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Depiction of Health. 2022;13(Suppl 1): 66-74.
doi: 10.34172/doh.2022.17
  Abstract View: 29
  PDF Download: 8

Health Care System Management

Original Article

Mass Testing and Verbal Screening to Control COVID-19 Pandemic: The Second Phase of National Mobilization Plan against COVID-19

Elaheh Kazemi 1 ORCID logo, AliReza Raeisi 2 ORCID logo, Akhtardanesh Nima 1, Rezanejad Asl Parisa 1 ORCID logo, Zahra Shirzadi 1, Aghamohamadi Saeide 1 ORCID logo, Babak Farrokhi 1 ORCID logo, Siamak Mirab Samiee 3 ORCID logo, Saeid Ghalehei 1, Jafar Sadegh Tabrizi 4* ORCID logo

1 Network Management Centre, Deputy for Public Health, Iranian Ministry of Health and Medical Education, Tehran, Iran
2 Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
3 Reference Health Laboratory, 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
*Corresponding Author: Email: js.tabrizi@gmail.com

Abstract

Background. As an emerging disease, COVID-19 is considered more than just a health crisis, as it socially affects communities. Therefore, community-oriented solutions via the primary health care system can better manage and control this pandemic. The Ministry of Health and Medical Education, and the executive branch of the Deputy Minister of Public Health, played an influential role in controlling the epidemic with the community-based and network-based interventions in the National Mobilization Plan against COVID-19.

Methods. A cross-sectional descriptive study was conducted. The data from portal of Network Management Center, Centers for Disease Control and Prevention (CDC), CLIS system, Reference Health Laboratory, and electronic record systems of the public health networks of all universities across the country were used to assess the second step of the National Mobilization Plan against COVID-19. Data was collected from April 13 to August 11, 2020, and was analyzed using SPSS software.

Results. During the second phase, more than 42 million people were screened by health care providers. About 98.4% of this population were diagnosed with no problems, and 0.4% were referred to the selected COVID-19 comprehensive health centers for examination and medical procedures by physicians. Of all the direct and referred patients of the selected COVID-19 comprehensive health centers, 55.3% had no problems, 37.8% needed to be tested, and 3.6% needed to be referred to a hospital, and 3.3% received outpatient care. In the first days of laboratory screening, 11% of PCR were positive. By the end of the second step of the National Mobilization Plan against COVID-19, this rate had increased to 25%.

Conclusion. In times of crisis and epidemic conditions, the health network system and the primary health care providers can effectively manage outpatients and reduce the burden of hospitalization. Only 3.6% of outpatients in the network system were referred to hospitals. The rest were cared for and followed up by the primary health care providers. Therefore, strengthening the network system structure and primary health care should be further considered.

Keywords: COVID-19, Epidemic, Screening, PHC, PCR

Extended Abstract

Background

COVID-19 was diagnosed in December 2019 in Wuhan Province, China. This disease was officially confirmed in Iran on February 20. It quickly spread throughout the country, with all provinces becoming involved in this epidemic in the first half of March. The Iranian Ministry of Health and Medical Education (MOHME) and Deputy for Public Health were responsible for managing and controlling the epidemic and formed the National Corona Headquarters. In the Islamic Republic of Iran, five stages of the National Mobilization Plan (NMP) against COVID-19 have been carried out until September 2021. This study aims to introduce the second step of the NMP against COVID-19 as a successful experience in screening, controlling, and managing the epidemic through public health.

Methods

The present study is a cross-sectional descriptive study. The information related to the second step of the NMP against COVID-19 was collected from the four digital systems of the public health system (Sib, Sina, Nab, and Parsa). Data from all 63 universities of medical sciences and health services throughout the country in 4 months of the second step of the NMP against COVID-19 (April 13 - August 11, 2020) was retrieved. Data related to COVID-19 diagnostic tests in the first two months of the second phase of the NMP against COVID-19 were collected from the portal of the Network Management Center and the Centers for Disease Control and Prevention (CDC), and then through the CLIS system (COVID-19 Laboratory Information System) of the Ministry of Health and Medical Education (MOHME). After data collection, data cleaning was performed. The final data were reported using descriptive statistics (frequency, percentage, average), and SPSS software version 16 (IBM SPSS Statistics version 16) was used to analyze the data.

Results

In the second NMP, approximately 42 million Iranians were screened by health care providers in rural and urban areas. About 98.4% of this population were diagnosed with no problems, and 0.4% were referred to the selected COVID-19 comprehensive health centers for examination and medical procedures by physicians. Of all the direct and referred patients of the selected COVID-19 comprehensive health centers, 55.3% had no problems, 37.8% needed to be tested, and 3.6% needed to be referred to a hospital, and 3.3% received outpatient care (chloroquine administration). At the beginning of the second step of the NMP against COVID-19, the ratio of positive PCR tests to all samples was 11% on April 23. Ratios after that were 13% on May 23, 39% on June 23, 23% on July 23, and at the end of the second step on August 23, it was 25%.

Conclusion

In times of crisis and epidemic conditions, the health network system and the primary health care providers can effectively manage outpatients and reduce the burden of hospitalization. Primary health care improves the performance of health systems in cases of crisis and epidemic by lowering overall health care expenditure. To achieve full health coverage and reforms, we should strengthen primary health care. Therefore, primary health care is essential, and like hospitals, it should be seriously considered by health system policymakers.Practical Implications of ResearchIn general, according to the present study results, primary health care and the use of the network system in healthcare have a significant effect on disease prevention, control, and management during the epidemic and have reduced the burden of hospitalization. Therefore, it is suggested that the primary healthcare network system be supported and prioritized by health system policymakers.

Ethical Considerations

This study used secondary data and aggregate reports, and no intervention was made.

Conflict of Interest

The authors declare that this study is the result of an independent study and has no conflict of interest with other organizations and individuals.

Aknowledgment

Researchers need to express their gratitude to all the people who somehow participated in implementing this project and the development of related documents. We also thank all the managers and experts of the Deputy Minister for Public Health - MOHME and the Deputies for Public Health of the universities who used all their efforts to manage and control the disease during the epidemic. The present study summarizes the measures taken by the Deputy Minister for Health in the field of the COVID-19 epidemic, which is the result of the effective measures taken by the health care providers.


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Submitted: 11 Sep 2021
Revision: 06 Oct 2021
Accepted: 13 Oct 2021
ePublished: 09 Apr 2022
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