ABSTRACT
Definition of World Health Organization 1948 for Health includes social domain which two other domains of health, physical and mental, have counter effects on it. Quantity and quality of an individual relation to community in order to improve population welfare is a definition for social health. Social capital and security improvement and reduction of impoverishment and inequity is the impact of this relation and it's opposite side is increasing social problems. In this article, by reviewing social health situation of Iranian community and analysis of it's determinants, improvement strategies have been provided and role of Ministry of Health and Medical Education [MOHME] proposed. This is a descriptive and analytic study; A conceptual framework were described based on a nationally committed definition of social health and used for description and analysis. Secondary data of reviewing existing research and documents were utilized for situational analysis; Focus group discussion of steering/stakeholder committee members and review of the best evidences and international experiences made analysis and proposed interventions. The evidences show that average increasing rate of social problems during recent years is 15% annually. Albeit, it is not possible to draw the increasing or decreasing trend of social health indices precisely since past 2 decades due to the lake of surveillance system. Several social problem reduction and social health improvement interventions are running by organization but, inadequate sensitivity of responsible persons, not to evaluate the current interventions, inadequate utilization and coverage of population from primary level preventive services, inappropriate selection of essential interventions, allocation of most available resources to tertiary level of prevention [after harm services], weakness of activity implementation system and intersectoral collaboration for executing interventions, disintegration of social health related financial resources and inadequate sensitivity and competencies of people in combating to social problems and risks are obstacle to effective interventions in improving social health indices. Economical, political, international and technological big changes should be added to these reasons. Social health progress will not be achieved without intersecotral collaboration; Improvement of existing situation is not under duties and responsibilities of MOHME, so proposed direction including vision, strategic objectives and interventions, for social health should be implemented partially by MOHME; Remaining parts required advocacy to be done by other sectors. It is essential that the proposed program be approved in health policy council of MOHME for implementation of this direction and achieving to it's objectives and then be approved by health and food security high council and social council of country; after that the intersectoral collaboration agreements of social health improvement should be supervised deeply
ABSTRACT
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
ABSTRACT
The Islamic Republic of Iran, in her 20 year vision by the year 2025, is a developed country with the first economic, scientific and technological status in the region, with revolutionary and Islamic identity, inspiring Islamic world, as well as effective and constructive interaction in international relations. Enjoying health, welfare, food security, social security, equal opportunities, fair income distribution, strong family structure; to be away from poverty, corruption, and discrimination; and benefiting desirable living environment are also considered out of characteristics of Iranian society in that year. Strategic leadership towards perceived vision in each setting requires restrictive, complete and timely information. According to constitution of National Institute for Health Researches, law of the Fifth Development Plan of the country and characteristics of health policy making, necessity of designing a Health Observatory System [HOS] was felt. Some Principles for designing such system were formulated by taking following steps: reviewing experience in other countries, having local history of the HOS in mind, superior documents, analysis of current production and management of health information, taking the possibilities to run a HOS into account. Based on these principles, the protocol of HOS was outlined in 3 different stages of opinion poll of informed experts responsible for production on management of information, by using questionnaires and Focus Group Discussions. The protocol includes executive regulations, the list of health indicators, vocabulary and a calendar for periodic studies of the community health situation
ABSTRACT
According to the last existing documents, the prevalence rate of mental disorders is about 20% which is considered to be 14% of all country's burden of disease. In the fifth economical, social, and cultural development plan of the country in accordance with the 20 year vision, "healthy human being" and "comprehensive health" approaches and also improving of mental health indicators are emphasized. Aim of study was preparing national policy and interventions for promoting mental health. Using secondary data, analytical review of country's mental health programs, recommendations of WHO, descriptive situation of mental health and its trend during the last decade were drafted and a group of experts and stakeholders was formed following a sound stakeholder's analysis. After three Focus Group Discussions [FGDs], main points of the meetings, influencing factors of present situation, and oncoming strategies were agreed upon. Based on different studies and the experts' opinions, the prevalence of mental disorders in the last decade has increased. Coverage of mental health programs in two last decades in the best could be equal to rural population. Urban areas have been deprived of these services. Analysis of mental health system of the country shows that internal environment is weak and the external one is concede to be in threat. Eight principal challenges in country's mental health are considered. Improving current situation requires increasing internal capacity of mental health system and developing inter-sectoral cooperation. During next five years, the Ministry of Health, Iran should mainly focus on improving mental health services particularly in urban and peri-urban areas, promoting mental health literacy of different groups and minimizing mental health risk factors
ABSTRACT
Improvement of national and provincial health indices requires intersectoral collaboration and community participation; So, National High Health and Food Security Council and Provincial Health and Food Security Councils [PHFSC] have been implemented since 2006. The main responsibilities of PHFSCs are, assessment of province health situation and effects of executive organizations on it's improvement, to define and approve the province health strategic plan, developing of AIDS and HIV prevention and control plan and resolving intersectoral issues of health. The goal of this study is first 3 years performance assessment of the PHFSCs. This is a descriptive evaluation study which included all the PHFSCs. The outcome assessment indicators were determined by content analysis of "the approved tasks" and also "the essential aspects for promoting of PHFSCs" by focus group discussions. Situational analysis was provided by two researcher made questionnaires; one for co Assessment of the contents of content analysis of PHFSCs all meetings minutes [from establishment year to the end of 2008] and another for gathering viewpoints of Secretaries of PHFSCs. Data analysis shows that the meeting's agendas of the PHFSCs have less followed the prioritized major health issues of provinces and national burden of diseases; most issues were in the domain of communicable disease control and non-communicable diseases risk factors control included scarcely. Only in two Universities of Medical Sciences [UMSc] province comprehensive health plan were proposed. None of the UMSc approved a secretariat for PHFSC in its organizational top chart. PHFSCs secretaries believed that, the main obstacles of the PHFSCs' successes, are weak financial resources, and lack of decisions executive enforcements. PHFSCs performances are moderate and moderate to low due to lack of comprehensive strategic plan and no implementation model for intersectoral decisions, other organizations believe on the effectiveness of the PHFSCs less and the main burden of disease of the provinces not mostly included in the agenda of PHFSCs. Following proposals are highly recommended for PHFSCs promotion: training and empowerment of UMSc and organizations for developing comprehensive health plan in the province and defining the responsibilities of each organizations for, determining policy priorities of common health issues of the provinces by High Health and Food Security Council and publicizing them by the Ministry of Health and the other relevant ministries and approving the structure and working system of the PHFSC secretariat in UMS by the Board of Trustees of UMS