168 research outputs found
Political analysis of health technology assessment implementation in Iran
No full textBACKGROUND: Health technology assessment (HTA) is a critical tool for evidence-based decision-making in healthcare systems, yet its implementation in low- and middle-income countries such as Iran remains understudied. This study examines the political dynamics of HTA implementation in Iran, focussing on the roles, interests and interactions of key stakeholders. By addressing the gap in understanding the political challenges and opportunities associated with HTA implementation, this study aims to provide actionable insights for policymakers and practitioners. METHODS: A qualitative study design was employed, using in-depth semi-structured interviews with 19 stakeholders from 6 categories: interest groups, political leaders, donors, financial decision-makers, beneficiaries and bureaucracies. Participants were selected through purposive sampling to ensure representation across sectors. Data were analysed using thematic analysis, guided by the political analysis framework of Campos and Reich. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to ensure methodological rigour. RESULTS: The findings reveal significant barriers to HTA implementation in Iran, including limited political will, competing priorities, inter-agency coordination challenges and concerns about equity and access. Interest groups, such as physicians and pharmacists, expressed concerns about restricted clinical autonomy and limited access to innovative treatments. Political leaders emphasized the difficulty of prioritizing HTA amidst competing healthcare and economic issues, whilst donors highlighted the need for alignment with national priorities and long-term sustainability. Financial decision-makers acknowledged the potential of HTA to improve resource allocation but raised concerns about budgetary constraints. Beneficiaries stressed the importance of transparency and inclusion, and bureaucrats underscored the need for stronger leadership and capacity building. CONCLUSIONS: The study underscores the importance of strong political leadership, stakeholder engagement and institutional capacity building for successful HTA implementation in Iran. Practical steps include strengthening inter-agency coordination mechanisms, ensuring transparent and inclusive decision-making processes, aligning donor support with national health priorities and investing in training programs to build technical capacity within government agencies. By addressing these challenges, policymakers can enhance the integration of HTA into the health system, ensuring efficient and equitable resource allocation
Mapping the social networks of key actors in the development of health technology assessment in Iran
No full textBackground: Health Technology Assessment (HTA) is vital for evidence-based policymaking and resource allocation. In Iran, HTA development involves diverse actors with varying levels of power, influence, and support. Understanding their interactions is key to strengthening HTA processes. Methods: We applied Social Network Analysis (SNA) to map relationships among 27 stakeholders identified through document review and expert interviews. Data were collected via an online questionnaire completed by 83 experts (response rate: 72.2%), assessing five dimensions: power, position, interest, influence, and support. Network metrics, including degree, closeness, betweenness, and eigenvector centrality, were analyzed using R Version 4.4.1. Results: The Ministry of Health and Medical Education, Food and Drug Administration, Insurance Organizations, and Parliament were perceived as the most influential actors. The Plan and Budget Organization (degree centrality 0.34) and National Institute of Health Research (0.26) emerged as key connectors with high bridging roles. Overall, the network exhibited low density (0.13) and limited clustering (0.11), indicating sparse connectivity. Peripheral actors, such as the Chamber of Commerce, were largely disconnected from the network. Conclusion: HTA development in Iran is shaped by a few central institutions, but weak connectivity and limited engagement of peripheral actors hinder collaboration. Strengthening stakeholder communication, enhancing inclusiveness, and securing sustainable funding are critical for more effective HTA implementation and evidence-informed health policy
Iran's Health System Transformation Plan: A SWOT analysis
No full textBackground: Societies are characterized by evolving health needs, which become more challenging throughout time, to which health system should respond. As such, a constant monitoring and a periodic review and reformation of healthcare systems are of fundamental importance to increase the efficiency and effectiveness of healthcare services delivery, equity, and sustainable funding. The establishment of President Rouhani's government in Iran, on May 5, 2014, the settlement of the new Ministry of Health and Medical Education administration (MoHME) and the need for change in the provision of healthcare services has led to the "Health System Transformation Plan" (HSTP). The aim of the current investigation was to critically evaluate the health transformation plan in Iran. Methods: Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis enables to identify and assess the strengths and weaknesses within an organization or program, as well as the threats and opportunities outside the given organization or program. To identify SWOT of the HSTP in Iran, all articles concerning this program published in scholarly databases as well as in the gray literature were systematically searched. Subsequently, all factors identified at the first round were thematically classified into four categories and for reaching consensus on this classification, the list of points and factors was sent to 40 experts - policy- and decisionmakers, professors and academicians, health department workers, health activists, journalists. Results: Thirty-four subjects expressed comments on classification. Incorporating their suggestions, the SWOT analysis of Iran's HSTP was revised, finalized and then performed. Conclusion: HSTP in Iran, like many of the initiatives that have been recently introduced and not fully implemented, have various challenges, difficulties and pitfalls that health policymakers need to pay attention to. Interacting with criticisms, taking into account public opinion and strengthening the plan can make the project more effective, and it can be anticipated that in the future, better conditions in the health sector will be achieved. © Iran University of Medical Sciences
Redefining Khabar Al-Ahad Based on Rashid Rida’s Rational Approach in Al-Manar
No full textThis paper discusses the Rida controversy with hadith scholars. The controversy stems from Rida’s a priori to the traditions that are popular and well-known among hadith scholars, especially the category of khabar al-ahad hadith. The root of their problem lies in Rida’s rational critique of the categories and implications of khabar al-ahad. He considers dilalah (connotation) of khabar al-ahad to be nothing more than just zanni al-dilalah (presumption and uncertainty). The implication is that hadith in this category cannot be used as a basis for belief because belief is based on qat’i al-dilalah (certainty of proposition). The research method used was descriptive-analytic method. This method was combined with a historical-philosophical approach. Therefore, analyzing and describing Rida’s thoughts as a whole is the main work in this article. The next step was to combine the analytical-philosophical approach to the roadmap from the genuine part of Rida’s line of thought. This activity is expected to help the author in finding answers on how Rida rationalizes khabar al-ahad and its implications. Finally, this article finds the conclusions, including: a) Rida’s efforts in rationalizing khabar al-ahad are based on the views of the mutakallimūn (theologians), manat}iqah (logic experts) and falasifah (philosophers), b) Rida has been trapped in his own over a priori thinking on khabar al-ahad, c) Rashid Rida’s rationalization of khabar al-ahad actually leads to ambiguity and uncertainty
Mapping research trends of universal health coverage from 1990 to 2019: Bibliometric analysis
No full textBackground: Universal health coverage (UHC) is one of many ambitious, health-related, sustainable development goals. Sharing various experiences of achieving UHC, in terms of challenges, pitfalls, and future prospects, can help policy and decision-makers reduce the likelihood of committing errors. As such, scholarly articles and technical reports are of paramount importance in shedding light on the determinants that make it possible to achieve UHC. Objective: The purpose of this study is to conduct a comprehensive analysis of UHC-related scientific literature from 1990 to 2019. Methods: We carried out a bibliometric analysis of papers related to UHC published from January 1990 to September 2019 and indexed in Scopus via VOSviewer (version 1.6.13; CWTS). Relevant information was extracted: the number of papers published, the 20 authors with the highest number of publications in the field of UHC, the 20 journals with the highest number of publications related to UHC, the 20 most active funding sources for UHC-related research, the 20 institutes and research centers that have produced the highest number of UHC-related research papers, the 20 countries that contributed the most to the research field of UHC, the 20 most cited papers, and the latest available impact factors of journals in 2018 that included the UHC-related items under investigation. Results: In our analysis, 7224 articles were included. The publication trend was increasing, showing high interest in the scientific community. Most researchers were from the United States, the United Kingdom, and Canada, with Thailand being a notable exception. The Lancet accounted for 3.95 of published UHC-related research. Among the top 20 funding sources, the World Health Organization (WHO), the Bill and Melinda Gates Foundation, and the National Institutes of Health (NIH) accounted for 1.41, 1.34, and 1.02 of published UHC-related research, respectively. The highest number of citations was found for articles published in The Lancet, the American Journal of Psychiatry, and the Journal of the American Medical Association (JAMA). The top keywords were �health insurance,� �insurance,� �healthcare policy,� �healthcare delivery,� �economics,� �priority,� �healthcare cost,� �organization and management,� �health services accessibility,� �reform,� �public health,� and �health policy.� Conclusions: The findings of our study showed an increasing scholarly interest in UHC and related issues. However, most research concentrated in middle- and high-income regions and countries. Therefore, research in low-income countries should be promoted and supported, as this could enable a better understanding of the determinants of the barriers and obstacles to UHC achievement and improve global health. © Mahboubeh Khaton Ghanbari, Masoud Behzadifar, Leila Doshmangir, Mariano Martini, Ahad Bakhtiari, Mahtab Alikhani, Nicola Luigi Bragazz
The barriers to the application of strategic purchasing and the role of health policy- and decision-makers: past, current status, ethical aspects and future challenges
No full textHealthcare systems are complex, multi-level, highly integrated organizations, comprising of different professional figures, institutions, and resources. Such breadth and complexity reflect the multi-dimensionality of the concept of health, which implies the adoption of a holistic approach. Health, rather than merely being the absence of disorders or infirmity, is a highly dynamic state, which represents the abilities of an individual to cope with adverse social, physical and emotional/psychological events and conditions, continuously adapting to them. Ensuring an adequate health state is one of the most important concerns, and the healthcare systems are called to renew themselves in order to meet with the new challenges and health needs. Throughout the last decades, due to demographic shifts and transitions, epidemiological and societal changes, technological achievements and scientific advancements, healthcare systems have undergone an extensive series of reform plans. Therefore, health policy- and decision-makers have made efforts to develop and implement initiatives for preserving the quality of the healthcare provisions. Strategic purchasing is an approach of purchasing that takes into account several health-related issues such as a proper, comprehensive planning of service delivery, the design and selection of the best packages of services and provisions, the appropriate selection of providers and the allocation of economical and financial incentives to provide better services and to motivate managers to adopt appropriate policies to implement strategic purchasing. Here, we intend to consider the various dimensions and aspects that can be effective in strategic purchasing, as well as the main barriers and obstacles that hinder its full implementation
An interview with Ali M. Ahad
No full textAli Mumin Ahad is a Somali scholar with multifaceted interests and a personal life story that brought him from Somalia to Italy, and now to Australia. Ali obtained his undergraduate degree in Economics at the Somali National University, and then moved to Italy where he earned his master’s degree in agribusiness at Università Cattolica del Sacro Cuore, in Milan. His doctorate was awarded by La Trobe University in Australia, while he now holds a position as Honorary Research Fellow at Melbourne University, Faculty of Arts. In his works, Ali focuses on Somali history, including colonialism, on literature, and on questions of migration and integration. He is the author of the book “Somali Oral Poetry and the Failed She-Camel Nation State: A Critical Discourse Analysis of the Deelley Poetry Debate (1979-1980)”, published in 2015. Ali is also an eminent voice of Italian post-colonial studies: his “I peccati storici del colonialismo” is a must-read for those interested in understanding the legacy of Italian colonialism in Somalia. Marco Zoppi has conducted this interview for WardheerNews.com, and wishes to thank Ali M. Ahad for his kind availability
The economic burden of breast cancer in western Iran: a cross-sectional cost-of-illness study
No full textAbstract Background Breast cancer is a significant global health challenge, affecting millions annually and imposing a considerable burden on healthcare systems and economies worldwide. This cross-sectional study aims to determine the economic impact of breast cancer in Lorestan Province, western Iran. Methods A retrospective cost-of-illness analysis utilizing a cross-sectional design was performed from November 2023 to July 2024. Data were collected using patient medical records and telephonic interviews. Costs were categorized into direct medical costs, direct non-medical costs, and indirect costs. A bottom-up approach was employed for cost calculation from a societal viewpoint, with a prevalence-based analysis. Results The study analyzed 525 patients with an average age of 42.74 ± 11.75 years. The total economic burden of breast cancer was estimated at 10,275.07 per patient. Direct medical costs comprised 70.2% of the total expenses, primarily attributed to hospitalization, chemotherapy, and laboratory tests. Direct non-medical costs, including accommodation and transportation for patients and their companions, accounted for 12.5%. Indirect costs, largely stemming from productivity losses due to morbidity and mortality, represented 17.3% of the total burden. Conclusion Breast cancer imposes a substantial economic burden on patients and their families in Lorestan Province. Enhancing health insurance coverage, providing government subsidies for treatment, and improving healthcare infrastructure to offer advanced diagnostic and treatment options locally are critical steps to alleviate this burden. Early detection and prevention programs can facilitate earlier diagnosis and reduce treatment costs. Comprehensive policies addressing both medical and non-medical expenses are necessary to improve patients’ quality of life and lessen the financial challenges associated with breast cancer in Iran
Investigation of compression behavior of PE/EVA foam injection molded parts
No full textThe main objective of the presented work is to evaluate the compression behavior of a polymeric foam blend by using a robust framework for the testing sequence of foaming injection molded parts, with the aim of establishing a standard testing cycle for the evaluation of new matrix material. The research purpose is to assess parameters influencing compression behavior and give useful suggestions for the implementation of a finite element analysis. The polymeric blend consisted of a mixture of low density polyethylenes (LDPEs), a high- density polyethylene (HDPE), an ethylenevinyl acetate (EVA) and an azodicarbonamide (ADC). The thermal, rheological and compression properties of the blend are fully described, as well as the injection molding process for two specimen types
Laser welding of polypropylene using two different sources
No full textIn this paper, laser weldability of neutral polypropylene has been investigated using fibre and carbon dioxide lasers. A design of experiment (DoE) was conducted in order to establish the influence of the main working parameters on the welding strength of the two types of laser. The welded samples were characterized by carrying out visual and microscopic inspection for the welding morphology and cross-section, and by distinguishing the tensile strength. The resulting weld quality was investigated by means of optical microscopy at weld cross-sections. The tensile strength of butt-welded materials was measured and compared to that of a corresponding bulk material
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