scholarly journals Policy Making Challenges in the scope of Oral Health in Developing Countries A Qualitative Study of the Islamic Republic of Iran

2019 ◽  
Author(s):  
Mohammad Mohammadpour ◽  
Peivand Bastani ◽  
Arash Ghanbarzadegan ◽  
Jamshid Bahmai

Abstract Background As the strategies proposed for oral health improvement in developed countries do not adapt for the setting of the developing ones, this study is to identify the challenges of oral health policy making in developing countries.Methods It was a qualitative study conducted in 2019 in Iran as a middle-eastern developing country. The study population included all the experts who have enough experience in the scope and have the eagerness to participate. Snowball sampling was used to include the participants and after 12 semi-structured interviews saturation was achieved. Guba and Lincoln criteria containing acceptability, validity, reliability, and transferability were used to assure the study reliability and finally five-stage framework analysis method was used to analyze the data.Results The analysis of the results of the interviews resulted in the identification of 7 main themes and 20 sub-themes as the main challenges of achieving oral health in a developing country. The main themes identified were: policy making, implementing, educational, stewardship, prevention, insurance, and resource allocating. Conclusion: According to the present results, it seems that national coverage of oral health and the integration of these services in prevention ones and serious attention to the private sector can be considered as the most important strategies for achieving improved oral health.

2020 ◽  
Author(s):  
Mohammad Mohammadpour ◽  
Peivand Bastani ◽  
Arash Ghanbarzadegan ◽  
Jamshid Bahmaei

Abstract Background: As the strategies proposed for oral health improvement in developed countries do not adapt for the setting of the developing ones, this study aimed to identify the challenges and barriers of oral health policymaking in Iran as a low-income developing country. Methods: This is a qualitative study conducted in 2019 in Iran as a middle-eastern developing country. The study population consisted of all the experts who had enough experience in the oral health and were willing to participate in the study. Snowball sampling was used to select 12 participants for semi-structured interviews and saturation was achieved after 16 interviews with them. Guba and Lincoln criteria including credibility, transferability, confirmability and dependability were used to determine the reliability and transparency, and finally five-step framework analysis method was used to analyze the data. Results: The analysis of the results of the interviews resulted in identification of 7 main themes and 20 sub-themes as the main challenges of achieving oral health in Iran as a developing country. The main themes identified were: policymaking, implementing, educational, stewardship, prevention, insurance, and resource allocating. Conclusion: According to the present results, it seems that the national coverage of oral health and integration of these services in prevention and serious attention to the private sector can be considered as the most important strategies for achieving improved oral health. Keywords: oral health, developing country, policymaking, strategy.


2020 ◽  
Author(s):  
Mohammadtaghi Mohammadpour ◽  
Peivand Bastani ◽  
Arash Ghanbarzadegan ◽  
Jamshid Bahmaei

Abstract Background: As the strategies proposed for oral health improvement in developed countries do not adapt for the setting of the developing ones, this study aimed to identify the challenges of oral health policy implementation in Iran as a low-income developing country. Methods: This is a qualitative study conducted in 2019 in Iran as a middle-eastern developing country. The study population consisted of all the experts who had enough experience in the oral health and were willing to participate in the study. Snowball sampling was used to select 12 participants for semi-structured interviews and saturation was achieved after 16 interviews with them. Guba and Lincoln criteria including credibility, transferability, confirmability and dependability were used to determine the reliability and transparency, and finally five-step framework analysis method was used to analyze the data. Results: The analysis of the interviews resulted in identification of 7 main themes that are categorized in 5 problems of policy implementation proposed by Matus framework. The main themes of executive and preventive challenges to implement oral health policies are categorized as organizational problem, the main themes of educational and resource challenges are situated as the material problems, and the present main themes of insurance, policy making and trusteeship challenges are considered as the legal, policymaking and perspective. Conclusion: According to the present results, the implementation of oral health policies has faced some challenges. It seems that the national coverage of oral health and integration of these services in prevention and serious attention to the private sector can be considered as the most important strategies for achieving improved oral health in Iran.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Saeed Shahabi ◽  
Ahmad Ahmadi Teymourlouy ◽  
Hosein Shabaninejad ◽  
Mohammad Kamali ◽  
Kamran Bagheri Lankarani ◽  
...  

Abstract Background Although the main aims of sanctions are the political and economic pressures on governments, literature has demonstrated the harsh effects of sanctions on the general public, especially on the patients, poor and disabled people. Since the international sanctions regime negatively affected almost all dimensions of Iran’s health sector, this qualitative study was conducted to investigate the situation of the physical rehabilitation sector after these sanctions. Methods This qualitative study was conducted from January 2019 to June 2019 in Iran using Skype, telephone, and face-to-face in-depth semi-structured interviews. Purposive and snowball sampling approaches were used to identify the participants. Also, framework analysis approach was applied to analyze the collected data. Results In total, 38 individuals including health policy-maker, faculty member, rehabilitation expert, Physiotherapist, Occupational therapist, and Orthotist/Prosthetist, were involved in the study. Based on our findings, a number of challenges facing the Iranian physical rehabilitation sector during the international sanctions period included: 1) socioeconomic challenges (inadequate funding, rising inflation rate, high unemployment rate, catastrophic expenditures, and inappropriate employment status of practitioners); 2) education challenges (decreased international collaboration and shortage of training devices and materials); 3) international challenges (rising issues in accessing services for patients from neighborhood countries); and 4) service delivery challenges (shortage of raw materials for producing the orthoses and prostheses, hardening of the importing the needed equipment, inappropriate infrastructures, and impossibility to use external assistance). Conclusion After international sanctions, the Iranian physical rehabilitation sector has faced considerable multifaceted challenges. Therefore, the international community must be aware of the situation and be concerned about the irreparable consequences.


2016 ◽  
Vol 34 (4) ◽  
pp. 280-289 ◽  
Author(s):  
Ellen T Crumley

Background Internationally, physicians are integrating medical acupuncture into their practice. Although there are some informative surveys and reviews, there are few international, exploratory studies detailing how physicians have accommodated medical acupuncture (eg, by modifying schedules, space and processes). Objective To examine how physicians integrate medical acupuncture into their practice. Methods Semi-structured interviews and participant observations of physicians practising medical acupuncture were conducted using convenience and snowball sampling. Data were analysed in NVivo and themes were developed. Despite variation, three principal models were developed to summarise the different ways that physicians integrated medical acupuncture into their practice, using the core concept of ‘helping’. Quotes were used to illustrate each model and its corresponding themes. Results There were 25 participants from 11 countries: 21 agreed to be interviewed and four engaged in participant observations. Seventy-two per cent were general practitioners. The three models were: (1) appointments (44%); (2) clinics (44%); and (3) full-time practice (24%). Some physicians held both appointments and regular clinics (models 1 and 2). Most full-time physicians initially tried appointments and/or clinics. Some physicians charged to offset administration costs or compensate for their time. Discussion Despite variation within each category, the three models encapsulated how physicians described their integration of medical acupuncture. Physicians varied in how often they administered medical acupuncture and the amount of time they spent with patients. Although 24% of physicians surveyed administered medical acupuncture full-time, most practised it part-time. Each individual physician incorporated medical acupuncture in the way that worked best for their practice.


Author(s):  
Amalia De Leo ◽  
Eloisa Cianci ◽  
Paolo Mastore ◽  
Caterina Gozzoli

The COVID-19 pandemic put the Italian health system under great stress. The sudden reorganization of work practices and the emotional impact of the large number of the victims had many consequences on the well-being of the healthcare professionals (HCPs) involved in managing the crisis. In the available literature, most studies have focused on the risk aspects while only few studies also take into account protective factors. For this reason, it was decided to conduct, within psycho-sociological perspective, a qualitative study with the aim to explore in depth the protective and risk factors as experienced by HCPs who worked in the Italian healthcare system during the COVID-19 outbreak. A total of 19 semi-structured interviews were conducted with HCPs–9 nurses and 10 physicians (7M and 12F) with an average age of 43 (SD = 13.4)–selected using snowball sampling. Considering three different levels of analysis the results highlight the protective and risk factors: personal history level (intrinsic/ethical motivation and flexible role versus extrinsic motivation and static role), interpersonal level (perception of supportive relationships with colleagues, patients, and family versus bad relationships), and organizational level (good leadership and sustainable work purpose versus absence of support from management and undefined or confused tasks).


2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Sogand Tourani ◽  
Narges Rafiei ◽  
Shahnaz Rimaz ◽  
Seyed Kazem Malakouti ◽  
Alireza Heidari

BACKGROUND፡ Recently, one of the challenges in the health system of the country is the need for research contributing to policy-making. Therefore, it is crucial to develop activities in the field of knowledge Translation (KT). This study aimed to propose KT improvement strategies in universities of medical sciences in Iran.METHODS: In this qualitative study, 18 semi-structured interviews were conducted with key informants from the medical universities in Iran during January-July 2018. The transcribed documents were analyzed using the Gale framework analysis approach. Data organization was carried out using MAXQDA version 10 software.RESULTS: According to framework analysis, six KT improvement strategies were identified including improving the abilities and skills of researchers, improving the processes and quality of knowledge production, revising policies and laws, mproving the prerequisites, culture-building, and promoting the, use of evidence.CONCLUSION: Given the challenges and strategies outlined in this study, it seems that the mechanism of KT and its effects on improving health plans for policymakers and researchers has not been elucidated yet. Therefore, considerable changes in prerequisites, knowledge production processes, academic procedures, policies and laws are necessary for implementing KT in universities of medical sciences in Iran. 


2021 ◽  
Vol 57 (3) ◽  
Author(s):  
Phumudzo Raphulu ◽  
Modjadji Linda Shirindi ◽  
Mankwane Daisy Makofane

Caring for children with cerebral palsy presents numerous circumstances which may contribute to mothers’ inability to cope with the demands of meeting their children’s needs. A qualitative study supported by explorative, descriptive and contextual designs was undertaken. Purposive and snowball sampling facilitated the identification of twelve participants who were interviewed through semi-structured interviews. The enquiry was based on the ecosystems approach. Thematic data analysis was followed through Tesch’s eight steps and Guba’s model was used for data verification. The findings highlighted the necessity to enhance the psycho-social functioning of mothers through collaboration of social workers, health professionals and various organisations.


Author(s):  
Razieh Zahedi ◽  
Leila Nemati-Anaraki ◽  
Shahram Sedghi ◽  
Mamak Shariat

Background & Aim: Patient decision aids are detailed and personalized health education materials that assist patients in decision making. According to expert viewpoints, this study aimed to determine important factors in implementing the prenatal screening decision aid in Iran. Methods & Materials: In this qualitative study, 24 experts, including seven obstetricians, four information scientists, five managers or policymakers, and eight midwives, were selected using purposive and snowball sampling approaches. Semi-structured interviews were conducted to collect the data between January 2020 and June 2020 in Tehran, Iran. A prenatal screening decision aid was presented to the participants, and we asked them to raise their concerns and thoughts regarding the factors influencing the implementation of patient decision aids. We used MAXQDA 10 and applied conventional content analysis for data analysis. Results: Two organizational and personal factors themes were identified to implement Iran's prenatal screening decision aids. Conclusion: We identified the viewpoints of experts regarding major factors in patient decision aids implementation for prenatal screening. Before implementing prenatal screening decision aids in Iran, it would be helpful to consider these organizational and personal factors. Prenatal screening decision aids can provide better information for pregnant women and strengthen their decision-making ability.


Author(s):  
Gary Lamph ◽  
John Baker ◽  
Tommy Dickinson ◽  
Karina Lovell

Abstract Background: High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England. Aims: This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment. Method: A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach. Results: Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important. Conclusions: For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.


Author(s):  
Louis Lefèvre ◽  
Maud Jourdain ◽  
Jean-Pascal Fournier

Abstract Aim: Our objective was to explore the processes and determinants leading physicians to integrate estimated glomerular filtration rate (eGFR) in their drug prescriptions Background: Access to patients’ eGFR would allow primary care pharmacists to optimise their role in the procedure of safe prescribing. Some rare physicians actively integrate eGFR in their prescriptions, in a sporadically and uncoordinated manner. Methods: Qualitative study using semi-directed interviews conducted among 12 French physicians who integrated eGFR in their drug prescriptions, (February 2016–April 2017). These voluntary participants were recruited through different means: Twitter®, forums, direct contact and snowball sampling. Data analysis was based on the grounded theory approach, underpinned by a comprehensive perspective of interactionist orientation. Findings: Residency and training, professional experience – including experiences of adverse drug reactions – and the membership in various communities of professionals were key drivers for the integration of eGFR in prescriptions. The theoretical aim was above all safe prescribing in order to reduce adverse drug reactions, with the control by a dispensing pharmacist and/or other healthcare professionals. Nevertheless, none of the physicians had received any feedback from any healthcare professionals. Despite their disappointment, the physicians remained convinced of the interest of integrating eGFR in their prescriptions and would continue to do so. Characteristics associated with integration of eGFR in drug prescriptions belong partly to Roger’s theory of innovations. If a widespread diffusion of this habit takes place, it will be necessary to evaluate its adoption by both physicians and pharmacists.


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