مجله تحقیقات نظام سلامت حکیم
سال یازدهم شماره 3 (پیاپی 42، پاییز 1387)

Integration of health services and medical education - the brief manifest of Iran’s Ministry of Health and Medical Education (MOHME) - has been studied mainly from the perspective of health service and medical education quality so far. The objective of present study however, is to examine the impact of integrated structure of MOHME on domestic research utilization. Macro-level policy makers in charge of designing the national research and innovation system are expected to benefit from the results of this study.

The study was conducted in form of Grounded Theory and through interviews with a wide range of persons ranging from policy makers to healthcare providers in medical and non-medical groups.

‘Integration’ has not fully evolved yet. Beyond the structural changes that have been created at the higher levels of MOHME and medical universities, a set of processes should have been defined for attainment of the desired goals. Neither the created structural changes have covered the level of educational and research groups, nor the set of needed processes has been defined. The issue of inadequate research utilization is not limited to health sector, but is also present in other pillars of the national research and innovation system.

From the perspective of health research, the national research and innovation system should be defined at the macro level before making any decisions about changing the current structures. The reason is that the main problems of the research system in Iran are not confined to medical sciences or the ‘integration’, but more general and drastic issues are existent. Any putative structural changes in the ‘integration’ and medical sciences should be viewed only as secondary to these main issues.

The objective of this study is to assess the medicines and materials dispensed by medicinal herbs sellers in Tehran for treatment of drug addiction.

This study consisted of a qualitative study and a chemical laboratory analysis. In-depth interviews with a sample consisting of 52 medicinal herbs sellers from 22 zones of Tehran’s Municipality and 32 drug dependents or their family members were performed, and thin layer chromatography was done for 55 specimens from handmade anonymous materials sold by medicinal herbs sellers for treatment of addiction.

Eighty five percent of the studied herb sellers were active in treatment of addiction. The prescribed herbs consisted of Lavandula, Valerian, Citrus, Bishop’s weed fruit, and sweet balm. Although only 20% of the herb sellers disclosed dispensing chemical compounds as well as herbals, but all of the analyzed specimens included at least one chemical. Ninety one percent of the specimens contained diphenoxylate and 58% included at least one opioid. The cost of treatment ranged from 100 thousand to two million Iranian Rials per patient. Seventy five percent of addicts judged the dispensed medicines and material as either ineffective or addictive.

Widespread and active involvement of herb sellers in prescription and selling of handmade chemical compounds for treatment of addiction, despite its illegality, and the large public demand for such medicines pose a serious challenge for the concerned policymakers. Scientific approach to herbal medicine, supervision of Ministry of Health and Medical Education on their production, licensing their sale, development and application of supervisory regulations, systematic training of those involved in production, prescription, and sale of herbal medicines, and public awareness rising are recommended.

Road traffic crashes are the main cause of trauma mortality in most of world countries especially Iran. The objective of this study is to evaluate RTC mortality and morbidity in the last 10 years (1997-2006).

Data were obtained from Iran official reports of police, health sources and the Statistical Centre of Iran (SCI). These data include population, registered motor-vehicles number, RTC, RTC injuries and deaths, during the period of 1997–2006. Statistical analysis was performed by Stata 8 software and significance of mortality change was evaluated by Poison distribution.

RTC fatalities increased between 22.1 (95%CI, 21.7-22.4) per 100,000 and 40.5 (95%CI, 40.1-41.0) per100,000 from 1997 to 2005, but in the last year of 2006, this trend is reversed and there was declined to 39.1 (95%CI, 38.7-39.6) per 100,000. RTC injuries has been increased from 110 to 401 per 100000 population from 1997 to 2005, but decreased to the 393 per 100000 in 2006.

This paper shows road traffic crashes mortality and morbidity in Iran in recent ten years and the decrease in the last year. This decline was most probably the result of a variety of interventions, including legislation, police enforcement, improvements in traffic and transport, health care facilities and media and public education. It is recommended that efforts of all responsible organizations continue in unique leadership.