[What should we do for improving Iranian social health? Situational analysis, national strategies and role of ministry of health and medical education]

ABSTRACT

Definition of World Health Organization 1948 for Health includes social domain which two other domains of health, physical and mental, have counter effects on it. Quantity and quality of an individual relation to community in order to improve population welfare is a definition for social health. Social capital and security improvement and reduction of impoverishment and inequity is the impact of this relation and it's opposite side is increasing social problems. In this article, by reviewing social health situation of Iranian community and analysis of it's determinants, improvement strategies have been provided and role of Ministry of Health and Medical Education [MOHME] proposed. This is a descriptive and analytic study; A conceptual framework were described based on a nationally committed definition of social health and used for description and analysis. Secondary data of reviewing existing research and documents were utilized for situational analysis; Focus group discussion of steering/stakeholder committee members and review of the best evidences and international experiences made analysis and proposed interventions. The evidences show that average increasing rate of social problems during recent years is 15% annually. Albeit, it is not possible to draw the increasing or decreasing trend of social health indices precisely since past 2 decades due to the lake of surveillance system. Several social problem reduction and social health improvement interventions are running by organization but, inadequate sensitivity of responsible persons, not to evaluate the current interventions, inadequate utilization and coverage of population from primary level preventive services, inappropriate selection of essential interventions, allocation of most available resources to tertiary level of prevention [after harm services], weakness of activity implementation system and intersectoral collaboration for executing interventions, disintegration of social health related financial resources and inadequate sensitivity and competencies of people in combating to social problems and risks are obstacle to effective interventions in improving social health indices. Economical, political, international and technological big changes should be added to these reasons. Social health progress will not be achieved without intersecotral collaboration; Improvement of existing situation is not under duties and responsibilities of MOHME, so proposed direction including vision, strategic objectives and interventions, for social health should be implemented partially by MOHME; Remaining parts required advocacy to be done by other sectors. It is essential that the proposed program be approved in health policy council of MOHME for implementation of this direction and achieving to it's objectives and then be approved by health and food security high council and social council of country; after that the intersectoral collaboration agreements of social health improvement should be supervised deeply