Health in the 5[th] 5-years development plan of Iran: main challenges, general policies and strategies

Access to the right to the highest attainable level of health is a constitutional right that obliges governments and other players to take step to increase all individuals' chances of obtaining good health. At the least, health and education are two crucial requirements for this as well. Iran's vision 2025 is going to lead the country to a developed state with the highest rank of economic, scientific and technological status in the region. Enjoying health, welfare, food security, social security, equal opportunities, etc, are also considered as part of characteristics of Iranian society in 2025. Although health system of Iran has many achievements in providing health services specially for the poor following the Islamic Revolution of 1979, but the evidences gathered to develop the 5[th] 5-years economical, social and cultural plan [5[th] 5YDP:2011-2015], listed a variety of main challenges in stewardship, financing, resources generation and service provision functions of the existing health system. Thus, to overcome the main challenges, about 11% of general policies of 5[th] 5YDP are directly address health related issues with emphasizing on healthy human and comprehensive health approach with considering: Integration of policy making, planning, evaluation, supervision and public financing; Developing both quantity and quality of health insurance system and reducing out-of-pocket expenditures for health services to 30% by the end of the 5[th] plan. The strategies of 5[th] 5YDP adopted by the parliament as an Act will change the health system fundamentally through tuning the main drivers; so, its implementation needs brave leaders, capable managers, motivated technical staff and social mobilization

[Waist circumference cut off in relation to hypertension in Iran]

Cardiovascular disease is the most important reason for mortality in many countries, and because of its increasing prevalence, it is vital to recognize the related risk factors. Hypertension is a major risk factor for CVD. Waist circumference [WC] cut point is a simple way to recognize hypertension. WC cut off points vary for different races, making it necessary to determine WC cut off points in Iranians. This study was conducted to determine the waist circumference cut off in related to hypertension in Iran. We enrolled 83772 individuals, 41775 men and 41997 women, aged eighteen years and older from cities and villages throughout the country. The cut off point for waist circumference was determined and exams for blood glucose and COL, TG was done. Cut off points for waist circumference were determined for hypertension using the ROC curve analysis, yielding 89 cm for men and 93 cm for women. These results showed that the cut off point for WC in Iran is higher than other Asians and is more similar to whites; the present study shows that waist is ciruimference a strong determinant in relation to hypertension

[Prevalence of asthma among 1 5 to 64 years old in Kurdistan, Iran 2006]

There is geographic variability in the prevalence of asthma. Since there is inadequate of study on asthma in Iran, this study was performed in order to determine the prevalence of asthma in Kurdistan province. This cross-sectional study was performed as part of Iranian national survey to determine the risk factors of non communicable disease. This study includes 500 men and 500 women. Prevalence of history of asthma was 2.3%. There was no statistically significant association between asthma and place of residence, smoking and body mass index. Asthma were found in 6 [1.8%] of men and 17 [5%] of women [p=0.02]. Prevalence of asthma increased with increasing age [p<0.001]. The prevalence of asthma in this study was similar with other studies in Iran and seems lower than similar countries

[Prevalence of hypertension in Iranian urban and rural populations aged over 20 years in 2004]

Several studies have shown differences in HTN prevalence between urban and rural populations. The aim of this study was to compare the prevalence of HTN and the status of HTN awareness, treatment and control between Iranian urban and rural populations aged over 20 years. As a part of a nation-wide survey in 2004 on risk factors of non-communicable diseases, a cross-sectional study was performed on 75.132 adults aged over 20 years. In all participants, blood pressure was measured for twice in a standard method, followed by a collection of data on patients' awareness, treatment and control of HTN. The data were compared between urban and rural populations. The crude prevalences of HTN were 30.5% [CI 95%: 30.496- 30.50], 29.2% [CI 95%: 29.19-29.21], and age-adjusted prevalences were 26.09% [CI 95%: 26.086-26.094] and 26.03% [CI 95%: 26.015-26.025] for urban and rural populations, respectively. Rural residents were significantly less aware of HTN, its treatment and control than urban people. Considering the similarity of age-adjusted HTN prevalence between Iranian rural and urban communities, there is the same burden on our health system. With respect to the lower degree of HTN awareness and control in rural residents, and the integral role of rural health system in diminishing the mentioned difference, further developments are recommended for system

Hypertension and pre-hypertension: prevalence, awareness and management among Iranian adults older than 20 years

Hypertension [HTN] is an important worldwide challenge. The 7th report of the Joint National Committee [JNC7] provided the last classification of blood pressure levels and introduced the new category of prehypertension. The aim of this study was to estimate the national prevalence of HTN and prehypertension according to the JNC7 guideline and to determine the status of HTN awareness, treatment and control in Iranian adults aged older than 20 years. This cross-sectional study was a part of a nationwide survey on the risk factors for non-communicable diseases, which was conducted in 2004. In 75112 over 20 year old adults, two blood pressure measurements were obtained by a standard method and blood pressure levels were classified according to the JNC7 criteria. Data on patients' awareness, management and treatment of HTN were also collected. The age-adjusted prevalence of HTN and prehypertension was 25.3% and 49.7% in men, and 26% and 38% in women, respectively. Only 35% of hypertensive subjects were aware of their disease, and effective control was observed in 21.4% of them. Considering the high prevalence of HTN and prehypertension and the low awareness and effective control of HTN, our country is facing a serious health problem

Rapid assessment of trachoma [RAT] in south provinces of Iran

To evaluate four southern provinces of Iran for trachoma by rapid assessment of trachoma [RAT] during 2004. This descriptive study was performed in rural areas of four probable contaminated provinces in south of Iran including Bushehre, Kerman, Hormozgan, and Sistan and Baluchestan. By multistage sampling, 5328 subjects including 4782 children aged 1-9 years and 546 adults were selected and examined based on the World Health Organization [WHO] protocol. Children were evaluated for presence of follicular and intense trachoma and adults were examined for presence of trachomatous trichiasis. Prevalence of these types of trachoma was determined and compared with acceptable WHO limits. Only in Sistan and Baluchestan province, 7 cases of active follicular trachoma were observed equal to a local prevalence of 0.5% and a total prevalence of 0.15%. No case of severe trachoma was observed. Trichiasis was seen in 0.03% of adult subjects including 0.17% in Bushehr province and 0.03% in Kerman province. No trichiasis was detected in Hormozgan or Sistan and Baluchestan provinces. The prevalence of active follicular trachoma and Trichiasis is less than the accepted level of WHO. There seems to be no need for nationwide intervention in this regard