Challenges facing international students at Iranian universities: a cross-sectional survey.

BACKGROUND: This study examines the challenges faced by international students at Tehran University of Medical Sciences (TUMS) and provides insights into their experiences and needs. METHODOLOGY: A self-developed structured questionnaire was administered to international students who completed their first year at TUMS. Data were collected from 165 participants (76% response rate) and analyzed using SPSS 22.0. RESULTS: The study reveals that international students encounter various challenges, including difficulties accessing information, language barriers, ineffective communication, administrative inefficiencies, cultural issues, financial constraints, and limited scholarship opportunities. Analysis of students' characteristics indicates that the length of study at TUMS is significantly associated with the challenges experienced. The findings highlight the importance of enhancing support services and resources for international students, such as language classes, academic counseling, scholarships, and cultural exchange programs. CONCLUSION: Addressing these challenges can foster a more supportive environment, contributing to the academic success and well-being of international students at TUMS and similar universities.

Responsiveness of hospitals to inpatient and outpatient services in the low- and middle-income countries: A systematic review.

Responsiveness is the ability of health system to satisfy non-clinical people's expectations. This review aimed at assessing responsiveness of hospitals' services in the low- and middle-income countries, and identifying the influencing factors. This systematic review followed the PRISMA guidelines. PubMed, Scopus, Web of Science and ProQuest were searched. Studies of all designs aiming to assess responsiveness of hospitals' services in the period from 2005 up to the end of 2018 were included. Quality was appraised based on McMaster University tool. Results were presented as a narrative review. Fifteen studies originated from five low-middle- income countries have been included. Results have been proposed under five subtopics; level and distribution of responsiveness and its domains at hospitals, rank of domains according to the participants, and factors affecting responsiveness and its related domains. Most studies have focused on responsiveness level, but not the distribution. Socioeconomic status, organisational, systemic, and contextual factors have led to varied responsiveness, consequently, policymakers would benefit from these valuable results while planning for improving health system in order to accomplish its intrinsic goals. Further research is required in the low- and middle-income countries other than the five included in this review. Using the World Health Organization questionnaires for measuring responsiveness is recommended, and the contextual variations should be considered.

Nurses' Perspectives on Inpatient Care Responsiveness at the Gazan Public Hospitals.

BACKGROUND: Responsiveness is one of the intrinsic goals of health systems. This study aimed at assessing the responsiveness of inpatient care in accordance to nurses' perspectives, particularly in internal medicine 'medical' and surgical departments, at the Gazan public general hospitals in 2020. METHODS: This cross-sectional descriptive study was conducted at 5 public general hospitals in Gaza. Data were collected from 277 nurses using an interview-based questionnaire composed mainly of 36 items to measure responsiveness on a 4-point Likert scale. Descriptive statistics, independent t-test and analysis of variance (ANOVA) using SPSS 22.0. RESULTS: The overall responsiveness was about 77.5%. Access to social support was the highest-performing domain but it was the less important. Dignity was the second-highest in performance but the most important domain. Choice of provider and quality of basic amenities were almost the lowest in both performance and importance. Hospital, marital status, educational level, position at work, income, department, and the experience in the current ward have led to significant differences in the level of responsiveness. CONCLUSION: Supply-side should be considered to delineate the status quo of responsiveness accurately. There is a room for further improvement in the interpersonal domains of responsiveness without extravagant expenditures. Policymakers need to emphasize on better allocation of budget for client-orientation domains of responsiveness as well. Hospital characteristics had a pivotal role in creating significant differences among respondents. Likewise, socioeconomic status and cultural diversity of nurses led to significant variations in their responses, hence, this calls for robust and well-designed researches, including non-public hospitals, to determine the most influential factors.

Assessment of public hospitals performance in Gaza governorates using the Pabón Lasso Model.

BACKGROUND: Measuring hospital performance can be undertaken in different areas including efficiency, productivity, and quality. Many studies have been conducted using several indicators in this regard. AIM: This study aimed at measuring efficiency of obstetrics and gynaecology, and paediatrics departments at the public hospitals affiliated with the Palestinian Ministry of Health in 2016, 2017 and 2018. METHOD: This descriptive study includes 12 hospitals; four (A-D) and eight (E-L) providing obstetrics and gynaecology, and paediatrics services, respectively. Data were collected from health annual reports for the 3-year study period. Pabón Lasso charts were drawn using Microsoft Excel 2013. RESULTS AND CONCLUSION: During the 3 years, hospitals B, D and C lied in zones 3, 1 and 2, respectively. Hospital A was in Zone 4 in 2016 and 2018, but in Zone 1 in 2017. In 2016, hospitals E, F and H were in Zone 3, while, hospitals I, J, K, and L were in Zone 1. In 2017, hospital G shifted from Zone 2 to Zone 3, and backed to Zone 2 in 2018. Hospital L has moved from Zone 1 to Zone 2 in 2018, whereas other hospitals have remained in the same zones. Inefficiency in hospitals provides an important opportunity for addressing the gaps in a quality and less costly manner. Emphasis antenatal care in primary healthcare is important. Further researches are required to cover other types of hospitals through employing frontier techniques of efficiency measurement.

Evaluation of performance at Palestinian public hospitals using Pabón Lasso model.

BACKGROUND: Hospitals have a paramount role in provision of health care services, which in turn significantly impacts the performance of any health system, especially in developing countries. AIM: This study aimed to evaluate the performance of the Ministry of Health general hospitals in Gaza according to their surgical and internal medicine departments during a 3-year period (2016, 2017 and 2018) using Pabón Lasso model. METHOD: This descriptive study includes the overall public general hospitals in Gaza Strip (7). Data have been collected from the officially disseminated reports, mainly about average length of stay, bed occupancy rate, and bed turnover ratio in the surgical and internal medicine departments for the study period. Pabón Lasso charts have been drawn using MS Excel 2013. RESULTS AND CONCLUSION: For surgical departments, about 42.8% were efficient (zone 3) during the 3 years, while, 42.8% were inefficient (zone 1). Only one hospital was relatively efficient (zone 4) in 2017 and 2018. Regarding internal medicine departments, 28.6%-42.8% of hospitals were efficient during the study period, 14.3%-42.8% were inefficient, and 28.6%-42.8% were relatively efficient (zone 2 and 4). It is recommended to count on such type of analysis in decision-making and identify obstacles for best utilization of the available resources. Inefficiency in hospitals serves as a good opportunity for resources mobilization or innovation in demand-creating interventions, thereby, regular evaluation of resources' distribution. Further research is required by applying frontier techniques of efficiency measurement.

A leadership model for Iranian health-care organizations.

PURPOSE: Leadership is the ability to influence, guide and encourage employees to achieve organizational goals. Leadership has a significant role in organizations' success or failure. Thus, this paper aims to develop a model to elucidate leadership practices in the Iranian health-care organizations (HCOs). DESIGN/METHODOLOGY/APPROACH: Qualitative approach was used in this study due to its explorative nature. Semi-structured interviews were conducted with 32 key managers and 30 professionals working at different HCOs. Inductive analysis was carried out using the grounded theory approach to develop an initial leadership model for HCOs. The proposed model subsequently was verified by an experts' panel. FINDINGS: The proposed leadership model emerged from the Iranian HCOs encompasses six main categories: leader, followers, high-ups and peers, context, processes and outcomes. Leader, followers and contexts as main categories did also have further sub-categories. RESEARCH LIMITATIONS/IMPLICATIONS: Study findings are cautiously transferrable as it reflects the Iranian context. While the model was verified, it might still benefit from more and diverse views. PRACTICAL IMPLICATIONS: This model can be used by health-care policymakers and managers for improving managers' leadership competencies and practices and enhancing health outcomes through motivating and mobilizing health-care resources toward achieving organizational goals. ORIGINALITY/VALUE: This study aims to give an answer for "what is the current status of leadership in Iranian HCOs?" and "how can we reinforce the strengths and address the weaknesses?"