The Role of Supplementary Insurance in Achieving Universal Health Coverage: A Comprehensive Review.

Background: The gradual movement towards universal health coverage (UHC) is an important issue in many countries. The aim of this study is to identify the role of supplementary health insurance in achieving universal coverage. Methods: This comprehensive review study was conducted to identify the role of supplementary health insurance in achieving universal health coverage. 4894 articles were found in the search in databases (Scopus, PubMed, and Web Science), and finally42 articles were selected. Considering the criteria of titles and abstracts, the reviewed articles were assessed, and a thematic analysis approach was used to analyze the collected data. Results: The review showed 52 Sub dimensions in 7 dimensions. Policymakers can draw on international experiences to ensure that private health insurance contributes to achieving universal health coverage by Providing clarity within the national health financing policy framework regarding the role of private health insurance. Enhancing understanding of how supplementary health insurance impacts the performance of the healthcare system. They are improving oversight of private health insurance, regulating financial protection and consumer support, and implementing thorough market surveillance and proper allocation of health subsidies between the private and public sectors. Conclusion: Supplementary insurance holds promise as a complementary tool in achieving universal health coverage. Addressing gaps in primary insurance and providing additional financial protection can contribute to enhanced access, improved quality of care, and reduced financial barriers to healthcare services. However, careful attention must be given to affordability, equity, regulation, and coordination with primary insurance schemes to ensure its effective implementation and prevent unintended consequences.

Network governance theory as basic pattern for promoting financial support system of the poor in Iranian health system.

BACKGROUND: The share of out-of-pocket payments in Iranian families has the greatest burden on the poor and lead to an impoverishment caused by catastrophic health expenditures. In order to improve access of the poor to public resources, it is necessary to create a better governance system and effective policy-making. The purpose of this study is to improve network effectiveness of the Iranian health system and to design a financial protection network for the poor, based on the network governance theory. METHODS: We are using a quantitative method framework in conjunction with a Social network analysis (SNA) strategy. To draw an optimal network, we conducted interviews with experts by focusing on the arrangement and relationship among different institutions. The research sample was purposefully selected. We used UCINET software for data analysis and NetDraw software to draw networks. RESULTS: In this article, an optimal network was proposed with the following characteristics: First, the problem of the density of relationships among several central institutions and the isolation of the other institutions have been solved. Second, in our model, the relationships have been distributed in a balanced manner among all institutions in the network. Third, the number of participants has been reduced and consensus on poor people support policies has been achieved in this optimal network. Forth, executive organizations keep their central positions and upper institutions are not at the central position, so that the power is distributed in favor of more balanced governance. However, in order to increase efficiency and to have coherent decision-making, it is necessary to establish a "core" for this optimal network. The "core" has to include the organizations with the most relationship with others. CONCLUSION: The result revealed that the usefulness of network analysis as a tool for proposing the effectiveness of governance. By strengthening the relationship among the main actors, an organized system of network management can be achieved. The network has to include all actors from different levels, from policy-making to implementation. The network also has to clarify the tasks from identifying the poor to covering costs. From an academic perspective, this study showed the adequacy of network analysis as a tool for policy sciences. Governance in our optimal health financial protection model follows the shared-governance pattern due to its high density, low centralization and low distance. The model of network governance can be the source of changes in the health governance system. It is a necessary structural condition to provide access to universal health coverage.

Core competencies for health headquarters: a systematic review and meta-synthesis.

BACKGROUND: The availability of human resources for the health sector is not enough requirement for addressing health needs. Instead, it is necessary to take effective steps to meet the requirements of the health care system in case the system has the necessary competencies. This study was performed to identify the competencies of health headquarters in meeting the needs of the health system. METHODS: This thematic synthesis was performed to develop a set of central themes that summarize all the topics raised in the articles reviewed in this study. The quality of the articles was assessed by the Standards for Reporting Qualitative Research. RESULTS: We included 12 articles from seven countries. Seven central themes were inductively developed from the analysis: (1) Leadership and management, (2) Analyzing, interpreting, and reporting, (3) Public health knowledge, (4) Interpersonal relationship, (5) Personality competencies, (6) Cultural and community competencies, and (7) International/Global health competencies. CONCLUSION: The findings of this review may help to address how to recruit and retain health headquarters, optimize the headquarters ability and expertise, and develop some approaches to promote their scientific, practical, and professional levels. These issues can drive the organization toward their visions, strategies, and great objectives.

Prevalence of Psychiatric Disorders in Iran: A Systematic Review and Meta-analysis.

The prevalence of mental disorders in Iran is rising for many reasons including the population growth and its problems, the collapse of the family foundation, the economic problems, etc. Epidemiological studies of psychiatric disorders play an important role in determining the general mental health of the population and policy-making and future planning of service delivery. To identify the relevant studies, two authors independently searched different scholarly databases including Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, Psych INFO, and Iranian databases such as MagIran, SID, IranPsych, and Irandoc from 1st January 2007 up to 1st July 2018. The gray literature (through Google Scholar) was also mined. Studies written in English or in the Persian language were searched. After searching the databases and removing duplicates cases, a total of 10 studies were selected and included in the study, which reported a total of 14 prevalence rates. There were a total of 72,262 participants, of whom 32,925 were male and 39,337 were female. The prevalence of psychiatric disorders in studies which used screening tool was 31.03% (95% confidence interval: 25.99-36.07). The prevalence was 25.42% in studies which used clinical interviews (95% CI: 15.96-34.88). There is an undeniable fact that the prevalence of mental disorders in Iran has been increasing, and this could be a warning to policy-makers and health system managers. Hence, it is necessary to pay attention to this issue to maintain social capital, vitality, and efficiency of individuals and society as a whole.

Assessing Iran's health system according to the COVID-19 strategic preparedness and response plan of the World Health Organization: health policy and historical implications.

BACKGROUND: The role of health systems in the management of disasters, including natural hazards like outbreaks and pandemics, is crucial and vital. Healthcare systems which are unprepared to properly deal with crises are much more likely to expose their public health workers and health personnel to harm and will not be able to deliver healthcare provisions in critical situations. This can lead to a drammatic toll of deaths, even in developed countries. The possible occurrence of global crises has prompted the World Health Organization (WHO) to devise instruments, guidelines and tools to assess the capacity of countries to deal with disasters. Iran's health system has been hit hardly by the COVID-19 pandemic. In this study, we aimed to assess its preparedness and response to the outbreak. METHODS: The present investigation was designed as a qualitative study. We utilized the "COVID-19 Strategic Preparedness and Response Plan" devised by WHO as a conceptual framework. RESULTS: The dimension/pillar which scored the highest was national laboratories, followed by surveillance, rapid response teams and case investigations. Risk communication and community engagement was another pillar receiving a high score, followed by infection prevention and control and by country-level coordination, planning and monitoring. The pillars/dimensions receiving the lowest scores were operational support and logistics; case management; and points of entry. DISCUSSION: The COVID-19 pandemic has represented an unprecedent event that has challenged healthcare systems and facilities worldwide, highlighting their weaknesses and the need for inter-sectoral cooperation and collaboration during the crisis. Analyzing these experiences and capitalizing on them, by strengthening them,will help countries to be more prepared to face possible future crises.

Emergency health evaluation of affected population during disasters: Are there new approaches?

INTRODUCTION: Disasters are inescapable phenomena. Once they occur, reliable and objective information becomes vital in sound decision-making to respond. Emergency health evaluation of affected population can be used to gather information about the patterns of access to medical care, basic household needs, and other health needs. The objective of this review was to summarize evidence from scientific studies on the various methods of emergency health evaluation following disasters. MATERIALS AND METHODS: A comprehensive list of studies was provided in May 2017 by an extensive search using PubMed, Web of Sciences, Ovid Medline, ProQuest Research Library, and World Health Organization Library. RESULTS: Of the 1592 retrieved articles, 21 articles were included in this review. In a majority of the studies (n = 18), a questionnaire was used and an interview was conducted to collect information, but in three studies, smartphone-based methods were used. Sampling method in most of the studies was cluster sampling in Community Assessment for Public Health Emergency Response method. But in eight studies, random sampling method was used. In a majority of the studies, the demographic status of samples and in 18 studies, the condition of diseases, water, shelters, health, food, mortality rate, and existing medical services were investigated. CONCLUSIONS: Although new methods such as social media and smartphones were already investigated in some articles, but these approaches require further investigation since there is a growing need for new methods.

A Comparative Study on Different Pharmaceutical Industries and Proposing a Model for the Context of Iran.

Medication is known as the main and the most effective factor in improving public health. On the other hand, having a strong and effective pharmaceutical industry will, to a very large extent, guarantee people's health. Therefore, this study was prospected to review the different pharmaceutical industries around the world and propose a model for the context of Iran. This is a qualitative as well as a comparative study which was carried out in 2015. At the first stage, using the World Bank website, countries were divided into four groups of low-income, lower-middle-income, upper-middle-income, and high-income economies. Then, four countries of Afghanistan, India, Brazil, and Canada were chosen from these four groups, respectively. Secondly, data gathered from these countries were given to two 12-member expert panels. Finally, using the articles and the results of expert panel groups, useful and effective policies were extracted for the growth and development of Iran's pharmaceutical industry. Findings of the study indicated that the following seven items are the essential policies for the context of Iran: establishment of high academic centers as well as research institutes, using weak patent law, supporting research and development centers at universities and pharmaceutical companies, backing national pharmaceutical companies up, implementing generic rules, gradual economic liberalization, and membership in world trade organization. Since, pharmaceutical industry is an effective and inseparable part of every health system, proper and evidence-based policies should be taken into account in order to develop this industry and, ultimately, meet the public needs.

Average medical visit time in Iran: A systematic review and meta-analysis.

Background: Visit length is an indicator that can be used to assess patients' satisfaction of the health care services. In recent years, some studies have focused on the mean visit time in Iran. This study aimed at determining the average visit time in Iran by performing a systematic review and meta-analysis. Methods: In this study, Embase, PubMed/MEDLINE, Scopus, ISI/Web of Science databases, and Google Scholar search engine, as well as Iranian national databases/thesauri, such as MagIran, SID, and Irandoc were used. These databases were searched from their inception until September 2017. The quality of retained studies was assessed using the STROBE checklist. Average visit length was reported using stochastic model with 95% confidence interval (CI). I2 and Q tests were used to assess the heterogeneity of the studies. A sensitivity analysis was conducted to ensure the stability of the results. Results: After searching the scholarly databases and reviewing the articles based on inclusion and exclusion criteria, 6 studies were finally selected. Based on the random model, the mean visit time was 4.89 minutes in Iran, ranging from 4.66 to 5.12 minutes (p=0.82). The most time visit in specialists belonged to psychiatrists with 9.12 (7.28 to 10.96) minutes (p=0.19) and the lowest belonged to internists with 3.59 (2.24 to 4.95) minutes (p=0.00), respectively. Conclusion: The average visit time in Iran was estimated to be 4.89 minutes. To increase patients' satisfaction and provide a better disease treatment and management in Iran, the following suggestions could be helpful: properly distributing physicians across the country, reducing waiting lists, and implementing the use of guidelines to standardize the visit time.