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Introduction: Osteoporosis is an important health problem and the most common metabolic bone disease, that according data statistic, more than 6000000 Iranian have this disease.
Material and Methods: This research is a descriptive analytical study which has been conducted in order to evaluate application prevention behaviors of osteoporosis in health caregivers and how them educating for women referred to the health care centers of Arak City in 2002.
The research units were composed of 24 health caregivers 110 women referred to these centers that had been selected by convenience.
Results: The results of the research show medium age of caregivers were 33.7 years and in women were 29.3 years. (%58). Caregivers and (%80.9) women had adequate education intake daily and (%80.2) caregivers and (%16.4) women had regular exercise, (%62.5) Caregivers and %63.5) women exposed to the sunlight. Also the results show (%49.1) units research in the day gave discussion of caregivers about osteoporosis. (%79) intake calcium, (%90) exercise, (%85.5) exposing to the sunlight, but (%80.9) women did not discuss about taking hormonal drugs.
Conclusion: The result show significant relation between age, educational level and family history of osteoporosis in health caregivers with before education, but relation between adequate calcium intake in women and education was nonsignificant and relation between doing exercise and education was significant.

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Introduction: Normal growth of children is an index of their health. So growth monitoring is a routine service provided in most health care systems. This study has been performed in order to assess the effectiveness of growth monitoring regarding incidence of failure to thrive (FTT) and head circumference. Materials and methods: There was a historical cohort study in which the children who were 12 -14 months old at the time of study under the coverage of health service of Aboozar health center, Tehran medical university, were evaluated. We used linear, logistic and Cox modeling for detecting statistical association of the distinguished variables. Results: There was no significant association between number of growth monitoring visits and the size of head circumference (linear model). In addition to, there was a significant association between the number of growth monitoring visits and incidence of FTT (logistic model). Conclusion: According to our data, it seems that growth monitoring has a preventing role in growth of failure to thrive children.

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Background: All members of society should have equal access to necessary health care. The main goal of this research is to determine the status of health care access in eight selected countries and to suggest a new model for Iran. Materials and Methods: This study was done comparatively on eight countries. In order to define a framework for categorizing the countries Jordan scales was employed. In this method, based on the kind of insurance system, countries are divided into 4 groups, from each 2 countries were selected. Data obtained from each country were placed in comparative tables. For presenting the final model, Delphi technique was utilized in two stages. Results: To increase equity in their health care systems, all the countries in this study utilized such strategies as insurance coverage for all, defined health care packages, appropriate human resources, family physicians, referral system and high level of GNP in health sector. Also, low direct payment by patients, expansion of insurance coverage and the existence of out of pocket pay limit in pharmaceutical and medical services were also very helpful. These policies have been made in a way that the level of individuals' income did not affect the access to such services. Conclusion: Equitable access to health care services in Iran necessitates the establishment of national health insurance system aiming at omission of parallel insurance, provision of medical care coverage for all the basic medical services especially health care coverage for the elderly and patients with chronic psychological problems.

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Background: Considering the importance of the presence of volunteer health care communicators and the reduction in their cooperation with health centers or their breaking off their communication in recent years, this study was done to explore the educational needs of health care communicators and their instructors. Materials and Methods: In a qualitative study, data were obtained through focus group discussions (FGDs) and individual depth interviews (IDIs) for need assessment from three groups of active volunteer health care workers, inactive volunteer health care workers and health instructors. In total, 14 FGD and 5 DII were held to cover the aims of research chosen by aimed sampling. The analysis was carried out by qualitative content analysis. Results: Three major themes emerged from data analysis, including the concepts of soft and hard tools (time, space, educational tools, and educational content), educator (teaching methods, awareness, and skills), and learner (application, literacy, experience learning level, and motivation). Conclusion: Many of the educational needs of the health care communicators and their educators had not been met which, in many cases, had led to the discontinuation of their cooperation with health centers. Hence, presenting the obtained feedback to officials for meeting their needs can be an effective measure in improving the activities of the communicators and their continuous presence in the health care system.

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Abstract

Background: Client satisfaction as an important indicator to assess the quality of provided services has found a special place over the past few decades. The main purpose of this study is to compare the client satisfaction in the public health posts and outsourced health posts affiliated to Qom university of medical Sciences in 2014.

Materials and Methods: This was a descriptive analytic (cross- sectional) study.The participants were 216 clients, who had referred to 10 public health posts and outsourced health posts of Qom province. Health posts  were selected by cluster sampling from different urban areas  and participants were selected by simple sampling methods. A researcher made questionnaire was used to measure the data on a 5-point Likert scale, which it's validity and reliability were confirmed by experts panel and Cronbach's alpha coefficient, respectively. After collection, the data were analyzed by SPSS 20, and descriptive statistical methods, Mann-Whitney test, chi-square, with 0.05 significant level.

Results: Among 60 health posts, 20 health posts (33.33%) were outsourced and 40 (66.66%) were managed by the public sector. Results showed that in health centers outsourced , overall satisfaction of the child care and vaccinations and maternity care were respectively, 64.5 and 55.42 and 67.43 percent and in public health posts were respectively, 35.5 and 44.58 and 37.66 percent and this difference was significant. Client satisfaction in the public health posts of the vaccination (57.1%) compared with client satisfaction in the outsourced health posts (47.2%) was higher, also at public health posts, satisfaction of the scientific skill employees (55.1 percent) assigned to the outsourced health posts (44.9%) was even greater, that this difference was significant.

Conclusion: Results of the present study showed that, there is a significant difference in satisfaction of clients in public health posts and outsourced health posts It seems necessary to pay special attention to employee training programs by managers and also considering the results of client satisfaction in performance appraisal of personnel in health care posts.

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