Health protection challenges of slums residents during the COVID-19 pandemic, according to the social determinants of health framework: A case study of Kerman city in Iran.

BACKGROUND: Coronavirus disease-2019 (COVID-19) pandemic can aggravate the health problems in slum areas. The present study intends to examine the challenges of health protection of slum's residences during the COVID-19 pandemic with the Social Determinants of Health perspective, in Kerman city in Iran. MATERIALS AND METHODS: The present study was a qualitative content analysis. Data were collected by purposeful sampling in-depth and semi-structured interviews with 16 people. The interviews were conducted (from October to December 2020) with the local representatives of the slum's residents, health-care workers, managers of facilitation offices, and welfare social service centers that are located in slum areas (Interview's guide is attached). The textual material from the interviews was entered into the MAXQDA software and directed content analysis was used to analyze the data. RESULTS: Data analysis led to the identification of 4 categories (Sociocultural, Situational, Economical, and Physical environment) and 12 subcategories: Sociocultural: lack of awareness, begging culture, low trust in disease control programs, low bottom-up planning, and increasing violence; Situational: decreasing donors' activities and canceling important meetings; Economical: unemployment, decreasing in income, and increasing limitations of many institutions in providing resources; and Physical environment: inadequate space and inappropriate conditions in some houses and alleys for people protection against Corona viruses. CONCLUSIONS: Slum residents have faced many challenges during the COVID-19 pandemic. These challenges can affect the health of slum and other urban dwellers. Multidisciplinary thinking and actions are needed. Increase awareness and engagement slum residents in control disease programs should be considered.

Basic Criteria, Models, and Indicators of Intersectoral Collaboration in Health Promotion: A Scoping Review.

BACKGROUND: In this study, the basic criteria, models, and indicators of intersectoral collaboration in health promotion were investigated to facilitate the implementation of collaboration. METHODS: This scoping review was conducted using datasets of Embase, Web of Science, Scopus, and PubMed, and search engines of Google, Google Scholar, and ProQuest. RESULTS: 52 studies were included, and 32 codes in Micro, Meso, and Macro level, were obtained. Micro-level criteria had the highest frequency. Among the models used in the reviewed studies, social network analysis, Diagnosis of Sustainable Collaboration, Bergen, and logic models had the highest frequency. Among the indicators studied, the number of participants and the level of collaboration as well as its sustainability were the most frequent indicators. CONCLUSION: The findings identified the most important and widely used criteria, models, and indicators of intersectoral collaboration in health promotion which can be useful for decision-makers and planners in the domain of health promotion, in designing, implementing, and evaluating collaborative programs.

Social Trends Affecting the Future of Iran's Health System: A Qualitative Study Using Focus Group Discussion.

BACKGROUND: Social issues have short- or long-term as well as positive or negative effects on health systems. Identifying and analyzing events and trends help managers to make the vision and strategic planning. The purpose of this study is to identify the social trends and their impacts on the future of the Iranian health system. METHODS: Focus group discussion (FGD) was used to collect the data in 2017--18. The participants were selected through purposive sampling and the snowball method. The discussions were all written and recorded with the consent of the participants. A qualitative content analysis was used to analyze the data. RESULTS: The participants believed that the most important social trends affecting future of health system in Iran are increase health literacy, demographic transition, nutritional pattern, migration and urbanization, marginal settlement, rising unemployment, and increased usage of personal cars. CONCLUSIONS: The increase in health problems, healthcare costs, and mortality because of social behaviors and trends are considered as threats to the health system. Therefore, policymakers should reduce their negative effects by taking into account and focusing on these trends and making appropriate plans.

The proportion of unmet costs considering inpatients billing of selected hospitals, after 2014 Health System reform implementation in Isfahan Province.

INTRODUCTION: Since 2013, in Iran's health care, the contribution of direct payments for health-care services was estimated more than 50 % of all expenditures. In May 2014, Iran's health-care reform was established to improve health services quality and reduce patients' out-of-pocket payments <10% in urban and 5% in rural areas. Therefore, the purpose of this study is to investigate unmet costs (those which are not covered either by the insurance companies nor the recent reform coverage mentioned in Sections 1.2.2 and 1.2.1, Article 6 of the Health Minister Reform Guideline) in the inpatient billings within the first 5 months from the reform implementation. METHODS: This study was conducted as a cross-sectional research in the second half of 2014 on the selected hospitals in Isfahan Province. Data were collected by investigating 97,000 inpatients' billing records issued by 28 hospitals affiliated to Isfahan University of Medical Sciences using census method. RESULTS: Findings of the study showed that the average of unmet costs paid by the inpatients constituted 21.8% of the total billing costs in 28 hospitals, and the average unmet costs paid by each patient was 1,903,832 Rials. CONCLUSION: Considering the definition of unmet cost in the context of health-care reform guideline and hospitals' problems in providing some costly services, drugs, and medical equipment (that were not covered by insurance organizations and the reform scheme) within the obligations of the reform, it is necessary to review these obligations and further interact with insurance companies about expanding the coverage to some costly services required by the patients.

Organizational Climate and Work Addiction in Shahid Sadoughi University of Medical Sciences, 2014: a Case Study.

INTRODUCTION: The occupational nature of employees in headquarters units of the University requires them to deal with support issues. Thus, there is some pressure on these employees to complete their assignments on time so that employees in the line units can accurately and expeditiously perform their duties. As a result, work addiction behaviors are sometimes observed among the headquarters personnel. Considering the importance of work addiction and recognizing the factors that intensify it, this study investigated the relationship between organizational climate and the work addiction of headquarters personnel at the Shahid Sadoughi University of Medical Sciences. METHODS: This descriptive-analytic study was conducted using stratified random sampling of 151 University employees in 2014. The data collection tool was an organizational climate questionnaire, which was supplemented by the Work Addiction Risk Test (WART). The data were analyzed using the Pearson test, Spearman test, independent t-test, Mann-Whitney test, one-way analysis of variance (ANOVA), and the Kruskal-Wallis test using IBM-SPSS version 20. RESULTS: The findings of this study showed that the organizational climate was at a moderate level, and employees were in the danger level in terms of work addiction. In addition, among the dimensions of organizational climate, the risk dimension had a significant relationship with work addiction (p<0.05), and the dimensions of structure and responsibility were significantly different from occupational group and monthly salary (p<0.05). Single employees showed a significant difference from married employees in the two dimensions of criteria and conflict (p<0.05). CONCLUSION: Since the organizational climate score was low and the work addiction score was at the high-risk level, this issue demands more attention of senior managers and human resource officers of organizations to improve the organizational climate and increase employees' awareness of work addiction.