In June 2014, the first Health Complex was established in the suburban area of Tabriz, a northwes... more In June 2014, the first Health Complex was established in the suburban area of Tabriz, a northwest city of Iran. Health Complexes, as one of the decentralized models, have been formed based on universal health coverage principles. However, nearly two years after commencing work in the province, Health Complexes experience a high turnover of health care workers. This study aims to explore why primary health care workers set aside their roles in the health system and leave their jobs in opposition to the planned objectives. In this qualitative research, purposive and snowball sampling techniques were used for participants' selection. Data were collected through semistructured interviews and documentary review. Interviews were conducted with health officials, health care specialists, and other health workers who had left their jobs in Health Complexes in the suburban areas of Tabriz. Inductive and deductive content analysis was used to analyse data. The leading causes for health care workers leaving a job were divided into four main categories including organizational policies and regulations, financial and economic factors, sociocultural, and personal factors. Developing evidence‐informed interventions and strategies to improve payment systems, provide job security and opportunities for professional development, and adopt cooperative leadership are essential to decrease the turnover rate of health care workers at Health Complexes.
Objective: This study aimed to comprehensively determine the factors that affect the hospitals' f... more Objective: This study aimed to comprehensively determine the factors that affect the hospitals' functional preparedness in response to disasters. Methods: A systematic review of studies published in English and Persian up to the end of 2022 was performed by searching PubMed Central, Web of Science, Scopus, ProQuest, SID, and Elmnet databases. Articles that assessed hospitals' functional preparedness were searched by using a combination of medical subject heading terms and keywords including disaster, emergency, preparedness, hospital preparedness, health care facilities preparedness, hospital functional preparedness, health care facilities functional preparedness, readiness, and effective factors. Additionally, journals and gray literature were manually searched. Two independent reviewers screened the eligible papers. The inclusion criteria were the full text should be published up to the end of 2022, in both Persian and English, and focus on hospital preparedness. The extracted data were manually analyzed, summarized, and reported using the content analysis method. Results: Of the 3465 articles, 105 studies were eventually included in the final analysis. Eighty-two influential factors were identified and classified into seven categories: government, coordination, control, and commanding (7 factors), existing guidelines and preparedness plans (12 factors), regulations (6 factors), supplying of resources (37 factors), education and training (8 factors), multi-layered information management and communication systems (8 factors), and contextual factors (4 factors). Conclusion: There are different dimensions of hospital preparedness for disasters, each of which is influenced by several independent factors. Addressing these factors will enhance the actual functional preparedness of hospitals encountering disasters.
Objectives: The aim of the present study was to identify factors associated with h delayed initia... more Objectives: The aim of the present study was to identify factors associated with h delayed initiation of post-exposure prophylaxis (PEP) among animal bite victims. Methods: This cross-sectional study assessed biting patterns among 3032 cases that were referred to Tabriz Rabies Center. The delay was described as the initiation of PEP more than 48 hours (h) after possible exposure to the rabies virus. Determinants of delay in initiating PEP were recognized by a decision tree model. Results: Totally, 8.5% of the victims who were bitten by an animal had a delay of more than 48 h in the initiation of PEP. The relative frequency of a delay more than 48 h in females was higher than in males (12.9% compared to 8.5%) (p-value= 0.004). Relative frequency of a delay of more of 48 h from carnivorous (dog, jackal, fox) was significantly less than others (p-value< 0.001). Of the decision tree, the overall classification accuracy was 89.5%, with 44.1% sensitivity and 92.3% specificity. The iden...
Background: This study aimed to conduct a systematic review of models describing the integrated l... more Background: This study aimed to conduct a systematic review of models describing the integrated logistics operations performed as a response to natural disasters, with the hope to identify the challenges and limitations of healthcare systems in natural disaster management. Methods: A systematic literature search was carried out in PubMed/Medline, Scopus, Google Scholar, and bibliographies of retrieved articles using MeSH headings and keywords such as natural disaster, logistics, model. A total of 98 publications were identified through the search process. Seven potentially relevant articles met the inclusion criteria. The key demographic, clinical, and pathological information of all qualified studies were extracted from the full-text articles. Results: Among the seven included studies, six had either model data or considerations on distribution methods. Storage, human resources, infrastructures, primary priority items, coordination of organizations, and information and communicatio...
Background and Objectives : Malta fever, a zoonosis disease, which is a common health problem am... more Background and Objectives : Malta fever, a zoonosis disease, which is a common health problem among people of East Azerbaijan, has imposed sanitary and economic damage to the society. The purpose of this study was to determine the effect of interventions based on the need and epidemiological characteristics to control brucellosis in Charoaymaq city. Materials and Methods : This is a descriptive-analytic study which was conducted by collecting the information and applying interventions on the suspected patients of Malta fever in Charoaymaq. A reliable questionnaire , approved by the Iranian Ministry of Health and Medical Education was used for data collecting. According to the epidemiological situation of Malta fever in the region, some interventions such as providing face to face education to the patients and their families, establishing cooperation with organizations that play role on fighting with Malta fever were designed and applied. Follow up of the patients were conducted an...
Aims: Since the "International Congress on health and crisis management in disasters and eme... more Aims: Since the "International Congress on health and crisis management in disasters and emergencies" has provided a valuable opportunity for researchers to come together from all around the country, its output can be used as one of the indicators of disaster health research development. This article explores trend of original researches in the recent five Congress. Methods: Based on the abstract book of the last five Congress, investigated variables were: number of articles regarding to presentation methods, type of article and methodology of study. Articles were considered as research papers that were based on a defined methodology, data collection and analysis and the results of them were reported. To determine the type of research papers, the first priority was author's opinions. In about the cases that the study types were not explicitly stated, the issue discussed in a meeting and decision make with consensus. Results: At the last five congresses 1866 articles have been presented at all, that 343 Article (18.4 percent) were oral and 1523 Article (81.6%) were posters. 356 (19.1 percent) were original articles and 1510 (80.9 percent) were non original. The trend of original articles show incremental slope from 2012 to 2003 to 18.5 percent rate, but this slope in 2007 up to 2012 is not significant (3.1 percent). Conclusions: The trend of reporting of original researches as an important indicator of development of health in disaster research in the country is increasing, but accelerating of this increase will require: 1) developing and training of research methodology in the disaster, 2) developing educational programs to train researcher in this field and 3) the systematic and financial support of the disaster risk reduction and management research in the country.
Background and Objectives: Since 2014, the "health system transformation plan" was desi... more Background and Objectives: Since 2014, the "health system transformation plan" was designed and implemented in order to solve some of the problems in Iranian health system. One of the goals of this plan is to reduce direct payments by inpatients. This study aimed to compare the direct payments by inpatients, before and after implementing the transformation plan. Material and Methods: In this analytical-descriptive study, 1351 cases were selected (all cases). Direct costs paid by the inpatients were extracted from medical records and then analyzed using SPSS v.19 software and applying Uman-Whitney test. Results: The overall level of direct costs paid by inpatients before and after implementing the transformation plan has been decreased from 704 286 to 491815 Rials. A statistical relationship was observed between implementing the plan and the reduction of direct costs; but in detailed costs, there was no change. Conclusion: Health system transformation plan reduced the direc...
Background: The frequency and severity of disaster occurrence and emergency situation, and the im... more Background: The frequency and severity of disaster occurrence and emergency situation, and the importance of disaster risk communication of relief organizations to increase the readiness of societies in the case of disaster is increasing around the world. This study aimed to identify relief organizations' strategies to improve disaster risk communication in Iran. Methods: This qualitative study was conducted with the participation of 25 managers, relief workers, and people who had experiences in response to one of the disasters. The data were collected using semi-structured interviews and analyzed using conventional content analysis.Results: The analysis of the data of this study led to the identification of 3 categories and 9 sub-categories regarding strategies of relief organizations to improve risk communication. These categories are 1) management of information and training communication (facilitation of training processes, diverse training strategies, and integrated informi...
Background and Objectives : Pre-hospital Emergency Medical Services (EMS) is one of the most impo... more Background and Objectives : Pre-hospital Emergency Medical Services (EMS) is one of the most important components of health care systems. Community awareness about its services could improve the performance. This study is aimed at assessing the citizens' awareness and satisfaction about Shiraz EMS. Materials and Methods : Through this cross-sectional study, 1680 residents of Shiraz citizens have been selected by cluster random sampling. Each person has been asked some questions about their knowledge and also satisfaction of EMS performance with a valid and reliable questionnaire through phone interview. The data were analyzed with SPSS using T- test, Anova and Regression with "0.05" level of significance. Results : This study revealed that the knowledge of the residents who are living in lower socioeconomic part of the city is lower than the residents of the other areas. The mean awareness score of each area was significantly different comparing to the other areas, bas...
Background and objectives : Rabies is an acute and fatal infectious disease that is very importan... more Background and objectives : Rabies is an acute and fatal infectious disease that is very important due to high economic losses to livestock and the amounts of expenditures that are paid for purchasing serum and vaccine. The main way of disease transmitting is bites by rabid animals. Animal bite is an important threat for human health. The main aim of this research was epidemiological study of animal bite in the students of Hashtrood town. Material and Methods : In this cross-sectional study, animal bitten students' data were collected trough the records of Hashtrood health centers registry lists between 2006-2009. The census data collecting method was used and the data were analyzed with statistical software SPSS15. Results : The incidence of animal bites in the past 5 years was 9.07 per 1,000 students. From 439 animal bitten students, 80.9% were male and 19.1% were female. According to the results, 88.4% were rural and 11.2% were urban residents. Dogs bite was the cause of 87.9...
Journal of Research in Medical and Dental Science, 2018
Patient safety is one of the main part of quality of services provided by healthcare systems. It ... more Patient safety is one of the main part of quality of services provided by healthcare systems. It is necessary to evaluate patient safety culture among medical staff in a constant manner. This study was aimed to evaluate patient safety culture among medical working staff of Imam Hussein Hospital of Hashtroud, East Azerbaijan, Iran. The present cross-sectional study was carried out in 2017. Ninety eight staff was recruited through census sampling. Data collection tool was Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire including 42 questions and 12 dimensions. Data were analysed using SPSS software (ver.16), descriptive data; t-test, and ANOVA tests. The results showed that patient safety culture was at its average level and the highest and lowest means were for “teamwork within units” with 72.14±91.30 and “staffing” with 43.13±62.99, respectively. Based on obtained results, it is suggested that managers should identify effective factors on patient safety culture and ...
Background: After the Kermanshah earthquake on November 12, 2017, Tabriz University of Medical Sc... more Background: After the Kermanshah earthquake on November 12, 2017, Tabriz University of Medical Sciences dispatched a response team to the earthquake-stricken areas. This team provided the affected people with health services for 10 days. This article intends to examine the experience of this team in Kermanshah earthquake-stricken areas. Materials and Methods: After the team’s return from Kermanshah, a meeting was held to examine the challenges and review the learned lessons with 60 participants, including authorities and the people who were members of the team. The discussed issues were coded using content analysis. The similar codes were merged, and then categories were extracted. Results: The analysis of discussions led to 9 categories of experiences that included delay in recalling process and its challenges, lack of preparedness, use of the virtual space capacity, lack of proper assessment of the health needs and the estimation of facilities, management experience of the team on...
In June 2014, the first Health Complex was established in the suburban area of Tabriz, a northwes... more In June 2014, the first Health Complex was established in the suburban area of Tabriz, a northwest city of Iran. Health Complexes, as one of the decentralized models, have been formed based on universal health coverage principles. However, nearly two years after commencing work in the province, Health Complexes experience a high turnover of health care workers. This study aims to explore why primary health care workers set aside their roles in the health system and leave their jobs in opposition to the planned objectives. In this qualitative research, purposive and snowball sampling techniques were used for participants' selection. Data were collected through semistructured interviews and documentary review. Interviews were conducted with health officials, health care specialists, and other health workers who had left their jobs in Health Complexes in the suburban areas of Tabriz. Inductive and deductive content analysis was used to analyse data. The leading causes for health care workers leaving a job were divided into four main categories including organizational policies and regulations, financial and economic factors, sociocultural, and personal factors. Developing evidence‐informed interventions and strategies to improve payment systems, provide job security and opportunities for professional development, and adopt cooperative leadership are essential to decrease the turnover rate of health care workers at Health Complexes.
Objective: This study aimed to comprehensively determine the factors that affect the hospitals' f... more Objective: This study aimed to comprehensively determine the factors that affect the hospitals' functional preparedness in response to disasters. Methods: A systematic review of studies published in English and Persian up to the end of 2022 was performed by searching PubMed Central, Web of Science, Scopus, ProQuest, SID, and Elmnet databases. Articles that assessed hospitals' functional preparedness were searched by using a combination of medical subject heading terms and keywords including disaster, emergency, preparedness, hospital preparedness, health care facilities preparedness, hospital functional preparedness, health care facilities functional preparedness, readiness, and effective factors. Additionally, journals and gray literature were manually searched. Two independent reviewers screened the eligible papers. The inclusion criteria were the full text should be published up to the end of 2022, in both Persian and English, and focus on hospital preparedness. The extracted data were manually analyzed, summarized, and reported using the content analysis method. Results: Of the 3465 articles, 105 studies were eventually included in the final analysis. Eighty-two influential factors were identified and classified into seven categories: government, coordination, control, and commanding (7 factors), existing guidelines and preparedness plans (12 factors), regulations (6 factors), supplying of resources (37 factors), education and training (8 factors), multi-layered information management and communication systems (8 factors), and contextual factors (4 factors). Conclusion: There are different dimensions of hospital preparedness for disasters, each of which is influenced by several independent factors. Addressing these factors will enhance the actual functional preparedness of hospitals encountering disasters.
Objectives: The aim of the present study was to identify factors associated with h delayed initia... more Objectives: The aim of the present study was to identify factors associated with h delayed initiation of post-exposure prophylaxis (PEP) among animal bite victims. Methods: This cross-sectional study assessed biting patterns among 3032 cases that were referred to Tabriz Rabies Center. The delay was described as the initiation of PEP more than 48 hours (h) after possible exposure to the rabies virus. Determinants of delay in initiating PEP were recognized by a decision tree model. Results: Totally, 8.5% of the victims who were bitten by an animal had a delay of more than 48 h in the initiation of PEP. The relative frequency of a delay more than 48 h in females was higher than in males (12.9% compared to 8.5%) (p-value= 0.004). Relative frequency of a delay of more of 48 h from carnivorous (dog, jackal, fox) was significantly less than others (p-value< 0.001). Of the decision tree, the overall classification accuracy was 89.5%, with 44.1% sensitivity and 92.3% specificity. The iden...
Background: This study aimed to conduct a systematic review of models describing the integrated l... more Background: This study aimed to conduct a systematic review of models describing the integrated logistics operations performed as a response to natural disasters, with the hope to identify the challenges and limitations of healthcare systems in natural disaster management. Methods: A systematic literature search was carried out in PubMed/Medline, Scopus, Google Scholar, and bibliographies of retrieved articles using MeSH headings and keywords such as natural disaster, logistics, model. A total of 98 publications were identified through the search process. Seven potentially relevant articles met the inclusion criteria. The key demographic, clinical, and pathological information of all qualified studies were extracted from the full-text articles. Results: Among the seven included studies, six had either model data or considerations on distribution methods. Storage, human resources, infrastructures, primary priority items, coordination of organizations, and information and communicatio...
Background and Objectives : Malta fever, a zoonosis disease, which is a common health problem am... more Background and Objectives : Malta fever, a zoonosis disease, which is a common health problem among people of East Azerbaijan, has imposed sanitary and economic damage to the society. The purpose of this study was to determine the effect of interventions based on the need and epidemiological characteristics to control brucellosis in Charoaymaq city. Materials and Methods : This is a descriptive-analytic study which was conducted by collecting the information and applying interventions on the suspected patients of Malta fever in Charoaymaq. A reliable questionnaire , approved by the Iranian Ministry of Health and Medical Education was used for data collecting. According to the epidemiological situation of Malta fever in the region, some interventions such as providing face to face education to the patients and their families, establishing cooperation with organizations that play role on fighting with Malta fever were designed and applied. Follow up of the patients were conducted an...
Aims: Since the "International Congress on health and crisis management in disasters and eme... more Aims: Since the "International Congress on health and crisis management in disasters and emergencies" has provided a valuable opportunity for researchers to come together from all around the country, its output can be used as one of the indicators of disaster health research development. This article explores trend of original researches in the recent five Congress. Methods: Based on the abstract book of the last five Congress, investigated variables were: number of articles regarding to presentation methods, type of article and methodology of study. Articles were considered as research papers that were based on a defined methodology, data collection and analysis and the results of them were reported. To determine the type of research papers, the first priority was author's opinions. In about the cases that the study types were not explicitly stated, the issue discussed in a meeting and decision make with consensus. Results: At the last five congresses 1866 articles have been presented at all, that 343 Article (18.4 percent) were oral and 1523 Article (81.6%) were posters. 356 (19.1 percent) were original articles and 1510 (80.9 percent) were non original. The trend of original articles show incremental slope from 2012 to 2003 to 18.5 percent rate, but this slope in 2007 up to 2012 is not significant (3.1 percent). Conclusions: The trend of reporting of original researches as an important indicator of development of health in disaster research in the country is increasing, but accelerating of this increase will require: 1) developing and training of research methodology in the disaster, 2) developing educational programs to train researcher in this field and 3) the systematic and financial support of the disaster risk reduction and management research in the country.
Background and Objectives: Since 2014, the "health system transformation plan" was desi... more Background and Objectives: Since 2014, the "health system transformation plan" was designed and implemented in order to solve some of the problems in Iranian health system. One of the goals of this plan is to reduce direct payments by inpatients. This study aimed to compare the direct payments by inpatients, before and after implementing the transformation plan. Material and Methods: In this analytical-descriptive study, 1351 cases were selected (all cases). Direct costs paid by the inpatients were extracted from medical records and then analyzed using SPSS v.19 software and applying Uman-Whitney test. Results: The overall level of direct costs paid by inpatients before and after implementing the transformation plan has been decreased from 704 286 to 491815 Rials. A statistical relationship was observed between implementing the plan and the reduction of direct costs; but in detailed costs, there was no change. Conclusion: Health system transformation plan reduced the direc...
Background: The frequency and severity of disaster occurrence and emergency situation, and the im... more Background: The frequency and severity of disaster occurrence and emergency situation, and the importance of disaster risk communication of relief organizations to increase the readiness of societies in the case of disaster is increasing around the world. This study aimed to identify relief organizations' strategies to improve disaster risk communication in Iran. Methods: This qualitative study was conducted with the participation of 25 managers, relief workers, and people who had experiences in response to one of the disasters. The data were collected using semi-structured interviews and analyzed using conventional content analysis.Results: The analysis of the data of this study led to the identification of 3 categories and 9 sub-categories regarding strategies of relief organizations to improve risk communication. These categories are 1) management of information and training communication (facilitation of training processes, diverse training strategies, and integrated informi...
Background and Objectives : Pre-hospital Emergency Medical Services (EMS) is one of the most impo... more Background and Objectives : Pre-hospital Emergency Medical Services (EMS) is one of the most important components of health care systems. Community awareness about its services could improve the performance. This study is aimed at assessing the citizens' awareness and satisfaction about Shiraz EMS. Materials and Methods : Through this cross-sectional study, 1680 residents of Shiraz citizens have been selected by cluster random sampling. Each person has been asked some questions about their knowledge and also satisfaction of EMS performance with a valid and reliable questionnaire through phone interview. The data were analyzed with SPSS using T- test, Anova and Regression with "0.05" level of significance. Results : This study revealed that the knowledge of the residents who are living in lower socioeconomic part of the city is lower than the residents of the other areas. The mean awareness score of each area was significantly different comparing to the other areas, bas...
Background and objectives : Rabies is an acute and fatal infectious disease that is very importan... more Background and objectives : Rabies is an acute and fatal infectious disease that is very important due to high economic losses to livestock and the amounts of expenditures that are paid for purchasing serum and vaccine. The main way of disease transmitting is bites by rabid animals. Animal bite is an important threat for human health. The main aim of this research was epidemiological study of animal bite in the students of Hashtrood town. Material and Methods : In this cross-sectional study, animal bitten students' data were collected trough the records of Hashtrood health centers registry lists between 2006-2009. The census data collecting method was used and the data were analyzed with statistical software SPSS15. Results : The incidence of animal bites in the past 5 years was 9.07 per 1,000 students. From 439 animal bitten students, 80.9% were male and 19.1% were female. According to the results, 88.4% were rural and 11.2% were urban residents. Dogs bite was the cause of 87.9...
Journal of Research in Medical and Dental Science, 2018
Patient safety is one of the main part of quality of services provided by healthcare systems. It ... more Patient safety is one of the main part of quality of services provided by healthcare systems. It is necessary to evaluate patient safety culture among medical staff in a constant manner. This study was aimed to evaluate patient safety culture among medical working staff of Imam Hussein Hospital of Hashtroud, East Azerbaijan, Iran. The present cross-sectional study was carried out in 2017. Ninety eight staff was recruited through census sampling. Data collection tool was Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire including 42 questions and 12 dimensions. Data were analysed using SPSS software (ver.16), descriptive data; t-test, and ANOVA tests. The results showed that patient safety culture was at its average level and the highest and lowest means were for “teamwork within units” with 72.14±91.30 and “staffing” with 43.13±62.99, respectively. Based on obtained results, it is suggested that managers should identify effective factors on patient safety culture and ...
Background: After the Kermanshah earthquake on November 12, 2017, Tabriz University of Medical Sc... more Background: After the Kermanshah earthquake on November 12, 2017, Tabriz University of Medical Sciences dispatched a response team to the earthquake-stricken areas. This team provided the affected people with health services for 10 days. This article intends to examine the experience of this team in Kermanshah earthquake-stricken areas. Materials and Methods: After the team’s return from Kermanshah, a meeting was held to examine the challenges and review the learned lessons with 60 participants, including authorities and the people who were members of the team. The discussed issues were coded using content analysis. The similar codes were merged, and then categories were extracted. Results: The analysis of discussions led to 9 categories of experiences that included delay in recalling process and its challenges, lack of preparedness, use of the virtual space capacity, lack of proper assessment of the health needs and the estimation of facilities, management experience of the team on...
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