Amirhossein Takian

Tehran University of Medical Sciences- School of Public Health · Global Health & Public Policy

Background Smuggling health goods given the importance and critical nature of health services should be undeniably addressed and controlled by all countries. This issue is especially more widespread in developing countries with more damaging consequences. This paper therefore aims to identify and analyze the challenges of preventing smuggling of he...

: The economic sanctions imposed on Iran in recent decades have impacted the country's healthcare system and the health of its people. However, there has not been a thorough examination of the full scope and changes in these effects over time. Therefore, we designed a mixed-methods study, comprising a parallel quantitative analysis and qualitative...

Objectives This study aimed to identify the types of transparency interventions in the health systems of the low-income and middle-income countries and the outcomes of such interventions in those systems. Method We searched major medical databases including PubMed, Embase and Scopus, for any kind of interventional study on transparency in health s...

Non-communicable diseases (NCDs) cause 74% of global deaths annually, for which poor diet is the leading risk factor. Diet improvement could prevent 20% of global deaths. This paper presents a policy package for socio-cultural factors, strategies, and policies to promote a healthy diet in Iran. This is a qualitative health policy analysis. We condu...

Introduction In recent years, smuggling of health goods has apparently increased in the country. Despite the preventive and regulatory measures taken to combat this problem, the outcomes seem to be undesirable. This study thus aims to identify and elucidate the role of economic barriers in the prevention of smuggling health goods in Iran. Method W...

Insufficient physical inactivity and an unhealthy diet are significant health risk factors globally. Dietary risk factors were responsible for approximately 16.5% of all deaths in Iran in 2019. This paper aimed to propose a dietary policy package for the health sector to reduce the risk of an unhealthy diet, which might effectively help prevent and...

Background A significant share of medical care, primary health care, and health-related education and research in Iran is provided by the Ministry of Health and its affiliated universities of medical sciences. We aimed to identify a set of key metrics for monitoring their efficiency in the four areas of medical care, primary health care, education...

Background Economic sanctions aim to exert pressure on political and economic foundations. Hypothesizing that sanctions might affect various aspects of population health, this study, as a component of a broader investigation to ascertain the trend effects of sanctions on selected health outcomes in Iran, seeks to explore the experiences of Iranian...

Background This tracked obesity inequality and identified its determinants among the population of Iran. In addition, it examined the impact of implemented policies on these inequalities. Methods This study was performed in two phases. First, we conducted a rapid review of the disparity in obesity prevalence in Iran. Then we investigated the main...

Background: In line with the advancement of Artificial Intelligence (AI), innovative solutions have been designed to improve healthrelated Sustainable Development Goals (SDGs). Accordingly, there is an increasing trend in the realm of AI and SDG research areas. Objectives: This study aimed to analyze the trends and patterns of AI research in health...

Background This article explores the concept of institutionalization, which is the process of transforming ideas into programs and automating actions, in the context of health system governance and sustainable development. Institutionalization is a key mechanism for creating accountable and transparent institutions, which are essential for achievin...

Background Policymakers require precise and in-time information to make informed decisions in complex environments such as health systems. Artificial intelligence (AI) is a novel approach that makes collecting and analyzing data in complex systems more accessible. This study highlights recent research on AI’s application and capabilities in health...

: Some countries have adopted the whole-of-government (WoG), whole-of-society (WoS) approach to face the recent global crisis caused by the COVID-19 pandemic. By applying the WoG approach, sectors beyond health have to work across boundaries to achieve an integrated government response to particular issues, such as global health emergencies. Furthe...

Introduction Health Equity Impact Assessment (HEIA) is a decision support tool that shows users how a new program, policy, or innovation affects health equity in different population groups. Various HEIA reporting and dissemination tools are available, nevertheless, a practical standard tool to present the results of HEIA in an appropriate period t...

Background Sustainable development goals’ (SDGs) analysis can be caused a better understanding of factors contributing to access to health services and help shape policies to attain health goals. This review aimed to measure and compare the SDGs between Iran and selected categories. Methods This study was a comparative cross-sectional study. We id...

Introduction Artificial Intelligence (AI) represents a significant advancement in technology, and it is crucial for policymakers to incorporate AI thinking into policies and to fully explore, analyze and utilize massive data and conduct AI-related policies. AI has the potential to optimize healthcare financing systems. This study provides an overvi...

Background The governance of health systems is complex in nature due to several intertwined and multi-dimensional factors contributing to it. Recent challenges of health systems reflect the need for innovative approaches that can minimize adverse consequences of policies. Hence, there is compelling evidence of a distinct outlook on the health ecosy...

Measuring health inequalities is essential to inform policy making and for monitoring implementation to reduce avoidable and unfair differences in health status. We conducted a geospatial analysis of child mortality in Iran using death records from the Ministry of Health and Medical Education from 2016 to 2018 stratified by sex, age, province, and...

The first case of COVID-19 in Iran was identified on February 19th, 2020. The National COVID-19 Committee (NCC), led by the President and membered by relevant ministers and officials from the army and other organizations, was immediately established to increase inter-sectoral collaboration and coordination. The NCC’s immediate decisions were school...

Objective: Iran is one of the main hosts of Afghan refugees. This study aims to provide comprehensive evidence to increase Afghan migrants’ access to healthcare services in Iran. Methods: To assess the health system’s response to Afghan migrants in Iran, we conducted three phases for SWOT analysis, including: 1-developing a review and comprehensive...

Background Contextual risk factors such as social capital have a vital role in affecting behavioral and biological risk factors of NCDs. We aimed to systematically identify the relationship between different aspects of social capital (SC) with metabolic, and behavioral risk factors of non-communicable diseases (NCDs). Methods This is a systematic...

Background: Cardiovascular Disease (CVD) is the leading cause of death in developing countries. CVD risk stratification guides the health policy to make evidence-based decisions. Aim: To provide current picture and future trend of CVD risk in the adult Iranian population. Methods: Nationally representative datasets of 2005, 2006, 2007, 2008, 2...

Non-communicable diseases represent 71% of all deaths worldwide. In 2015, Sustainable Development Goals, including target 3.4 of SDGs, were seated on the world agenda; "By 2030, reduce premature mortality from NCDs by one-third. More than half of the world's countries are not on track to reach SDG 3.4, and the COVID-19 crisis has hampered the deliv...

Introduction: The prevalence of vitamin A deficiency (VAD among children 15–23 months has risen from 0.5–18.3% within ten years in Iran. The success of the public health programs for controlling VAD depends on the different stakeholders' commitment, ownership, and responsibility. That is why it’s so important to identify and employ them. Method: Th...

Background Policymakers require precise, in-time information to make informed decisions in complex environments such as health systems. Artificial intelligence (AI) is a novel approach that makes collecting and analyzing data in complex systems more accessible. This study highlights recent research on AI's application and capabilities in health pol...

Aim: To describe and analyze the information architecture and information pathways of the road traffic death recording, registration and reporting system in Guilan Province, northernIran. Methods: We used Business Process Mapping, a qualitative approach. This participatory and iterative approach consists of a document review, key informant inter...

Context: Health systems’ main mission is to improve society’s well-being and fulfill their health needs. Objectives: This study aimed to describe the intrinsic and extrinsic events that had influenced Iran’s health system over the previous decade, as well as to identify the possible factors influencing it until 2025 and investigate their positive/n...

Background and aim Community-based initiatives are important for obesity prevention. This study aimed to evaluate the activities of municipal obesity prevention clubs (OBCs) in Tehran, Iran, using a participatory approach. Methods The evaluation team was formed, and the members identified the OBC's strengths, and challenges and provided suggestion...

We conducted this study to rank conflict of interest (COI) actors in Iran's health system. Based on a review of relevant literature, we extracted a list of 27 actors within seven categories who play roles in the COI in the health system. We considered three criteria for ranking the actors: the actor's interest, power, and authority concerning COI....

Background Non-communicable diseases (NCDs), also known as chronic diseases, specifically cardiovascular diseases (CVD), cancers, respiratory diseases, and diabetes are the main reason for more than two-thirds of global deaths, in which the unhealthy diet is one of the primary risk factors. The golden solution to reducing obesity and CVD linked to...

Background: Decreasing calories, salt, sugar and fat intake is considered the golden solution to reduce obesity and cardiovascular diseases (CVDs) related to unhealthy diet. This study aimed to investigate the health system induced barriers to a healthy diet in Iran. Methods: This is a qualitative health policy analysis. We collected data throug...

Background Non- communicable diseases (NCDs) are the main cause of death, which lead to over 73% of death and 62% of DALYs globally. As an unhealthy diet is the leading behavioral risk factor of NCDs, in line with the national action plan for the prevention and control of NCD, this study explored the nutrition-related stewardship problems to reduce...

Background The re-emerging dominance of the Taliban in Afghanistan in 2021 caused a new wave of Afghan refugees heading Iran and neighboring countries. Iran in the Middle East and Germany in Europe are two major host countries to the largest populations of Afghan refugees. In both countries, several studies have been done to assess the health condi...

Background: The impact of the COVID-19 pandemic on human life has led to profound consequences in almost all societies worldwide, and this includes its significant impact on all aspects of health. Health equity has been among the main challenges in any healthcare system. However, with the COVID-19 crisis worsening health inequalities, the need to p...

The importance of health systems has been reinforced by the commitment of Low- and Middle-Income Countries (L&MICs) to pursue the targets of Universal Health Coverage, Health Security, and to achieve Health-related Sustainable Development Goals. The COVID-19 pandemic has further exposed the fragility of health systems in countries of all income gro...

Background The prevalence of childhood obesity (CO) and related complications is high and alarmingly increasing in Iran. This study applied a mixed Delphi & Policy Dialogue approach to exploring and prioritizing policy options to control childhood obesity in Iran. Methods This study is organized in three Delphi phases followed by a policy dialogue...

Abstract Background Providing an equitable Universal Health Coverage (UHC) is key for progressing towards the sustainable development goals in the health systems. To help policymakers make hypertension services more equitable with existing (limited) resources in Iran, we examined the inequality of the prevalence, awareness, treatment, and control (...

This policy brief presents a collaborative structure for governing the national food assistance program for vulnerable groups, as a part of a comprehensive social support system. The authors call for attention to the number of suggestions to improve the quality of formulation and implementation of this program, which is facilitated by a network...

Objectives: This study aimed to determine the opportunities of and barriers to communicable diseases surveillance system (CDSS) during the COVID-19 pandemic and the extent to which the disease integrated into the CDSS in the Kurdistan region of Iraq. Study design: A descriptive qualitative approach was applied. Methods: We conducted seven semi...

Background: To improve healthcare services’ quality, countries should measure their health systems’ efficiency and performance by robust methods. Objectives: We aimed to develop a national study to measure the efficiency of the health system in Iran. Methods: The literature review identified several methods for measuring efficiency; the most common...

Intersectoral collaboration, as a key component of interventions in addressing complex public health problems, can be structured, selective, and designed to be constructive. Social network analysis can help examine and strengthen such collaborative structures with a systemic approach. This policy brief aims to suggest operational steps and an opt...

Introduction As the major cause of premature death worldwide, noncommunicable diseases (NCDs) are complex and multidimensional, prevention and control of which need global, national, local, and multisectoral collaboration. Governmental stakeholder analysis and social network analysis (SNA) are among the recognized techniques to understand and impro...

Objectives: With the application of a systems thinking lens, we aimed to assess the national COVID-19 response across health systems components in Switzerland, Spain, Iran, and Pakistan. Methods: We conducted four case studies on the policy response of national health systems to the early phase of the COVID-19 pandemic. Selected countries include d...

Despite increasing global attention to the national human papillomavirus (HPV) immunization program, this program is controversial in Iran. Evidence indicates that HPV vaccination is not cost-effective in Iran. Using cost-effectiveness analysis for decision-making about public health interventions such as vaccination is controversial because its po...

Food security and climate change are multidimensional issues. Therefore, a lack of knowledge about the most essential variables made these concepts more complex for decision-making and highlighted the need for credible decision support methods. Here, we aim to develop an accurate tool by using the analytic hierarchy process (AHP) method to explore...

Background: The determinants and correlates of severe mental disorders are less understood compared to the common mental disorders, both in the world and in Iran. In this study, we aimed to identify a wide range of determinants of severe stress, severe anger, and severe sadness among Iranian population. Methods: This study is part of a large nat...

Background and Purpose: Afghans are the main refugee population in Iran. Gaining insight into the precise needs of this population, their health, and wellbeing are crucial for appropriate planning and consequential interventions to improve their life experience. Materials and Methods: A total of 20 legal Afghan refugees residing in Tehran were stud...

Background Social determinants have a significant impact on children’s development and their abilities and capacities, especially in early childhood. They can bring about inequity in living conditions of children and, as a result, lead to differences in various dimensions of development including the social, psychological, cognitive and emotional a...

Background Noncommunicable diseases (NCDs) are the first reason for death worldwide, in which poor diet is the leading risk factor. It is estimated that 20% of all death is related to food. The Unhealthy diet includes many foods with excessive salt, sugar and fat. This paper reports a national study on the socio-cultural determinants affecting salt...

Integration between different components of the food system would foster achieving food and nutrition security as a key pillar of sustainable development. Significant improvement has been made in the field of food and nutrition security as well as in institutionalizing integration in food and agriculture, nutrition and health policymaking to achiev...

Multi-stakeholder processes - as a necessary part in the development of public policies - can provide diverse perspectives to inform and to improve food security policy-making. Iran’s National Food Assistance Program (NFAP) is one of the major welfare programs in Iran that reduces food insecutiry to low-income households. This study aimed to identi...

Background: Measuring the efficiency and productivity of hospitals is a key tool to cost contamination and management that is very important for any healthcare system for having an efficient system. Objective: The purpose of this study is to examine the effects of contextual factors on hospital efficiency in Iranian public hospitals. Methods: This...

The policies of health systems are inspired by ethical priorities. A critical review of policies can reveal the ethical theories/justice schools behind them. This study aimed to identify the ethical theory(ies) underpinning the Iranian health system governance over the past 50 years. This was a qualitative study conducted in two stages during 2019...

Climate Change and Food Price: A Systematic Review and Meta-Analysis of Observational Studies, 1990-2021 Ramesh Allipour Birgani1 , Ali Kianirad2 , Sakineh Shab-Bidar1 , Abolghasem Djazayeri1 , Hamed Pouraram1* , Amirhossein Takian3,4,5* 1 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medic...

The 17 Sustainable Development Goals (SDGs) were adopted by the United Nations (UN) General Assembly in 2015 to set the world on the path to peace, prosperity, and sustainable development. As a result of the global focus on SDGs, in particular SDG 3—ensuring a healthy life and promoting well-being for all—and its 13 targets, significant progress ha...

Introduction As a result of recent demographic changes, Iran has revised its reproductive health programs. To respond to the essential need for monitoring the new programs and policies, this study aimed to identify tailored, appropriate, and measurable RH indicators in the Iranian context, using available evidence and international indicators. Meth...

Introduction As a building block of all health systems and a multi-sectoral domain, eHealth has a critical role to accelerate the achievement of sustainable development goals (SDGs), particularly universal health coverage (UHC). Our objective was to provide a better understanding of the recent experiences on eHealth policy, particularly in framing...

The health of migrants and refugees, which has long been a cause for concern, has come under greatly increased pressure in the last decade. Against a background where the world has witnessed the largest numbers of migrants in history, the advent of the COVID-19 pandemic has stretched the capacities of countries and of aid, health and relief organiz...

Background: Social determinants have a significant impact on children’s development and their abilities and capacities, especially in early childhood. They can bring about inequity in living conditions of children and, as a result, lead to differences in various dimensions of development including the social, psychological, cognitive and emotional...

Background Many stakeholders are involved in the complicated process of policy making in integrated early childhood development (IECD). In other words, there are many challenges for IECD policy making in developing countries, including Iran. The aim of this study was to identify potential stakeholders and their interactions in IECD policy making in...

PurposeSendai Framework is an international disaster risk reduction strategy that helps prioritization of disaster risk governance in all policies, strategies, and programs. Considering its geographical location and topographic characteristics, Iran experiences numerous hazards. Natural disasters adversely affect the health of population directly t...

Background To assess the potential impact of a tax-induced cigarette price increase on financial and health outcomes by different socioeconomic groups. Methods In a modeled condition using pooled cross-section data from Household Income and Expenditure Survey (2002–2017) and Iran 2019 population data, a methodology of an extended cost effectivenes...

Background The structure of the Iranian health system has raised this hypothesis that a part of the Knee Replacement Surgery (KRS) services are provided due to Physician-Induced Demand (PID). Methods This paper used an unbalanced individual panel data covering the steady-state 15,729 KRSs performed by 995 surgeons provided by the Armed Forces Insu...

Background: Despite increasing global attention to the national human papillomavirus (HPV) immunization program, this program is controversial in Iran. Evidence indicate that HPV vaccination is not cost-effective in Iran. Using cost-effectiveness analysis for decision-making about public health interventions such as vaccination is debated, because...

Background Given the potential of intersectionality to identify the causes of inequalities, there is a growing tendency toward applying it in the field of health. Nevertheless, the extent of the application of intersectionality in designing and implementing health interventions is unclear. Therefore, this study aimed to determine the extent to whic...

Objectives: Noncommunicable diseases (NCDs) are non-infectious health conditions caused by genetic, physiological, environmental, and behavioral factors. Currently, NCDs account for almost two-thirds of deaths globally. The present study aimed to explore the patients' adherence level to the key-recommendations, and the main barriers toward the prac...

Background About 30% of children < 5 years old are estimated to experience vitamin A deficiency worldwide. Globally, vitamin A deficiency can be reduced by five major interventions: supplementation, dietary modification, fortification, promotion of both public health, and breastfeeding. This prospective policy analysis (Prospective policy analysis...

Background: Noncommunicable diseases (NCDs) are the first reason for death worldwide, in which an unhealthy diet is the leading risk factor. It is estimated that 20 percent of all death is related to food. The Unhealthy diet includes many foods with excessive salt, sugar and fat. This paper reports a national study on the socio-cultural determinant...

This study aimed to identify mothers’ preferences and willingness-to-pay (WTP) for human papillomavirus (HPV) vaccines (in this case, bivalent and quadrivalent) in Iran. We used a discrete choice experiment (DCE) method to present mothers with choices between two hypothetical profiles of vaccines, described by combinations of five attributes, each...

Background: Health inequities are among debatable and challenging aspects of health systems. Achieving equity through social determinants of health approach has been mentioned in most upstream national plans and acts in Iran. This paper reports the findings of a systematic review of the current synthesized evidence on health equity in Iran. Methods...

Background Integrated early childhood development (IECD) is a comprehensive approach to optimal development of children in different developmental domains from fetal stage to eight years of age. The aim of this study was to identify the factors affecting the process of policy-making for early childhood development and to clarify how these factors a...

Purpose Noncommunicable diseases (NCDs) count for over 80% of premature death worldwide. More than 76% of the total burden of diseases in Iran is devoted to NCDs. In line with the World Health Organization action plan, Iran has developed its national action plan that led to establishment of the National Committee for Prevention and Control of NCDs...

Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We u...

Background: Since December 2019, the world has been facing one of the most critical health threats of the last decades. In March 2021, the official number of deaths passed 2.6 million worldwide. Most countries have developed policies to control the disease. Nevertheless, countries have experienced different outcomes related to their various adapte...

Background Global concerns regarding the significant burden of non-communicable diseases and injuries (NCDIs) exist from both public health and economic perspectives. Our research focuses on the reduction of fatal risks due to NCDIs and the citizens’ preferences about health programs and intervention to reduce premature death due to NCDIs. Governme...

Introduction Health financing systems have a key role in achieving universal health coverage (UHC) across the globe. However, little is known about how best to monitor health financing system progress towards UHC, especially in low- and middle-income countries. This is a protocol of a study that will aim to assess health financing system progress t...

Background: Refugees' access to quality healthcare services might be compromised, which can in turn hinder universal health coverage (UHC), and achieving Sustainable Development Goal (SDG), ultimately. Objective: This article aims to illustrate the status of refugees' access to healthcare and main initiatives to improve their health status in Iran...

COVID-19 has become the biggest global challenge since World War II, which has disrupted all aspects of human life worldwide. The numerous uncertainties, unpredictable direction of the pandemic, and psychological, social, economic, political, cultural, humanitarian, and development consequences of the pandemic have led to the most dangerous threat...

Background: The impact of pricing strategies on different socioeconomic groups is not uniform. There is urgency in addressing of characteristics of household demand to make a policy choice in line with development goals. Objectives: This study was done to assess the effect of welfare loss from counterfactual tax-induced cigarette price increases on...

The novel coronavirus disease (COVID-19) pandemic has been exhausting the entire global economy. As the greatest challenge to sustainable development in all societies and health systems, noncommunicable diseases (NCDs) and their relevant risk factors are the main causes of illness and death during the 21st century in high, middle, and low-income co...

Background: There are one-third of children in the world with Vitamin A deficiency. The prevalence of vitamin deficiency in children aged 15-23 months in Iran has increased 18 times and in rural areas. The present article aims to an analysis of related documents to the existing policies on this vitamin in our country. Materials and methods: This...

This debate article highlights that to perform efficiently and meaningfully, the structure and organization of a health system need to be adjusted to its philosophy, mission, and expected duties. Development of the required organizational structure, in line with the objectives and strategies of the national health policy are fundamental principles...

Background: Tackling noncommunicable diseases (NCDs) and their multifaceted, complex risk factors requires identifying policy gaps and translation of successful experiences for each setting. As advocated by World Health Organization (WHO), reducing sugar, salt, and fat are among best buys for prevention and control of NCDs. This article reports the...

The article's abstract is no available.

Background: Insufficient transparency in prioritization of health services, multiple health insurance organizations with various and not-aligned policies, plus limited resources to provide comprehensive health coverage are among the challenges to design appropriate Health Insurance Benefit Package (HIBP) in Iran. This study aims to analyze Policy...

Background: In the health sector, competency-based education focuses on the desired performance characteristics of health professionals through designing and implementing the evidence-based standards, performance indicators and, quality outcomes. This paper aims to explore core competencies required for health policy graduates, aiming to prepare do...