Suchergebnisse

INTRODUCTION: Iran's Health System Reform Plan (HSRP) were initiated in public and hospitals affiliated to Medical Sciences Universities in June 2015. The purpose of the present paper is to provide a critical analyse of the HSRP and its outcomes. METHODS: The study was carried out as a review critical analyse in 2019. The pertinent articles were searched for in Science Direct, PubMed, Ovid, and Google Scholar using keywords "health sector," "reform plan," "health system reform," "health services," "health care system," and "Iran." Published articles in scientific national and international journals in Persian and English language, of which the full-texts were available, were entered into the study. Finally, from a total of 75 articles obtained, 45 studies were carefully reviewed. RESULTS: Several factors, which impact in the success of Iran's HSRP such as social-economic and political outlooks, lack of official information and a comprehensive management system, in addition to failure to extend continuous performance control, economic sanctions against Iran. Other factors are limitations on financial transactions between Iran and the rest of the world due to the sanctions, relying merely on a few instructions, and negligence of the required infrastructures. In terms of advantages of the plan, relative decrease in patient's share in medical expenses, improvement of emergency wards, and relative decrease in the rate of C-section operations are notable. CONCLUSION: Better implementation of Iran's HSRP entails the provision of resources and facilities such as stable and adequate resources, proper management of available resources, payment mechanisms reform, attracting, and facilitating private sector's participation.

Background and Aim: Women with gestational diabetes are at risk for type 2 diabetes. Development of self-efficacy is an important tool for active participation in treatment and behavioral change and can have a significant effect on type 2 diabetes-preventative behaviors. Therefore, it is necessary to search for an effective teaching method to improve the self-efficacy of these individuals. Accordingly, the aim of the present article is to determine the effect of smartphone-based education on self-efficacy in women with gestational diabetes (GDM). Materials and Methods: This randomized clinical trial was conducted on 90 women with GDM (n=45 individuals per group) at Yas Medical Center, Tehran. GDM software was installed on the cell phone of the intervention group. The control group only received the prenatal routine training. The self-efficacy questionnaire was completed before and 6 weeks after the intervention by the two groups. Data analysis was carried out using Chi-square, t-test, independent t-test, and Fisher exact test in SPSS ver. 16. P-value 0.05 was considered as the significance level. Results: There was a statistically significant difference between the two groups in terms of self-efficacy changes before and 6 weeks after the intervention (p 0.001), meaning that these changes were significantly higher in the experimental group than the control group. Conclusion: Smartphone-based education can increase self-efficacy in women with GDM as an effective and low-cost method