Factors Affecting Community Health Volunteers’ Motivation to Participate in Health Programs in Comprehensive Health Service Centers

Introduction:  Community health volunteers link people and health workers and they voluntarily contribute to community health. Given the importance of the engagement of volunteers in promoting health programs and improving the quality of care provided, this study aimed to explore the experience and perceptions of community health volunteers of comprehensive health service centers in the western regions of Ahvaz to identify the most critical factors motivating their participation in health programs. Methods: This qualitative study was conducted in 2017 on community health volunteers in comprehensive health service centers in western Ahvaz. The data were collected through semi-structured in-depth interviews conducted face-to-face with 35 community health volunteers. The conventional qualitative content analysis approach was used to analyze the collected data. Results: Data analysis revealed 302 primary codes, 27 subthemes, and ten main themes. The ten main themes extracted in this study, including the physical context, organizational context, social context, climatic context, cultural context, increasing health knowledge, material factors, psychological factors, social factors, and spiritual factors, constituted the factors affecting the community health volunteers’ motivation to participate in health programs. Conclusion: Community health volunteers’ motivation to participate in health programs is influenced by factors such as physical context, organizational context, social context, climatic context, cultural context, increasing health knowledge, material factors, psychological factors, social factors, and spiritual factors. Thus, failure to pay attention to these factors will reduce the community health volunteers’ incentives to promote health programs, decrease volunteers’ cooperation with centers, reduce the quality of care provided, and ultimately waste the funds spent on volunteers’ training and preparation

Analysis of equality in Iranian household healthcare payments during Iran’s fourth development program

Introduction: Today, the provision of healthcare should be efficient and equitable to achieve the health system’s goals. The aim of this study was to survey equality in healthcare expenditures and its effects on income redistribution. Methods: This study was a descriptive-analysis, cross-sectional study that was conducted with data obtained from the Statistical Center of Iran (SCI) during 2006 and 2011. The source population and study population were the urban and rural residents of Iran and their households’ income and expenditures on health. The analysis was based on annually aggregated data from all provinces relative to their share of the total population. The data were collected using a pre-tested checklist consisting of two sections. The first section was used to retrieve data about total gross non-food expenditures of households. The second section retrieved out-of-pocket payments for healthcare. The data that were collected were analyzed using a Microsoft Excel spreadsheet. The Kakwani index was used to measure the extent of the deviation from equity. The redistributive effect of healthcare costs was considered as the impact of healthcare payments on households’ income distribution. Results: The overall Kakwani index during the fourth development program for urban households was progressive (OKI = 0.013), but it was regressive for rural households (OKI = -0.012). Healthcare payments had a negative effect on income redistribution in urban areas during the entire period of the study, and they had a positive effect in rural areas, except for the years 2010 and 2011, for which the effects were negative and non- existent, respectively. Conclusion: By regarding the regressive Kakwani index and the negative effect of healthcare expenditures on income redistribution in some years, the government can use health grants, such as increasing health facilities and supplementary insurance, to increase the ability of households to deal with the cost of developing a remedy and reducing health inequalitie