 40 ). Physical assault exposure was higher in our study’s mental illness caregivers than in the MS group.…”

Section: Discussionmentioning

confidence: 71%

Traumatic Events Exposure and Post Traumatic Stress Disorder in Caregivers of Patients with Bipolar Disorder, Bipolar Disorder and Comorbid Post Traumatic Stress Disorder and Multiple Sclerosis

Bahramian

Shabani

Naserbakht

et al. 2023

Med. J. Islam. Republ. Iran

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Background: Chronic diseases affect the lives of the patient and caregiver. Caring for a patient with a chronic psychiatric illness, such as bipolar disorder, is a stressful and challenging activity. Caregivers of severe psychiatric patients are the primary victims of violence by patients. Caring for these patients can be very stressful for the caregiver to the extent of experiencing post-traumatic stress symptoms. This study compares the frequency of trauma exposure and PTSD in the caregivers of patients with bipolar disorder type 1(BD-1), bipolar disorder type 1, comorbid post-traumatic stress disorder (BD-1+PTSD), and multiple sclerosis (MS).The MS group served as the control group.Methods: This cross-sectional study with convenient sampling was conducted at three hospitals in Tehran, Iran, from April 2020 to January 2022. One hundred eighty caregivers answered a clinical demographic questionnaire. We then used the Trauma History Questionnaire (THQ) to assess the frequency of exposure to different types of trauma. Then, the Persian version of the SCID-5, a valid and reliable instrument for psychiatric diagnoses, was used to diagnose PTSD. Chi-square was used for analyzing data.Results: Exposure to trauma has a significant difference between the groups. BD-1 + PTSD patients' caregivers were exposed to more physical assaults than others (P < 0.0001) There was a significant difference between sexual harassment in the MS group (P = 0.010). There was a significant difference between the three groups in the development of PTSD (P = 0.003). PTSD prevalence in the BD-1 + PTSD caregiver group is more than in other groups. In the caregivers of BD-1+PTSD, the caregiving experience caused traumatic exposure and the development of PTSD in all caregivers.Conclusion: This study shows that the prevalence of exposure to traumatic events and PTSD is higher in the caregivers of BD-1 patients, especially if the patient has comorbid PTSD. Detecting these symptoms early and using intervention can make the caregiving burden more tolerable.

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“…Yet, healthcare is required at all stages of life; indeed, in rural areas, young people seem to face access barriers that are specific to their stage of life as they complete the "biological, cognitive, and psychosocial transition into adulthood" (3,30). This is particularly true for young women and their specific healthcare needs, including reproductive and sexual care, abortion services, preventive care, prenatal care, and maternal health (7,28,29,32,(34)(35)(36).…”

Section: Evidence From Australia Canada and Swedenmentioning

confidence: 99%

“…In their study of rural healthcare access in Australia, Thomas et al (2017) find that rural residents have higher rates of morbidity and mortality due to unique environmental hazards specific to rural areas, conservative socio-cultural values, insufficient number of healthcare service providers, significant geographic distance to many healthcare services, and poorly distributed services; combined, all of these barriers limit access to healthcare services (110). As a result, rural residents must often travel long distances to access necessary care (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). Ultimately, this lengthy travel combined with associated costs intensifies access barriers (27,32,(35)(36)(37)(38)(39)(40)(41).…”

Section: Limitationsmentioning

confidence: 99%

Access Barriers to Healthcare Services by Young Women in Rural Areas: A Qualitative Study in Australia, Canada, and Sweden

Golestani¹

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Scholars and public health professionals recognize that rural populations in both lowincome and high-income countries are jointly impacted by the accessibility and maldistribution of healthcare resources and services. Existing studies find a sizable gap between rural residents' healthcare expectations compared to the healthcare services they receive. This qualitative study contributes to the literature in its exploration of the selfperceived barriers and challenges that young rural women face before and during accessing healthcare services in rural areas of Australia, Canada, and Sweden. Semi-structured interviews with rural young women living in three selected rural communities were conducted. Postulated potential barriers were evaluated using a conceptual framework which builds from a combination of three theories, including the Andersen Behavioral Model, the Health Belief Model, and the Healthcare Access Barriers Model.The results demonstrate that limited healthcare resources, combined with inadequate distribution of staffing, health equipment, and hours of operation, negatively impacted rural young women's access. Additionally, many women had insufficient information about available health services. This created a pervasively negative attitude towards the health system that further impeded rural women's desire to access healthcare. Some resulting ramifications include ignorance of potential health issues, self-diagnosis, and homemedicating.In these small communities, concerns about confidentiality and shortages in available female providers forced some young women to travel to other villages or towns to receive healthcare services. This travel was a more common choice when accessing services, such as a pelvic examination or abortion. Other factors that impacted behaviours included the Chapter 1: IntroductionAfter multiple attempts at rescheduling and then waiting long hours, a young woman is forced to have her first pelvic examination by a male physician who is also her neighbour in the rural district where she lives. Another young woman travels several hours to reach a healthcare facility in another town to protect her anonymity and avoid judgment by familiar faces in her community clinic. This trip incurs additional travel costs and leaves her exhausted. These examples demonstrate the difficulty that young women residing in rural communities and villages experience in accessing high-quality and appropriate health services. Consequently, this thesis explores factors that affect young rural women's ability to identify their health needs, prioritize them, and then seek and obtain appropriate healthcare services-all while facing obstacles including uncomfortable emotions, discomfort, fear, and embarrassment.Access to equitable, quality, and appropriate health services is a global issue of importance within the United Nations Sustainable Development Goals (1). Notably, a considerable percentage of the world's population lives in small communities in rural regions. In these settings, women's health is affected by...

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Perceived Barriers to Implementing Sexual Health Programs from the Viewpoint of Health Policymakers in Iran: A Qualitative Study

Cited by 6 publications

References 21 publications

Government-Controlled Mass Media as an Obstacle to Health Policy Making: The Case of Iran

Government-Controlled Mass Media as an Obstacle to Health Policy Making: The Case of Iran

Traumatic Events Exposure and Post Traumatic Stress Disorder in Caregivers of Patients with Bipolar Disorder, Bipolar Disorder and Comorbid Post Traumatic Stress Disorder and Multiple Sclerosis

Access Barriers to Healthcare Services by Young Women in Rural Areas: A Qualitative Study in Australia, Canada, and Sweden

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