Comparing the Pattern of Menopausal Symptoms, Concern and Attitudes in Urban and Rural Postmenopausal Iranian Women

OBJECTIVES: Although hormonal changes during menopause are inevitable in this period, the severity of the menopausal symptoms can be controlled. Accepting menopause and having a positive attitude toward it can also help. Given the results of previous studies, and since environmental factors affect the pattern of menopausal symptoms the present study was conducted to compare the pattern of menopausal symptoms, concern and attitudes in urban and rural postmenopausal women. METHODS: This cross-sectional study was conducted on urban and rural postmenopausal women residing in and around Tabriz, Iran. Cluster sampling was used to select the subjects. The data collection tools used included a demographic questionnaire to assess women's experiences during menopause. RESULTS: This study examined 544 urban and rural postmenopausal women between March and September 2015. The women had a mean age of 51.8 ± 3.1. After adjusting the basic variables, the mean scores of menopausal symptoms and their subscales showed significantly higher scores in the physical and psychological subscales in the urban women, while the rural women had significantly higher scores in the concern subscale. CONCLUSIONS: Rural women were significantly different from urban women in terms of menopausal symptoms, concern and attitudes. Hot flushes, a common menopausal symptom, and decreased sexual desire were more common in the urban women; in contrast, the rural women experienced more concern about menopause and its consequences.

Women's burden of disease and injuries in east Azerbaijan

The aim of this study is assessment of burden of disease in East Azerbaijan women. In this project we used of disability adjusted life years [DALY] as an index of burden of disease. Cardiovascular disease, cancers and unintended injuries 71.98% of DALY for premature death. The 3 leading causes of YLD in East Azerbaijan province were: psycineurotic disorders, musculoskeletal and urogenital diseases. This study shows that YLL is 3 fold of YLD and this indicated to lower quality of life of women.

Maternity and child health care services delivered by public health centers compared to health cooperatives: Iran's experience

Reform programs in some developing countries are focused in transferring these services to nongovernmental organizations or groups. In this WHO grant study our aim was to implement and evaluate the efficacy of a new model for transferring state service delivery governance to nongovernmental groups and studying if they can be efficient in field of child and maternity health services compared to public health centers. In this comparative study a total of 1000 households were selected systematically from the population covered by 9 health centers transferred to cooperatives and 18 current public health centers. Data were collected during a three months long study period and analyzed by SPSS 10 statistical package. Chi-Square and t-tests were used to analyze data. Overall health care coverage was higher for either cooperative or public health centers compared to private sector physicians [p = 0.005].Around 88.8% of under 6 years aged children were under coverage of health services provided by health centers in both groups and no difference was found. There was no statistically significant difference in quality of child health care services in declaring the date of health care visit and follow up in due time. There was no difference between the groups in perfect filling child growth cards but the ability of mothers in interpreting child growth cards was statistically higher for the population covered by cooperative health centers [p = 0.02]. Growth status of children based on growth percentiles were relatively similar in two groups. Some health indices of target groups covered by public and cooperative health centers such as family planning, child health cares, perinatal cares, and the numbers of households covered by health volunteers were studied. The results showed that in all of these fields cooperative health centers had better rates. Observed differences were statistically significant [family planning: p = 0.03, infant health care: p = 0.03, 1-6 years old children cares: p = 0.009]. The proportion of those women owning a vaccination record [card] was higher in population covered by cooperative health centers [p = 0.004]. The rate for performing a cervical smear examination during the national program for cervical cancer screening was higher for the women covered by cooperative health centers [p = 0.01]. No difference was found between the knowledge level of women covered by cooperative health centers about the importance of cervical examination when compared with public health centers. We conclude that in the field of target group children's health care and maternity health services, cooperatives sector not only acts as well as public sector meeting the standards of the program, but also has got a better function in some areas. This can be assumed as an achievement for the policy of transferring the health services to cooperative health centers along with ongoing governmental supervision