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Given the increasing rate of divorce in Iran, together with the need to adopt preventive measures based on cultural conditions, a requirement of utmost importance is to explore the reasons that drive Iranian couples to seek a divorce. In this nationwide study, which was conducted in nine capital cities chosen from 31 provinces in Iran, a total of 3,200 men and women (1,600 couples), who had petitioned the court for a divorce, received individual expert counseling services through a reliable and valid questionnaire. Of the 17 reasons that the divorce seekers provided as explanation for their decision, three were prominent: the inability to resolve conflicts, which led to disputes, dissatisfaction with the manner by which their spouses expressed their love and emotions, and discontent regarding a spouse’s personality traits. The findings highlighted the necessity of planning for enhanced conflict resolution and communication among men and women in Iranian society.

Introduction As a result of recent demographic changes, Iran has revised its reproductive health programs. To respond to the essential need for monitoring the new programs and policies, this study aimed to identify tailored, appropriate, and measurable RH indicators in the Iranian context, using available evidence and international indicators.Method This is an applied mixed-methods research, which was conducted in four phases: Identification of goals of RH policies and programs, scoping review of the RH indicators in the literature, developing and ranking the identified indicators, and finalization of indicators. Qualitative content analysis was used to analyze the textual data of the documents and policies. We analyzed the studies in the scoping review by narrative synthesis. The final indicators were selected through the consensus of experts, with a cut-off point of 75%. Result We identified 689 indicators through document analysis and scoping review. After three round of screening, a total of 37 RH indicators were finalized. The first five indicators with the highest score were: total fertility rate, population under 15 years, total population, population aged 65 years and older, and age-specific fertility rate.Conclusion: The nature and number of indicators for monitoring and evaluation of reproductive health programs might vary at different organizational levels; hence the need to develop specific indicators for each level is pivotal. In addition, the need for collection, processing and dissemination of reliable data for evaluation of these programs is essential.

Background Subjective accounts of divorce seeking individuals is a useful complement to sociological and psychological causes of divorce at both individual and community level. Regarding the increasing trend of divorce worldwide, the need for a questionnaire measuring subjective reasons of divorce is felt more and more. Objectives The aim of this study was to develop and validate perceived causes of a divorce questionnaire in Iranian society. Methods This was an instrument development study that carried out in 2016, based on extensive literature reviews and interviews with individuals referring to "Family Intervention Centers to Reduce Divorce" in Kerman, Fars and Alborz provinces (Iran). At first, 38 items expressing the perceived reasons for divorce were extracted; then, 29 items were used in the questionnaire according to the experts' judgment. After that, the questionnaire was given to 570 participants. The structural validity was evaluated using two methods: exploratory factor analysis via principle axis factoring, and known group comparisons by paired-samples t-test. The internal consistency of the questionnaire was also examined by calculating the Cronbach's alpha and corrected item-total correlation. SPSS version 20 was used for statistical analysis. Results The mean age (± SD) of women and men was 32.3 (±8.9) and 36.8 (±10.6), respectively. Based on an expert panel, content validity of 29 items was approved. Using principle axis factoring and varimax rotation, two components were extracted. These two factors were called "instrumental/external reasons" and "expressive and relationship-centered reasons." Factor loading of all 29 items was higher than 0.32. Cronbach's alpha of the two subscales was 0.84 and 0.85, respectively. Corrected item-scale coefficient of all items was more than 0.2. Conclusions According to the acceptable validity and reliability of the Perceived Reasons for Divorce Seeking Questionnaire, it can be used to ascertain people's reasons for divorce seeking.

Introduction. Iran is confronted with increasing trend of divorce in recent decades. Considering the probable role of sexual dissatisfaction in the breakdown of marriages, the Ministry of Health recently decided to enrich the educational content of the premarital education programmes. The aim of this study was to compare the effectiveness of the new program with the classic one. Methods. Three hundred fifty-one women were divided into two premarital education groups: classic education (n=162) and new education (n=189). The mental health, quality of life, marital satisfaction, and sexual satisfaction of women were evaluated one year after marriage. Results. At one-year followup, both groups showed improvement in mental health (P<0.001); however physical health-related quality of life decreased in both groups. The two groups showed no significant difference in terms of sexual satisfaction and marital satisfaction. Marital satisfaction showed significant correlation with sexual satisfaction (r=0.55, P<0.001). Conclusion. The new program of premarital education showed no superiority over the classic method. Considering the increasing rate of divorce in Iran, the premarital education programmes may not be successful in achieving their goals. Revision of the premarital education programme is warranted.

Background: To identify the prevalence of behavioural (Pre-pregnancy), obstetrical and medical risks of pregnancy in Iranian women. Methods: A total of 2993 postpartum women who delivered in 23 randomly selected hospitals of six provinces were enrolled in this nationwide cross-sectional study. A structured questionnaire was completed based on interviewees’ self-reports and medical record data, consisting of socio-demographic characteristics, behavioural, obstetrical and medical risks, before and during pregnancy. Results: Less than 6.0% had no health insurance and 5.0% had no prenatal visit before labour. Unintended pregnancy was reported by 27.5% of women. Waterpipe and/or cigarette smoking was reported by 7.1% of them and 0.9% abused opiates during pregnancy. Physical abuse by husband in the year before pregnancy occurred in 7.5% of participants. The rate of cesarean section was 50.4%. Preterm birth, low birth weight, and stillbirth were seen in 6.8, 7.7, and 1.2% of deliveries respectively. The most frequent medical risk factors were urinary tract infection (32.5%), anemia (21.6%), and thyroid disease (4.1%). Conclusion: More effort should be devoted by health policymakers to the establishment of a preconception counselling (health education and risk assessment) and surveillance system; although obstetrical and medical risks should not be neglected too.

Objective To determine the prevalence of contraceptive use and unmet need for family planning in Iran and to explore the public-health implications. Methods A nationwide cross-sectional study was conducted by interviewing 2120 married women aged 15–49 years. The sample population was enrolled in 6 large Iranian cities (Tehran, Mashhad, Tabriz, Isfahan, Shiraz, and Ahvaz) and 2 small cities (Zahedan and Kerman) from September 22 to December 20, 2011. Results The overall contraceptive prevalence rate was 81.5% and the unmet need for any method of contraception was 2.6% (95% confidence interval, 2.0%–3.3%). Given the frequency of women who used traditional contraceptive methods (22.3%), the unmet need for modern methods was estimated as 17.4%. The main reasons given for unmet need for family planning were low perceived risk of pregnancy (41.8%) and family opposition (21.8%). Unwanted pregnancy was reported by 30.7% of the participants. Conclusion A high rate of unmet need for modern contraceptive methods might potentially lead to increased rates of unwanted pregnancies and induced abortions. Healthcare policymakers should, therefore, be warned against a sense of complacency that family planning in Iran does not need their support.