6 research outputs found

    Distribution of Mortality among 1-59 Month-Old Children Across Iranian Provinces in 2009: The National Mortality Surveillance System

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    Objective: To determine the distribution of mortality in 1 59 month-old children across Iranian provinces in a national mortality surveillance system. Methods: This national survey was conducted in 2009. A questionnaire was designed and standardized for collecting mortality data of children aged 1 - 59 months. The project team, consisting of collaborators from the whole 40 medical universities, filled in the questionnaires and returned them to the Ministry of Health and Medical Education (MOHME). Results: The mortality in 1 - 59 month-old children was unequally distributed across provinces. The mortality was higher among children of less- educated mothers than in children of more- educated mothers. There was a reverse association between 1 - 59 months mortality and socioeconomic status across Iran as a whole and within most provinces. Conclusions: Our results suggest that socioeconomic distribution in mortality of 1 - 59 month-old children favors the better-off in Iran as a whole and in most of its provinces. Investigating why mortality is higher in some provinces deserves special attention. Furthermore, it is advisable to conduct provincially-representative surveys to provide update estimates of different health situations and to allow their monitoring over time

    Mortality inequality in 1-59 months children across Iranian provinces: National Hospital Medical Records System

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    Objective: To determine inequality in mortality in 1-59 months children across Iranian provinces using hospital medical records system. Methodology: After designing and examining a national questionnaire in hospitals for mortality data collection of children 1-59 months, 40 Medical Universities were asked to fill in the questionnaires and return to the main researcher in the health ministry in 2009. Results: Mortality in 1-59 months children was unequally distributed across Iranian hospitals. Cough, drowsiness, and eating and drinking problem were the most important reasons of hospitalization in both genders. There were significant differences between boys and girls in vomiting (p=0.005), drowsiness (p=0.024), and bleeding (p=0.004). Most of the patients had very bad and not suitable situation at entrance (p=0.211). There was a significant difference between two sexes in vaccination (p=0.019). There was no significant difference between boys and girls on first weight in hospital, last weight, breaths per minute, and pulse rate per minute (p > 0.05). The first five most important diagnosis were congenital, accident (girls) pulmonary (boys), cardiovascular, CNS and metabolic diseases. Conclusions: Our results suggest that inequality in 1-59 months mortality based on hospital medical records system needs more attention in Iran as a whole and in most of its provinces by policy-makers. Investigating why inequality is higher in some provinces deserves special attention. In addition, it is advisable to conduct provincial representative surveys to provide recent estimates of heath inequalities and to allow monitoring over time

    Frequency of Exclusive Breastfeeding and Its Affecting Factors in Tehran, 2011

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    This study was designed to assess the frequency of exclusive breastfeeding in two health centers of Shahid Beheshti University of Medical sciences in Khak Sefid, Tehran, Iran. A total of 175 mothers, referred for the third dose of their infants' DPT vaccination program participated in the study by completing a questionnaire regarding characteristics of their pregnancy, delivery and exclusive breastfeeding within the first six months of birth. Two-variable analysis and logistic regression test were applied to evaluate factors influencing exclusive breastfeeding. Results indicated that the frequency of exclusive breastfeeding, i.e., breastfeeding within the first six months of birth without the use of any other food with or without vitamin supplementation, was 31.17% (95% CI=23.77%-38.57%), which means 48 infants of 154<179 days old Among 154 infants (<179 days old) 48 did not have a history of being separated from their mothers. In logistic regression analysis, the variables which were directly associated with exclusive breastfeeding, with 0.05 significance level of alpha, included breastfeeding within the first hour of birth, eight times or more breastfeeding per day and receiving breastfeeding education during pregnancy. Variables with a negative association with breastfeeding included lack of breast milk, presence of a breast problem that could hinder breastfeeding, bottle feeding, physician or family's advice not to breastfeed and infant's refusal to breastfeed. Frequency of breastfeeding within the six months of birth is less than similar frequencies which are obtained by asking about breastfeeding on the day of the interview. It is recommended to apply real frequency for assessment, evaluation and programming of exclusive breastfeeding during the first six months of birth

    Priority strategic directions in adolescent health in Iran based on the WHO's Global Accelerated Action for the Health of Adolescents

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    OBJECTIVES: In line with the World Health Organization's Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance, the goal of the current research was to identify critical strategies for adolescents' health and to determine the role and distribution of responsibilities among the leading players in the field of adolescent health in Iran. METHODS: The current qualitative and applied study is part of the Ministry of Health and Medical Education's "Adolescent, Youth and School Health" plan to develop the "National Adolescent Health Plan Document" in 2020. First, stakeholder analysis was done, then a pool of nationally appropriate strategies was selected from the list of priority strategies recommended by the WHO in the AA-HA! through several group sessions. After that, the experts selected priority strategies based on the criteria of feasibility, acceptability, effectiveness, guaranteed resources, coordination with other plans and temporal priority, scoring, and executive priorities. Eventually, the priority strategies were assigned to different players/stakeholders in the field over several sessions bearing in mind the methods of implementation and the target groups. RESULTS: The experts identified 58 priority strategies/actions for adolescent health under the seven priority areas of positive development, sexual protection, reproductive health, mental health, substance abuse, self-harm, violence, unintentional injury, communicable and non-communicable diseases, nutrition, and physical activity. CONCLUSIONS: The highest identified priority areas were in the areas of vaccination; special health care package for service providers; training and education to promote health literacy and self-care, life skills, sexual awareness, and prevention/protection against violence; community-based mental health services, planning for adolescents' spare time, substance use prevention

    Identification of Indicators for Reproductive Health and Population Programs Monitoring in Iran

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    Background & aim: Given recent demographic changes, Iran has revised its reproductive health (RH) programs. To respond to the need for monitoring the new programs and policies, this study aimed to identify appropriate indicators for RH and population programs monitoring in the Iranian context.Methods: A mixed-methods approach was applied which was conducted in four phases: identification of goals of RH policies and programs, a scoping review of the RH indicators, developing and ranking the identified indicators, and indicators' finalization. The final indicators were selected through consensus, with a cut-off point of 75%. Data was collected from June 21, 2020, until February 18, 2021. Data analysis was conducted simultaneously during each stage of the study. MAXQDA.11 and MS Excel 2017 software were used in the first and third phases for data analysis.  Results: A total of 37 RH indicators were finalized after three rounds of screening. The first five indicators with the highest score were: total fertility rate, population under 15 years, total population, population aged 65 years and older, and age-specific fertility rate. The lowest score was related to the recuperation index (degree of recuperation relative to fertility decline at younger ages).Conclusion: The nature and number of indicators might vary at different organizational levels; so, the need to develop specific indicators is pivotal

    The Iranian blood pressure measurement campaign, 2019: study protocol and preliminary results

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    Purpose Hypertension is one of the most important risk factors for premature mortality and morbidity in Iran. The objective of the Iranian blood pressure (BP) measurement campaign was to identify individuals with raised blood pressure and providing appropriate care and increase the awareness among the public and policymakers of the importance of tackling hypertension. Methods The campaign was conducted in two phases. The first (communication) phase started on May 17th (International Hypertension Day). The second phase started on June 8th, 2019, and lasted up to July 7th during which, blood pressures were measured. The target population was Iranians aged >= 30 years. Participants voluntarily referred to health houses in rural and health posts and comprehensive health centers in urban areas in the setting of the Primary Health Care network. Additionally, over 13,700 temporary stations were set up in highly visited places in urban areas. Volunteer healthcare staff interviewed the participants, measured their BP, and provided them with lifestyle advice and knowledge of the risks and consequences of high blood pressure. They referred participants to physicians in case their BP was high. Participants immediately received a text message containing the relevant advice based on their measured BP and their past history. Results Blood pressure was measured for a total of 26,678,394 participants in the campaign. A total of 13,722,148 participants (51.4%) were female. The mean age was 46 +/- 14.1 years. Among total participants, 15,012,693 adults (56.3%) with no past history of hypertension had normal BP, 7,959,288 participants had BP in the prehypertension range (29.8%), and finally, 3,706,413 participants (13.9%) had either past medical history of hypertension, used medications, or had high BP measured in the campaign. Conclusion The campaign was feasible with the objective to increase the awareness among the public and policymakers of the importance of tackling hypertension in Iran
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