Search

Purpose: This research paper aims to delve into the perceptions of health susceptibility among Iranian, Afghan and Tajik individuals hailing from asylum-seeking or refused asylum-seeking backgrounds currently residing in Finland, Norway and Sweden. Design/methodology/approach: Semi-structured interviews were conducted between May and October 2022 involving a sample size of 27 participants. An adapted framework based on the health belief model along with previous studies served as a guide for formulating interview questions. Findings: Notably influenced by cultural background, religious beliefs, psychological states and past traumatic experiences during migration journeys – before arrival in these countries till settling down – subjects' perception of health concerns emerged significantly shaped. Additionally impacting perspectives were social standing, occupational status, personal/family medical history, lifestyle choices and dietary preferences nurtured over time, leading to varying degrees of influence upon individuals' interpretation about their own wellness or illness. Practical implications: Insights garnered throughout the authors' analysis hold paramount significance when it comes to developing targeted strategies catering culturally sensitive health-care provisions, alongside framing policies better aligned with primary care services tailored explicitly around singular demands posed by these specific communities dwelling within respective territories. Originality/value: This investigation represents one among few pioneering initiatives assessing perceptions regarding both physical and mental well-being within minority groups under examination across Nordic nations, unveiling complexities arising through intersecting factors like individual attributes mingling intricately with socio-cultural environments, thereby forming unique viewpoints towards health-care belief systems prevalent among such population segments. [ABSTRACT FROM AUTHOR]

Purpose: Reducing health inequalities between the poor and the rich is one of the challenges that the Iranian healthcare sector is facing. One of the goals of the Iranian Government in the Healthcare Sector Evolution Plan (HSEP) is claimed to be creating an opportunity for the poor to use inexpensive services. The purpose of this paper is to provide an analysis of the status of the poor in the HSEP. Based on this evaluation, the authors will provide policy recommendations to improve the benefits of the HSEP for the poor people. Design/methodology/approach: This paper is based on a qualitative study conducted in 2017. The research sample includes policymakers, experts and scholars at the macro-level of the Iranian healthcare system who were well-aware of the financial support for the poor. Overall, 35 semi-structured interviews were carried out. Data were analyzed based on the thematic analysis method. Findings: The effects of the HSEP on the poor were studied in terms of their positive outcomes and challenges. Despite the achievements of the HSEP for all people, the most important challenge was the lack of targeted state subsidies for the poor. These subsidies should have included free insurance coverage, reducing inpatient payment and allocation of a separate budget for the poor. Originality/value: Adopting some policies to target public health subsidies toward the poor such as free insurance specific for the poor (based on means testing), as well as user fee exemption and waivers could improve access to health services for them in Iran. In addition, separate funding for such policies, strengthening health prevention and health care services for marginalized populations, and improving their health literacy could help ensure the poor's benefiting more from the health care services. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to identify the most important factors for strategic purchasing of health services in the health sector by the Iran Health Insurance Company and to provide an applicable model for other similar organizations in developing countries.Design/methodology/approach The present qualitative study was conducted in 2017 to identify the factors affecting the implementation of strategic purchasing of health services in the health sector by the Iran Health Insurance Company and to provide an indigenous and practical model through two phases: semi-structured interview followed by a Delphi process.Findings According to the findings of this study, Ministry of Welfare, Labor and Social Security plays a central role in the strategic purchasing. In addition, this was also approved by the representatives of citizens in communities concerning professional associations, insurance agencies and representative of the Council of Ministers. Model development explored 9 themes and 54 sub-themes.Research limitations/implications Based on the model, most attention has been paid to consumer role and inter-sector leadership of the company with other relevant organizations and systems including other insurance organizations and the welfare ministry. More importantly, the health insurance company should be able to communicate with providers and to choose the best providers, receiving price information through competition in the most appropriate mechanism. Guided by this model, it can strategically buy the best and the most effective services for its insured population.Social implications It might help developing societies to promote their health systems based on targeting the health budgeting and financial constraints so that it is prioritized according to the strategic purchasing criteria and consequently, economic evaluation.Originality/value The linchpins of the present study are as follow: first, the pragmatic model presented in the paper could help developing health systems to overcome the impediment in the implementation progress of strategic purchasing. Second, the model satisfies the need of enough knowledge to apply strategic purchasing in the health system. Third, the indigents have long been given special protection and consideration in the model that has continued to capture the attention of every policy-maker, in particular, developing countries, the portion of which is significant. Fourth, based on this model, attention has been paid to consumer role and inter-sector leadership of organization with other relevant organizations and systems. Fifth, this model could be correspondent for every insurance company in countries with similar developing conditions. [ABSTRACT FROM AUTHOR]

Purpose: Nongovernmental organizations (NGOs) play a critical role in modern health-care systems complementing state organizations. The purpose of this paper is to investigate the challenges of NGOs' participation in Iran's health-care system. Design/methodology/approach: This qualitative study was conducted in 2020. Data were collected through semi-structured interviews with 26 participants: 11 managers and experts at the office of NGOs in the Ministry of Health (MOH) and universities of medical sciences and 15 chief executive officers (CEOs) of health-related NGOs in Tehran, Iran. The participants were chosen using the non-probabilistic approach of purposive sampling with maximum variation. Data analysis was performed using the thematic analysis method and MAXQDA 10 software. Findings: Challenges of NGOs' participation in Iran's health-care system are categorized into external and internal challenges. Financial issues, the process of getting permissions, lack of trust in NGOs, weak relationships with the public sector and lack of law are identified as main challenges. Building trust in NGOs, passing the NGOs' law, making people more familiar with NGOs and capacity development are the most important measures that improve the role of NGOs and resolve barriers to their participation in Iran's health-care system. Originality/value: In this study, for the first time, the challenges of NGOs' participation in Iran's health-care system are investigated by examining the views of both the public sector and NGOs. Improving the participation of NGOs in the health-care system provides Iran's MOH with the opportunity to make use of the NGOs' capacities to eliminate public health issues. [ABSTRACT FROM AUTHOR]

Purpose: High quality health-care delivery is not only the governments' responsibility but also every prisoner's right. Health care in prison and, particularly, of Iranian prisoners is increasingly important topic because of the rising number of the prison population. This paper aims to explore health-care managers' perspectives and experiences of prisons and the barriers to health-care delivery in Iranian prisons.Design/methodology/approach: A qualitative research design was conducted in Iran from October 2018 to August 2019. The participants consisted of 51 health-care managers (50 men and one woman) from Iranian prisons. A combination of face-to-face (N = 42) and telephonic (N = 9) semi-structured interviews were used because of the geographical distribution of the respondents. The first part of the interview guide consisted of demographic characteristics, and the second part consisted of three main open ended-questions. Interviews were recorded and transcribed, and thematic descriptive analysis was used to interpret the data.Findings: The barriers to health-care delivery in Iranian prisons were categorized into four main topics: human resources, financing, facilities and barriers related to the health-care delivery process. Data synthesis identified the following themes for barriers to human resources: barriers to human resources planning (with eight sub-themes); barriers to education (with three sub-themes); and motivational barriers (with seven sub-themes). Moreover, barriers to financing consisted of five sub-themes. The barriers to facilities consisted of barriers related to physical infrastructures (with two sub-themes) and barriers related to equipment (with six sub-themes). Finally, barriers to the health-care delivery process included the following themes: communication barriers (with six sub-themes); legal barriers (with five sub-themes); and environmental-demographic factors (with seven sub-themes).Originality/value: Identifying the barriers to health-care delivery in Iranian prisons plays a critical role in the improvement of planning, decision-making and the health-care delivery process. [ABSTRACT FROM AUTHOR]

Purpose: Leadership is the ability to influence, guide and encourage employees to achieve organizational goals. Leadership has a significant role in organizations' success or failure. Thus, this paper aims to develop a model to elucidate leadership practices in the Iranian health-care organizations (HCOs). Design/methodology/approach: Qualitative approach was used in this study due to its explorative nature. Semi-structured interviews were conducted with 32 key managers and 30 professionals working at different HCOs. Inductive analysis was carried out using the grounded theory approach to develop an initial leadership model for HCOs. The proposed model subsequently was verified by an experts' panel. Findings: The proposed leadership model emerged from the Iranian HCOs encompasses six main categories: leader, followers, high-ups and peers, context, processes and outcomes. Leader, followers and contexts as main categories did also have further sub-categories. Research limitations/implications: Study findings are cautiously transferrable as it reflects the Iranian context. While the model was verified, it might still benefit from more and diverse views. Practical implications: This model can be used by health-care policymakers and managers for improving managers' leadership competencies and practices and enhancing health outcomes through motivating and mobilizing health-care resources toward achieving organizational goals. Originality/value: This study aims to give an answer for "what is the current status of leadership in Iranian HCOs?" and "how can we reinforce the strengths and address the weaknesses?" [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the respective risk perception toward the Covid-19 pandemic among the elderly in two developing countries and their lifestyle change and adaptation behavior as a result of that. Design/methodology/approach: In total, 22 in-depth interviews were conducted among people aged 60 to 85 in Iran and India. The interview guideline was based on two constructs inspired by the study of Gerhold (2020) – risk perception of the pandemic and change in lifestyle and adaptation to the pandemic situation. Findings: The results showed that although the majority of the interviewees initially experienced fear and anxiety during the stay-at-home order and the pandemic situation at large, they quickly adapted to the new situation with behavioral and attitudinal changes in ways relevant to the new normal. The results confirmed the maturation hypothesis proposed by Knight et al. (2000). Originality/value: This paper is an original study of the researchers and among the first contributing to the literature of the elderly studies in developing countries. It contributes to the knowledge required for future behavioral studies concerning the Covid-19 pandemic by evaluating the experiences, risk perception and adaptation approaches of the older people in India and Iran. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Migration, Health & Social Care is the property of Emerald Publishing Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose -- The purpose of this paper is to explore how the clinical governance policy and its main component, patient satisfaction, turned into practice and what they look like on the ground in the centralised health system of Iran. Design/methodology/approach -- A qualitative research stance was adopted incorporating three main sources of information: face to face in-depth interviews and focus groups conducted with hospital senior managers at the teaching hospitals in Kerman city, Iran, as well as documentary analysis of key policy texts. Nine hospital senior managers were purposefully selected for face-to-face interviews as well as a purposeful sample of 15 hospital senior managers for focus groups. Findings -- The documentary analysis revealed how clinical policy has been put into practice. The interview and focus group data analysis also disclosed four key themes with respect to how policy implementers in the Iranian centralised health system perceive nationally developed policies towards clinical governance and patient satisfaction. These include: a paper exercise; opaque, ambiguous policies; unstable policies; and separation of policy making from policy implementation. Originality/value -- The study revealed a perceived mismatch between the official proposals for clinical governance and their application in practice. The findings of this research lend support to the idea that there should be no separation between policy making process and its implementation; they are inseparable and should be treated in parallel, rather than in sequence. The study further suggests more accountability of the state towards its policies and public alike as a better governance of the health system. State-level sustainability followed by allocating proper resources to implementation fields and empowering policy implementers coupled with good systems of performance control are the keys to keep patient focus a top priority. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the factors influencing the leadership effectiveness of hospital managers in Iran. Design/methodology/approach: Top managers (15), middle managers (10) and operational managers (5) of public, private or social security hospitals in Tehran participated in a qualitative study using semi-structured in-depth interviews. Data were recorded, transcribed and then analyzed via MAXQDA 10 software. Findings: The findings were categorized into two main themes of internal and external factors with eight sub-themes. The most important internal factors that had an influence on the leadership of the hospital managers were intra-organizational relations, manager's personality traits, knowledge, attitude and skills of the manager. The most important external factors included extra-organizational relations, macro-level health policies, access to special financial resources, and social, economic and political factors. Research limitations/implications: The results call for a need to understand and analyze the socioeconomic factors influencing managers' leadership while adopting appropriate strategies. Practical implications: The results of the current study can help design training programs for hospital managers, and suggest criteria for appointing hospital managers across the country and this can enhance the effectiveness of their leadership. Health sector policymakers and decision makers should reform the programs that target training and empowerment of hospital managers so that the right people with the right competencies will hold such positions. Social implications: The results of this study showed that leadership effectiveness is also influenced by social and external factors. On the other hand, the effectiveness of management leadership can play a significant role in the quality of care provided to the community, patient satisfaction and in hospital social performance through the appropriate management of all hospital resources. Such factors should also be considered in training and appointing hospital managers. Originality/value: Although there are several studies on hospital managers' leadership worldwide, this study is the first to investigate the leadership effectiveness of hospital managers in Iran. [ABSTRACT FROM AUTHOR]

Purpose: The effectiveness of non-governmental organization (NGO) participation in the healthcare sector has been demonstrated globally. The purpose of this paper is to investigate the status of Iranian NGOs' contribution to health policy-making, the barriers to and strategies for developing their contribution. Design/methodology/approach: In this qualitative study, 25 participants were recruited from health-related NGOs in Tabriz, Iran. Semi-structured, in-depth qualitative interviews were conducted. Furthermore, a set of relevant documents were collected and their contents evaluated. The text of documents and interviews were analyzed using a thematic (deductive–inductive) approach using NVivo software. Findings: Most NGO activity has been in the area of providing services, whereas the least amount of activity has been in the domain of policy-making. Factors that were influential for NGO participation in policy-making were divided into three categories: those related to government, to civil society and within NGOs themselves. The primary barriers to participation in policy-making were related to government and the way that NGOs operated. Recommendations include the production of supportive law, financial aid to NGO and infrastructure that facilitates NGO participation. Practical implications: Financial support from the government and legislation of supportive laws could help to realize the potential of NGOs. Originality/value: No such research has been undertaken before to evaluate what activities health-related NGOs undertake, their contribution in health policy-making and obstacles and facilitators of this contribution. NGOs can play a key role in ensuring accountability, transparency and empower citizens to demand basic health services from government. [ABSTRACT FROM AUTHOR]

Purpose: Currently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on insured. One way to get out of existing conditions is to empower the insured in order to involve them actively in maintaining and improving health. The paper aims to discuss these issues. Design/methodology/approach: This qualitative study was done using the content analysis method. Based on the purposive sampling method and theoretical saturation criterion, 24 individuals including 12 health insurance experts and 12 insured participated in the study in 2018. The semi-structured interview method was used to collect data. Data were analyzed using MAXQDA10 software. Findings: Having analyzed the interviews, 750 codes were obtained. These codes were categorized into two categories of "insurance experts" and "insured" and ten subcategories of "informing and educating, cost reduction, intersectional activities, expectations from the insured, services package, access to services, inability to pay costs, participation, and expectations from the insurance organization." Originality/value: This qualitative study was conducted to assess and determine the effective strategies for empowering the insured under health insurance. The results of this study are helpful to the health insurance organizations and health decision makers to detect the effective ways to develop the quality of insurance services, improve the status of insured, and increase access to health care goods and services. [ABSTRACT FROM AUTHOR]

Purpose Health Sector Evolution Plan (HSEP) is known as the biggest and most comprehensive reform in Iran's health system. One of the goals of HSEP is to reduce inequity in the healthcare financing. The purpose of this paper is to demonstrate HSEP agenda setting from the perspective of equity in healthcare financing (EHCF) using the multiple streams model.Design/methodology/approach This qualitative study was conducted by 26 documents review and analysis, and 30 semi-structured interview with Iranian key informants in the field of HSEP that were selected based on purposeful and snowball sampling method. Data were collected using a researcher-made checklist based on the goals. All audio-taped interviews were transcribed and analyzed thematically. Data management and analysis were performed using the framework analysis in MAXQDA software.Findings The framework analysis identified 12 complementary sub-themes totally. Problem stream included four sub-themes (high share of Out Of Pocket, high index of catastrophic health expenditures, low EHCF index, and inappropriate economic state and sanctions). Focus on EHCF in general policies of the Iran World Health Organization's report in 2000, the Targeted Subsidies Law and emphasis on equalizing healthcare financing in the Fourth and Fifth Development Plan were considered as policy stream sub-themes. Finally, political stream showed four sub-themes including strong support from the Minister of Health for HSEP, mass media, the pressure of WHO and people's request to reduce health costs.Research limitations/implications The limitations of the present study included paying attention to one package (evolution in the treatment sector) of three health packages to assess EHCF, as well as the lack of similar national and international evidence in implementation framework.Practical implications The results of this study can be used to analyze other health sector reforms around the word and can help the formulation and implementation of most practical reforms, especially in field of health system financing.Social implications This study gives a holistic view about health system policy setting that can be used for understanding policy-making streams to population.Originality/value This is the first study that has examined HSEP (the biggest health sector reform in Iran) from the perspective of agenda setting. In addition, using the popular and well-known Kingdon's model to explain HSEP agenda setting is one of the strengths of this study. Furthermore, taking advantage of a wide range of related views by including highly informed people increased the strength of the results of the study. In addition, the short interval between the interview and reviewing the results on reforms reduced the recall bias of the participants in the study. [ABSTRACT FROM AUTHOR]

Purpose Education systems throughout the world seek to take the advantage of every presenting opportunity for achieving a standard level of ethical accountability and capability. The purpose of this paper is to explain the challenges of professional ethics training from the perspective of faculty members at the Ardabil University of Medical Sciences (ARUMS).Design/methodology/approach The present qualitative framework analysis held interviews with 21 key faculty members were selected using the purposeful and snowball method to interview from ARUMS in 2016. The duration of each interview varied between 45 and 120 min. The data obtained were analyzed in MAXQDA-10. Codes were extracted using inductive methods.Findings Three main themes were extracted from the interviews, namely, educational efficacy, professional interaction and equity in education along with 12 subthemes, namely, teacher's personal capability, work in the area of expertise, regular class attendance, quality class attendance, inclusion of theoretical bases, the teacher as an ethical role model, respect for the student, encouragement of ethical behaviors, respect for the patient's rights, fair assessment, attention to differences and positive discrimination.Practical implications This study results could help to improve the quality of training and ethical standards in medical education.Originality/value To comply with the codes of ethics in research, permission was obtained from the Ethics Committee and the participants were ensured about the confidentiality of their data and their right to withdraw from the study at any stage. Given that this project was a qualitative study, the authors did not have a moral or practical problem in the study. This study was approved with number "IR.ARUMS.FEC.1394.25" at the Ardabil University of Medical Sciences Research Ethics Council. The cooperation of participants in the study was completely voluntary; moreover, the authors obtained written consent from participants for the study. [ABSTRACT FROM AUTHOR]

Purpose: Accreditation helps to ensure safe and high-quality services in hospitals. Different occupational groups have various hospital accreditation experiences. The purpose of this paper is to investigate nurses' accreditation experience and its effects on Iranian teaching hospital service quality.Design/methodology/approach: This was a qualitative study involving a phenomenological approach to studying nurses' hospital accreditation experience and understanding the effects on Iranian teaching hospital service quality. Data were collected using two focus groups in which nurses were selected using purposive sampling. Transcripts were analyzed using content analysis.Findings: Nurses' experiences showed that hospital administrators and nurses had greater role in implementing accreditation than other occupational groups. Accreditation improved patient-centeredness, patient safety, logistics and managerial processes and decision making. However, a weak incentive system, extra documentation and work stress were negative experiences.Practical Implications: Nurse experience, as the most important care team member, reveals accreditation's strengths and weaknesses and its effects on service quality.Originality/value: The author used a phenomenology approach to measure accreditation effects on service quality - a valuable tool for understanding a phenomenon among those that experience hospital accreditation processes. [ABSTRACT FROM AUTHOR]

Purpose Hypertension is the most common chronic disease throughout the world. Self-care is the key criteria in determining the final course of the disease. However, the majority of elderly people do not observe self-care behaviors. The purpose of this paper is to analyze the experiences of elderly people with hypertension in order to understand the barriers of their self-care behaviors.Design/methodology/approach This is a qualitative study with a conventional content analysis approach conducted in Tehran, Iran in 2017. Data collection was done among 23 participants – 14 elderly people; 6 cardiologists, geriatric physicians and nurses working in the cardiovascular ward; and 3 caregivers – who were selected by purposeful sampling. Using semi-structured, face-to-face interviews, data collection was continued until data saturation.Findings Three main categories, including attitude limitations, inefficient supportive network and desperation, all showed barriers to self-care by the experiences of elderly people with hypertension.Originality/value Lack of knowledge of the disease and its treatment process is one of the main barriers to self-care in elderly people with hypertension. Deficient supportive resources along with economic and family problems exacerbate the failure to do self-care behaviors. [ABSTRACT FROM AUTHOR]

Purpose According to the great importance of community health as well as the ever-increasing development of health technologies, the importance of designing an interactive model of factors affecting health technology assessment (HTA) can be highlighted. The purpose of designing and implementing the framework of health information system assessment is to ensure that the required accurate data which are necessary to measure the main health indicators are available. The purpose of this paper is to design an interactive model of factors affecting HTA.Design/methodology/approach This is a cross-sectional, descriptive-analytic study conducted in the Iran Ministry of Health and Medical Education in the second half of 2017. A sample of 60 experts and professionals working in the field of health technologies are selected using purposive and snowball sampling methods. Two researcher-made questionnaires are used to collect the required data. The collected data are analyzed using decision-making trial and evaluation laboratory (DEMATEL) and MATLAB R2013a.Findings The results showed that “Legal dimension,” “safety,” “Effectiveness” and “Social dimension” were the affecting factors and net causes, and “Current application,” “Knowledge of technology,” “Ethical dimension,” “Costs” and “Organizational dimension” were the affected factors and net effects in the interactive model. Furthermore, “Legal dimension” with the coordinates C: [1.88, 1.27] and “Ethical dimension” with the coordinates C: [1.75, −75] were known as the most affecting and most affected factors in the interactive model, respectively.Originality/value The DEMATEL model is an appropriate tool for managers and policy makers to structure and prioritize factors influencing the HTA. Policy makers and decision makers can use this model for identifying relationships among factors and prioritize them. Because health policy makers and managers have a major role in formulating the regulations and guidelines related to the HTA, they should pay more attention to the legal considerations in their decisions and use the management tools to move the available resources toward implementing and enforcing rules and guidelines related to the HTA. [ABSTRACT FROM AUTHOR]

Purpose A sentinel event is an unexpected occurrence resulting in death or serious physical or psychological injury or the risk thereof. The purpose of this paper is to investigate the influencing factors of sentinel events in the emergency department of a military hospital in Tehran to find out some of the effective solutions. Design/methodology/approach In this qualitative study with content analysis approach, 20 hospital healthcare personnel participated as participants from the fields of medicine and nursing. Purposive random sampling and semi-structured interviews were used for data collection. Atlas.ti software version 5.2 was used for data analysis. Findings Four themes and 32 subthemes were identified by numerous revisions and combining the codes. The four main themes of sentinel events were: causes, incidence barriers, cause prevention solutions, and barriers' improvement solutions. Moreover, these main factors were related to these issues: staff and patients' education, communication, assessment, patients and their companions, employee rights, leadership, care continuum, human factors, physical environment, information management and medication use. Some solutions were also suggested according to these factors and a policy was recommended. Practical implications Hospital managers and authorities should try to find the main causes of sentinel events by periodical analysis to find ways to prevent them in the future, using logical and reasonable solutions. Originality/value This study confirms that strategies to reduce the sentinel events in emergency departments should focus on empowerment of all staff. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to identify barriers to seeking help among abused Iranian women.Design/methodology/approach This qualitative research was carried out using content analysis approach. The participants were 24 married women who were selected from health care centers, recreational centers, and two universities in Tehran, Iran. Semi-structured interviews were used to collect the data.Findings During data analysis, four themes emerged that explained barriers to seeking help in the participants: “fear of negative consequences of help-seeking,” “lack of resources,” “beliefs and attitudes,” and “indirect experiences of not being supported.”Originality/value This study has practice and policy implications for promoting help-seeking among abused women. Based on the results, to promote help-seeking, intervention plans must focus on empowering women to improve their education and employment, eliminating attitudes and beliefs hindering help-seeking, and fortifying formal and informal support systems for abused women. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to identify the obstacles and challenges of talent management as well as its success factors in Iranian automotive industries.Design/methodology/approach This research is a kind of discoverer research done by qualitative approach. The methodology to data collection was interview and research sample was 15 manager in automotive industries. Data analysis was carried out by the coding method, and concepts, minor and major contexts were extracted and lastly the conceptual framework was formed.Findings Based on the findings of the research, framework of obstacles and challenges in talent management was classified into four categories that are structural challenges and barriers, environmental challenges and barriers, behavioral challenges and barriers and lastly managerial challenges and barriers. In addition, the framework of talent management success factors were categorized into three main sections that are structural success factors, environmental success factors and finally managerial success factors.Originality/value Problem finding of talent management in automotive industry and identifying obstacles, challenges and success factors in talent management with qualitative approach through interviews with experts from the Iranian industries is the research value. [ABSTRACT FROM AUTHOR]

Purpose: Studies show that economic sanctions have had major negative impacts on health systems during the past years. The aim of this study is to identify the impacts of US sanctions on the performance of public hospitals in Iran. Design/methodology/approach: A qualitative research study was conducted between October 2019 and September 2020 in Kermanshah Province, Iran. Semi-structured, face-to-face interviews, lasting between 25 and 90 min, were carried out with 20 participants in seven public hospitals affiliated to the authors' institution in Kermanshah Province. Inductive thematic analysis was used to identify themes in the data. Findings: Five main themes emerged from the analysis: resource management challenges; financial restrictions; interruptions in planning; reductions in the quality of service delivery; and changes in organizational relationships. Originality/value: The results of the present study demonstrate that US economic sanctions have considerably reduced access to necessary medical equipment and medicines for public hospitals in Iran. Policymakers should monitor the distribution of equipment and pharmaceutical products within public hospitals in Iran and take actions to ameliorate shortages during times of economic sanctions. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore experiences of Afghan refugees from health service delivery in Mashhad, Iran. Design/methodology/approach - This is a descriptive study with contextual and qualitative design. Semi-structured interview conducted with 19 Afghan refugees and their caregivers and a focus group session were held with Afghan medical science students. Purposive sampling technique was used to select participants. Data were analysed by qualitative content analysis of Graneheim and Lundman. Lincoln and Guba's criteria were implemented to ensure trustworthiness. Findings - The results with the core concept of "position of immigrants in the health system" were presented at four themes of "perceived discrimination", "snowed with loneliness", "feeling inferior", and "gratitude". Research limitations/implications - This study has some implications for researchers and practitioners. The present study is the first study that was done on the health of Afghan refugees in Iran, therefore it can be a ground for further research. In addition, it has valuable results regarding the Afghan immigrants' experience of health care system of Iran. Practical implications - It can be useful for improving the condition of immigrants in Iran and for improving Iran's health system. In order to improve the health system in Iran, authorities should pay much attention to transcultural caring and needs of minorities. Furthermore, health workers should be trained to appropriately take care of all patients, without prejudice. Originality/value - Overall the study revealed that there is inequity in access to health services among Afghan refugees in Iran. The findings, although not generalized, offer important insights into health care providers in Iran which should be delivering health service without prejudice. The authors recommended that policies of public medical insurance and assistance programme should be implemented for providing affordable health care services for Afghan refugees. [ABSTRACT FROM AUTHOR]

Purpose – Clinical governance should be based on cultural elements that value lifelong learning, skill development and research. The purpose of this paper is to introduce a set of indicators to improve educational governance in hospitals. Design/methodology/approach – Key indicators were identified from the international and national literatures. Later, the indicators were rated and prioritized by a multidisciplinary panel of medical professionals using two rounds of Delphi technique. Subsequently at two consensus meetings, the panel evaluated the indicators. Findings – A set of 51 draft indicators were identified. The expert panel members rated 28 indicators as high priority indicators for measuring educational performance of the hospitals. Practical implications – This set of indicators can be used to measure the educational performance of the hospitals in identifying the gaps and take steps to resolve them. Originality/value – Education and training is the basic component of clinical governance. Hospital staff education and training is a fundamental step towards organizational and individual development. To improve the educational performance at hospital level it is necessary to reliably measure such performance. This can be done through developing and using relevant indicators. There are limited systematic studies, especially in middle and low income countries, to introduce appropriate indicators. This study has investigated developing a set of indicators to measure and improve the educational performance in hospitals. [ABSTRACT FROM AUTHOR]

Purpose: The importance of champion leaders including tech-savvy leaders to digital government has been highlighted in the literature. Meanwhile, what was in the authors' interest to explore was the role of business-savvy leaders or non-governmental digital champions as units of analysis, those who mobilized people's interest in digitalization and bypassed governmental barriers through this popular mobilization. They could be considered policy entrepreneurs for understanding policy change in the digitalization of the health sector. This study sought to shed light on the barriers and drivers of digital health in Iran. Design/methodology/approach: The researchers conducted interviews with actors of digital health businesses in Iran, including the Health Information Technology Center affiliated to the Ministry of Health and Medical Education (MOHME) administrative body and authorities, private companies active in digital health and health service providers. The purposive sampling method was applied, and 15 experts with relevant and valuable experiences as well as maximum variation to obtain representativeness and rich data were interviewed. Trustworthiness criteria were also used to assure the quality of the results. The data were analyzed based on directed content analysis using the MAXQDA10 software. Findings: It was found out how popular diffusion was effective to overcome barriers to health digitalization. Access to the internet and diffusion of information technology helped the net-enabled businesses to connect directly to people and provide services to them. Diffusion of these services forced the public sector to adjust itself, and thus MOHME banned digital consultation services because of the so-called "insecure and unknown physicians", following the increased popularity of digital services diffusion, but they were not able to resist popular diffusion of new technology. Hence, it was allowed to work. The main barriers to telemedicine spreading in Iran have been divided into five main categories including government incapacity for digital health governance, conflict of interest, professional obligations for information transparency, protection of patients' rights and data security and privacy. Originality/value: As a game changer in digital health governance in Iran, popular diffusion will determine the future of digital health. To the best of the authors' knowledge, this study is among the first ones to explore digital health governance in relation to the private digital health business in Iran with a public policy approach. [ABSTRACT FROM AUTHOR]

Purpose: The importance of management capacity in the health sector has been increasingly recognized. The World Health Organization (WHO) (2008) has claimed that limited "management capacity" in low-income countries is one of the main obstacles toward achieving health-related goals. The aim of this study is to answer the research question: "What are the elements of management and leadership capacity of senior managers from the perspective of senior managers." Design/methodology/approach: Semi-structured individual interviews were conducted with 20 senior health managers. Sampling method was purposive. Data were collected using a researcher-made interview guide. The transcribed text was analyzed using framework analysis. Findings: Five main themes emerged from the analysis are: (1) competencies required for managers; (2) selection and appointment of managers; (3) establishment of managers' database; (4) deployment of functional support system; and (5) environmental sensitivity. Each of these themes contains sub-themes. Research limitations/implications: Due to the COVID-19 pandemic, the interviews were conducted virtually. This may have had an impact on obtaining wealthy data because in a face-to-face interview, it is possible to question and answer, get additional explanations and understand the interviewee's mentality. Practical implications: Extracting elements of management and leadership capacity helps managers to assess management capacity and leadership comprehensively and effectively. In addition, effective and useful operations can be done to strengthen the management and leadership capacity. Originality/value: This is the first study that has identified the main elements of management and leadership capacity from the perspective of senior health managers in Iran. This article provides the components of the health system management and leadership capacity that can be used at top management level. [ABSTRACT FROM AUTHOR]

Purpose: Noncommunicable diseases (NCDs) count for over 80% of premature death worldwide. More than 76% of the total burden of diseases in Iran is devoted to NCDs. In line with the World Health Organization action plan, Iran has developed its national action plan that led to establishment of the National Committee for Prevention and Control of NCDs (INCDC), whose aim is 30% mortality reduction attributed to NCDs by 2030. The stewardship of health system is the cornerstone of performing and sustaining meaningful actions toward prevention and control of NCDs. The literature is tiny on how to materialize the stewardship and governance of health system. The purpose of this article is to report the findings of a national study that aimed to identity functions and subfunctions of stewardship of NCDs and its related risk factors in Iran. Design/methodology/approach: This is a qualitative study. The authors conducted interviews with 18 purposefully selected interviewees until the authors reached saturation. Thematic content analysis was used for analysis and MAXQDA 10 was employed for data management. The difficulty of coordinating with interviewers and health policymakers in the field slowed the process of research progress. Findings: The authors identified seven themes and categorized them as main functions for appropriate stewardship of NCDs in Iran, including intelligence generation; strategic framework; evidence-based policies/decisions; system design; resource allocation/development; capacity-building and enforcement/alignment; and categorized them as important. Practical implications: The seven themes presented as stewardship functions include concepts and practical examples of the experiences and performance of leading countries in the field of NCDs control that can help policymakers and health managers for better descion-making. Originality/value: Iran adopted its national action plan in 2015 and WHO selected Iran as a fast-track country in 2017. The study confirmed that to achieve the global targets, appropriate and contextual stewardship for any specific setting is fundamental. Iran needs to improve its stewardship for prevention and control of NCDs and implement its national action plan. Therefore, the functions and policies outlined in this article for the proper performance of NCDs can improve more meaningful practices in this area in Iran and many other countries. [ABSTRACT FROM AUTHOR]

Purpose: Health-related issues are widely covered in news agencies by medical and health journalists. The quantity, format and quality of their coverage influence the general public as well as policymakers and professions. Current studies and observations suggest that news agencies are more dominated by medical topics (disease, symptoms, epidemiology, treatment and medicines) than general public health issues (risk prevention, health protection, education and promotion). This study explores the causes of the current situation in Iran and generates solutions for supporting health-promoting media that may also prove beneficial for other countries. Design/methodology/approach: A qualitative study was conducted to explore the coverage of health-related topics in selected news agencies. Stakeholders, including health journalists, health professionals and public relations staff at the Iranian Ministry of Health and Medical Education were interviewed. Data were collected until data saturation was reached. The transcripts of all the 17 interviews conducted were analyzed using conventional content analysis. Findings: Four groups of causes were identified, including individual factors, organizational factors, socioeconomic factors and the different nature of medicine and public health. The participants proposed several solutions that were classified into three categories, including the empowerment of stakeholders through capacity development, organizational change and mutual communication and culture change. Originality/value: Creating health-promoting media is a complex but urgent task, and providing a comprehensive and deep understanding of the dynamic interdependencies of the multiple factors at play in it and developing and implementing the most effective interventions for it requires a systematic approach. [ABSTRACT FROM AUTHOR]

Purpose: Increased dietary salt content is one of the effective factors of hypertension and a major public health challenge globally. Although the positive effects of dietary salt reduction on health are universally accepted, people can hardly reduce their salt intake. The purpose of this study is to identify the inhibitory factors of dietary salt reduction among 20–65-year-old women in Yazd City, Iran. Design/methodology/approach: This study was conducted using a deductive content analysis approach based on the communication for the behavioral impact (COMBI) framework. The purposeful sampling method was applied with maximum variation in terms of different educational levels, age groups, occupational status and residential areas to select the participants. Snowball sampling was used to select health-care professionals. Furthermore, semi-structured interviews and focus-group discussions were conducted with 31 local women and 11 health-care professionals working in the City until data saturation was achieved. Data were analyzed using Graneheim and Landsman's method. Findings: After data analysis, 617 initial codes were extracted over the perceived barriers. After merging similar codes, 223 codes were extracted. The barriers were classified into five main categories of family, personal, organizational, educational and socio-cultural barriers. Originality/value: Based on the COMBI framework, the results demonstrated that the most important barriers for reducing salt intake were negative attitude toward restrictions on dietary salt intake, insufficient and incorrect beliefs about the health risk of salt, lack of family support, inadequate health literacy and low self-efficacy in Yazd City. Among these barriers, lack of family support was considered as the most effective factor in reducing salt consumption. So, by focusing on this area and providing the community with the required education, the amount of salt consumed by families can be reduced. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the challenges of providing primary health care (PHC) to Afghan immigrants in Tehran as an important global human right issue. Design/methodology/approach: In this exploratory study, a total of 25 purposively selected PHC providers, including physicians, psychologists and midwives, were approached for face-to-face, semi-structured interviews, lasting 30 min on average. Thematic analysis was used to analyze the data. Findings: The most common challenges of providing PHC to Afghan immigrants were categorized at individual, organizational and societal levels. Communication barriers and socioeconomic features emerged at the individual level. The organizational challenges included mainly the lack of insurance coverage for all immigrants and the lack of a screening system upon the immigrants' arrival from the borders. At the societal level, the negative attitudes toward Afghan immigrants were causing a problematic challenge. Research limitations/implications: The main limitation was the possibility that only health-care professionals with particular positive or negative perspectives about immigrants enter into the study, because of the voluntary nature of participation. Practical implications: Findings can help policymakers adopt evidence-informed strategies for facilitating PHC provision and improving the access to health care in immigrants as a global human right concern. Social implications: This study alerts about undesirable consequences of certain attitudes and behaviors of the society toward immigrant health. Originality/value: To the best of the authors' knowledge, this is one of the first studies conducted in PHC centers in Tehran Province that explores the challenges of providing PHC to Afghan immigrants. [ABSTRACT FROM AUTHOR]

Purpose - The aim of this study is to explore mortality data collection after a destructive earthquake in Bam, Iran. Design/methodology/approach - This is a case study of mortality data collection using a qualitative approach. The study data were collected through interviews with people involved with data collection and processing in Iran, and an evaluation of routinely collected data. Findings - The results indicated that there were many limitations affecting data collection after the earthquake. These limitations are rooted in basic problems within the existing data collection system and a lack of co-ordination between the groups collecting data, including national and international aid groups that provided help after the earthquake. Research limitations/implications - The research is based on a very large and destructive earthquake; the results may be different for other natural disasters such as floods. Practical implications - The main target group of this study is the decision makers involved with the disaster relief issues at national and international levels. This issue of data collection is imperative for future disaster aid. Originality/value - The study highlights the problems affecting routine collection of mortality data after a disaster, arising from the scant attention paid to proper documentation. [ABSTRACT FROM AUTHOR]