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Background: The aim of this study was to assess unmet needs for health care (UNHC) and its causes during COVID-19 pandemic among pregnant women in Iran. Methods: This cross-sectional study was performed among pregnant women in Kurdistan province in 2020 with a sample size of 800 people who were selected by multi-stage sampling method. Data were collected by a questionnaire. Chi-square test was used to examine the relationship between independent variables including demographic variables with dependent variables of perceived need and benefiting from health services. Also, multiple logistic regression was used to determine the relationship between independent variables and outcome variable. Statistical tests were performed using STATA software package.Results: The highest UNHC were related to dental services with 66%, rehabilitation services with 58.6% and psychological services with 43.2% and the lowest were related to hospital services with 12%, midwifery services with 15.6% and physician visit services with 39.1%. The most important reasons for UNHC were fear of getting COVID-19 and the cost of the service. The variables of age group and spouse education for physician visit services; age group for midwifery services; age group, education and employment status for dental services; age group, supplementary insurance and economic status for rehabilitation services; and age group and economic status for psychological services were significantly associated with UNHC (PConclusion: A significant percentage of health care needs of pregnant women were unmet, for which the fear of getting COVID-19 and financial barriers were the main reasons.

Background Access to universal health coverage and reducing the prevalence of catastrophic health expenditure (CHE) to 1% are the commitments of the Islamic Republic of Iran. The aim of this study was to investigate the prevalence of households exposed to CHE. Methods This cross-sectional study was performed on 2000 households in five provinces of Iran in 2021. Data were collected through interviews using the World Health Survey questionnaire. Results Data from households whose health care costs were more than 40% of their capacity to pay were included in the group of households with CHE. Determinants of CHE were identified using multivariate regression analysis. 8.3% of households were exposed to CHE. The variables of being a female head of household, use of inpatient, outpatient, dental, and rehabilitation services, families with disabled members and low economic status of the households were significantly associated with increased odds of facing CHE. Conclusion In the final year of the sixth five-year development plan, Iran has not yet achieved its goal of "reducing the percentage of households exposed to CHE to 1%," and a high percentage of Iranian households still face CHE. Policymakers should pay attention to factors increasing the chance of facing CHE in designing interventions and this can help the goal of financial protection against health costs.

Background: Nowadays, children spend a lot of time during the day in front of the television(TV) and using their phones. We aimed to evaluate screen time and phone use in Iranian children and their relation to the socioeconomic status of children's families.Methods: This descriptive analytical study was done on 10-12-year-old children from Kurdistan, Fars, and Markazi provinces. Cluster sampling was used for sampling. Date collection included completing demographic questionnaires, calculating BMI of children and phone & tablet use, screen time, and socioeconomic status. We used linear and logistics regression to estimate the final model and decomposition method of the Oaxaca. The concentration index and the concentration curve were used to measure and illustrate socioeconomic inequalities. All analysis was conducted with the Stata / SE 14.0 software.Results: 1590 children (52.58% boys) were enrolled in our study, 594 (74%) of boys and 420 (56%) of girls had daily Screen Time activities for more than two hours, and 388 (48.20%) of boys and 211 (28.20%) of girls use mobile phones and tablets for more than two hours a day. Screen Time activities were significantly higher in boys, older children, higher BMIs, more educated mothers, and 35

Background: Higher health costs and financial burden are imposed on people with disabilities due to their health status associated with their disability. Measuring the incidence of catastrophic health expenditures (CHE) can provide good evidence for health policymakers to assess the current state of financial protection of the health system. The aim of this study was to investigate the percentage of households with disabled children aged 0 to 8 years who had faced CHE due to the health costs of these children in Iran.Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0 to 8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Households whose health expenditures for disabled members in the family were more than 40% of the household payment capacity were included in the group of households with CHE. Determinants of CHE were identified using logistic regression.Findings: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR=18.89, 95%CI: 10.88- 29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR= 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR= 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR= 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR= 2.71, 95%CI, 1.60-4.69), and type of basic health insurance [having Iranian Health Insurance: Adjusted OR= 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR= 1.66, 95%CI, 1.06-2.61] significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.

Background: The aim of this study is to investigate the status of perceiving need, seeking behavior and utilization of health services in the elderly population of Sanandaj (west of Iran).Methods: This is a cross-sectional study conducted on 800 elderly people in Sanandaj. Subjects were selected using multistage sampling and data were collected using self-report questionnaires. A multivariate logistic model with odds ratios (ORs) was used to determine the relationship of independent variables with seeking perceived need. Also, Concentration Index was used to measure the inequality in using health services. Results: The perceived need for outpatient (during the last 30 days) and inpatient healthcare (during the last 12 months) were 69.7% and 29.7%, respectively. Among them unmet need for outpatients and inpatients healthcare was 46.6% and 17%, respectively. Having health insurance (adjusted OR 12.08; 95% confidence interval [CI] 1.04-140.11), middle economic status (adjusted OR 5.18; 95% CI 1.30-20.51), and age group between 65-70 years (adjusted OR 7.60; CI 1.42-40.61) increased the chances of seeking inpatient care and age group between 60-65(adjusted OR 0.41; 95% CI 0.18-0.95)reduced the chances of seeking outpatient care. There was also inequality in using outpatient health services, concentrated in the Rich population.Conclusion: The elderly population suffers from unmet healthcare needs, especially in outpatient services. The most important reason for not seeking outpatient services was financial barriers and for inpatient services was self-medication. So, designing targeted policies and interventions to address barriers in conversion of need to demand in the elderly population is essential.

Background: Physical inactivity (PI) is a public health concern around the world that has been growing with the advent of technology. It has often been studied in adults. This study aims to determine the prevalence of physical inactivity in Iranian children aged 10-12 years and the impact of socioeconomic inequality on it.Methods: In this descriptive study, the study population consisted of 10-12 years old children from an Iranian population from Kurdistan, Fars and Markazi provinces in 2018. The sample size was 1590 individuals. The sampling method was cluster sampling. Data was collected using demographic questionnaire, modifiable activity questionnaire (MAQ) and socioeconomic questionnaire. Linear and logistic regression were used to estimate the final model and the Oaxaca analysis method was applied. All analyses were performed in Stata/SE 14.0.Results: Of the 1590 participants, 52.82% were male. The results showed that 25.79% of the subjects had physical inactivity and 7.30% had moderate physical activity during the week. The average physical activity during one week was more in boys than in girls (P-valueResults: One-fourth of the study population had physical inactivity in this age group and required serious interventions. Socioeconomic levels, parental literacy, and children’s sex were factors affecting the level of physical activity. Raising parental awareness, designing specific programs for girls, such as increasing access to sports facilities, are strategies to reduce physical inactivity in children.

Background: Coronavirus 2019-nCoV was first identified in China in 2019. One of the most important indices noticed by experts, policymakers and managers which is daily evaluated in epidemics and a lot of judgments are made based on it, is case fatality rate (CFR) index of the disease. CFR can change during epidemics. This study aims to calculate CFR index for nCov-2019 in Iran and answer the following question: Is it right to base judgment on CFR all the time during epidemics and is it right to judge based on that since the outbreak of an epidemic?Methods: This research is a descriptive study. Its required data was obtained from the website of The Ministry of Health and Medical Education of Iran from February 20th 2020 until March 14th 2020. CFR index was calculated when the death toll of a disease is divided by the total number of people infected by that disease. Excel 2013 software was used to a1nalyze the data.Results: According to the findings of this study, In Iran, until March 14th 2020, 11364 people have been infected by Coronavirus 2019-nCoV and 514 people died of it. CFR index had a descending trend and it was 100%, 18.6%, 8.8%, 3.1%, 3.3%, 4.5% on the first, fifth, tenth, fifteenth, twentieth and twenty fifth day, respectively. Conclusion: In emerging epidemics, an index must not be based to judge a health system’s performance until that epidemics condition has not been clarified. It would be suggested that in the outbreak of an epidemic, specifically emerging diseases, CFR must not be the base of judgment. Making judgments, specifically, in the outbreak of emerging epidemics based on fatality rate can lead to an information bias.