1 / 17

Global Learning Process for Scaling Up Poverty Reduction: Shanghai Conference May 25-27, 2004

Global Learning Process for Scaling Up Poverty Reduction: Shanghai Conference May 25-27, 2004.

ayala
Télécharger la présentation

Global Learning Process for Scaling Up Poverty Reduction: Shanghai Conference May 25-27, 2004

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Global Learning Process for Scaling Up Poverty Reduction: Shanghai Conference May 25-27, 2004

  2. Primary Health Care and the Rural Poor in the Islamic Republic of IranAmir Mehryar & Shirin Ahmad-niaCenter for Population Studies & ResearchMinistry of Science, Research & Technology, Tehran, IranApril 22, 2004

  3. Outline and Objectives of Presentation • Brief description of Iranian Primary Health Care System • Evidence of Improvements in Health Status of Rural Population • The Role of Primary Health Care System • Factors Underlying the Success of Iranian PHC • Lessons Learned

  4. Rural Population of Iran • Iran has experienced a high rate of urbanization over the past 50 years. • Currently about one-third of Iran’s population, around 24 million, live in rural settlements. • Rural settlements are defined by population size (less than 5000) and/or absence of an officially recognized municipal administration. • In 1996 about 64000 rural settlements were identified.

  5. Relative Deprivation of Rural Population in Terms of: • Government investment, including most of the subsidized goods • Private income/expenditure • Access to social services: • Education • Health • Social Insurance • Poverty levels

  6. Organization & Structure of Iranian Health Network & the PHC System • Nationally • In Urban Areas • In Rural Areas

  7. Components of PHC System in Rural Areas • Rural Health House • Based in a village • Staffed by 2 or more Behvarz • Covering a population of 1,500 individuals • Rural Health Center • Based in a large village • Supervising/supporting 5 health houses • Staffed by at least one GP & several health workers • Offering outpatient care,oral health, basic environmental sanitation, maternity facilities • District Health Center • Supervising and supporting several Health Centers • Medical trained personnel, laboratories, Behvarz Training Centers • Referral to District Hospitals & higher levels of care

  8. Basic Features of Iran’s Rural PHC System • Community participation • Recruitment of locally acceptable providers (Behvarz) • Careful training/retraining of health workers • Continuous monitoring/supervision/motivation • Emphasis on appropriate technologies • Simple but well integrated health information system

  9. The Behvarz • Criteria for Selection • Responsibilities • Training

  10. The Health Information System • Household file • Vital horoscope • Statistical wheel • Monthly report forms

  11. Impact on Health Outcomes • Impressive improvements in health indicators of rural population since 1980s in terms of: • Health of children • Infant and child mortality • Preventive health/medical care • Health of mothers • Mortality • Antenatal care • Postnatal care • Reproductive health & family planning • Environmental hygiene • Considerable narrowing of urban-rural disparities in health outcomes

  12. Changes in Maternal Mortality Ratios of Urban and Rural Areas, 1974-1996.

  13. Changes in Infant Mortality Rates of Urban and Rural Areas, 1974-1996.

  14. Changes in Under 5 Mortality Rates (per 1000) of Urban & Rural Areas, 1988-2000.

  15. Urban-Rural Differences in Antenatal Care Visits, 2000.

  16. Urban-Rural Difference in Using Different Contraceptives, 2000.

  17. Factors Underlying the Success of Iranian PHC System • Learning and Experimentation Concept of Behvarz tried in two pilot projects: • Kavar rural district (Shiraz University) • West Azarbijan (World Health Organization) • Leadership Commitment to Change • Political commitment to provide basic health care services to poor population • Reallocation of government health budget towards preventive and public health care • Institutional Innovation • Decentralization • Selection and training of Behvarz

More Related