[3 years performances of the provincial health and food security councils in I.R. Iran: the way forward]

ABSTRACT

Improvement of national and provincial health indices requires intersectoral collaboration and community participation; So, National High Health and Food Security Council and Provincial Health and Food Security Councils [PHFSC] have been implemented since 2006. The main responsibilities of PHFSCs are, assessment of province health situation and effects of executive organizations on it's improvement, to define and approve the province health strategic plan, developing of AIDS and HIV prevention and control plan and resolving intersectoral issues of health. The goal of this study is first 3 years performance assessment of the PHFSCs. This is a descriptive evaluation study which included all the PHFSCs. The outcome assessment indicators were determined by content analysis of "the approved tasks" and also "the essential aspects for promoting of PHFSCs" by focus group discussions. Situational analysis was provided by two researcher made questionnaires; one for co Assessment of the contents of content analysis of PHFSCs all meetings minutes [from establishment year to the end of 2008] and another for gathering viewpoints of Secretaries of PHFSCs. Data analysis shows that the meeting's agendas of the PHFSCs have less followed the prioritized major health issues of provinces and national burden of diseases; most issues were in the domain of communicable disease control and non-communicable diseases risk factors control included scarcely. Only in two Universities of Medical Sciences [UMSc] province comprehensive health plan were proposed. None of the UMSc approved a secretariat for PHFSC in its organizational top chart. PHFSCs secretaries believed that, the main obstacles of the PHFSCs' successes, are weak financial resources, and lack of decisions executive enforcements. PHFSCs performances are moderate and moderate to low due to lack of comprehensive strategic plan and no implementation model for intersectoral decisions, other organizations believe on the effectiveness of the PHFSCs less and the main burden of disease of the provinces not mostly included in the agenda of PHFSCs. Following proposals are highly recommended for PHFSCs promotion training and empowerment of UMSc and organizations for developing comprehensive health plan in the province and defining the responsibilities of each organizations for, determining policy priorities of common health issues of the provinces by High Health and Food Security Council and publicizing them by the Ministry of Health and the other relevant ministries and approving the structure and working system of the PHFSC secretariat in UMS by the Board of Trustees of UMS