5 research outputs found
Network governance theory as basic pattern for promoting financial support system of the poor in Iranian health system
Background: The share of out-of-pocket payments in Iranian families has the greatest burden on the poor and lead to an impoverishment caused by catastrophic health expenditures. In order to improve access of the poor to public resources, it is necessary to create a better governance system and effective policy-making. The purpose of this study is to improve network effectiveness of the Iranian health system and to design a financial protection network for the poor, based on the network governance theory. Methods: We are using a quantitative method framework in conjunction with a Social network analysis (SNA) strategy. To draw an optimal network, we conducted interviews with experts by focusing on the arrangement and relationship among different institutions. The research sample was purposefully selected. We used UCINET software for data analysis and NetDraw software to draw networks. Results: In this article, an optimal network was proposed with the following characteristics: First, the problem of the density of relationships among several central institutions and the isolation of the other institutions have been solved. Second, in our model, the relationships have been distributed in a balanced manner among all institutions in the network. Third, the number of participants has been reduced and consensus on poor people support policies has been achieved in this optimal network. Forth, executive organizations keep their central positions and upper institutions are not at the central position, so that the power is distributed in favor of more balanced governance. However, in order to increase efficiency and to have coherent decision-making, it is necessary to establish a �core� for this optimal network. The �core� has to include the organizations with the most relationship with others. Conclusion: The result revealed that the usefulness of network analysis as a tool for proposing the effectiveness of governance. By strengthening the relationship among the main actors, an organized system of network management can be achieved. The network has to include all actors from different levels, from policy-making to implementation. The network also has to clarify the tasks from identifying the poor to covering costs. From an academic perspective, this study showed the adequacy of network analysis as a tool for policy sciences. Governance in our optimal health financial protection model follows the shared-governance pattern due to its high density, low centralization and low distance. The model of network governance can be the source of changes in the health governance system. It is a necessary structural condition to provide access to universal health coverage. © 2021, The Author(s)
Power structure among the actors of financial support to the poor to access health services: Social network analysis approach
The extent of universal health coverage in terms of financial protection is worrisome in Iran. There are challenges in health policies to guarantee financial accessibility to health services, especially for poor people. Various institutions offer support to ensure that the poor have financial access to health services. The aim of this study is to investigate the relationship network among the institutions active in this field. This study is a policy document analysis. It evaluates the country's legal documents in the field of financial support to the poor for healthcare after the Islamic Revolution in Iran. The researchers looked for the documents on the related websites and referred to the related organizations. The social network analysis approach was chosen for the analysis of the documents. Block-modelling and multi-dimensional scaling (MDS) was used to determine the network structures. The UCINET software was employed to analyse the data. Most the main actors of this network are chosen from the government budget. There is no legal communication and cooperation among some of the actors because of their improper position in the network. Seven blocks have been clustered by CONCOR in terms of the actor's degree of similarity. The social distance among the actors of the seven blocks is very short. Power distribution in the field of financial support to the poor has a fragmented structure; however, it is mainly run by a dominant block consisting of The Supreme Council of Welfare and Social Security, Health Insurance Organization, and the Ministry of Health and Medical Education. The financial support for the poor network involves multiple actors. This variety has created a series of confusions in terms of the type, level, and scope of responsibilities among the actors. The weak presence legislative and regulatory institutions and also non-governmental institutions are the main weak points of this network. © 2017 Elsevier Lt
Studying the Effect of Programmed Instruction on Performance and Venous Blood Sampling Error before sending the Samples to the laboratory at Selected Hospitals in Ilam in 2015
One of the common methods of diagnosis in intensive care units of blood is phlebotomy that requires knowledge and skill of the nurses. Respecting blood taking safety is of the most important topics in nursing care and its great impact on the reduction of pre-analytic errors has been detected. Considering the importance of roles nurses in accurate blood collection, and relevant nursing care, this study was conducted to investigate the effect of educational intervention Programmed instruction methods on the reduction of pre-analytic errors of the selected intensive care units of the education and health centers affiliated with Ilam University of Medical Sciences. This study was quasi-experimental of single group conducted through pre-test and post-test method. The used tools include the questionnaire of demographic data and measuring the performance of nurses about venous blood sampling and the check list of assessment of the compliance of venous blood sampling process by nurses with guidelines adopted in this regard. SPSS 16 was used to analyze the data. The descriptive statistics mean, standard deviation, frequency and percentage were used. In inferential statistics, ANOVA and chi-square tests were used. The results indicated a significant relationship between demographic variables gender, work experience, and type of employment and the observed error rate was statistically significant