المؤلفون: Mohammad Mehdi Kiani, Hakimeh Mostafavi, Fatemeh Ebrahimi, Reza Majdzadeh, Efat Mohamadi, Alexander Kraemer, Alireza Olyaeemanesh, Amirhossein Takian

المصدر: BMC Health Services Research, Vol 24, Iss 1, Pp 1-8 (2024)

مصطلحات موضوعية: Sanction, Health, Chronic diseases, Rare diseases, Health impact, Iran, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Economic sanctions aim to exert pressure on political and economic foundations. Hypothesizing that sanctions might affect various aspects of population health, this study, as a component of a broader investigation to ascertain the trend effects of sanctions on selected health outcomes in Iran, seeks to explore the experiences of Iranian citizens associated with the imposed sanctions. Methods This is a qualitative study. We conducted 31 semi-structured interviews with randomly selected patients diagnosed with at least one chronic and rare disease from diverse backgrounds across four provinces in Iran. We analyzed data using an inductive content analysis approach, facilitated by the MAXQDA10 software. Results We identified three primary themes: direct effects, side effects, and coping strategies. The immediate effects were perceived to be manifested through the restriction of healthcare service availability and affordability for citizens. The side effects included the economic hardships experienced in individuals’ lives and the perceived devastation caused by these difficulties. Some coping mechanisms adopted by patients or their families/relatives included prioritizing comorbidities, prioritizing health needs within families with multiple ill members, and readjusting health/illness requirements in light of daily living needs. Conclusion In addition to the inherent burden of their illness, patients faced substantial healthcare costs as a result of sanctions, restricted access to medications, and availability of low-quality medications. We advocate considering these challenges within the healthcare system resilience framework as a crucial first step for policymakers, aiming to determine actionable measures and mitigate the adverse effects of sanctions on citizens, particularly the most vulnerable groups.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/1472-6963

URL الوصول: https://doaj.org/article/ba6854708e0a4bd8baf56e04c9396ef9

المؤلفون: Amirhossein Takian, Alireza Olyaeemanesh, Masoomeh Gholami, Mohammad Javad Kabir, Mehrdad Mohammadi

المصدر: BMJ Open, Vol 14, Iss 6 (2024)

مصطلحات موضوعية: Medicine

الوصف: Objectives This study aimed to identify the types of transparency interventions in the health systems of the low-income and middle-income countries and the outcomes of such interventions in those systems.Method We searched major medical databases including PubMed, Embase and Scopus, for any kind of interventional study on transparency in health systems. We also looked for additional sources of information in organisational websites, grey literature and reference checking. Using the PRISMA algorithm for identifying related studies, we included 24 articles.Results Our initial search, from 1980 to August 2021, retrieved 407 articles, 24 of which were narratively analysed. Response to a problem (mostly corruption) was the main reason for the initiation of a transparency intervention. Transparency interventions differed in terms of types, performance methods, collaboration partners and outcomes. They help improve the health system mostly in the short term and in some cases, long term.Conclusion Although our findings revealed that transparency initiatives could reduce some problems such as counterfeit drugs and corruption, and improve health indicators in a short term, still their sustainability remains a concern. Health systems need robust interventions with clearly defined and measured outcomes, especially sustainable outcomes to tackle corruption fundamentally.

وصف الملف: electronic resource

Relation: https://bmjopen.bmj.com/content/14/6/e081152.full; https://doaj.org/toc/2044-6055

URL الوصول: https://doaj.org/article/151837daecf44469887f79891c2e130e

المؤلفون: Leila Pouraghasi, Alireza Olyaeemanesh, Mehdi Jafari

المصدر: Health Technology Assessment in Action, Vol 8, Iss 2 (2024)

مصطلحات موضوعية: Universal Health Coverage, Utilization, Access, Pediatric Dentistry, Dental Care for Children, Economic biology, QH705-705.5

الوصف: Background: Poor oral and dental health significantly affects public health, impacting over half the world’s population. Dental caries can undermine children’s academic success and career prospects. Social inequities result in unequal access to oral healthcare, particularly among populations with lower socioeconomic status (SES). National policies that improve access to oral health can reduce these disparities. Objectives: This study aims to compile policies implemented by various countries to achieve universal health coverage (UHC) for pediatric dental services. Methods: This scoping review was conducted according to Arksey and O’Malley’s framework and is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A systematic search was conducted on databases including Scopus, PubMed, Magiran, SID, Irandoc, Google Scholar, the WHO website, and the databases of Iran’s Ministry of Health. The search aimed to identify literature discussing governmental steps taken to achieve UHC for pediatric dental health, published between January 1, 2011, and December 31, 2022. The results were charted and presented in a table. Results: This review included 22 studies. Six themes were identified based on the roles played by key players in this field, including schools, government policy and support, community-oriented preventive plans, insurance support, parents’ awareness, and inequality in accessing dental services. Conclusions: A comprehensive policy that reduces barriers to access, increases utilization, and engages all stakeholders—including parents, schools, and community centers—can effectively achieve UHC for pediatric dental health.

وصف الملف: electronic resource

Relation: https://htainaction.tums.ac.ir/index.php/hta/article/view/245; https://doaj.org/toc/2645-3835

URL الوصول: https://doaj.org/article/df9c17e5749e4ff6aedf352b33e6c9a0

المؤلفون: Efat Mohamadi, Zhila Najafpour, Mohammad Mehdi Kiani, Morteza Mohammadzadeh, Amirhossein Takian, Alireza Olyaeemanesh

المصدر: Journal of Health Sciences and Surveillance System, Vol 12, Iss 1, Pp 32-42 (2024)

مصطلحات موضوعية: produce health, sustainable development goals (sdgs), health, policy, contextual factors, Public aspects of medicine, RA1-1270

الوصف: Background: There are substantial differences in the health outcomes across countries. Then, assessment of the status of health indicators can give us a valuable information to adjust policies to improve the health status in the world. This paper examines differences and relationships of health status and contextual factors.Methods: This is a multi-country cross-sectional study performed using secondary data of different sources in 2019. We identified indicators that revealed the relationships of health status and health coverage and also contextual factors by expert panel which consist of two categories of indicators: (1) producing health indicators as dependent variables (Life expectancy, Healthy life expectancy, Maternal mortality ratio, Under-five mortality rate and Universal Health Coverage (UHC) service coverage indicator); (2) contextual indicators as independent variables (Current Health Expenditure, Skilled health professionals density, Population density and Government Type). Also, countries were categorized based on the income level and six regions of World Health Organization (WHO). We used SPSS 20 software for a descriptive analysis and R 2018 software for statistical analysis and also drawing of scatter charts.Results: Results showed a considerable gap between the average of life expectancy (84.2 vs. 53 years) and healthy life expectancy rate (72-63.3 years). This disparity was observed in the Maternal mortality and Under-5 mortality rate (from 882 to 3 per 100000 live births), (5 is 2.1 and the highest is 127.3). Although there was a marginal correlation between population density indicator and life expectancy, healthy life expectancy, and under-5 mortality rate indicators (±0.2), there was no correlation between population density and maternal mortality rate with UHC (P>0.05).Conclusion: There is a considerable difference between countries in producing health indicators based on contextual indicators; a comprehensive health system approach that can result in improvement in the health outcome.

وصف الملف: electronic resource

Relation: https://jhsss.sums.ac.ir/article_49814_e602afc17c03aff3f9faa9782d4ff18e.pdf; https://doaj.org/toc/2345-2218; https://doaj.org/toc/2345-3893

URL الوصول: https://doaj.org/article/9fc984480005495d9c2efcb7518a4ba3

المؤلفون: Alireza Olyaeemanesh, Amirhossein Takian, Hakimeh Mostafavi, Mohammadreza Mobinizadeh, Ahad Bakhtiari, Fateme Yaftian, Abbass Vosoogh-Moghaddam, Efat Mohamadi

المصدر: International Journal for Equity in Health, Vol 22, Iss 1, Pp 1-13 (2023)

مصطلحات موضوعية: Health Equity, Inequality in health, Health Equity Impact Assessment (HEIA), Health Impact Assessment (HIA), Health Policy, Public aspects of medicine, RA1-1270

الوصف: Abstract Introduction Health Equity Impact Assessment (HEIA) is a decision support tool that shows users how a new program, policy, or innovation affects health equity in different population groups. Various HEIA reporting and dissemination tools are available, nevertheless, a practical standard tool to present the results of HEIA in an appropriate period to policymakers is lacking. This work reports the development of a tool (a checklist) for HEIA reporting at the decision-making level, aiming to promote the application of HEIA evidence for improving health equity. Methods This is a mixed-method study that was carried out over four stages in 2022–2023: 1) identifying HEIA models, checklists, and reporting instruments; 2) development of the initial HEIA reporting checklist; 3) checklist validation; and 4) piloting the checklist. We also analyzed the Face, CVR, and CVI validity of the tool. Results We developed the initial checklist through analysis of 53 included studies and the opinions of experts. The final checklist comprised five sections: policy introduction (eight subsections), managing the HEIA of policy (seven subsections), scope of the affected population (three subsections), HEIA results (seven subsections), and recommendations (three subsections). Conclusion Needs assessment, monitoring during implementation, health impact assessment, and other tools such as monitoring outcome reports, appraisals, and checklists are all methods for assessing health equity impact. Other equity-focused indicators, such as the equity lens and equity appraisal, may have slightly different goals than the HEIA. Similarly, the formats for presenting and publishing HEIA reports might vary, depending on the target population and the importance of the report.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/1475-9276

URL الوصول: https://doaj.org/article/baf5f661d51d44148668f25745ca49cf

المؤلفون: Marita Mohamadshahi, Nafiseh Hosseini Yekta, Mahshid Chaichi-Raghimi Chaichi-Raghimi, Mohammadreza Mobinizadeh, Zeinab Fakoorfard, Parisa Aboee, Alireza Olyaeemanesh, Zahra Gharib-Naseri

المصدر: Health Technology Assessment in Action, Vol 8, Iss 1 (2024)

مصطلحات موضوعية: Traditional Persian Medicine, Non-Alcoholic Fatty Liver, Cost-Effectiveness, Economic biology, QH705-705.5

الوصف: Background: In the context of Persian traditional medicine, there are several therapeutic strategies for managing diseases, ranging from lifestyle changes to herbal remedies. Objectives: Given the application of Persian traditional medicine in the management of chronic diseases, the burden of chronic illnesses, and the public’s recourse to traditional medicine specialists, this study aimed to assess the cost-effectiveness of traditional medicine dietary regimens for the treatment of non-alcoholic fatty liver disease from the perspective of the payer. Methods: In this study, we investigated the cost-effectiveness of providing nutrition counseling for lifestyle modification (changes in the aforementioned Setteh-e-Zarurieah) by a traditional medicine specialist compared to receiving counseling from a nutritionist for nonalcoholic fatty liver disease from the payer’s perspective. The outcomes measured were changes in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes, body mass index (BMI), and the grade of fatty liver. Cost and effectiveness data were entered into Excel software, and the ICER ratio was calculated. Results: The results indicated that the dietary regimen prescribed by Persian traditional medicine when compared to the nutritionist’s recommended diet, resulted in a lower decrease in AST and ALT enzymes but led to a greater decrease in BMI (mean change = 0.42) and a significant change in the grade of fatty liver (OR = 9.75). Since the costs of tests, ultrasounds, and visits were equal in both groups, the cost difference was zero. In the first scenario, where traditional medicine is considered an alternative therapy and liver enzymes are the primary focus, providing nutritional counseling services by Persian traditional medicine may not be cost effective. However, if we consider the grade of fatty liver and BMI as the primary variables, providing nutritional counseling services by Persian traditional medicine may be cost-effective. Conclusions: Based on the available evidence, the treatment of fatty liver using Persian traditional medicine can be considered an effective and cost-effective complementary (or alternative) intervention. Considering the long-term costs imposed by the health system and insurance organizations, it is predicted that adding visits to Persian traditional medicine specialists may reduce overall healthcare system costs.

وصف الملف: electronic resource

Relation: https://htainaction.tums.ac.ir/index.php/hta/article/view/212; https://doaj.org/toc/2645-3835

URL الوصول: https://doaj.org/article/99a8e5b849de4582a530438f089cbbe7

المؤلفون: Nafiseh Salehnia, Abbas Assari Arani, Alireza Olyaeemanesh, Hossein Sadeghi Saghdel

المصدر: علوم بهداشتی ایران, Vol 11, Iss 2, Pp 75-86 (2023)

مصطلحات موضوعية: social determinants of health, public health, population health, health policy, Medicine (General), R5-920

الوصف: Background and Purpose: In recent decades, research has shown that social determinants of health (SDH) affect population health more than medical care. Therefore, identifying the SDH has become a top priority. Materials and Methods: It is an explanatory-sequential mixed-method study. We used the meta-synthesis method in the first step to identify and prioritize social determinants of population health in Iran. Then, the identified factors were shown in a semantic map. Afterward, we used fuzzy Delphi to screen and determine each factor’s importance in Iran. Results: A total of 172 factors were identified and classified into 4 levels: individual, local, national, and global. After screening items, parental competence, hope, addiction, types of pollution, inflation, and unemployment rate (the crisp value of defuzzification 9-10) are generally the most important determinants of population health at the individual and national levels in Iran. Conclusion: The resulting semantic map of SDH demonstrates the substantial effect of non-health policies on the health of Iran’s population. This finding proposes health as a complex and comprehensive system needing an interdisciplinary approach to address its multiple determinants. Specifically, the comparative analysis of this research shows that among the determinants of health in Iran, parental competence, individual behaviors such as addiction, and spiritual and mental health, including depression, suicide, and stress, are the most important SDH in Iran.

وصف الملف: electronic resource

Relation: http://jhs.mazums.ac.ir/article-1-855-en.pdf; https://doaj.org/toc/2322-553X; https://doaj.org/toc/2322-4797

URL الوصول: https://doaj.org/article/75b4d5ad583641838082656127484fa5

المؤلفون: Amitis Ramezani, Rahim Sorouri, Saiedeh Haji Maghsoudi, Sarah Dahmardeh, Delaram Doroud, Mona Sadat Larijani, Sana Eybpoosh, Ehsan Mostafavi, Alireza Olyaeemanesh, Mostafa Salehi-Vaziri, Anahita Bavand, Ghazaleh Zarghani, Ladan Moradi, Fatemeh Ashrafian, Fahimeh Bagheri Amiri, Parisa Mashayekhi, Zahra Tahmasebi, Alireza Biglari

المصدر: Scientific Reports, Vol 13, Iss 1, Pp 1-9 (2023)

مصطلحات موضوعية: Medicine, Science

الوصف: Abstract The optimal booster vaccine schedule against COVID-19 is still being explored. The present study aimed at assessment of the immunogenicity and antibody persistency of inactivated-virus based vaccine, BBIP-CorV and protein-subunit based vaccines, PastoCovac/Plus through heterologous and homologous prime-boost vaccination. Totally, 214 individuals who were previously primed with BBIBP-CorV vaccines were divided into three arms on their choice as heterologous regimens BBIBP-CorV/PastoCovac (n = 68), BBIBP-CorV/PastoCovac Plus (n = 72) and homologous BBIBP-CorV (n = 74). PastoCovac booster recipients achieved the highest rate of anti-Spike IgG titer rise with a fourfold rise in 50% of the group. Anti-RBD IgG and neutralizing antibody mean rise and fold rise were almost similar between the PastoCovac and PastoCovac Plus booster receivers. The antibody durability results indicated that the generated antibodies were persistent until day 180 in all three groups. Nevertheless, a higher rate of antibody titer was seen in the heterologous regimen compared to BBIP-CorV group. Furthermore, no serious adverse event was recorded. The protein subunit-based booster led to a stronger humoral immune response in comparison with the BBIP-CorV booster receivers. Both the protein subunit boosters neutralized SARS-CoV-2 significantly more than BBIP-CorV. Notably, PastoCovac protein subunit-based vaccine could be successfully applied as a booster with convenient immunogenicity and safety profile.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/2045-2322

URL الوصول: https://doaj.org/article/8d9efc4af8e341c0b3b0fc6327053195

المؤلفون: Ahad Bakhtiari, Amirhossein Takian, Alireza Olyaeemanesh, Masoud Behzadifar, Afsaneh Takbiri, Saharnaz Sazgarnejad, Sahar Kargar

المصدر: International Journal of Public Health, Vol 68 (2023)

مصطلحات موضوعية: migrant and refugee health, healthcare access, SWOT analysis, health systems, Iran, Public aspects of medicine, RA1-1270

الوصف: Objective: Iran is one of the main hosts of Afghan refugees. This study aims to provide comprehensive evidence to increase Afghan migrants’ access to healthcare services in Iran.Methods: To assess the health system’s response to Afghan migrants in Iran, we conducted three phases for SWOT analysis, including: 1-developing a review and comprehensive analysis of documents, laws, and, programs, 2-conducting semi-structured interviews with policymakers and experts, and 3-mapping the results through the Levesque’s conceptual framework for healthcare access.Results: We evaluated the response of the health system to Afghan migrants’ health needs in three domains: 1-Approachability and ability to perceive migrants; 2-Ability to reach, engage, and availability and accommodation and appropriateness; 3-The ability to pay and affordability. For each of the three domains, we identified strengths, weaknesses, opportunities, and threats, complemented with evidence-based suggestions to improve migrants’ access to needed healthcare services.Conclusion: Given the rising trend of immigration and deteriorating financial crises, we recommend appropriate strategies for the adoption of specialized focus services, gateway services, and restricted services. Also simplifying financial procedures, and implementing innovative insurance mechanisms are essential.

وصف الملف: electronic resource

Relation: https://www.ssph-journal.org/articles/10.3389/ijph.2023.1606268/full; https://doaj.org/toc/1661-8564

URL الوصول: https://doaj.org/article/616bcc315ff04ea39c49e8a255adda52

المؤلفون: Mahin Nomali, Neda Mehrdad, Mohammad Eghbal Heidari, Aryan Ayati, Amirhossein Yadegar, Moloud Payab, Alireza Olyaeemanesh, Bagher Larijani

المصدر: Health Science Reports, Vol 6, Iss 8, Pp n/a-n/a (2023)

مصطلحات موضوعية: challenges, clinical research, COVID‐19, narrative review, pandemics, Medicine

الوصف: Abstract Background and Aims The COVID‐19 pandemic has presented significant challenges to clinical research, necessitating the adoption of innovative and remote methods to conduct studies. This study aimed to investigate these challenges and propose solutions for conducting clinical research during the pandemic. Methods A narrative review was conducted (approval ID: IR.AMS.REC.1401.029), utilizing keyword searches in PubMed and Web of Science (WOS) citation index expanded (SCI‐EXPANDED) from January 2020 to January 2023. Keywords included COVID‐19, clinical research, barriers, obstacles, facilitators and enablers. Results Out of 2508 records retrieved, 43 studies were reviewed, providing valuable insights into the challenges and corresponding solutions for conducting clinical research during the COVID‐19 pandemic. The identified challenges were categorized into four main groups: issues related to researchers or investigators, issues related to participants and ethical concerns, administrative issues, and issues related to research implementation. To address these challenges, multiple strategies were proposed, including remote monitoring through phone or video visits, online data collection and interviews to minimize in‐person contact, development of virtual platforms for participant interaction and questionnaire completion, consideration of financial incentives, adherence to essential criteria such as inclusion and exclusion parameters, participant compensation, and risk assessment for vulnerable patients. Conclusion The COVID‐19 pandemic has significantly impacted clinical research, requiring the adaptation and enhancement of existing research structures. Although remote methods and electronic equipment have limitations, they hold promise as effective solutions during this challenging period.

وصف الملف: electronic resource

Relation: https://doaj.org/toc/2398-8835

URL الوصول: https://doaj.org/article/f19d394a04ba42fca561324b28b1fc7f