People-Centeredness and Community Engagement Based on “Each Home as a Health Post” Initiative to Control COVID-19 in the Islamic Republic of Iran: The Fourth Phase of National Mobilization against COVID-19

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Extended Abstract
Background
In December 2019, a new viral disease of the coronavirus family (COVID-19) was reported in China and spread rapidly worldwide. COVID-19 has caused health, social and economic problems around the world. In Iran, the first disease cases were reported on February 19, 2020. Subsequently, various measures were taken, including the closure of schools, universities, public places, cinemas, concerts, theaters, restaurants, and reception halls, the cancellation of competitions, and reduced office hours. The Iranian Ministry of Health and Medical Education (MOHME) established various committees at national, provincial, and district levels under the Deputy for Public Health supervision.Additionally, operational teams at comprehensive health service centers have been active in several stages to combat COVID-19. The management and control of the COVID-19 pandemic were based on a neighborhood and family-centered manner. The "Each Home as a Health Post" (HAHP) program was considered in the fourth step.
Methods
This cross-sectional descriptive study presents the measures taken and their results in the fourth step of the National Mobilization Plan against COVID-19 in Iran from November 2020 to April 2021.The information used in this study is based on the data recorded in the computer program (Portal) of the Network Management Center of the Deputy Minister of Health of the MOHME.The fourth step was devised to manage and control the COVID-19 epidemic with public participation and coordination between departments involving Basij Organization, the Iranian Red Crescent, volunteers, and NGOs. In this step, four teams were formed in each neighborhood, including contact tracing, home care, supervisory, and support teams.Excel 2016 software was used to analyze the present study's data, and ArcMap software version 10.8 was applied to draw thermal maps.
Results
From the beginning of the disease epidemic to the end of the fourth step of the National Mobilization Plan against COVID-19, there were 2,215,445 cases, of whom 66,327 died and 1,772,688 recovered. During the implementation of this program, there were 3.2 members per contact tracing team. This number was equal to 3.2, 2.9, and 3.8 people per team for support, home care, and supervisory teams, respectively. Also, on average, the contact tracing teams tracked 135.9 cases per team. This number was 518.6 visits per team for supervisory teams, 75.3 for home care teams, and 52.2 households for support teams. During the program's implementation, 3065.3 PCR tests and 3596.7 rapid tests were taken per 100,000 population, of which 15.5 Percentage were found positive. The average contact tracing in people with close contact with the sick person was 4.87 per patient with a positive test. 72.5% of the contact tracing cases were in urban areas and 27.5% in rural areas. 15.9% of these individuals were referred to the selected comprehensive health service centers for COVID-19, and 60.3% had a PCR test. Rapid testing was performed for 51.7% of home care cases, of whom 9.1% were positive. Supervisory teams identified one place that did not follow standard protocols per 10.2 visits and legally closed one place per 16.2 of the mentioned places.
Conclusion
The COVID-19 pandemic was the most devastating disaster in recent history. The disease challenged all political, economic, social, and health policies and exposed the weaknesses of the governments. Observance of preventive behaviors and interventions can play a crucial role in reducing the incidence of the disease. However, because the pandemic period of the disease is too long, factors such as exhaustion, indifference, a simplistic view of the disease, and economic issues of households may lead to reduced compliance with preventive protocols and, eventually, the emergence of a new peak. Policymakers must develop and implement various support policies for vulnerable groups until the general vaccination is completed and the disease is controlled. According to statistics and information, the measures taken to manage and control COVID-19 in Iran, have been valuable and effective. However, this process depends on the continuation of policies and protocols by the government and society.
Practical Implications of Research
According to the results of the present study, it can be said that one of the ways to control COVID-19 is to improve its detection process in the earlier stages and follow up close contact cases in order to break the disease transmission chain.
Ethical Considerations
Since this article used the aggregate data in the Primary Health Care Management center, no special ethical considerations were required.
Conflict of Interest
The authors state no conflict of interest in the present study.
Acknowledgment
We are grateful to the health defenders in every region of the country who make personal sacrifices to safeguard their compatriots’ health. We would also like to thank all the managers, experts, and staff at the Deputy for Public health of the University of Medical Sciences who have cooperated in collecting information for this study.