Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey

Background: Changes in modern societies develop the perception that the external environment is essential in organization’s practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. Methods: A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. Results: The mean score of hospitals’ social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals’ ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. Conclusion: It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals’ social responsibility level, especially through concentrating on their staff ’s working environmen

The comparison of selected statistical indicators of a hospital before and after the implementation of health reform plan: Isfahan-2015

زمینه و اهداف: مرحله سوم طرح تحول نظام سلامت با ابلاغ کتاب ارزش نسبی خدمات و مراقبت‌های سلامت اجرایی شد. با توجه به تأثیر این کتاب بر عملکرد بیمارستان‌ها و مراکز آموزشی درمانی، مطالعه حاضر با هدف تعیین ومقایسه نشانگرهای آماری منتخب یک مرکز آموزشی درمانی قبل و بعد از اجرای مفاد این کتاب انجام گرفت. مواد و روش‌ها: مطالعه توصیفی- تحلیلی حاضر، به صورت مقطعی در سال 1394 انجام شد. نشانگرهای آماری، با بررسی فرم‌های فعالیت مرکز و مراجعه به مدیریت آمار دانشگاه علوم پزشکی اصفهان، با کسب مجوز و رعایت اصل محرمانگی اطلاعات، جمع‌آوری و با نرم افزار آماري SPSS  (ويرايش 17) تحلیل شد. مقایسه نشانگرها توسط آزمون‌های آماری برای نمونه‌های زوج شده انجام و در سطح معنی‌داری 0/05>P تحلیل شد. یافته‌ها: ابلاغ کتاب ارزش نسبی، موجب افزایش معنادار در نشانگرهای درصد اشغال تخت، تخت روز اشغالی، میانگین مدت اقامت بیمار و تعداد مرگ و میر و کاهش معنادار در نشانگرهای فاصله چرخش تخت و چرخش اشغال تخت شد. در نشانگرهای میانگین تعداد بستری شدگان و ترخیص شدگان افزایش و در نشانگرهای تعداد مراجعین اورژانس و سزارین کاهش معنادار مشاهده شد. نتیجه‌ گیری: اجرای کتاب مذکور، بر برخی از نشانگرها (درصد اشغال تخت، تخت روز اشغالی، تعداد سزارین) تأثیر گذار و بر دیگر نشانگرها (تعداد بستری شدگان، مراجعین سرپایی، مراجعین اورژانس، ترخیص شدگان و تعداد اعمال جراحی) بدون تأثیر بوده است. البته تعمیم نتایج مطالعه به سایر بیمارستان‌ها، نیازمند مطالعه گسترده‌تری می‌باشد.Background and Aim: The third phase of health reform plan in Iran came into force since the announcement of the book named value of the notification. Due to the influence of this book on hospitals performance,this study aimed to determine and compare the selected statistical indicators of a teaching hospital before and after the implementation of the contents of this book.Materials and Methods: The present cross-sectional descriptive-analytical study was conducted in 2015. Data (statistical indicators) were collected, with the permission and considering the confidentiality of information, through reports review and on-site visiting and analyzed using SPSS (version 17) software.The comparison of selected indicators between paired samples were performed. Correlations were considered significant at α=0.05.Results: Announcement of the value of the notification book resulted in a statistically significant increase in bed occupancy ratio, occupied bed day, average length of stay, and number of hospital death and also a significant decrease of bed turnover interval and rate. Furthermore, a significant increase of inpatients andoutpatients visits and significant decrease of emergency visits and caesarean were also observed.Conclusion: Implementation of the aforementioned book significantly affected some statistical indicators (bed occupancy ratio, occupied bed day, and caesarian), but it has no significant effect on other statistical indicators (inpatients and outpatients visits, emergency visits and number of surgeries). However, extendingthe results of this study to other hospitals requires more extensive studies

Institutionalisation is a Vital Element for Fairness of Priority Setting in the Package Design if the Target is Universal Health Coverage; Comment on "Evidence-Informed Deliberative Processes for Health Benefits Package Design – Part II: A Practical Guide"

The Evidence-Informed Deliberative Processes (EDPs) guide provides a practical framework for fair priority setting of the Health Benefits Package (HBP) that countries can reasonably use. The steps presented in the EDPs are applicable for prioritising health services in designing HBP and are consistent with practical experience in countries. However, institutionalisation must be considered an element of fairness in the priority-setting process if the aim is to reach broader goals of a health system, such as universal health coverage (UHC). Otherwise, the EDPs for priority setting might not be integrated into the formal health system or impactful, resulting in a waste of time and resources, which is unfair. Institutionalisation means formalising the desired change as an embedded and integrated system so that the change lasts over time. For the institutionalisation of EPDs, four stages are suggested, which are (1) establishing a supportive legal framework, (2) designating governance and institutional structure, (3) stipulating the EDPs processes and (4) individual and institutional capacity building

The human cost of economic sanctions and strategies for building health system resilience: A scoping review of studies in Iran

Objectives This review aimed to analyse the impacts of international economic sanctions on the overall health status of Iranians and the health system performance of Iran, in addition to identifying effective strategies for making the health system resilient to sanctions. Study design A scoping review. Methods Three databases and grey literature were reviewed, and additional papers were identified in the lists of references. Two authors reviewed papers to check duplications and screen through inclusion/exclusion criteria. Furthermore, a narrative approach was employed to synthesise the findings. Results Given overall health impacts, economic sanctions are believed to have adverse effects on Iranian's health and cause significant financial hardships in accessing healthcare services. These hardships mostly affect those in marginalised and vulnerable groups. Economic sanctions degrade Iran's health system by negatively impacting health services' availability. The detrimental effects of sanctions on economic and social circumstances were also documented. Economic sanctions could also adversely affect health research and education. Most strategies identified for health system resilience to sanctions are related to the health system governance. Conclusions Even if essential medicines and supplies are exempted from the sanction regime, the impact of economic sanctions on public health is unavoidable. The quantification of the effect economic sanctions on different health-related areas needs by further research. The measures identified for dealing with sanction can be considered in other countries but more work is needed to explore how health of people can be resilient against negative consequences of sanctions

Interventions to increase participation of NGOs in preventive care: A scoping review.

Background and aims Nongovernmental organizations (NGOs) have enormous potential to effectively prevent and manage diseases; however, little research is available on interventions used to improve NGOs' participation in this area. A scoping review was conducted to identify options proposed or implemented to improve the participation of the NGOs in preventive care. Methods Pubmed, Web of Science, and ProQuest were extensively searched. Google Scholar was also searched to find potential studies related to the subject. Relevant keywords were used in the English language. The reference list of relevant studies was also scanned. Studies were screened with defined inclusion and exclusion criteria. Relevant data were then extracted. Two individuals independently screened and extracted studies. The interventions implemented or proposed to promote the participation of the NGOs in the implementation of preventive interventions were deductively identified and classified. Results Eighteen articles were included in our review. We identified 31 interventions and categorized them into 11 strategies, including (1) building strong collaboration among NGOs and with governments; (2) expanding networks and sustained relations among NGOs; (3) evaluating the NGOs' performance; (4) increasing intersectoral collaboration; (5) advocating for the role of NGOs; (6) supporting NGOs from the side of government; (7) empowering the abilities and capabilities of NGOs; (8) defining the precise roles and responsibilities of the parties; (9) strengthening the health system governance; (10) increasing the health literacy of the community; and (11) developing required regulations, rules, and policies. None of the interventions identified had evidence of its effectiveness. Conclusion The current evidence on effective interventions to strengthen NGOs' participation in implementing health care is scanty. It means there is an information gap in the effect of interventions to improve NGOs' participation in health

Malaria intermittent preventive treatment in Nigeria: a qualitative study to explore barriers

BACKGROUND: While the use of sulphadoxine pyrimethamine (SP) is effective in preventing malaria infection during pregnancy, there are challenges limiting its uptake in Nigeria. This study aimed at exploring the barriers to IPTp usage among pregnant women in Kano state - Nigeria. METHODS: This is a qualitative study. The purposive sampling strategy was used for identification and selection of 14 key informants for interviews. In addition, six focus group discussions (FGDs) were conducted with pregnant women (3 FGDs) and married men (3 FGDs). The conventional content analysis method was used to interpret meaning from the content of the data. MAXQDA 10 software was used for data management and analysis. RESULTS: Poor policy implementation, poor antenatal care attendance, inadequate access to intermittent preventive treatment at the community levels, lack of sustainable funding, and poor community engagement emerged as major barriers to IPTp use in Nigeria. CONCLUSION: While the political will to allocate sufficient financial resources could help improve service delivery and IPTp usage among pregnant women, community participation is critical to sustain the gains

Evaluation of board performance in Iran’s universities of medical sciences

Background: The critical role that the board plays in governance of universities clarifies the necessity of evaluating its performance. This study was aimed to evaluate the performance of the boards of medical universities and provide solutions to enhance its performance. Methods: The first phase of present study was a qualitative research in which data were collected through face- to-face semi-structured interviews. Data were analyzed by thematic approach. The second phase was a mixed qualitative and quantitative study, with quantitative part in cross-sectional format and qualitative part in content analysis format. In the quantitative part, data were collected through Ministry of Health and Medical Education (MoHME). In the qualitative part, the content of 2,148 resolutions that were selected by using stratified sampling method were analyzed. Results: Participants believed that the boards had no acceptable performance for a long time. Results also indicated the increasing number of meetings and resolutions of the boards in these 21 years. The boards’ resolutions were mostly operational in domain and administrative in nature. The share of specific resolutions was more than the general ones. Conclusion: Given the current pace of change and development and the need to timely respond them, it is recommended to accelerate the slow pace of improvement process of the boards. It appears that more delegation and strengthening the position of the boards are the effective strategies to speed up this process

Individual and institutional capacity-building for evidence-informed health policy-making in Iran: a mix of local and global evidence

BACKGROUND: Providing valid evidence to policy-makers is a key factor in the development of evidence-informed policy-making (EIPM). This study aims to review interventions used to promote researchers' and knowledge-producing organizations' knowledge and skills in the production and translation of evidence to policy-making and explore the interventions at the individual and institutional level in the Iranian health system to strengthen EIPM. METHODS: The study was conducted in two main phases: a systematic review and a qualitative study. First, to conduct the systematic review, the PubMed and Scopus databases were searched. Quality appraisal was done using the Joanna Briggs Institute checklists. Second, semi-structured interviews and document review were used to collect local data. Purposive sampling was used and continued until data saturation. A qualitative content analysis approach was used for data analysis. RESULTS: From a total of 11,514 retrieved articles, 18 papers were eligible for the analysis. Based on the global evidence, face-to-face training workshops for researchers was the most widely used intervention for strengthening researchers' capacity regarding EIPM. Target audiences in almost all of the training programmes were researchers. Setting up joint training sessions that helped empower researchers in understanding the needs of health policy-makers had a considerable effect on strengthening EIPM. Based on the local collected evidence, the main interventions for individual and institutional capacity-building were educational and training programmes or courses related to the health system, policy-making and policy analysis, and research cycle management. To implement the individual and institutional interventions, health system planners and authorities and the community were found to have a key role as facilitating factors. CONCLUSION: The use of evidence-based interventions for strengthening research centres, such as training health researchers on knowledge translation and tackling institutional barriers that can prevent well-trained researchers from translating their knowledge, as well as the use of mechanisms and networks for effective interactions among policy-makers at the macro and meso (organizational) level and the research centre, will be constructive for individual and institutional capacity-building. The health system needs to strengthen its strategic capacity to facilitate an educational and training culture in order to motivate researchers in producing appropriate evidence for policy-makers

Two-Step Estimation of the Impact of Contextual Variables on Technical Efficiency of Hospitals: The Case Study of Public Hospitals in Iran

Background: Measuring the efficiency and productivity of hospitals is a key tool to cost contamination and management that is very important for any healthcare system for having an efficient system. Objective: The purpose of this study is to examine the effects of contextual factors on hospital efficiency in Iranian public hospitals. Methods: This was a quantitative and descriptive-analytical study conducted in two steps. First, we measured the efficiency score of teaching and non-teaching hospitals by using the Data Envelopment Analysis (DEA) method. Second, the relationship between efficiency score and contextual factors was analyzed. We used median statistics (first and third quarters) to describe the concentration and distribution of each variable in teaching and non-teaching hospitals, then the Wilcoxon test was used to compare them. The Spearman test was used to evaluate the correlation between the efficiency of hospitals and contextual variables (province area, province population, population density, and the number of beds per hospital). Results: On average, the efficiency score in non-teaching hospitals in 31 provinces was 0.67 and for teaching hospitals was 0.54. Results showed that there is no significant relationship between the efficiency score and the number of hospitals in the provinces (p = 0.1 and 0.15, respectively). The relationship between the number of hospitals and the population of the province was significant and positive. Also, there was a positive relationship between the number of beds and the area of the province in both types of teaching and non-teaching hospitals. Conclusion: Multilateral factors influence the efficiency of hospitals and to address hospital inefficiency multi-intervention packages focusing on the hospital and its context should be developed. It is necessary to pay attention to contextual factors and organizational architecture to improve efficiency