People's Voice and Civil Society Participation as a Core Element of Universal Health Coverage Reforms: Review of Experiences in Iran.

Health governance challenges can make or break universal health coverage (UHC) reforms. One of the biggest health governance challenges is ensuring meaningful participation and adequately reflecting people's voice in health policies and implementation. Recognizing this, Iran's Health Transformation Plan (HTP) lays out the country's blueprint for UHC with an explicit emphasis on the 'socialization of health.' 'Socialization' is seen as a key means to contribute to HTP objectives, meaning the systematic and targeted engagement of the population, communities, and civil society in health sector activities. Given its specific cultural and historical context, we sought to discern what notions such as 'civil society,' 'non-governmental organization,' etc mean in practice in Iran, with the aim of offering policy options for strengthening and institutionalizing public participation in health within the context of the HTP. For this, we reviewed the literature and analysed primary qualitative data. We found that it may be more useful to understand Iranian civil society through its actions, ie, defined by its motivation and activities rather than the prevailing international development understanding of civil society as a structure which is completely independent of the state. We highlight the blurry boundaries between the different types of civil society organizations (CSOs) and government institutions and initiatives, as well as high levels of overlaps and fragmentation. Reducing fragmentation as a policy goal could help channel resources more efficiently towards common HTP objectives. The National Health Assembly (NHA) model which was first launched in 2017 offers a unique platform for this coordination role, and could be leveraged accordingly.

A Qualitative Study of the Status of Children's Play From the Viewpoints of Experts and Suggestions for Promotion Interventions.

BACKGROUND: The latest national census reports the population of Iranian children (1 - 8 years old) about 11 millions. On the other hand, the latest population policies approved by supreme cultural revolution council (SCRC) will make this population increase faster. Childhood development is one of the social determinants of health, of which "child's play" is a part. OBJECTIVES: This study is an effort to identify difficulties and challenges of the plays influential on Iranian children's health nationwide, in order to present enhancive strategies by utilizing the views of stakeholders and national studies. PATIENTS AND METHODS: Analyzing children's play stakeholders, main organizations were identified and views of 13 informed people involved in the field were investigated through deep semi-structured interview. A denaturalized approach was employed in analyzing the data. In addition to descriptions of the state, interventions development, and designing the conceptual model, national reports and studies, and other countries' experiences were also reviewed. RESULTS: Society's little knowledge of "children's plays", absence of administrators for children's play, shortage of public facilities for children's play and improper geographical and demographic availability, absence of policies for Iranian "toy", and little attention of media to the issue are the five major problems as stated by interviewees. CONCLUSIONS: The proposed interventions are presented as "promoting the educational levels of parents and selected administrators for children's play", "approving the play and toy policy for Iran 2025", and "increasing public facilities for children's play with defined distribution and availability".

Knowledge and behaviors regarding early childhood caries among low-income women in Florida: a pilot study.

PURPOSE: This study evaluated the oral health knowledge and behaviors in pregnant women and mothers of young children in relation to early childhood caries to assess the need for an educational oral health program. METHODS: Interviews were conducted from a sample of 103 Medicaid-eligible participants; 56 pregnant women and 47 mothers with children under the age 6 in Florida. The data were collected using a 4-page questionnaire with closed-ended questions and analyzed using SAS/STAT 9.22. RESULTS: Overall, 79 of 101 study participants (78%) did not receive any dental care during pregnancy. There was a significant relationship between the frequencies of mother's tooth brushing and how frequently toddlers' teeth were brushed (C=0.29; p=0.04), and the mothers' self-reported oral health ratings and how frequently they brushed their toddlers' teeth (r2=0.29; p=0.03). CONCLUSION: Mothers' oral hygiene habits are significantly related to the oral hygiene habits of their children. Oral health education, during and after pregnancy, would be beneficial to promote healthier mouths for the mothers and their children.

Dropouts and social determinants of health; policy for the prevention of school dropout, qualitative study of the causes and interventions.

BACKGROUND: Indicators of the level of education are the most important parameters influencing each country's development. Social indicators considered to be a determinant of one's health consists of two constituents namely; (1) Rate of students enrolled in elementary, guidance, secondary and higher education and (2) the rate of adult literacy. This study is aimed to evaluate the situation of school dropouts in Iran, their causes, and appropriate interventions. METHODS: Data were collected through literature review (including published researches and analysis of documents), focus group discussions with the presence of experts from (Department of Community Health, Academy of Medical Sciences) and interviews with stakeholders then these data were classified and presented in three sections namely; current situation, causes and solutions. RESULTS: Results showed that Iran's current situation in terms of school dropouts is unsatisfactory in comparison to developed countries and in some countries in the region. Influencing factors for school dropouts were classified into (1) Individual factors such as intellectual disability and behavioral disorders (2) group factors such as peer groups, family problems and children's reduced interests in school and (3) major factors such as educational system and the changes of value, economic, cultural, and political issues. CONCLUSIONS: The present study, with the presentation of statistical documents specifically of the current problem of school dropouts in all levels of the Iranian society has been determined and aside from identifying the causes and factors affecting school dropouts, provision of strategies in three levels of prevention to combat this problem has been addressed.