Health needs of people living with HIV/AIDS: from the perspective of policy makers, physicians and consultants, and people living with HIV/AIDS

HIV/AIDS has been concentrated among injecting drug users in the country. This study aimed to investigate and identify health and treatment needs of people living with HIV/AIDS in Iran. This qualitative study was conducted in 2012 in Iran. The study groups consisted of experts, practitioners, and consultants working with People Living with HIV/AIDS and their families. Data was collected through Focus Group Discussions and deep interviews. Data were analyzed using content analysis method. The findings of this study included the needs of people living with HIV/AIDS, which were classified in three main categories. The first category was prevention and counseling services with several sub-groups such as education and public and available consultation, distribution of condoms to vulnerable groups, increasing counseling centers in urban areas, providing appropriate psychological and supportive counseling, and family planning services. The second category included diagnostic and treatment services and had several sub-groups such as full retroviral treatment, Tuberculosis treatment and continuing care, providing care and treatment for patients with hepatitis, and providing dental services. The third category included rehabilitation services and had some sub-categories such as home care, social and psychological support, nutritional support, and empowering positive clubs. This study puts emphasis on making plans based on the priorities to meet the needs of people living with HIV/AIDS in Iran

Seeking comfort: women mental health process in I.R. Iran: a grounded theory study

Psychosocial factor is considered as intermediate social determinant of health, because it has powerful effects on health especially in women. Hence deeper understanding of the mental-health process needed for its promotion. The aim of this study was to explore women's experience of the mental-health problem and related action-interactions activities to design the appropriate interventions. In-depth interviews with women 18-65 years were analyzed according to the grounded theory method. The selection of Participants was based on purposeful and theoretical sampling. In this study, a substantive theory was generated; explaining how female with the mental-health problem handled their main concern, which was identified as their effort to achieve comfort [core variable]. The other six categories are elements in this process. Daily stress as a trigger, satisfaction is the end point, marriage is the key point and action-interaction activities in this process are strengthening human essence, Developing life skills and help seeking. Better understanding the mental-health process might be useful to design the interventional program among women with mental-health problems

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

How Iranian women conceptualize mental health: an explanatory model

In Iran, more than 25% of women suffer from mental disorders. Mental disorders and subclinical problems are associated with socioeconomic problem .At the community level, mental health promotion can reduce social damage. The aim of this study as a part of community based mental health promotion intervention was to explore how mental health in Iranian women is viewed. According to a qualitative method in 2012, participants were selected by purposeful sampling from married women 18 to 65 years who are residents in Tehran. Fifteen in depth individual interviews were conducted with regard to the concept of mental health, causal pathway and help-seeking behavior according to explanatory model. Mental health was perceived as the same of emotional well-being. It conceptualized not only lack of mental disorder but also sense of satisfaction and healthy functioning. According to participant`s view, the causal pathway of mental health problems were classified to individual, familial and social factors. Physical and behavioral problems were related to individual factor, Lack of marital adjustment was one of the most important issues in familial item and in social factor, cultural context and socio- economic problems were extracted .In help seeking process, all of the participants believed that the religion has important effect in mental health. Marital adjustment is an important stage in process of mental health in women

Service users and providers expectations of mental health care in Iran: a qualitative study

Mental disorders are known to be an important cause of disabilities worldwide. Despite their importance, about two thirds of mentally ill people do not seek treatment, probably because of the mental health system's inability to decrease the negative side effects of the interaction with the mental health services. The World Health Organization has suggested the concept of responsiveness as a way to better understand the active interaction between the health system and the population. This study aimed to explore the expectations of mental health service users and providers. Six focus group discussions were carried in Tehran, the capital of Iran. In total, seventy-four participants comprising twenty-one health providers and fifty-three users of mental health system were interviewed. Interviews were analyzed through content analysis. The coding was synchronized between the researchers through two discussion sessions to ensure the credibility of the findings. The results were then discussed with two senior researchers to strengthen plausibility. Five common domains among all groups were identified: accessibility, quality of interpersonal relationships, adequate infrastructure, participation in decisions, and continuity of care. The importance of cultural appropriateness of care was only raised by service users as an expectation of an ideal mental health service. Both users and providers identified the most relevant expectations from the mental health care system in Iran. More flexible community mental health services which are responsive to users' experiences may contribute to improving the process of care for mental health patients

effectiveness of harm reduction programs in seven prisons of Iran

Starting in 1990 many programs were initiated to prevent and control the spread of HIV/AIDS in prisons in accordance with the policies of the Ministry of Health. This study attempts to evaluate the effectiveness of harm reduction programs vis-a-vis drug abuse and dependency in 7 prisons in Iran. The methodology used is Before-After testing and the sample population is incarcerated prisoners in 7 large prisons in 7 provinces with diverse geographical, criminal, and numerical factors and the population sample is estimated at 2,200 inmates. Findings show that Drug addiction tests conducted on prisoners, right after their admittance indicated that 57% used at least one of the three drugs of morphine, amphetamines, and hashish [52% morphine, 4.5% amphetamines, and 3.9% hashish]. Two months later, on the 2nd phase of the study, test results indicated that only 10% of subjects continued using drugs [P=0.05]. Heroin and opium were the two most prevalent drugs. Smoking, oral in-take, and sniffing were the three most popular methods. Of those who continued to use drugs in prison, 95% admitted to drug use records. Intervention policies in prisons resulted in reduction of drug consumption, from 57% of the newly admitted inmates to 10% after two months of incarceration

experiences of some addicted men to meth through the treatment and recovery tunnel

Background: Understand and identifying of the experiences of meth addicted persons while withdrawal, could provide a worthwhile apprehension of how being experienced of the method of treatment and its effect on patients. The purpose of this research was to explore the experiences of meth addicted persons during treatment by the [rebirth] method

Methodology: This study was accomplished by qualitative approach and content analysis method. Verdigs rehabilitation center, one of the subsets of Charitable Societies of rebirth locating in Karajs Vardavard, was the place this study accomplished. Data collection has done through deep semistructured interview and field's observation. Sampling methods were a mixture of purposive and snowballing that continued until data saturation reached to 15 in number

Findings: Results of the study, through the treatment and recovery tunnel imply that the experiences of participants, is dividable to three main steps including: the first week presence in rehabilitation center, participating in programs and recovery

Conclusion: It seems that the treatment programs of the center, considering extracted categories of this study, was relied on participants needs and participants described the treatment positive and successful

[Assessment of medical excellence centers in Iran]

The assessment of "scientific excellence" is taking on increasing importance in the development of research policies. Evaluation of Medical Excellence Centers makes it possible for stakeholders to promote and establish the quality of scientific activities. Despite such importance, efficient methods to identify and evaluate the function of these scientific institutions, is not well known. Thus, in 2009 the Ministry of Health and Medical Education Deputy for Medical Education ordered the design of appropriate assessment and evaluation tools. The goal of this activity was to implement an assessment system for centers of excellence and find a true understanding of their performance. The evaluation was performed using the tools and indicators based on a systematic approach for evaluating "input", "process" and "output ". This present study reports the findings of this evaluation. The findings suggest that 8S.7% of the institutions studied have been stationed in Tehran. From total scientific institutions assessed, 66.6% had a documented strategic plan. The evaluation report of these strategic plans were not provided by any of excellence centers. These institutions mainly relied on government resources for their activities. Over 50% of academic institutions had no report of financing from charity organizations, NGOs, private organizations and overseas sources. In the area of capacity building, the highest median score was 7.5, which was related to the existence of proper structure for international scientific communication. 50% of the centers had no demand- oriented projects and no partnerships with other academic institutions abroad. The main output of these institutions was indexed scientific articles, academic achievement leading to health services in the field was reported by these institutes. Based on the finding of this evaluation, scientific performance of center of excellence is contrary to the main mission of these centers. Predicting the future by western universities led them to realize that if they did not change their strategies they will not succeed. For developing countries such as Iran, learning from this experience is an opportunity

[Excellence assessment model for Iranian medical centers]

Medical excellence centers have consistently sought to improve scientific status, expand the knowledge base, increase the number of expert researchers, create a dynamic environment, and promote a productive and effective international scientific network during the past several decades. In Iran since 1379, medical excellence centers joined the research structure as the highest scientific institutions. The senior management of the higher education system in the country is responsible for evaluation of these newly established scientific institutions. Assessment of these centers shows the quality their activities, which can contribute to quality improvement through dynamic feedback for the planning and activity development. In order to perform this assessment the Iranian Ministry of Health and Medical Education as an important part of higher education system designed a model of assessment and put it on its agenda in 2010. This article aims to describe the process of developing the tools for needed for this evaluation. The evaluation criteria has been developed based on "input", "process" and "educational, research, and services outcome" indexes. This evaluation has been considered as a comprehensive one because of including all aspects of management such as supply and training human resources, financing, providing equipment, process of empowerment and knowledge production as well as output in the field of education, research, industry and services. This scientific approach to the assessment of excellence centers makes them capable of being aware of their strengths and the assessment of excellence centers makes them capable of being aware of their strengths and weaknesses. As a result, they can improve their scientific capacity and activities