Journal of Education and Health Promotion

Health needs assessment of the residents of the informal settlements in South‑Eastern Iran: A case study of Bam city

Document Type : Original Article

Authors

. Naeimeh Poortaheri
. Khalil Alimohammadzadeh 1
. Seyed Mojtaba Hosseini 2
. Ali Maher 3
. Mohammadkarim Bahadori 4

1 Associate Professor, Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran/ Health Economics Policy Research Center, Tehran Medical Sciences Islamic Azad University, Tehran, Iran

2 Assistant Professor, Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran

3 Assistant Professor, Department of Health Policy, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Full Professor, Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract
BACKGROUND: Informal settlements are considered as one of the social problems in societies. As
the residents do not have adequate access to basic services, including health services, their health
is at risk. This study was conducted to evaluate the access to health services and determine the
health needs of informal settlements in Bam city.
MATERIALS AND METHODS: This cross‑sectional study was carried out in the spring of 2020 in
Bam. The sample size was 400 residents of informal settlements in Bam, and the multi‑stage random
cluster sampling was used. A researcher‑made questionnaire was used to collect the required
data. The validity of the questionnaire was confirmed using the content validity, and its reliability
was 85% by Cronbach’s alpha. The data were analyzed using the SPSS version 23 software and
descriptive statistics (frequency, mean, standard deviation, and percentage) as well as analytical
statistics (Mann–Whitney and Kruskal–Wallis tests).
RESULTS: More than 50% of the individuals had good access to general practitioners and health
centers. However, over 50% had poor access to dental, para‑clinical, specialist, and hospital services.
Furthermore, 49.3% of the people assessed their health status as poor in the previous year. A total
of 46 items in the areas of communicable and non‑communicable diseases, women’s health, mental
and social health and addiction, environmental health, etc., were identified as the most important
health needs of the informal settlement residents.
CONCLUSION: Informal settlements are facing various health problems including environmental
health, mental and social health, and addiction, meeting which requires collaboration of all
stakeholders as well as provision of a comprehensive program and appropriate service packages.

Keywords

Bam
health access
health needs assessment
informal settlements
South‑eastern Iran
  1. Habitat UN. Urbanization and development: Emerging futures.
    World Cities Rep 2016;3:4‑51.
    2. Ross AG, Zaman K, Clemens JD. Health concerns in urban slums:
    A glimpse of things to come? JAMA 2019;321:1973‑4.
    3. Friesen J, Friesen V, Dietrich I, Pelz PF. Slums, space, and state of
    health – A link between settlement morphology and health data.
    Int J Environ Res Public Health 2020;17:2022.
    4. Bakhtiari  A, Takian  A, Sayari  AA, Bairami  F, Tabrizi  JS,
    Mohammadi  A, et al. Design and deployment of health
    complexes in line with universal health coverage by focusing
    on the marginalized population in Tabriz, Iran. Teb Va Tazkiye
    2017;25:213‑32.
    5. Kahkesh  FH. Monitoring the situation of slum dweller, face
    of urban poverty the case of mallashieh‑Iran. Am J Sci Res
    2011;10:101‑9.
    6. Integrated Health System (sib). Ministry of Health and Medical
    Education. 2020. Available from: http://sib.mubam.ac.ir/. [Last
    accessed on 2020 Jul 30].
    7. Bengston  DN, Youn  YC. Urban containment policies and the
    protection of natural areas: The case of Seoul’s greenbelt. Ecol
    Soc 2006;11:3.
    8. Hay D, Varga‑Toth J, Hines E. Frontline Health Care in Canada:
    Innovations in Delivering Services to Vulnerable Populations:
    Canadian Policy Research Networks Ottawa, ON; 2006.
    9. Mony PK, Verghese L, Bhattacharji S, George A, Thoppuram P,
    Mathai  M. Demography, environmental status and maternal
    health care in slums of Vellore town, Southern India. Indian J
    Community Med 2006;31:230‑3.
    10. Heidari Jamebozorgi M. Developing a Health Management Model
    for the Slums Residents of Kerman Using Social Determinants
    of Health Approach. Kerman: Kerman University of Medical
    Sciences; 2019.
    11. Amiresmaili  M, Yazdi‑Feyzabadi  V, Heidarijamebozorgi  M.
    Health services utilization among slum dwellers: An experience
    from Iran. J Educ Health Promot 2019;8:210.
    12. Joulaei H, Bhuiyan AR, Sayadi M, Morady F, Afsar Kazerooni P.
    Slums’ access to and coverage of primary health care services:
    A cross‑sectional study in shiraz, a metropolis in Southern Iran.
    Iran J Med Sci 2014;39:184‑90.
    13. Razzaghi EM, Movaghar AR, Green TC, Khoshnood K. Profiles of
    risk: A qualitative study of injecting drug users in Tehran, Iran.
    Harm Reduct J 2006;3:12.
    14. Hall  JM. Marginalization revisited: Critical, postmodern, and
    liberation perspectives. ANS Adv Nurs Sci 1999;22:88‑102.
    15. Rahimi  H, Kalantari  A, Rafiee  N, Khosravi  S. Social trends
    affecting the future of Iran’s health system: A qualitative study
    using focus group discussion. Int J Prev Med 2019;10:115.
    16. Dehnavieh  R, Noorihekmat  S, Masoud  A, Moghbeli  MA,
    Rahimi H, Poursheikhali A, et al. Evaluating the Tabriz health
    complex model, lessons to learn. Iran J Epidemiol 2018;13:59‑70.
    17. Pourmohammadi K, Shojaei P, Rahimi H, Bastani P. Evaluating
    the health system financing of the Eastern Mediterranean
    Region  (EMR) countries using Grey Relation Analysis and
    Shannon Entropy. Cost Eff Resour Alloc 2018;16:31.
    18. World Health Organization  X. Health in 2015: From MDGs,
    Millennium Development Goals to SDGs, Sustainable
    Development Goals. 2015.
    19. Farid M, Tizvir A, Fashi Z. Health care status of residents of the
    slum areas of Karaj 2015. Alborz Univ Med J 2017;6:276‑82.
    20. Dehnavieh R, Rahimi H. Basic Health Insurance Package in Iran:
    Revision Challenges. Iran J Public Health 2017;46:719‑20.
    21. F e r n á n d e z ‑ O l a n o   C , H i d a l g o   J D , C e r d á ‑ D í a z R ,
    Requena‑Gallego M, Sánchez‑Castaño C, Urbistondo‑Cascales L,
    et al. Factors associated with health care utilization by the elderly
    in a public health care system. Health Policy 2006;75:131‑9.
    22. Owusu‑Ansah FE, Tagbor H, Togbe MA. Access to health in city
    slum dwellers: The case of Sodom and Gomorrah in Accra, Ghana.
    Afr J Prim Health Care Fam Med 2016;8:e1‑7.
    23. Turley R, Saith R, Bhan N, Rehfuess E, Carter B. Slum upgrading
    strategies involving physical environment and infrastructure
    interventions and their effects on health and socio‐economic
    outcomes. Cochrane Database Syst Rev 2013;1:CD010067. https://
    doi.org/10.1002/14651858.CD010067.pub2
    24. Kulabako RN, Nalubega M, Wozei E, Thunvik R. Environmental
    health practices, constraints and possible interventions in
    peri‑urban settlements in developing countries  –  A review of
    Kampala, Uganda. Int J Environ Health Res 2010;20:231‑57.
    25. Lotfi H, Mirzaee M, Edalatkhah F, Azizpour S. The marginalization
    crisis and informal settlements in the management of metropolitan
    cities and global approaches. Hum Geogr 2010;2(2):135‑145.
    26. Kimani‑Murage  EW, Schofield  L, Wekesah  F, Mohamed  S,
    Mberu  B, Ettarh  R, et al. Vulnerability to food insecurity in
    urban slums: Experiences from Nairobi, Kenya. J Urban Health
    2014;91:1098‑113.
    27. Gruebner O, Khan MM, Lautenbach S, Müller D, Krämer A, Lakes T,
    et al. Mental health in the slums of Dhaka – A geoepidemiological
    study. BMC Public Health 2012;12:177.
    28. Sehra V. Quality of community life and mental health in slums.
    Int J Health Sci Res 2018;8:127‑31.
    29. Bala  S, Valsangkar  S, Lakshman Rao  RL, Surya Prabha  ML.
    Impact of social determinants on well‑being of urban construction
    workers of Hyderabad. Indian J Occup Environ Med 2016;20:10‑3.
    30. Samouei R, Heidari K, Saghaeiannejad S, Karami S, Aghdak P.
    Evaluating the responsiveness of higher education system in
    relation to social determinants of health. J Educ Health Promot
    2020;9:291
  2. 31. Lumagbas LB, Coleman HL, Bunders J, Pariente A, Belonje A,
    de Cock Buning T. Non‑communicable diseases in Indian slums:
    Re‑framing the Social Determinants of Health. Glob Health Action
    2018;11:1438840.
    32. Khayatzadeh‑Mahani A, Labonté R, Ruckert A, de Leeuw E. Using
    sustainability as a collaboration magnet to encourage multi‑sector
    collaborations for health. Glob Health Promot 2019;26:100‑4.
    33. Mackenbach  JP, Bos  V, Andersen  O, Cardano  M, Costa  G,
    Harding S, et al. Widening socioeconomic inequalities in mortality
    in six Western European countries. Int J Epidemiol 2003;32:830‑7.
    34. Christensen  JH, Bloch  P, Møller SR, Søgaard CP, Klinker  CD,
    Aagaard-Hansen  J, et al. Health in All local Policies: Lessons
    learned on intersectoral collaboration in a community-based
    health promotion network in Denmark. Int J Health Plan Manag
    2019;34:216‑31.
    35. Ollila E, Baum F, Peña S. Introduction to Health in All Policies
    and the Analytical Framework of the Book. Health in All Policies.
    Ministry of Social Affairs and Health, Department for Promotion
    of Welfare and Health, Finland. Vol. 1; 2013.
    36. World Health Organization. Health in All Policies: Helsinki
    Statement. Framework for Country Action. World Health
    Organization; 2014.
    37. Adeleye OA, Ofili AN. Strengthening intersectoral collaboration
    for primary health care in developing countries: Can the health
    sector play broader roles? J Environ Public Health 2010;2010:6.
    38. Noorihekmat S, Rahimi H, Mehrolhassani MH, Chashmyazdan M,
    Haghdoost AA, Tabatabaei SVA, et al. Frameworks of performance
    measurement in public health and primary care system: A scoping
    review and meta‑synthesis. International Journal of Preventive
    Medicine. 2020;11:165.
Journal of Education and Health Promotion
Volume 11, Issue 5
June 2021
Pages 1-8

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us