ABSTRACT
BACKGROUND: Nowadays, emergencies and disasters are considered one of the biggest problems in human life. To reduce the risk of emergencies and disasters, governments must develop strategies and policies using evidence-based methods. Disaster databases are the main source and tool for storing and managing a wide range of data in this field. This study was conducted with the aim of exploring the necessary criteria and components of the emergency and disasters database in Iran. MARTIALS AND METHODS: This qualitative study was performed using content analysis in which 18 managers and experts with experience in registering, documenting, or responding to emergencies and disasters were selected through purposive sampling. Data collection was done using semi-structured interviews that continued until saturation. Data were analyzed by means of qualitative content analysis recommended by Landman and Graneheim. RESULTS: In total, three main concepts concerning the necessary criteria and components of the database of natural and artificial emergencies and disasters in Iran were explored. The main concepts include information resources, information evaluation, and information management. Subconcepts include data collection, information transfer, access to information, information validation, disaster leveling, information registering, information storage and retrieval, information analysis, and information dissemination. CONCLUSION: The experience of the participants showed that there are many challenges in the field of monitoring and gathering information about injuries and damages caused by emergencies and disasters in the country. The knowledge obtained from this study can be used to create and develop a database of emergencies and disasters in Iran. It will also provide insights for healthcare policymakers and managers in future planning areas to more effectively address identified challenges in preventing and responding to disasters at both regional and national levels.
ABSTRACT
BACKGROUND: The first case of COVID-19 was reported in Iran on February 19, 2020, in Qom. Since Mazandaran is one of the high-risk provinces with many patients and deaths, this study was conducted to investigate the epidemiological characteristics of COVID-19-related deaths in Mazandaran. MATERIALS AND METHODS: In this descriptive study, demographic information and clinical findings in patients who died following COVID-19 in the medical centers of Mazandaran University of Medical Sciences from February 8, 2020, to October 10, 2020, were extracted. Data were analyzed by using SPSS 21. Logistic regression was used to compare the data. P < 0.05 was considered as the significance level. RESULTS: Out of a total of 34,039 patients admitted during the 8 months, 2907 patients died. Of these, 1529 (52%) were male, and the rest were female. In terms of age, 10 cases in the age group of fewer than 15 years, 229 cases in the age group of 15-44 years, 864 patients in the age group of 45-64 years, and 1793 people in the age group of 65 years and over died. 2206 people (more than 75%) by personal visit referred to medical centers. The mortality rate was more than 8 cases per 100 hospitalized patients. Men were 16% more likely to die from COVID-19 than women. DISCUSSION AND CONCLUSION: Older adults over 65 have the highest incidence and death rate due to this disease. The incidence rate was higher in women, and the death rate was higher in men, which differs from the national pattern.
ABSTRACT
BACKGROUND: With the unprecedented expansion of COVID-19 in the world since December 2019, Iran's health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations. METHODS: The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously. RESULTS: Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community. CONCLUSIONS: According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions.
Subject(s)
COVID-19 , Pandemics , Humans , Iran/epidemiology , Qualitative Research , SARS-CoV-2ABSTRACT
Acceptance and willingness to receive the vaccine are among the main factors in the success or failure of a health system in implementing the vaccination program. The present study was conducted in Tehran, the political and economic capital of Iran, to determine the acceptance of the COVID-19 vaccine and identify its associated factors, and explain the most important barriers and acceptance strategies for vaccination. This research was a concurrent quantitative and qualitative mixed-method study. In the quantitative part, 1200 individuals aged more than 18 years were selected from the households in 22 districts of Tehran City, with a multistage stratified cluster sampling method. Two questionnaires were used to evaluate the acceptance of the COVID-19 vaccine and vaccine acceptance determinants. The qualitative content analysis method addressed the influencing factors, as well as challenges and strategies related to the acceptance of the COVID-19 vaccine in four groups of Tehran inhabitants: the elderly, people with underlying diseases, healthcare workers, and the general population. The related data were simultaneously collected by applying in-depth semi-structural interviews and a data analysis process. Furthermore, we used the Graneheim and Lundman method for data analysis. We analyzed the data of 1200 people with a mean (SD) age of 46.4 (11.1) years, and approximately 58% of them were men. The vaccine acceptance was 83.6% (95% CI: 81.3-85.9). Among those who welcomed vaccination, 58% preferred the imported vaccines, 25% the Iranian ones, and 17% both. There was a significant association between the variables of age (adjusted odds ratio [AOR] = 1.72, 95% CI: 1.01-2.93), being single (AOR = 0.54, 95% CI: 0.41-0.91), moderate pharmacotherapy adherence (AOR = 0.58, 95% CI: 0.4-0.85), and the willingness to receive COVID-19 vaccine. Qualitative study after interviewing 45 people from four study groups showed an insufficient social trust in healthcare system officials, pharmaceutical and vaccine production companies; distrust in the effectiveness of the vaccines, concerns about the vaccine adverse effects, being tracked by microchips after vaccination, traditional anti-vaccination movements, the feeling the inessentiality of vaccination, and uncertainty about the fair distribution of the vaccine. These concerns were the main challenges addressed by the study groups. A good proportion of Tehran residents reported their willingness to receive the COVID-19 vaccine. Additionally, they expressed their critical concerns, such as insufficient trust in the healthcare system, vaccine safeties, and adverse effects that were the significant barriers to vaccine acceptance. It seems that conflicts raised by the shortage of vaccines and their import due to the sanctions have led to intense desire and demand in the general population, and especially the elderly, for vaccination. Besides, vaccination phobia in some individuals requires further investigations.