RESUMEN
Background: Under-5 mortality is an important health indicator of a country's development and every country is committed todecrease it. Children under-5 years are vulnerable to the imbalance of socioeconomic inequality and are dependent on the adults toremain healthy. The aim of this study was to determine the association of socioeconomic factors with under-5 mortality in Zabol. Methods: This descriptive cross sectional study was performed on 2001 children younger than 5 years who were under the coverageof Zabol University of Medical Sciences between 2011 and 2015. The data were collected using standard questionnaires on mortality ofinfant and children 1-59 months old, questionnaires determining socioeconomic condition, and health center data files. The analyseswere performed using SPSS software version 21, and significance level was set at 0.05 for all tests. Results: The most common causes of death under 5 years of age included immaturity, congenital defects, and respiratory diseases. Inthe logistic regression model, father's addiction, maternal literacy, socioeconomic level, and household family size were significantlyassociated with under-5 mortality (P<0.05). Moreover, there was a correlation between a congenital defect in the Zahak region andimmaturity in the Hamun region with under-5 mortality. Conclusion: Low socioeconomic status, parental addiction, and low education level were the most probable risk factors for under 5mortality.
RESUMEN
BACKGROUND: Disrespectful and undignified care during childbirth has been documented in health facilities all over the world. The purpose of this study was to develop and pretest a new instrument, the Quality of Respectful Maternity Care Questionnaire in Iran (QRMCQI), with an ensured validity and reliability to evaluate and measure Respectful Maternity Care (RMC) in three sections of labor, delivery and post-partum. METHODS: This is a study with mixed sequential exploratory design. Here, the questionnaire design is a part of descriptive survey study and consists of five phases implemented in one year. The phases include item or questions generation, face validation, content validity assessment, confirmatory factor analysis and reliability assurance of the questionnaire. The participants were selected from the mothers referring to health care centers affiliated to Iran University of Medical Sciences in five cities after recruitment from hospital for after-care services of delivery. RESULTS: The primary questionnaire was developed, face validity was performed by experts and their comments were implemented. The content validity index (CVI), Kappa index and Content Validity Ratio (CVR) were calculated for each item and they were satisfactory in an acceptable range. Confirmatory factor analysis (CFA) showed good fit of the hypothesized model for 453 participants in the interview. Testing showed an acceptable internal consistency and reliability by calculating Cronbach's alpha coefficient for questions in labor (0.86), in delivery (0.85), and in postpartum care (0.78). CONCLUSION: We have developed a new instrument as the 59-item QRMCQI for evaluating respectful maternity care in Iran through a rigorous process of item generation and validity-reliability assessment besides confirmatory factor analysis that were in an acceptable range and can be used as a reliable instrument for RMC in Iran.
RESUMEN
BACKGROUND: Guidelines have produced and used in complex environment of health care system with its ethical, economical, legal and other aspects; that should be taken into account in any country. Modifying the format and content of guidelines might facilitate their usage and lead to improved quality of care and cost containment. We have produced this tool for explained above purpose. METHODS: A coordinating national team has settled at the office of minster of health and medical education, supported by a guideline review committee. An innovative and appropriate approach for adapting national health guidelines has consisted of eight steps, have defined For preparing the draft of each guideline a technical team which, including main author, her/his co-workers have nominated. The authors of each topic have systematically searched databases of the proposed Twenty-two International Sites, and then have selected at least five sources of them that were more relevant. The final recommendations have proposed by agreement of technical team and Guideline Review Committee. RESULTS: In less than 5 months, more than 500 authors in whole country have selected to prepare guidelines and, approximately 150 guidelines have provided in three volumes of the published and distributed book. Each guideline had a national ID number, constant forever; all topics should be reviewed every 3-5 years. CONCLUSION: National health guideline(s) would be essential means for policy making in health system and increased the cost containment and quality of care. Ministry of Health and Medical Education should provide and distribute the guidelines based on its accountability to legal responsibility.
