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1.  Health System Vision of Iran in 2025 
Iranian Journal of Public Health  2013;42(Supple1):18-22.
Vast changes in disease features and risk factors and influence of demographic, economical, and social trends on health system, makes formulating a long term evolutionary plan, unavoidable. In this regard, to determine health system vision in a long term horizon is a primary stage.
After narrative and purposeful review of documentaries, major themes of vision statement were determined and its context was organized in a work group consist of selected managers and experts of health system. Final content of the statement was prepared after several sessions of group discussions and receiving ideas of policy makers and experts of health system.
Vision statement in evolutionary plan of health system is considered to be :“a progressive community in the course of human prosperity which has attained to a developed level of health standards in the light of the most efficient and equitable health system in visionary region1 and with the regarding to health in all policies, accountability and innovation”. An explanatory context was compiled either to create a complete image of the vision.
Social values and leaders’ strategic goals, and also main orientations are generally mentioned in vision statement. In this statement prosperity and justice are considered as major values and ideals in society of Iran; development and excellence in the region as leaders’ strategic goals; and also considering efficiency and equality, health in all policies, and accountability and innovation as main orientations of health system.
PMCID: PMC3712583  PMID: 23865011
Iran; Health system; Vision statement
2.  Future of Health Care Delivery in Iran, Opportunities and Threats 
Iranian Journal of Public Health  2013;42(Supple1):23-30.
The aim of this study was to determine the impact of important social and technological trends on health care delivery, in the context of developing “Iran’s Health System Reform Plan by 2025”.
A detailed review of the national and international literature was done to identify the main trends affecting health system. To collect the experts’ opinions about important trends and their impact on health care delivery, Focus Group Discussions (FGDs) and semi-structured in-depth interviews techniques were used. The study was based on the STEEP model. Final results were approved in an expert’s panel session.
The important social and technological trends, affecting health system in Iran in the next 15 years are demographic transition, epidemiologic transition, increasing bio-environmental pollution, increasing slums, increasing private sector partnership in health care delivery, moving toward knowledge-based society, development of information and communication technology, increasing use of high technologies in health system, and development of traditional and alternative medicine. The opportunities and threats resulting from the above mentioned trends were also assessed in this study.
Increasing healthcare cost due to some trends like demographic and epidemiologic transition and uncontrolled increase in using new technologies in health care is one of the most important threats that the health system will be facing. The opportunities that advancement in technology and moving toward knowledge-based society create are important and should not be ignored.
PMCID: PMC3712596  PMID: 23865012
Trends; STEEP analysis; Health care reform; Iran
3.  Iran Health System Reform Plan Methodology 
Iranian Journal of Public Health  2013;42(Supple1):13-17.
The Ministry of Health and Medical Education of Iran, along with the country movement towards achievements of Iran’s Vision 2025 put compilation of the health system reform plan on its agenda. In this article, we are trying to show the method we used for developing this plan and how this method considered the general condition of the country along with maintaining the standards of scientific and technical programs. All steps of this planning are described in the paper and finally we discuss the techniques and the appropriateness of the method compare with the experience of the other countries.
PMCID: PMC3712604  PMID: 23865010
Iran; Health system reform; Foresight; Public policy
4.  Community Capacity Assessment in Preventing Substance Abuse: A Participatory Approach 
Community-based participatory research (CBPR) increasingly is being used to address health issues. Few evidence exist to indicate how builds the capacity of communities to function as health promoter and what resources are required to promote successful efforts. This article presents the result of a capacity assessment for preventing drug abuse through CBPR, which working with rather than in communities, to strengthen a community’s problem-solving capacity. For exploring the perception of stakeholders, a dynamic model of the dimensions of community and partnership capacity served as the theoretical framework.
In this descriptive research, stakeholder analysis helps us to identify appropriate of stakeholders (Key stakeholders). Data were collected using a topic guide concerned with capacity for preventing drug abuse. Interviews were audiotape and transcribed. Data were analyzed thematically.
CBPR has been undertaken to involve local people in making decisions about the kind of change they want in their community and the allocation of resources to reduce substance abuse. We identified key stakeholders and examining their interests, resources and constraints of different stakeholders.
The current study has shown the benefits of community-based participatory approach in assessing capacity. Through CBPR process people who affected by Drug issue engaged in analysis of their own situation and helps identity innovative solutions for their complex problem. This participatory approach to a capacity assessment resulted in a synergistic effort that provided a more accurate picture of community issues and concerns.
PMCID: PMC3494215  PMID: 23193506
Participatory; Community; Capacity; Stakeholders
5.  Serum Zinc Levels in Children and Adolescents with Type-1 Diabetes Mellitus 
There have been very few studies, with contradictory results, on the zinc status of children and adolescents with type-1 diabetes mellitus. The objective of this cross-sectional study was to determine zinc status based on the serum zinc concentration in type-1 diabetic children and adolescents and compare it with that of healthy controls.
Thirty children and adolescents with type-1 diabetes mellitus, aged 6 to 18 years, and 30 age- and sex-matched healthy controls participated in the study. Serum zinc, fasting blood sugar, hemoglobin A1c and serum albumin were measured by flame atomic absorption spectrophotometry, enzymatic colorimetry, ion-exchange chromatography and colorimetry using bromocresol green methods, respectively.
No statistically significant difference was found in the mean serum zinc concentration between diabetic patients and healthy controls (111.0 ± 3.1 and 107.1 ± 3.8 mg/dl respectively, P= 0.4). No correlations were found between the serum zinc levels and fasting blood sugar, hemoglobin A1c, or the duration of the disease in the patients.
The zinc levels of diabetic children and adolescents are not noticeably different compared to those of healthy controls and are independent of glycemic control and the duration of the disease.
PMCID: PMC3481736  PMID: 23113106
Zinc; Type-1 diabetes mellitus; Children; Adolescents; Hemoglobin A1c
6.  Assessing Health System Responsiveness: A Household Survey in 17th District of Tehran 
Responsiveness is an indicator by WHO to evaluate the performance of health systems on nonmedical expectations of consumers. This study measures the health system responsiveness and the factors affecting responsiveness in Iran health system.
World Health Survey (WHS) questionnaire was used to collect data on a two-stage cluster sampling in 17th District of Tehran in 2003. Of a sample of 773, 677 and 299 individuals who respectively had outpatient or inpatient services utilization responded to the responsiveness module of WHS questionnaire.
More than 90% of respondents believed that responsiveness issues were very important. Performance of outpatient services was better than hospital services in terms of responsiveness. "Prompt attention" and "quality of basic amenities" received low score for outpatient services. Service user variables had no significant effect on responsiveness, while type of centers was significantly related to responsiveness. Principal component analysis found three factors for both outpatient and inpatient services that explained 62% and 61% of total variances respectfully.
Iran health system should pay more attention to responding non-medical expectations of service users. It sounds that health system interventions are main determinant of responsiveness score compared to demographic or user variables. Training health staff, allocating more resources and reengineering some processes may play a role in improving responsiveness. Responsiveness domains seems to be tailored based on each society's cultural factors.
PMCID: PMC3371967  PMID: 22737485
Responsiveness; Outpatient services; Inpatient services; WHS; Iran
7.  Iranian Female Adolescent’s Views on Unhealthy Snacks Consumption: A Qualitative Study 
Iranian Journal of Public Health  2010;39(3):92-101.
Given the increasing prevalence of obesity among Iranian adolescents and the role of consumption of unhealthy snacks in this issue, interventions that focus on factors influencing food choice are needed. This study was designed to delineate factors associated with unhealthy snack use among female Iranian adolescents.
The theory of Planned Behavior served as the framework of the study. Qualitative data were collected via nine focus group discussions in two middle schools (6th to 8th grades) in a socio-economically diverse district in the city of Tehran in spring 2008. The study sample included 90 female adolescents aged 12–15 years. The sampling strategy was purposive method. Data analyzed using the “framework” method.
Major factors identified by the respondents were taste, peer pressure, parental influence, easy access to unhealthy snacks, limited availability of healthy snacks, appeal of snacks, habit, high price of healthy snacks, and media advertisements. Nutritional value and healthiness was not one of the first priorities when buying snacks, as adolescents thought it was too early for them to worry about illness and adverse consequences of eating junk foods.
For developing culturally sensitive evidence-based interventions that can motivate adolescents to choose healthy snacks, a broad range of factors should be taken into account.
PMCID: PMC3481626  PMID: 23113027
Adolescent; Snack; Qualitative research; Iran
8.  Metaplot: A Novel Stata Graph for Assessing Heterogeneity at a Glance 
Iranian Journal of Public Health  2010;39(2):102-104.
Heterogeneity is usually a major concern in meta-analysis. Although there are some statistical approaches for assessing variability across studies, here we present a new approach to heterogeneity using “MetaPlot” that investigate the influence of a single study on the overall heterogeneity.
MetaPlot is a two-way (x, y) graph, which can be considered as a complementary graphical approach for testing heterogeneity. This method shows graphically as well as numerically the results of an influence analysis, in which Higgins’ I2 statistic with 95% (Confidence interval) CI are computed omitting one study in each turn and then are plotted against reciprocal of standard error (1/SE) or “precision”. In this graph, “1/SE” lies on x axis and “I2 results” lies on y axe.
Having a first glance at MetaPlot, one can predict to what extent omission of a single study may influence the overall heterogeneity. The precision on x-axis enables us to distinguish the size of each trial. The graph describes I2 statistic with 95% CI graphically as well as numerically in one view for prompt comparison. It is possible to implement MetaPlot for meta-analysis of different types of outcome data and summary measures.
This method presents a simple graphical approach to identify an outlier and its effect on overall heterogeneity at a glance. We wish to suggest MetaPlot to Stata experts to prepare its module for the software.
PMCID: PMC3481754  PMID: 23113013
Heterogeneity; Meta-Analysis; Systematic review; Stata graph

Results 1-8 (8)