Breast cancer screening and early detection programs in Iran: A health policy analysis and recommendations

IF 1.7 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Zeinab Dolatshahi, Pouran Raeissi Dehkordi, Hassan Abolghasem Gorji, Seyed Massoud Hashemi, Nahid Reisi, Toraj Harati Khalilabad
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Abstract

Screening and early detection programs for breast cancer (BC) have significantly reduced mortality rates and enhanced survival rates globally. Breast cancer screening programs in low‐ and middle‐income countries like Iran need improvement. This study examines Iran's breast cancer screening and early detection (BCSED) policies, employing the Policy Triangle Model in two phases: a review of 27 documents including various related sources related of policies and strategies, followed by 20 semi‐structured interviews across four distinct levels: policy, regional, clinical, and community levels. Content analysis for documents and MAXQDA2020 software for the second phase were used, and findings integrated. In our analysis of 27 national documents and 20 interviews, we found 10 themes, 19 sub‐themes, and 42 specific codes across four dimensions of the mentioned framework. Main themes in the context dimension covered deficient interactions, deficiency in knowledge management, cultural challenges, and socioeconomic challenges. From the analysis of 27 national documents, we recognized service excellence schemes, personal health encouragement, and service levels. Policy formulation and monitoring and evaluation emerged as central themes for the process dimension, while stakeholder challenges were prominent in the actors' dimension. BCSED programs are multifactorial issues. Proposed strategies to address these issues include the dedicated funds for BC prevention programs, strengthening the Ministry of Health's stewardship role, elevating public awareness, and conducting systematic screening trials in select cities to provide valuable national evidence for future policymaking.
伊朗的乳腺癌筛查和早期检测计划:卫生政策分析与建议
在全球范围内,乳腺癌(BC)筛查和早期检测计划大大降低了死亡率,提高了存活率。伊朗等中低收入国家的乳腺癌筛查项目需要改进。本研究采用政策三角模型,分两个阶段对伊朗的乳腺癌筛查和早期检测(BCSED)政策进行了研究:查阅了 27 份文件,包括与政策和战略有关的各种相关资料,随后在政策、地区、临床和社区四个不同层面进行了 20 次半结构式访谈。第二阶段使用了文件内容分析和 MAXQDA2020 软件,并对分析结果进行了整合。在对 27 份国家文件和 20 次访谈的分析中,我们在上述框架的四个维度中发现了 10 个主题、19 个子主题和 42 个具体代码。背景维度的主要主题包括互动不足、知识管理不足、文化挑战和社会经济挑战。通过对 27 份国家文件的分析,我们认识到卓越服务计划、个人健康鼓励和服务水平。政策制定、监测和评估是过程维度的核心主题,而利益相关者的挑战则是行为者维度的突出问题。BCSED 计划是多因素问题。解决这些问题的建议策略包括为 BC 预防计划提供专项资金、加强卫生部的管理作用、提高公众意识,以及在选定城市开展系统筛查试验,为未来决策提供有价值的国家证据。
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来源期刊
World Medical & Health Policy
World Medical & Health Policy PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.10
自引率
7.30%
发文量
65
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