Zahra Jorjoran Shushtari; Marzieh Shirazikhah; Sina Ahmadi; Yahya Salimi; Akbar Biglarian; Ali Almasi; Toktam Paykani
Abstract
Background: Iran, after China, emerged as one of the first COVID-19 epidemic countries. Despite all efforts to interrupt new transmission chains, the virus continued to quickly spread across the country. WHO has highlighted a crucial role for social factors and intersectoral collaboration to tackle COVID-19. ...
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Background: Iran, after China, emerged as one of the first COVID-19 epidemic countries. Despite all efforts to interrupt new transmission chains, the virus continued to quickly spread across the country. WHO has highlighted a crucial role for social factors and intersectoral collaboration to tackle COVID-19. This study aimed to identify challenges related to the upstream determinants and downstream risk factors of COVID-19 infection in Iran as perceived by health professionals at different levels of service administration. Methods: We conducted a qualitative study in October 2020. A directed qualitative content analysis was done to explore the views of health professionals and administrators toward determinants of COVID-19 infection in Iran. Using a deductive approach, we tested the implications of the WHO Commission on the Social Determinants of Health (CSDH) framework regarding COVID-19. Results: The determinants of COVID-19 infection in Iran are referred to as: 1) upstream social determinants, including political considerations in dealing with COVID-19, conflicting authority structures between and within organizations and sectors, poor intersectoral collaboration, unstable macroeconomic environment, pandemic crisis management, poor governance in the health system, cultural and societal values, trust and social capital, and individuals’ socioeconomic status; and 2) downstream risk factors, including poor health literacy, poor compliance with COVID-19 prevention guidelines, secrecy related to the infection, individual’s health status, lifestyle, and virus characteristics. Conclusion: It is essential to motivate people to practice preventive COVID-19 infection behaviors. To change the behavior at the population level, a complex fusion of policy and practice, and dealing with the complexity of structural determinants and downstream risk factors are needed.
Mohammad Khammarnia; Seyed Mohammad Hashemi-Shahri; Alireza Ansari-Moghaddam; Seyed Mehdi Tabatabaei; Ali Naghizadeh; Mohammadhadi Abbasi; Seyed Mohammad Nasiruddin Tabatabaei; Fatemeh Setoodehzadeh; Mehdi Zangane Bayegi; Majid Sartipi
Abstract
Background: COVID-19 has become a global problem. In this case study, the experiences gained from disease control in rural areas are reported. Methods: An observational study was done in 2020 in Sistan and Balochestan, the largest province with most rural areas in the southeast of Iran. Results: After ...
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Background: COVID-19 has become a global problem. In this case study, the experiences gained from disease control in rural areas are reported. Methods: An observational study was done in 2020 in Sistan and Balochestan, the largest province with most rural areas in the southeast of Iran. Results: After identification of the first patient of Covid-19 in a rural area, three measures were taken including: 1. Diagnosis, screening and treatment of the disease (Incident command post was established and the village was completely quarantined, etc.; 2. Intersectoral coordination for epidemiological management (limiting traffic for people and any gathering); and 3. Identification of any Covid-19 positive cases. The results of these measures showed that after quarantining the village and performing the mentioned actions, the number of patients decreased, and the disease was controlled. Conclusion: Quarantine of the contaminated rural area and people’s traffic routes is one of the most important measures in controlling Covid-19.
