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The Use of Population Attributable Risk to Estimate The Impact of Preventive Interventions of Smoking Cessation in Chronic Obstructive Pulmonary Disease(COPD)
Seyedeh Mahdieh Namayandeh, Zahra Jafarabadi, Sanaz Azadi,
Volume 9, Issue 4 (Oct-Dec 2020)
Abstract
Chronic pulmonary disorders are a set of diseases that restrict respiration airflow(1).Most of these diseases are chronic obstructive pulmonary disease (COPD)(1). According to the WHO  report, mortality from COPD is increasing worldwide. It is expected to be the third leading cause of death worldwide by 2030(2) (the sixth leading cause of death in 1990(3). This disease causes significant costs for health systems(4). There is strong evidence between COPD and smoking as a major risk factor. Smoking cessation is the most effective measure to prevent or slow COPD progression (2,5).
The effect of smoking on COPD was assessed in selected studies using the odds ratio (OR). The data analysis results using the random effects method showed that the risk of COPD was higher in smokers and those exposed to cigarette smoke.(current smoker; 95% CI: 0.78 – 4.31, OR: 1.83, Ex-smoker; CI: 1.05 - 4.98, OR: 2.29, passive smoker; CI: 0.43_3.08 , OR: 1.15)(3,6).
According to the results of the 7th national survey of non-communicable disease risk factors (Steps 2016),the distribution of current smokers, ex-smokers, and passive smokers were 9.71, 14.63,and 31.53 among over 18 years old, respectively(7). Furthermore, the population attributed risk (PAR) of each factor with Levin formula (PAR=P(OR-1)/P(OR-1)+1) is 0.89%, 0.95%, and 82.5%, respectively, which indicates when smoking would eradicate in populations, we can propose to lower up to almost 90 % in the population’s  COPD.

What Can We Do to Improve the Health Policy-Making Cycle in the Islamic Republic of Iran with a Good Governance Approach? Recommendations for the Secretariat of the Supreme Council for Health and Food Security
Marziyeh Azadiyan, Abbas Vosoogh Moghadam, Ali Farhadimahalli,
Volume 12, Issue 2 (11-2023)
Abstract

Background: The primary purpose of the health system is to promote equitable health in society. The aim of this study is to offer some recommendations for improving the Iranian health policy-making cycle with a good governance approach.
Methods: The systematic review approach was employed to undertake this research. To track down articles published electronically between 2010 and 2021, a comprehensive search in the National Library's English databases, in December 2021, was conducted using the keywords such as public policy, policy, policy-making, health policy, good governance, health, and healthcare. In addition, the Persian equivalents of the aforementioned keywords were searched separately or in combination with Boolean operators (OR, AND) in databases such as Scopus, Ovid, Science Direct, Web of Knowledge, PubMed, IranMedex, Magiran, and SID to further pinpoint the desired articles. To evaluate and validate the quality of the selected articles, critical tools appropriate for the type of study were utilized (e.g., the SRQR tool for qualitative studies and the MMAT tool for mixed-methods studies), and finally, the research team conducted content analysis and categorized the findings.
Results: Findings revealed that the health policy-making cycle is an extensive and intra-sectoral concern. Good governance in the health system results in specialized and individualized opportunities for better health and reduces inequality. To accomplish this purpose, it is necessary to emphasize cross-sectoral participation, social responsiveness, and transparent processes, and incorporate the viewpoints of experts and implementers of the health policy-making system. Furthermore, the health system's sovereignty and progress toward good governance should be evaluated, which results in effective policies and health justice.
Conclusion: Considering the legal mission of the Supreme Council of Health and Food Security (the highest policy-making authority in the Ministry of Health), it is recommended that the council implement the practical recommendations of this research in actualizing and incorporating the good governance approach into the health policy-making cycle.
 


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