مجله تصویر سلامت
سال دوم شماره 4 (زمستان 1390)

This study was aimed to compare neonatal transport system in developed and developing countries. In this qualitative study, 12 neonatal transport systems in nine developed and developing countries including; United State of America, Britain, Canada, Australia, Sweden, Scotland, Hungary, India and China have been studied retrospectively using comparative approach. Selected transport systems were compared based on searching in neonatal transport systems websites according to four criteria of comparative study including: transport team personnel, transport types and organization forms, the situation of these countries in neonatal transport and neonatal health indicator of the mentioned countries. The results showed that trained nurses were working as the team’s major staff and medical or paramedic staff could be added to the team according to the transport’s condition. In all of the countries, appropriate regionalization and proper management were the most important factors in the success of the system. Also, neonatal transport system has had important impact on reducing neonatal mortality rate. Implementing appropriate system needs designing a suitable management network which is equipped with managerial, informational and communication systems as subsystem in communicating with Emergency Medical Services. Neonatal health should be improved by developing pregnancy care and expanding regionalization program among all providers in all levels of health system. For assuring the efficiency of the system, a regionalized neonatal transport system needs to be developed and resources must to be allocated according to the needs.

Medicinal plants are valuable natural resources that have been considered nowadays in developed countries as raw materials for converting into safe drugs for human. Antioxidants are compounds that effectively prevent oxygen free radical reactions and reduce damage or cell death, cardiovascular diseases and cancer. After extraction of floral and vegetative parts of Onopordon leptolepis plant, antioxidant potential was determined by two testes: 1. 1diphenyl-2-picrylhydrazyl (DPPH) free radical-scavenging and ferric-reducing antioxidant power (FRAP). The hydro-alcohol extract (methanol 70%) of floral and vegetative parts of O. leptolepis plant was found as the most active in scavenging DPPH radicals and in FRAP. The antioxidant potential of hydro-alcohol (H.A70%) extracts of the floral part of O.leptolepis showed weak effect than the extract of vegetative of O.leptolepis plant. Results showed that the hydro-alcohol extract (methanol 70%) of vegetative part can be considered for medicinal and food industries due to the high antioxidant properties.

Quality in health care has three main dimensions: Technical Quality, Service Quality and Customer Quality. This study aimed to assess the quality of delivered maternity care based on Comprehensive Quality Measurement in Health care (CQMH) model. This cross-sectional study was conducted with the participation of 185 pregnant women in their ninth month of pregnancy who were receiving maternity care from urban health centers and health posts in Tabriz in 2011. All participants were selected randomly from 40 health centers and health posts. Data were collected using researcher-made questionnaire which its validity was reviewed and confirmed by 10 experts and its reliability was confirmed according to Cronbach's alpha index (Service Quality (SQ); α = 0.85, Technical Quality (TQ); α = 0.77, Customer Quality (CQ); α = 0. 71). Final scores for each dimension were referred on a 0-100 scale with high values indicating better quality. Independent Samples Test and ANOVA followed by Tukey HSD Post Hoc Test were conducted to compare CQ, SQ, TQ and QI score between categorical variables. Data were analyzed using SPSS-17 statistical package. The average Quality Index was 58.59 of a 0-100 scale and average SQ, TQ, CQ scores were 75.3, 40.54, and 67.79 respectively.The results regarding customer quality indicated that the majority of the mothers remained in active participation and taking action phase. There was a significant gap between received maternity care and recommended standards. The quality of inter-personal and non-technical aspects of prenatal care was poor. Quality Index indicates that the current situation was worrying about quality of care from the patients’ perspective. Empowering pregnant women by engaging them in the service delivery process and decision-making can promote customer quality and pregnant women’s ability to take good decisions and good action and improve other aspects of quality.

Nowadays, technological development has made human beings life so complicated and makes his life prone to dangers like being disabled, unemployment or even death. In order to reduce these hazardous effects on human life, insurance has shown its effectiveness and acceptance in most countries around the world. Following survey aimed to study the life insurance demand function and its most effective factors (like annual income, inflation rate, dependency rate, education, and probability of head of household’s death) and their demand elastic ties. In this study, time series have been used and by deployment of OLS, each and every effective factor on life insurance demand has been studied; so the demand elasticity on each factor has been calculated. The survey findings showed that except education, the rest of the data were in the 5% level integrated from the degree one and there was no co-integration between them. After running the model on data, it illuminated that the income elasticity of life insurance demand was 0.112 and the demand elasticity of life insurance to the probability of head of household’s death, dependency rate, education and inflation rate were 0.221, 2.24, 0.211 and -1.33 respectively. There are positive relations between life insurance and gross national production, probability of head of household’s death, dependency rate and education. On the other hand, the relationship is negative between life insurance demand and inflation rate.

Universal insurance coverage is considered as one of the main goals of health systems around the world. Although Universal Health Insurance Law was legislated with the objective of covering all Iranian population under health insurance coverage in 1994, but imperfect insurance coverage has remained as a threatening dilemma. Heterogeneous statistics reported by insurer in Iran and the lack of appropriate, comprehensive databases have failed any judgments about the number of uninsured people and the reasons for it. Present study aimed to give better insight on insurance coverage among Iranian people and examine key reasons of imperfect coverage through a deep analysis of a national household survey. Data which were collected from a national survey of health care utilization in Iran that covered over 102000 people of Iranians were analyzed. The survey had been implemented in 2007 by Iran's Ministry of Health. In order to identify possible reasons for imperfect coverage, national and international databases like SID, Iranmedex, ISC, Pubmed, Scopus, official statistics of Statistical Center of Iran (SCI), Iranian Social Security Organization (ISSO) and Central Insurance of IRIRAN (CII) were searched. Data management was accomplished in Microsoft Excel software. Study results showed that 85% of Iranian households had health insurance coverage, compared to 15% without any coverage. Medical services insurance fund had the greater proportion of coverage (59.27%) and basic private insurance coverage was accountable for the least coverage (0.2%). More than half of households (51%) stated financial inability to pay as the main reason for not getting coverage, followed by the lack of knowledge about insurance (12%), unemployment (12%) and bypass by employers (10%). A worthwhile finding was that, 13% of households implied they felt no need to health insurance and 2% found it useless. Despite the great importance of appropriate data for insurance companies and the role of it for policy-makers, there are many challenges associated with accessibility and accuracy of the data. According to our analysis on national survey, 15% of Iranian residents have neither social nor private insurance coverage. The lack of information and coordination among insurance companies has led to double insurance coverage for some people. Financial inability, feeling no need for insurance, unemployment, the lack of insight, employer bypass and uselessness of insurance which had been ranked as main reasons for not getting coverage, should be taken into consideration by policy-makers.

Implementation of family physician program has increased the attendance of physicians and midwives in rural areas. The effectiveness of these interventions needs to be evaluated. The aim of study was to assess the quantity and quality of prenatal care and Family Physician Program outcomes. In this cross-sectional study, 751 rural pregnant women (12% of study population) of rural Tabriz from 2003 to 2008 were selected using stratified random sampling procedures. Data were extracted from mothers’ health files records and collected with valid check list from 1994 to 2001. Data were analyzed and compared with before and after the program implementation. The results showed that the number of visits by physician and midwife, BMI, Iron supplementation, initiation of first prenatal care and the number of sonography examinations as indicators of prenatal care increased significantly after the family physician program implementation but there were non-significant increase in folic acid and multivitamin supplement therapy and postnatal period care while there was no difference between maternal weight gain, the infants’ height-weight mean score in periods before and after implementing family physician program. The results indicated that the attendance of physician or midwife has improved some of the prenatal care in both quantitative and qualitative aspects but there was no strong evidence on its effectiveness in caring outcomes. As a result, further studies are necessary to determine outcomes of the plan.