Cultural adaptation, validation, and standardization of a developmental screening tool (ASQ-3) in Iranian children.

Objectives: This study aimed at culturally adapting, validating, and standardizing the Ages and Stages Questionnaire, third edition (ASQ-3) by implementing a nation-wide cross-sectional methodological study in order to provide a valid and reliable tool for determining the developmental status of Iranian children. Materials & Methods: This cross-sectional and methodological study was conducted on Iranian children between 1-66 months. The ASQ-3 tool was translated; following that, its face and content validity, as well as the cross-cultural adaptation were assessed by 51 specialists and experts in the field of pediatrics and child development. In order to determine the reliability of the ASQ-3 (using Cronbach's alpha), and cut-off points. All statistical analyses were performed using STATA software. Results: This study was enrolled in 2 phases. The face and content validity, as well as the cultural relevance of the Persian version of ASQ-3 was confirmed using panel of specialists views then researchers investigated 11,740 children aged 1-66 months in order to evaluate the reliability of the tool. The Cronbach's alpha coefficients (reliability) determined for the ASQ-3 and the cut-off points for the ASQ-3 of different age groups and domains were determined by calculating one and two SDs below the mean; the latter represents the main cut-off point, and the interval between the two represents the monitoring zone according to the ASQ-3 technical manual. Conclusion: The results of this study showed that the Iranian version of ASQ-3 is valid and reliable; moreover, the cut-off points designated for it can be implemented in the Iranian children community to assess their developmental status.

Perform the Regulatory Process: A National Approach for Evaluation of the Pre-Hospital Emergency Information System in I.R. Iran.

Evaluation of Emergency Medical Services Management Information System (EMSIS) makes it possible to assess the extent to which the objectives of supporting of healthcare delivery services. This paper presents an overview of the regulatory process in prehospital EMS electronic data registration and provides a minimum data set for the purpose of developing such a care system on a national scale. It further offers an evaluation framework for such systems.

Toward an Agile System: Iranian Information System for Covid-19-Affected Patients Data Collection from Iranian Hospitals.

COVID-19's rapid spreads has caused a global pandemic. On 19th February 2020, Iran reported its first confirmed cases of infections in Qom City and the number of diagnosed cases and the death toll rose exponentially in March [1-3]. Managing the disease, which is considered a pandemic according to the World Health Organization (WHO) [4], requires definite approaches differing according to various factors in each country, which may also lead to (in)effective dealing with the disease. In addition, using international data and information, and WHO advice, especially in the crisis and therapeutic procedures, is one of the best crisis management strategies [5]. For every plan by governances, the first step is collecting information on epidemic distribution for the purpose of isolating provinces and cities at a national scale. Thus, Ministry of Health and Medical Education of Iran (MOHME) attempted to collect the minimum required data on the infection-affected patients based on medical records and epidemiological factors, such as demographic data (gender, age and national code), exposure history (close contact with the infected, suspect patients or even having traveled) and signs and symptoms (fever, cough, shortness or difficulties in breathing, fatigue, anorexia, hemoptysis, sputum production, dyspnea, Myalgia, Pharyngalgia, nausea, vomiting, Diarrhea, Headache, Abdominal pain, Dizziness, etc.). Therefore, to ensure accuracy and validity, and to speed up data collection in an area, Information Technology (IT) tools were required [6]. In this regard, developing an information system with a simple format and user-friendly interface in the shortest possible time was the aim. This study presents the local information system developed in March 2020, which has been registering hospitalized Covide-19-affected patients in Iranian hospitals up till now. In other words, this paper introduces features and procedures of one of the national systems as a health registry that includes clinical information on admitted Covid-19 patients in Iranian hospitals from admission to discharge or death. This system is supported by MOHME, and along with outpatient Point of Care Information Systems (POCS), feeds the national and international pandemic reports and decisions.

Mortality inequality in 1-59 months children across Iranian provinces: referring system and determinants of death based on hospital records.

BACKGROUND: To determine inequality in mortality in 1-59 months children across Iranian provinces focusing on referring system and determinants of death. METHODS: After designing and examining a national questionnaire for mortality data collection of children 1-59 months, 40 medical universities have been asked to fill in the questionnaires and return to the main researcher in the health ministry in 2009. RESULTS: Mortality in 1-59 months children was unequally distributed across provinces (universities). The recommended refer was 3466 but only 1620 patients were referred. The first five important determinants of death were congenital (671 children or 20.9%), accident (547 children or 17.1%), pulmonary diseases (370 children or 11.5%), cardiovascular (266 children or less than 8.3%), central nervous system (263 children or 8.2%), and infectious and parasitic diseases (245 children or 7.6%), respectively. CONCLUSIONS: Our results suggest that inequality in 1-59 months mortality based on the hospital records, and specially referring system, needs more attention in Iran. In addition, it is advisable to conduct provincially representative surveys to provide recent estimates of hospital access inequalities and to allow monitoring over time.

Distribution of mortality among 1 - 59 month-old children across Iranian provinces in 2009: the national mortality surveillance system.

OBJECTIVE: To determine the distribution of mortality in 1 - 59 month-old children across Iranian provinces in a national mortality surveillance system.  METHODS: This national survey was conducted in 2009. A questionnaire was designed and standardized for collecting mortality data of children aged 1 - 59 months. The project team, consisting of collaborators from the whole 40 medical universities, filled in the questionnaires and returned them to the Ministry of Health and Medical Education (MOHME). RESULTS: The mortality in 1 - 59 month-old children was unequally distributed across provinces. The mortality was higher among children of less- educated mothers than in children of more- educated mothers. There was a reverse association between 1 - 59 months mortality and socioeconomic status across Iran as a whole and within most provinces. CONCLUSION: Our results suggest that socioeconomic distribution in mortality of 1 - 59 month-old children favors the better-off in Iran as a whole and in most of its provinces. Investigating why mortality is higher in some provinces deserves special attention. Furthermore, it is advisable to conduct provincially-representative surveys to provide update estimates of different health situations and to allow their monitoring over time. 

Mortality-related factors disparity among Iranian deceased children aged 1-59 months according to the medical activities in emergency units: National mortality surveillance system.

BACKGROUND: To determine disparity in mortality-related factors in 1-59 months children across Iran using hospital records of emergency units. MATERIALS AND METHODS: After designing and validating a national questionnaire for mortality data collection of children 1-59 months, all 40 medical universities has been asked to fill in the questionnaires and return to the main researcher in the Ministry of Health and Medical Education. Age and sex of deceased children, the type of health center, staying more than 2 h in emergency unit, the reason of prolonged stay in emergency, having emergency (risk) signs, vaccination, need to blood transfusion, need to electroshock and so on have also been collected across the country. There was also a comparison of children based on their BMI. Chi-square test has been applied for nominal and ordinal variables. ANOVA and t-student test have been used for measuring the difference of continuous variables among groups. RESULTS: Mortality in 1-59 months children was unequally distributed across Iran. The average month of entrance to hospital was June, the average day was 16(th) of month, and the average hour of entrance to hospital was 14:00. The average of month, day and hour for discharge was July, 16, and 14:00, respectively. The hour of discharge was statistically significant between children with and without risk signs. More than half (54%) of patients had referred to educational hospital emergency units. There were no statistically significant differences between children with and without emergency signs. There were statistically significant differences between children with and without emergency signs in age less than 24 months (0.034), nutrition situation (P = 0.031), recommendation for referring (P = 0.013), access to electroshock facilities (P = 0.026), and having successful cardiopulmonary resuscitation (P = 0.01). CONCLUSION: This study is one of the first to show the distribution of the disparity of early childhood mortality-related factors within a developing country. Our results suggest that disparity in 1-59 months mortality based on hospital records in emergency units needs more attention by policy-makers. It is advisable to conduct provincially representative surveys to provide recent estimates of hospital access disparities in emergency units and to allow monitoring over time.