A conceptual framework for socializing the Iranian health system

Background: Socializing the health system is a new approach to participatory governance that aims to promote community health and enhance sustainable health equity in the community. This approach is a part of health system reform in the Islamic Republic of Iran. Aims: This study aimed to develop a conceptual framework for socializing the health system in the Islamic Republic of Iran as a theoretical basis for this reform. Methods: Data were gathered through a review of the literature, in-depth interviews, focus group discussions, and panel discussions. Participants were experts in the field of health systems within the health ministry and medical universities. Content analysis was used to analyse the data and identify core values, principles, and approaches for socializing the health system. Results: The core values identified included human dignity, equity, ethics, and trust. The principles were participation, empowerment, human rights, and responsiveness. The approaches identified were good governance, a health-oriented focus, capacity-building, a process-oriented method, and improvement in the social determinants of health. A strong political will was considered essential for socializing the health system. Conclusions: The conceptual framework outlines requirements for socializing the Iranian health system. As this is a new approach in health system governance, however, it needs to be refined and redefined through implementation and evaluation.

A study on preterm births during 2013-2015, Shiraz, Iran.

Preterm birth is the leading cause of neonatal and infant mortality and a substantial portion of neonatal morbidities. The perinatal mortality and morbidity statistics in developing countries are inadequate. In this study, we assessed prevalence and health outcomes of preterm deliveries in tertiary care university hospitals. A retrospective study of hospital records of premature babies born in all the five governmental tertiary care settings during the time interval of 2013-2015 in Shiraz was conducted. Result of this study showed that there was an overall 127.6 premature births per 1000 live births in the study duration. 23.8% of premature newborn had RDS and Incidence of prematurity with RDS was 82.4 per thousand live births. 52.6% of premature newborns were hospitalised in NICU and 8.5% had ROP. Five percent suffered from sepsis and 1% suffered from NEC. Overall mortality was nearly 10% of all the premature newborn. In conclusion, this study showed that premature births and its complications for newborn need to be addressed more in Iran. Impact statement Preterm birth is the leading cause of neonatal mortality and morbidities. Mortality and morbidity statistics related to preterm infants are important healthcare indicators implying the quality of the perinatal health care system and are prerequisite for the identification of problems and implementation of preventive measures. However, the perinatal mortality and morbidity statistics in developing countries are inadequate. The aim of this study was to assess prevalence and health outcome of preterm deliveries in tertiary care university hospitals in Shiraz city, Iran. This study showed that prematurity rate was 12.7%. Among preterm cases, 52.6% were admitted to NICU. RDS occurred among 23.8% of the total premature neonates and 8.2% of the total live births. The incidence of NEC was 1/0% of the total premature neonates and 0.4% of the total live births. The incidence of sepsis was 5% of the premature neonates and 1.9% of the total live births and the incidence of ROP was 8.5% among the premature neonate. The overall mortality of premature neonates was 9.9% of the total premature neonates and 1.2% of the total live births. Rigorous measures for prevention of premature births and its complications for newborns are required in Iran.

Exposure to chemical hazards in petrol pumps stations in Ahvaz City, Iran.

The objective of this study was to assess the level of exposure to BTEX (benzene, toluene, ethylbenzene, xylenes) in petrol pump stations in Ahvaz City. Two of the biggest fuelling stations were selected randomly among total 12 fuel stations of Ahvaz City, Iran, during September 2013. Thirty air samples were taken from different positions in the fuelling stations and 15 samples were taken from the personal breathing zone of operators and of customers in fuelling stations. Measuring the ambient concentration of benzene, toluene, ethylbenzene, and xylenes was done according to the method advised by National Institute for Occupational Safety and Health (NIOSH) 1501. This study showed that the concentration of benzene was very high (compared with the Iranian occupational exposure limit [OEL] standard) in ambient air of petrol stations in Ahvaz, which is considered as a high risk to the health of workers. Controlling the level of benzene in petrol stations is necessary. A new designed petrol nozzle was proposed for this purpose.