Policy Analysis Of Iranian Pharmaceutical Sector; A Qualitative Study.

INTRODUCTION: Improving public health through providing affordable and accessible pharmaceuticals is among the concerns of governments worldwide. This study aimed to analyze Iran's pharmaceutical sector policies in order to identify the challenges and suggest some strategic solutions to overcome such challenges. METHODS: Top managers (15), middle managers (10), and operational managers (5) working in the Food and Drug Administration of Iranian Ministry of Health along with community pharmacists (5) participated in a qualitative study using semi-structured in-depth interviews. Data were recorded, transcribed, and then analyzed via MAXQDA 10 software. RESULTS: Policies for national pharmaceutical sector were divided into four groups of "research & development", "import & export", "pharmaceutical procurement", and "pharmaceutical supply and distribution". Then, the challenges faced by each sector were extracted. Considering the challenges, some policy options were recommended for growth and development of national pharmaceutical sector. CONCLUSION: Iran's pharmaceutical sector has managerial and administrative differences compared with overseas pharmaceutical sectors. These differences are the main reasons for the current status of Iran's pharmaceutical sector and have put Iran behind foreign pharmaceutical sectors. Iran's pharmaceutical sector has endured many critical periods during recent decades and has gained great experience during these stages. Therefore, it is believed that Iran's pharmaceutical sector, with its experience and potential, is capable of producing world-level medicines.

Empowerment of type 2 diabetic patients visiting Fuladshahr diabetes clinics for prevention of diabetic foot.

AIMS: Diabetic foot is one of the most serious and costly complications of diabetes. Empowerment is an important indicator in promoting foot care behaviors that helps patients to use their maximum abilities. This study was carried out with the aim of empowering patients with type 2 diabetes to prevent diabetic foot in the city of Fuladshahr, Isfahan, Iran. METHODS: This is a quasi-experimental study. 104 eligible patients were randomly assigned to two groups: intervention group and control group. The data were collected through a form of profile, empowerment questionnaire, and foot care behavior checklist. The questionnaires were completed by the two groups in the pre-intervention, 1 and 3 months after the end of the intervention. Data were analyzed in SPSS22 using independent t-test, paired t-test, Chi-square, ANOVA, LSD post hoc test and repeated data analysis. RESULTS: The results showed that there was no significant difference between two groups in terms of demographic variables. Independent t-test showed that there was no significant difference between the two groups in terms of mean score of empowerment and foot care behavior before intervention. However, the mean score of empowerment and foot care behavior of the experiment group was significantly higher than that of the control group in 1 and 3 months after the intervention (P < 0.001). CONCLUSION: The empowerment of diabetic patients is effective in promoting foot care behavior, and implementation of empowerment programs in diabetes clinics in this city is recommended.

Hospitals' readiness to implement clinical governance.

BACKGROUND: Quality of health services is one of the most important factors for delivery of these services. Regarding the importance and vital role of quality in the health sector, a concept known as "Clinical Governance" (CG) has been introduced into the health area which aims to enhance quality of health services. Thus, this study aimed to assess private and public hospitals' readiness to implement CG in Iran. METHODS: This descriptive and cross-sectional study was carried out in 2012. Four hundred thirty participants including doctors, nurses, diagnostic departments personnel, and support staff were chosen randomly from four hospitals (equally divided into private and public hospitals). Clinical Governance Climate Questionnaire (CGCQ) was used for data collection. Finally, data were entered into the SPSS 18 and were analyzed using statistical methods. RESULTS: Among the CG dimensions, "organizational learning" and "planned and integrated quality improvement program" scored the highest and the lowest respectively for both types of hospitals. Hospitals demonstrated the worst condition with regard to the latter dimension. Furthermore, both types of hospitals had positive picture regarding "training and development opportunities". Private hospitals scored better than public ones in all dimensions but there was only a significant difference in "proactive risk management" dimension between both types of hospitals (P< 0.05). CONCLUSION: Hospitals' readiness for CG implementation was "average or weak". In order to implement CG successfully, it is essential to have a quality-centered culture, a culture specified by less paperwork, more self-sufficiency, and flexibility in hospitals' affairs as well as centring on shared vision and goals with an emphasis on continuous improvement and innovation.