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Objective(s): This study seeks to determine the direct cost of wife abuse in the 5 Legal Medicine Centers (LMCs) in Tehran. Methods: This was a descriptive cross sectional study. Given the 18% prevalence of violence against women; with a precision of 5%, a sample size of 225 was estimated. A questionnaire was developed to collect data. The costs were calculated by adding marginal and principal costs. Principal costs included all monetary expenditures related to the medical care services, legal-judiciary follow up, commuting and sundry charges. Results: On average, each woman has spent 132234 Rls for healthcare services. This figure included on average 25156 Rls for visits, 23595 Rls for prescribed drugs, 33483 Rls for radiological studies and 50000 for laboratory tests. Given the total number of 9050 of female victims of the domestic violence attending LMCs in the year 2002, the total medical services was estimated at 2801133,4071 Rls. Total legal services charged by the Police Force in 2002 was 1,46517361910 Rls. In the same period, sundry charges was 320/71/350 Rls. The estimated total costs therefore reached as high as 2/056/941/667 Rls. Conclusion: The study findings indicate that in Iran high expenses of domestic violence is imposed and this needs an urgent attention. Public health inventions might help to reduce the cost of domestic violence against women.

This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders — service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) — participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients' substance abuse; patients' fear of stigma; occupational burnout of certain service providers; patients' dissatisfaction with some of the services provided by counselling centres/clinics; medical staff's failure to observe confidentiality; and patients' lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region. [ABSTRACT FROM AUTHOR]

Background and Aim: Children who work or live in the streets are one of the high-risk groups for HIV. The high population of street children and lack of comprehensive intervention programs for them increase their risk for HIV in Iran. This study intended to explore the situation of drug abuse in street children in Tehran, the capital city. Materials and Methods: This paper reports part of a comprehensive rapid assessment and response (RAR) research project on street children in Tehran during 2012-13. Data were collected by interviewing subjects using questionnaires. The sample size was 289 street children selected by time-location sampling in Tehran. Results: Data showed that about 25.6% of the street children had had some history of cigarette smoking, alcohol abuse, and/or drug abuse. Most of them were boys aged 15-18 years. The prevalence rate of cigarette and/or hubble-bubble smoking, alcohol consumption and drug abuse during the preceding 6 months 12.1%, 11% and 6.9%, respectively. Significant associations were found between alcohol consumption and drug abuse on the one hand and the children's age, type of occupation and home-leaving experience on the other. Further analysis of the data showed that the main reason for drug abuse was curiosity (56.6%), followed by mere enjoyment (39.6%) and leisure (35.8%). Conclusion: It can be concluded that drug abuse among street children is highly associated with gender, age, alcohol consumption, cigarette smoking and leaving home experience. Therefore, it is recommended to start drug abuse prevention programs at lower ages, with particular emphasis on boys. In addition, family intervention and improvement of children's lifestyle aiming at preventing home-leaving could be a main strategic plan for reducing drug abuse among street children. [ABSTRACT FROM AUTHOR]

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Background: It is widely agreed that the practices of clinicians should be based on the best available research evidence, but too often this evidence is not reliably disseminated to people who can make use of it. This “know-do” gap leads to ineffective resource use and suboptimal provision of services, which is especially problematic in low- and middle-income countries (LMICs) which face greater resource limitations. Family planning, including intrauterine device (IUD) use, represents an important area to evaluate clinicians’ knowledge and practices in order to make improvements. Methods: A questionnaire was developed, tested and administered to 438 individuals in China (n = 115), Kazakhstan (n = 110), Laos (n = 105), and Mexico (n = 108). The participants responded to ten questions assessing knowledge and practices relating to contraception and IUDs, and a series of questions used to determine their individual characteristics and working context. Ordinal logistic regressions were conducted with knowledge and practices as dependent variables. Results: Overall, a 96 % response rate was achieved (n = 438/458). Only 2.8 % of respondents were able to correctly answer all five knowledge-testing questions, and only 0.9 % self-reported “often” undertaking all four recommended clinical practices and “never” performing the one practice that was contrary to recommendation. Statistically significant factors associated with knowledge scores included: 1) having a masters or doctorate degree; and 2) often reading scientific journals from high-income countries. Significant factors associated with recommended practices included: 1) training in critically appraising systematic reviews; 2) training in the care of patients with IUDs; 3) believing that research performed in their own country is above average or excellent in quality; 4) being based in a facility operated by an NGO; and 5) having the view that higher quality available research is important to improving their work. Conclusions: This analysis supports previous work emphasizing the need for improved knowledge and practices among clinicians concerning the use of IUDs for family planning. It also identifies areas in which targeted interventions may prove effective. Assessing opportunities for increasing education and training programs for clinicians in research and IUD provision could prove to be particularly effective.

Abstract Background Individuals' experience of interacting with the healthcare system has significant impact on their overall health and well-being. To relate patients' experiences to a common set of standards, the World Health Organization (WHO) developed the concept of health system responsiveness. This study aimed to assess if the WHO responsiveness concept reflected the non-medical expectations of mental healthcare users in Teheran. Methods In this qualitative study, four mixed focus group discussions were formed, comprising 53 mental health service users in Tehran, Iran, in 2010. Content analysis was performed for data analysis. Responses were examined in relation to the eight domains of the WHO's responsiveness model. Results There were many commonalities between the findings of this study and the eight domains of the WHO responsiveness model, although some variations were found. Effective care was a new domain generated from our findings. In addition, the domain of prompt attention was included in two new labelled domains: attention and access to care. Participants could not differentiate autonomy from choice of healthcare provider, believing that free choice is part of autonomy. Therefore these domains were unified under the name of autonomy. The domains of quality of basic amenities, access to social support, dignity and confidentiality were considered to be important for the responsiveness concept. Some differences regarding how these domains should be defined were observed, however. Conclusions The results showed that the concept of responsiveness developed by the WHO is applicable to mental health services in Iran. These findings might help policy-makers' better understanding of what is useful for the improvement of mental health services.