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Depiction of Health. 2022;13(Suppl 1): 88-100.
doi: 10.34172/doh.2022.19
  Abstract View: 31
  PDF Download: 11

Community Involvement and Intersectoral Collaboration in Health Care System

Original Article

People-centeredness and Community Engagement based on “Each Home as a Health Post” initiative to Control COVID-19 in I.R. Iran: The Fourth Phase of National Mobilization against COVID-19

Ardeshir Khosravi 1 ORCID logo, Elham Rashidian 1 ORCID logo, Alireza Raeisi 2 ORCID logo, Seyed hossein Wassegh 1 ORCID logo, Azizollah Atefi 3 ORCID logo, Batoul Rabbani 1 ORCID logo, Mahin sadat Azimi 1 ORCID logo, Jafar Sadegh Tabrizi 4 ORCID logo, Mohammad Assai Ardekani 5 ORCID logo, Amin Ataey 1* ORCID logo

1 Center for Primary Health Care Network Management, Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
2 School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
3 Deputy for Public Health, Iranian Ministry of Health and Medical Education, Tehran, Iran
4 Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
5 Former Senior Advisor for Minister of Health and Medical Education, Senior Expert in Health System Development, Ministry of Health and Medical Education, Tehran, Iran
*Corresponding Author: Email: ataey5143@gmail.com

Abstract

Background. In December 2019, a new disease was reported in China that spread rapidly worldwide. This disease is called COVID-19, a viral infection of the coronavirus family. COVID-19 has caused health, social and economic problems around the world. In Iran, the first disease cases were reported in February 2020. This article aimed to describe the results of the fourth step of the National Mobilization Plan against COVID-19 pandemic.

Methods.The information used in this cross-sectional-descriptive study is based on the data recorded in the computer program (Portal) of the Network Management Center of the Ministry of Health and Medical Education.The fourth step was devised to manage and control the COVID-19 pandemic with public participation and coordination between departments. It was formed of four teams, 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. In this study, 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 supportive, 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% were positive. The average contact tracing in people with close contact with the infected people was 4.87 per patient with a positive test.

Conclusion. The COVID-19 pandemic challenged all political, economic, social, and health policies and exposed the weaknesses of the governments. According to statistics and information, the measures taken to manage and control COVID-19 in Iran have been valuable and effective. Still, the continuation of this process depends on the persistence of policies and protocols by the government and people in the society.

Keywords: COVID_19, Contact Tracing, Home Care, Pandemy, IRAN

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 in February 19, 2020. Subsequently, various measures were taken, including the closure of schools, universities, public places, cinemas, concerts, theaters, restaurants, and reception halls, cancellation of competitions, and reduced office hours. The Iranian Ministry of Health and Medical Education (MOHME) formed 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. "Each Home as a Health Post (HAHP)" program was taken into account in the fourth step.

Methods

In this cross-sectional descriptive study, the measures taken and their results are presented 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, Iranian Red Crescent, volunteers, and NGOs. In this step, four teams, including Contact Tracing, Home Care, Supervisory, and Support teams, were formed in each neighborhood.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 of COVID-19, of 60.3% had a PCR test. Rapid testing was performed for 51.7% of home care cases, of whom 9.1% turned out 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, simplistic view of the disease, 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 different vulnerable groups until the general vaccination is completed and the disease is under control. According to statistics and information, the measures taken in Iran to manage and control COVID-19 have been valuable and effective. However, the continuation of this process depends on the continuation of policies and protocols by the government and people in 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 available in the Center for Primary Health Care Management, no special ethical considerations were required.

Conflict of Interest

The authors state no conflict of interest in the present study.


Aknowledgment

We are grateful to all the health defenders in all parts of the country who sacrifice themselves in the stronghold of defending the health of their compatriots. 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.


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Submitted: 12 Sep 2021
Revision: 09 Oct 2021
Accepted: 13 Oct 2021
ePublished: 09 Apr 2022
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