[Views of managers, health care providers, and clients about problems in implementation of urban family physician program in Iran: a qualitative study]

Background and Aim: From 2011 to 2013 some efforts had been made in Iran to implement urban family physician program. The aim of this study was to determine the viewpoints of managers, providers, and clients of health care services about the problems in the implementation of urban family physician program in Iran

Materials and Methods: This study was a qualitative study. Data were collected through holding 21 sessions of focus group discussions and 37 individual interviews with managers, providers, and clients of health care services in Alborz, West Azerbaijan, and Kurdistan Provinces in 2014. Data were analyzed by means of content analysis method

Results: According to the results of this study, the problems on the implementation of urban family physician program in Iran can be classified into seven categories including: financial, cultural, educational, motivational, structural, administrative, and contextual problems

Conclusion: We propose definition and stabilization of the financial resources and establishment of appropriate rules for payments to solve financial problems, and also training of general population and staffs and involvement of the mass media in training to solve the cultural problems. In order to solve the educational problems reforms in medical curriculum are recommended. Motivational problems can be solved via encouraging the private sector and experts to take part in the program and also through guaranteeing the continuity of the program. Establishment of appropriate organizations and provision of protocols are recommended to solve the structural problems. Finally, to overcome the contextual problems it is suggested to promote cross-sectoral and inter-sectoral coordination and also attract support from policy-makers

[Comparison of health-care coverage between children with congenital hypothyroidism and healthy children in Iran]

Background and Aim: provision of timely healthcare for children under 5 years of age specially children with congenital hypothyroidism and also regular monitoring of growth through measuring weight, height and head circumference have been of great importance. The aim of this study was to make a comparison between healthy children and children with congenital hypothyroidism in regard to health-care coverage in Iran

Materials and Methods: this study was conducted in five provinces in different geographical areas of Iran in 2015. 240 children with congenital hypothyroidism and 240 healthy children were entered into the study. Children with congenital hypothyroidism were selected randomly from the national registere database. The children in the control group were matched with the children with hypothyroidism in regard to age, gender and place of residence. Anthropometric indices including weight, height and head circumference of the children of less than 3 years of age were recorded as the health care indices. STATA software version 13 was used for data analysis

Results: the mean percentage of measurement and record of weight, height and head circumference in children below 3 years of age with congenital hypothyroidism were 82.1, 78.7 and 55.4%, respectively. The mean percentage of measurement and record of weight, height and head circumference in healthy children [control group] below 3 years of age were 82.2%, 80.9 and 55.1%, respectively. There was a statistically significant difference between the two groups in relation to the percentage of height measurement [P =0.02]

Conclusion: according to the results of this study, percentage of measurement and record of the anthropometric indices in Iranian children of less than 3 years of age is low. More attention to the measurement and record of these physical growth indices in children of less than 3 years of age specially children with congenital hypothyroidism who need regular follow up, is essential

Food consumption pattern in pregnant women attending prenatal care centers in Maku

There is little information regarding the food consumption pattern and nutrient intake in pregnant women, especially those residing in deprived cities to determine the food consumption pattern and nutrient intake in pregnant women with further comparison of data in rural and urban areas of Maku-the west north of Iran. In this cross-sectional study 284 pregnant women [142 from urban areas and 142 from rural areas] were chosen randomly and privately interviewed using a face-to-face technique. Socio-demographic information such as age, educational level, family size, husband's occupation and pregnancy medical history were obtained by questionnaire. The data on dietary intake was collected using two 24-hour recalls and a food frequency questionnaire for 3 months. Mean consumption of grains and dairies was higher in rural women compared to those in urban areas. Fruit consumption by pregnant women in urban and rural areas was 140 g and 248 g, respectively. There was no significant difference regarding consumption of vegetables, pulses, fats and oils between two groups. All women consumed adequate amount of energy, protein, thiamin and niacin [>75% RDA]. Nutrients intakes including folate, B6, A, D vitamins, iron, phosphorus, calcium, magnesium and zinc were found to be insufficient in both groups [<75%RDA]. Our data indicated that the rural women had a better nutritional status than urban women. Further studies are needed to determine factors associated with food consumption pattern in these women

[ associations of total energy, macronutrients intake and meals-derived energy with body mass index]

In some works, a correlation between the percentage of meals-derived energy intake and the prevalence rate of obesity has been found. To explore any possible correlation between body mass index [BMI] and dietary energy, macronutrients intakes and also contribution of meals to energy intake. This was a cross-sectional study in which 348 male high school students aged 14-16 from Zarrin-shahr district, Isfahan, were investigated. The selection procedure was based on stratified random sampling from all high schools in the region followed by calculation of BMI [Weight/height[2]] for each individual. Data on food and nutrient intakes were gathered using a 24-hr dietary recall method. Obesity, overweight and thinness was defined on the basis of CDC 2000. The data showed that 9% of adolescents were thin, 6% overweight and 5% obese. While there was a positive correlation between total energy intake and BMI [r=0.31 p<0.03], no relationship was found between BMI and protein, fat or carbohydrate intakes. In all age groups, overweight/obese students had lower energy intake from breakfast. The adolescents aged 14 and 15 had higher energy intake from lunch [23.9+/-5.1% vs. 18.9+/-4.2% and 27.2+/-4.0% vs. 19.2+/-3.9%], respectively [p<0.01]. There was a significant correlation between total energy intakes and BMI, and also between the latter and the energy share of different meals which may have important implications in designing nutrition education programs to prevent overweight or obesity in school adolescents