qualitative study of community-based health programs in Iran: an experience of participation in I.R. Iran

Community-based health programs [CBHPs] with participatory approaches has been recognized as an important tool in health promotion. The goal of this study was to understand the nature of participation practice in CBHP and to use the data to advocate for more participation-friendly policies in the community, academy and funding organizations. In this qualitative study, 13 CBHPs, which were active for last 5 years have been assessed using semi-structural in-depth interviews with programs principal and managers and focus group discussions with volunteers and service users. Data analysis was based on the deductive-inductive content analysis considering the participatory approaches in these programs. The results show that, the main category of participation was divided to community participation and intersectional collaboration. The community participation level was very different from "main," "advisory" or "supporting" level. The process of recruitment of volunteers by the governmental organization was centralized and in non-governmental organizations was quite different. According to respondents opinion, financial and spiritual incentives especially tangible rewards, e.g., learning skills or capacity building were useful for engaging and maintaining volunteers' participation. For intersectional collaboration, strong and dedicated partners, supportive policy environment are critical. It seems that maintaining partnership in CBHP takes considerable time, financial support, knowledge development and capacity building

Parents or school health trainers, which of them is appropriate for menstrual health education?

The purpose of this community-based participatory research was to compare different training sources for adolescents' menstrual health education. From 15 middle schools in Tehran, through quota random sampling, 1823 female students were selected proportionally and allocated randomly to three groups [parent trained, schools' health trainers trained, and control]. Following a two-year training program, the adolescents' menstrual health was compared. In the present study, the school health trainers trained group showed a better feeling for rrienarche, compared to the two other groups [P < 0.001]. The need for adolescent health training was emphasized by 82% of the participants; they also believed that the appropriate age for such empowerment courses was about 12 years. In the school health trainers trained group, the offered age was significantly lower than in other groups [P < 0.001]. The adolescents trained by the school health trainers had a better practice of habits related to menstrual and hygiene practices, like having a bath during menstruation and the use of sanitary pads or cotton, compared to their counterpart groups [P > 0.05]. It is suggested that school-based health training leads to better menstrual health promotion and healthy puberty transition, and school health trainers play a key role in this regard

Evaluation of tuberculosis situation in economic cooperation countries in 2009; achievement and gaps toward millennium development goals

Evaluating the tuberculosis [TB] status of the Economic Cooperation Organization [ECO] member countries relation to goal 6-c of the third millennium, which includes that TB incidence, prevalence, and death rates should be halved by 2015, compared with their level in 1990. In 2009, we have critically reviewed the countries' Millennium Development Goals [MDGs] reports and extracted the data from the surveillance system and published and unpublished data. The main stakeholders, from both governmental and international organizations in the country have been visited and interviewed by the research team as part of the data validation process. The TB incidence is very heterogeneous among ECO countries, which differ from 21.7 in Iran to 230.7 per 100,000 in Tajikistan. TB incidence [per 100,000] is more than 100 in six countries and is from 50 to 100 in two countries and is less than 30 in two countries. Only in two countries the crude death rate [CDR] is higher than 70%. In seven countries the death rate is higher than 10 per 100,000. Two countries are among the 20 top world countries with the highest tuberculosis burden. There are some signs and signals indicating the bad condition of an ECO member including: incidence of more than 50 per 100000, CDR of less than 70%, death rate more than 10 per 100,000, and rating two member countries among 20 top countries with the highest burden in the world. Iran and Turkey could achieve MDGs by 2015, but if other countries do not prepare urgent intervention programs, they will not be able to fulfill the goals

Socioeconomic status and incidence of traffic accidents in metropolitan Tehran: a population based study

Population based estimates of traffic accidents [TAs] are not readily available for developing countries. This study examined the contribution of socioeconomic status [SES] to the risk of TA among Iranian adult s. A total of 64,200people aged>/=18years were identified from 2008 Urban Health Equity Assessment and Response Tool [Urban HEART] survey. 22,128 households were interviewed to estimate the overall annual incidence, severity and socioeconomic determinants of TAs for males and females in Iranian capital over the preceding year. Wealth index and house value index were constructed for economic measurement. Weighted estimates were computed adjusting for complex survey design. Logistic regression models were used to examine individual and SES measures as potential determinants of TAs in adults. The overall incidence of traffic accident was 17.3[95% CI 16.0, 18.7] per 1000 per year. TA rate in men and women was 22.6[95% CI 20.6, 24.8] and 11.8[95% CI 10.4, 13.2], respectively. The overall TA mortality rate was 26.6[95% CI 13.4, 39.8] per 100,000 person years, which was almost three times higher in men than that for women [40.4 vs. 12.1 per 100,000person years]. Lower economic level was associated with increased incidence and mortality of TA. Association between SES and incidence, and severity and mortality of TA were identified. TAs occur more in lower socioeconomic layers of the society. This should be taken seriously into consideration by policy makers, so that preventive programs aimed at behavioral modifications in the society are promoted to decrease the health and economic burden imposed by TAs

[Qualitative study of adolescences opinion among nutritional habits and believes]

More than 20% of Iranian population is in 10-19 years old age group; absolutely their health and progress have an important role in socio-economical future of country. According to results of different researches, their knowledge among nutrition is not adequate. So, this study was conducted to evaluate opinions of adolescence about nutritional habits and believes. in this qualitative study, data gathering conducted through 8 Focus Group Discussion [FGD]. 6-11 participants were selected according their gender and educational level in each group. Although the majority of participants agreed with the importance of nutrition on health, they mostly tend to use modern and publicized fast foods. Most female and male participants mentioned that there is difference between diet selection of girls or boys. They believed that girls had more attention to diet selection and taste and health of foods than gluttony and carelessly of boys. Adolescence knowledge to problem derived from unsafe nutritional habits were insufficient. It is remarkable that youth participation in scheduling have a great influence in their health program promotion

Observing principles of medical ethics during family planning services at Tehran urban healthcare centers in 2007

Family planning has been defined in the framework of mothers and children plan as one of Primary Healthcare [PHC] details. Besides quantity, the quality of services, particularly in terms of ethics, such as observing individuals' privacy, is of great importance in offering family planning services. A preliminary study to gather information about the degree of medical ethics offered during family planning services at Tehran urban healthcare centers. A questionnaire was designed for study. In the first question regarding informed consent, 47 clients who were advised about various contraception methods were asked whether advantages and disadvantages of the contraceptive methods have been discussed by the service provider. Then a certain rank was measured for either client or method in 2007. Finally, average value of advantage and disadvantage for each method was measured. In questions about autonomy, justice and beneficence, yes/no answers have been expected and measured accordingly. Health care providers have stressed more on the advantages of pills and disadvantages of tubectomy and have paid less attention to advantages of injection ampoules and disadvantages of pills in first time clients. While they have stressed more on the advantages and disadvantages of tubectomy and less attention to advantages of condom and disadvantages of vasectomy in second time clients. Clients divulged their 100% satisfaction in terms of observing turns and free charges services. Observance degree of autonomy was 64.7% and 77.3% for first time and second- time clients respectively. Applying the consultant's personal viewpoint for selecting a method will breach an informed consent for first and second time clients. System has good consideration to justice and no malfeasance