Nutrition and food security policy in the Islamic Republic of Iran: situation analysis and roadmap towards 2021

Background: All government policies and programmes for food and nutrition security should include providing healthy food, as well as providing economic and social availability for all people. Aim: This study aimed to analyse the current situation of Iranian food and nutrition security and establish a road map towards 2021. Methods: The applied methods were situation analysis and a mixed qualitative–quantitative method. The conceptual method used for developing this national document encompassed three areas: sustainable food supply, food safety and nutrition. Results: The outcomes of the Iranian food and nutrition security system in the past three decades include development of management infrastructure and improvement in food and nutrition security status. However, analysis of current programmes showed that there were some overlapping, intertwining and parallel works in the responsibilities of related organizations in the field of supervision of food safety [from production to supply]. The national document produced as the outcome of this paper was communicated by the Iranian Ministry of Health in 2012 and has been running for 2 years. Selected ministries are responsible for implementation of 20 national programmes by the end of the 5th Economic, Social and Cultural Development Programme [2016–2011]. The consensus of stakeholders by the end of the 6th Development Programme [2021] is to put all of the provinces in a safe or very safe situation in terms of food and nutrition security. Conclusion: The most important challenge in establishing national documents is to make them operational. This aim was achieved by an intersectoral nutrition and food security working group, which produced a general memorandum of understanding with the main organizations, the media, universities and private sector

role of national sectors in food and nutrition security: the experience of the Islamic Republic of Iran

Background: Solving the problem of food and nutrition security requires the integration of various sectors of the society. Determining the role of each sector in promoting people's health has presented intersectoral collaboration and transformed the theory of social health determinant approach into action. In this study, with a new approach, and in regards, the national organizations responsible for food and nutrition security have been classified and the role of each has been identified as functions and responsibilities

Methods: This qualitative study was conducted by studying the documents and programs related to food and nutrition security, as well as semi-structured interviews and focused group discussion with two groups, including experts and executives. To determine the role of organizations, the food supply chain was used

Results: According to the food chain, organizations responsible for food and nutrition security in Iran can be divided into three categories: 1. Responsible governance in the economic, political, social, technological, international, and environmental changes affecting food and nutrition security, 2. Responsible governance in the main process of food and nutrition security 3. Supportive sectors and systems for food and nutrition security. Generally speaking, it appears that the government responsible for the main process of food and nutrition security are made up of institutions responsible for providing adequate food, responsible governance for food safety, and responsible governance in the field of nutrition and body consumption

Conclusion: The findings of this study aimed to explain the expectations and responsibilities of ministries and organizations responsible for food and nutrition security

Dropouts and social determinants of health; policy for the prevention of school dropout, qualitative study of the causes and interventions

Indicators of the level of education are the most important parameters influencing each country's development. Social indicators considered to be a determinant of one's health consists of two constituents namely; [1] Rate of students enrolled in elementary, guidance, secondary and higher education and [2] the rate of adult literacy. This study is aimed to evaluate the situation of school dropouts in Iran, their causes, and appropriate interventions. Data were collected through literature review [including published researches and analysis of documents], focus group discussions with the presence of experts from [Department of Community Health, Academy of Medical Sciences] and interviews with stakeholders then these data were classified and presented in three sections namely; current situation, causes and solutions. Results showed that Iran's current situation in terms of school dropouts is unsatisfactory in comparison to developed countries and in some countries in the region. Influencing factors for school dropouts were classified into [1] Individual factors such as intellectual disability and behavioral disorders [2] group factors such as peer groups, family problems and children's reduced interests in school and [3] major factors such as educational system and the changes of value, economic, cultural, and political issues. The present study, with the presentation of statistical documents specifically of the current problem of school dropouts in all levels of the Iranian society has been determined and aside from identifying the causes and factors affecting school dropouts, provision of strategies in three levels of prevention to combat this problem has been addressed

Development of country-wide strategies to reduce the alcohol abuse

Evidence shows that in Iran alcohol abuse rate may be of concern, especially among the youth. The mental and social health and addiction Department of the Ministry of Health and Medical Education has designed a plan to prevent, treat, and rehabilitate the patients abusing alcohol in a time period of 2011-2015. In a 6-month period, three guiding committees of experts in the field of alcohol abuse reviewed the literature. The meetings of the steering committee were held in order to collect the comments of the policy-makers in recognition of the problem, orientation, and administration procedures for the suggested strategies. The first input was discussed in the committee meeting. In the orientation phase, intervention strategies were suggested whose base was the evaluation of the previous international guidelines. In the final phase, the suggested strategies and challenges and their possible solutions were criticized. Finally, using these strategies, appropriate interventions were defined. Preventing alcohol supply, school- and community-based prevention efforts, monitoring and vigilance were defined as primary prevention. While secondary and tertiary prevention are defined to be the treating and rehabilitating services for the alcohol abusers. We hope by using this strategy we will be able to control alcohol abuse in our country. The first step to reach this aim is done by breaking the taboo of giving alcohol-related information and news using media and educational programs especially to the young population

[Social health service packages, a model for urban heath system interventions]

Objective [s]: Health has preventive effects on physical and mental domains of health. Increment trend of social problems in the country and big cities, will be clear the importance of social health interventions, more. Changing social health situation requires designing and implementing new services based on the situation analysis of current social issues and interventions. Considering reengineering of health network system in urban areas by social determinants approach and redefining municipalities' role for it, preparing this package is an opportunity to complete the service provision in health network and to elucidate the role of municipality in social health service delivery

Methods: This is a qualitative, content analysis research. Data gathered by using various methods including: interviewing to municipality officials, group discussion in designing team, reviewing related research articles, reports and documents in deputy for social affair of Tehran municipality. Information was utilized for priority setting and designing the packages. Neighborhoods' health councils and regional municipalities officials comments and also existing indices were used for setting the priorities. In designing packages and proposed interventions, experts opinions, review of literatures and analysis of available capacities and assets were used

Results: The defined social health service packages are: common package for promoting social healthy behaviors and special packages for reducing substance abuse, crime, child abuse and divorce. Each package has 3 sections: necessity of service, explanation of services and requirement for implementing the services. The following six principals were agreed for designation: 1. Selected services should be based on the regional problems and assets. 2. Integrating public partnership and intersectoral collaboration in service provision. 3. Considering primary, secondary and tertiary prevention in each services package. 4. Using national and international best available evidences for designation. 5. Defining requirements of implementing and sustaining the services. 6. Based on the upstream rules and regulations

Conclusion: The new packages are based on the social health promotion approach in comparison to the existing social issues packages which theirs programs and protocols are more treatment oriented, combating disasters and social harms. On the other hand, in new packages, intersectoral collaboration and using local assets has been emphasized but the old protocols are based on governmental limited resources. If we believe that " Municipality is the important social health steward in urban areas" instead of " Municipality responsible for cleaning the face of city from harms such as, addicts, beggars, homeless and …" then we could ascertain that the designed packages will be implementable by municipalities in cooperation to all urban organizations. In order to sensitizing and political commitment, forming regional social health council under supervision of mayor and with cooperation of representatives of all governmental and non governmental and private section has been proposed

[Review of the thirty years experience of the lslamic Republic of lran on social determinants of health and health equity the future course: roles and orientations of the lslamic gonsultative assembly]

Over three decades of research on social determinants of health suggest unequivocal impact of factors like childhood development, education, employment, housing, entertainment, public transportation, agriculture and social support, on people's health. In the aftermath of the Islamic Revolution, there has been eye-catching progress in the areas of maternal and child health. The key role of the Islamic Consultative Assembly in examining and approving five years development plans of the Islamic Republic is irrefutable. The implementation of national development plans has often contained core determinants of health, in particular in the areas of employment, housing, social support, health services, environment and food security. The support rendered by the Islamic Consultative Assembly to promoting health in the past three decades, spurs further hope for greater strides in terms of health indicators of the country, in accordance with the following strategies: - To draw full support of the Health and Medical Commission of the Islamic Consultative Assembly, to ensure approval and monitoring of health oriented laws and regulations and policies in all 14 commissions of the Assembly; - To negotiate and win the support of all members of the Assembly's fractions, and heads of forums for provincial groups of parliamentarians. to encourage approval of health oriented policies at the Assembly and their implementation within provinces; - To cooperate with the Ministry of interior in promoting the performance of the Provincial Councils on Hearth and Food Security and Islamic Councils at city and village levels, to stimulate participation of all in improving the situation of their immediate environment; - To supervise and provide support to the Ministry of Health and Medical Education in further activating the National council on Health and Food Security; - To lunch a monitoring system at the Research Center of the Islamic Consultative Assembly to oversee indicators related to health equity.