Social trends affecting the future of Iran's health system: A qualitative study using focus group discussion

Rahimi, Hamed; Kalantari, Alireza; Rafiee, Noora; Khosravi, Sajad

doi:10.4103/ijpvm.ijpvm_322_18

Cited by 16 publications

(20 citation statements)

References 20 publications

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“…They suggested that in order to increase the e ciency of e cient centers, health o cials and managers needed to change the geographical areas covered, to oat the working hours of the specialized personnel in health centers, and to apply zoning [32]. Rahimi et al also considered migration and demographic transition as two social trends affecting the performance of the Iranian health system in the coming years [33].…”

Section: Discussionmentioning

confidence: 99%

“…However, in response to the rapid trend of declining fertility in Iran, pregnancy incentive policies have been on the agenda since 2014, limiting the provision of contraceptive services in health units and increasing the importance of pregnancy care. Even now, due to the change in the age pyramid and the movement towards increasing the elderly population [33], it is necessary for the health system to develop and provide appropriate services for this population group. Another factor that can affect e ciency is the population density and dispersion of villages around some districts and their type of settlement (permanent or nomadic).…”

Section: Discussionmentioning

confidence: 99%

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Performance Evaluation of The District's Primary Health Care System (DPHCS); Case Study Of Southeastern Iran

Rahimi¹,

Goudarzi²,

Hekmat³

et al. 2021

Preprint

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Background: Managers need to measure and evaluate the performance of their subordinates in order to plan, organize, and improve the performance of their organizations. In this study, the performance and efficiency of the district's primary health care system in the southeast of Iran were evaluated using the data envelopment analysis (DEA) model.Methods: The quantitative non-parametric data envelopment analysis was used to evaluate the performance of the primary care system in the districts. On the hand, human forcess, physical facilities, and vehicles were the variables used as the inputs, and the number of services and service recipients was considered as the outputs to measure efficiency. The data were analyzed using the DEAP software, and performance and efficiency were calculated with the output maximization approach and the assumption of variable returns to scale. It was carried out as linear programming with nine scenarios for nine districts in 2018.Results: The mean efficiency of the studied districts with the assumption of variable returns to scale was 0.76, indicating at least 24% capacity to increase efficiency in the primary care system of Kerman University of Medical Sciences without any increase in production factors. According to the mean values, Kerman and Kuhbanan were efficient while the other 7 districts were inefficient. The districts were divided into three groups: efficient, moderately efficient, and inefficient. Accordingly, the most inefficient primary health care systems were those of Shahr-e Babak, Baft, and Orzooieh.Conclusion: The results of this study showed inefficiency in most primary health care systems of the studied districts, indicating that primary care managers can provide more health services to the community through proper management of available resources. Inefficient districts can compare themselves with successful and reference districts and eliminate their shortcomings in order to improve their performance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Performance Evaluation of The District's Primary Health Care System (DPHCS); Case Study Of Southeastern Iran

Rahimi¹,

Goudarzi²,

Hekmat³

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Similar studies also stated that paying attention to informal settlements was one of the necessities in achieving health equity. [ 15 19 ] Considering that informal settlements and the problems they create are social problems, and that health is a multidimensional social issue, dealing with health issues and satisfying health needs require a comprehensive, inclusive, and universal approach emphasized by international approaches such as Social Determinants of Health (SDH) and Health in All Policies. The WHO believes that SDHs are the most effective factors in improving people's health and reducing inequalities.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] In addition, marginalization limits people's access to health-care services and affects the residents’ lives. [ 14 15 16 ] However, health is a key factor in the well-being and development of countries, especially in low- and lower-middle income countries. [ 17 ]…”

Section: Introductionmentioning

confidence: 99%

Health needs assessment of the residents of the informal settlements in South-Eastern Iran

Poortaheri

Alimohammadzadeh

Hosseini

et al. 2021

Journal of Education and Health Promotion

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BACKGROUND: Informal settlements are considered as one of the social problems in societies. As the residents do not have adequate access to basic services, including health services, their health is at risk. This study was conducted to evaluate the access to health services and determine the health needs of informal settlements in Bam city. MATERIALS AND METHODS: This cross-sectional study was carried out in the spring of 2020 in Bam. The sample size was 400 residents of informal settlements in Bam, and the multi-stage random cluster sampling was used. A researcher-made questionnaire was used to collect the required data. The validity of the questionnaire was confirmed using the content validity, and its reliability was 85% by Cronbach's alpha. The data were analyzed using the SPSS version 23 software and descriptive statistics (frequency, mean, standard deviation, and percentage) as well as analytical statistics (Mann–Whitney and Kruskal–Wallis tests). RESULTS: More than 50% of the individuals had good access to general practitioners and health centers. However, over 50% had poor access to dental, para-clinical, specialist, and hospital services. Furthermore, 49.3% of the people assessed their health status as poor in the previous year. A total of 46 items in the areas of communicable and non-communicable diseases, women's health, mental and social health and addiction, environmental health, etc., were identified as the most important health needs of the informal settlement residents. CONCLUSION: Informal settlements are facing various health problems including environmental health, mental and social health, and addiction, meeting which requires collaboration of all stakeholders as well as provision of a comprehensive program and appropriate service packages.

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“…The belief that there are many facts that give meaning to the individuals' life constitutes the fundamental belief of the researchers of a qualitative research. One of the most important ways to identify the students' experiences is the motivation to respond to the use of the qualitative method (16)(17)(18). The research participants consisted of 16 different classes of students (basic sciences and clinical sciences) and 12 professors and managers of Shiraz University of Medical Sciences.…”

Section: Methodsmentioning

confidence: 99%

Challenges and Motivational Facilitators of Social Accountability in Medical Students of Shiraz University of Medical Sciences: A Qualitative Study

et al. 2020

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Background: Accountability in the community is one of the main missions of the medical school. Objectives: The current study aimed at explaining the motivational facilitators and challenges in medical students of Shiraz University of Medical Sciences, Shiraz, Iran, for social accountability based on their experiences. Methods: The current study using semi-structured interviews was conducted on 28 individuals, 16 of whom were students and 12 professors and managers of the medical school. Purposeful sampling was used up to saturation. Data were analyzed using the content analysis method. First, conceptual codes were extracted and then grouped into several main themes. Selected concepts or main themes included facilitators, inhibitors, or challengers. Results: Selected concepts or main themes included facilitating factors and educational challenges for the social accountability of the students. The facilitators included informed choice, personality and moral commitment, content and process of motivation, promotion of community-based learning in the university, and the role of professors in motivation. The inhibitors or challenges included traditional routines, ineffective evaluations, manners of meeting the students’ needs, the lack of educational facilities, and the impact of the increased number of students on the quality of education. Conclusions: According to the current study findings, the conditions and facilities should be shared among medical education programs to provide a supportive environment for the students, and take a positive and effective step toward motivating them to improve their accountability.

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Social trends affecting the future of Iran's health system: A qualitative study using focus group discussion

Cited by 16 publications

References 20 publications

Performance Evaluation of The District's Primary Health Care System (DPHCS); Case Study Of Southeastern Iran

Performance Evaluation of The District's Primary Health Care System (DPHCS); Case Study Of Southeastern Iran

Health needs assessment of the residents of the informal settlements in South-Eastern Iran

Challenges and Motivational Facilitators of Social Accountability in Medical Students of Shiraz University of Medical Sciences: A Qualitative Study

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