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BACKGROUND AND OBJECTIVES: The long-term nature and capitalization of projects as well as the risks of the country's economic environment have made the provision of proper infrastructure as a permanent problem for national and local governments. Governments prefer to outsource the development and exploitation of capital assets to the private sector due to several reasons. In this matter, government institutions, due to their weaknesses in both technology and financing, are willing to create some optimal policy frameworks to utilize financial instruments to encourage private sector participation, as well as increase the share of revenues from the urban projects. The aim of this paper is to use the auction theory to improve the current mechanisms of public asset allocation. METHODS: This paper investigated the legal framework to design an allocation mechanism for the public assets using a qualitative approach. This qualitative method is based on the case study. This paper works on a series of library studies in order to analyze and familiarize with the problems, shortcomings, and inadequacies in the allocation of public assets exploitation plans in the Municipality of Tehran. FINDINGS: The obtained results indicate that the current rule can be improved in terms of choosing the process holding model, bidding criteria, and focusing on sharing future revenues in order to strengthen both the optimality and efficiency of outputs. CONCLUSION: This paper proposed the bidding mechanisms that can be employed based on the current rules. After determining the qualifications of the contractors, a two-step model can be utilized to provide the set of assets. The mechanism of holding bidding was provided based on the results of previous researches as well as the features of the current rule in the form of two stages of price detection and the First Price Sealed Bid Auction mechanism. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the process of implementation of a national nutritional programme for improving the nutritional status of children in Iran., Design: A cross-sectional process evaluation was carried out using field observations, document reviews, semi-structured interviews and focus group discussions., Setting: Data were collected across urban and rural areas of Qazvin and Semnan provinces of Iran, March-September 2014., Subjects: Mothers (n 362) of children under programme coverage were chosen for the survey. Senior nutrition officers, the head of Hygiene, Remedy and Insurance Affairs at Imam Khomeini Relief Foundation and community health workers were selected purposively for interviews. Mothers with at least one child under 6 years of age covered by the programme were selected to participate in focus group discussions., Results: Five steps of programme implementation were identified: supplementary food basket content, food basket distribution methods, selection of eligible children, distributed food consumption, and child growth monitoring and nutrition training sessions for mothers. The distributed food baskets did not have enough milk/dairy products, vegetables and fruits. Nearly 50 % of children consumed 75-100 % of the distributed milk and cake/biscuit, while staple foods were shared with other family members. When electronic cards were offered instead of food baskets, attendance for child growth monitoring and the food items participants chose with the cards tended to differ from what was originally designed., Conclusions: Focusing on food items that are mostly being used for child feeding (e.g. eggs or milk in food baskets) may be beneficial to assure the target child is receiving the distributed foods.

This study aimed to evaluate the effectiveness of the national food distribution program on the growth and nutritional status of malnourished or growth-retarded children in 2 provinces of Iran. A quasi-experimental design was used for the effectiveness evaluation. Qualitative data were gathered to explain the results. An intervention group consisted of 362 children aged 6-72 months who were under coverage of the program. These children received monthly food as foodstuff, food vouchers, or cash. A comparison group included 409 children aged 6-72 months who were selected from those covered by the Primary Health Care system. Children anthropometric indices were measured at the baseline and also 6 months later. Twelve focus group discussions were held with mothers who had at least 1 child under the coverage of the program. At the end of the study, the mean weight-for-age Z scores, height-for-age Z scores, and weight-for-height Z scores increased compared with the baselines in both groups (p < .001). The differences between 2 groups in weight-for-age Z scores, height-for-age Z scores, and weight-for-height Z scores were not significant at the end of the study (p = .62, p = .91, and p = .94, respectively). According to the mothers' reports, factors affected the program outcome, that is, children anthropometric indices were low income, intrahousehold food sharing, irregular distribution, quantity and quality of the distributed food, and insufficient training. Providing foods for the malnourished children living in low-income families helped to prevent a worsening of their nutritional status; however, it has not been effective in solving the problem, probably due to the weak implementation and lack of empowerment strategies., (© 2018 John Wiley & Sons Ltd.)

Objective: Access to hospitals in megacities in low and middle income countries might be hampered by travel barriers and distance. We assessed the 'inverse care law' hypothesis: whether hospitals tended to be built in the relatively better-off areas through the time., Methods: A longitudinal time-series study (1966 to 2011) in Tehran to measure inequality in the distribution of hospital beds. We assessed correlations between the district socioeconomic status and availability of hospital beds via regression analyses, estimated correlation, Gini and concentration indices, and used GIS models to map hospital distributions through time., Finding: We found a clear relationship between socioeconomic status and number of hospital beds per capita ( P -values <0.05). Gini coefficients were about 0.6 and 0.8 for public and private beds, respectively. A third of the variations in hospital bed distribution was explained by the welfare status of the district. For every extra residential room per capita, 130 to 280 extra beds were observed per ten thousand population at the district level. In 2011, out of 162 hospitals, 110 were located in six districts around the centre and northern part of the city. During the time period only two private hospitals were built in relatively disadvantaged districts., Conclusion: Over a period of about fifty years new hospitals had been established in the relatively affluent areas of the city and the relationship between socioeconomic status of district with total, private and public beds were direct and intensive. Results indicate the problem of inequality may remain over time and be resistant to policy initiatives and major political changes., (© The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com)

Introduction: Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children., Objective: This study aimed to evaluate the implementation aspect of the program and to explore key informants' perceptions and experience regarding the factors affected its implementation., Methods: Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases' checklist to interpret the viewpoints of the study participants., Results: Results showed that the program had successes in improving mother's knowledge on health, nutrition, and child care through health system and increased families' access to food, but there were some aspects that affected program's implementation. Some of these factors are the lack of clarity in the program's protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition., Conclusion: Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.

Background: Food aid programs are strategies that aim to improve nutritional status and to tackle food insecurity. This study aimed to evaluate the effect of a National Food Supplementary Program for Children on households' food security., Methods: The study sample included 359 mothers of children aged 6-72 months under the coverage of the program in two provinces of Iran. Demographic and socioeconomic characteristics of the households and percentage of supplementary food items consumed by target child were assessed by a questionnaire and checklist. Data on household food security were collected by locally adapted Household Food Insecurity Access Scale at the baseline of the study and 6 months thereafter., Results: At the baseline, only 4.7% of families were food secure, while 43.5% were severely food insecure, and these proportions were changed to 7.9% and 38%, respectively ( P < 0.001), at the end of the study. Odds of having worse food insecurity in households with medium and high wealth index was 65% and 87% lower than those with low wealth index, respectively (odds ratio [OR] = 0.35, 95% confidence interval [CI]: 0.2-0.61, and OR = 0.23, 95% CI: 0.12-0.43). Food sharing was common among more than 95% of the studied households. Mean maternal body mass index (BMI) increased significantly after 6 months ( P < 0.001). However, there was no significant association between mother's BMI and household food security in the baseline and at the end of the study ( P > 0.05)., Conclusions: Findings show that the food supplementary program for children can also improve the household food security status. Further research is needed to assess other factors that affect the effectiveness of this kind of programs.

Background: Current evidence consistently confirm inequalities in health status among socioeconomic none, gender,ethnicity, geographical area and other social determinants of health (SDH), which adversely influence health ofthe population. SDH refer to a wide range of factors not limited to social component, but also involve economic, cultural,educational, political or environmental problems. Measuring inequalities, improving daily living conditions, andtackling inequitable distribution of resources are highly recommended by international SDH commissioners in recentyears to 'close the gaps within a generation'. To measure inequalities in socio-economic determinants and core healthindicators in Tehran, the second round of Urban Health Equity Assessment and Response Tool (Urban HEART-2)was conducted in November 2011, within the main framework of WHO Centre for Health Development (Kobe Centre)., Method: For 'assessment' part of the project, 65 indicators in six policy domains namely 'physical and infrastructure','human and social', 'economic', 'governance', 'health and nutrition', and also 'cultural' domain were targetedeither through a population based survey or using routine system. Survey was conducted in a multistage random sampling,disaggregated to 22 districts and 368 neighborhoods of Tehran, where data of almost 35000 households(118000 individuals) were collected. For 'response' part of the project, widespread community based development(CBD) projects were organized in all 368 neighborhoods, which are being undertaken throughout 2013., Conclusion: Following the first round of Urban HEART project in 2008, the second round was conducted to trackchanges over time, to institutionalize inequality assessment within the local government, to build up community participationin 'assessment' and 'response' parts of the project, and to implement appropriate and evidence-based actionsto reduce health inequalities within all neighborhoods of Tehran.