ایران

The present study investigated the prevalence of intestinal parasites in individuals who referred to hospitals affiliated with Zahedan University of Medical Sciences, Zahedan, from 2019 to 2023.

The present descriptive study was conducted cross-sectionally and consisted of 5,976 individuals referring to the hospitals with gastrointestinal. To describe the data, mean (standard deviation) and number (percentage) were used according to the studied groups.

The results of the study showed that 1,510 people were diagnosed positive. The highest rate of infection by intestinal protozoa was related to Giardia, affecting 528 people (8.8%), while the lowest rate of infection was related to Endolimax nana, affecting 10 people (0.16%). The highest prevalence rate of infections by intestinal worms was related to Entrobius vermicularis, with 64 people (1.07%), whereas the lowest prevalence rate was associated with Trichuris trichiura, with 19 cases (0.31%). 

The comparison of the percentage of pollution in the current study with other relevant studies in the past years showed that the prevalence of intestinal parasitic diseases in this region has decreased significantly, similar to other regions of the country. At the same time, the rate of infection by intestinal protozoa is significantly higher than by intestinal worms. This issue can be due to their direct and easier transmission compared to the worm eggs or larvae.

As the burden of cancer is increasing worldwide, especially in developing and low-income countries including Iran, the design and implementation of screening programs heavily depends on basic epidemiological data in each country. Therefore, this study was conducted with the aim of investigating the epidemiology of common cancers in Asadabad County, Hamadan Province, in western Iran.

This descriptive-cross-sectional study examined cancer registry reports in Asadabad County from 2012 to 2022. The total number of new cancer cases over 11 years from 2012 to 2022 in Asadabad County was 1482, most of whom were men (60.4%) and over 60 years old (54.3%). Finally, the collected data were analyzed in SPSS and ArcGIS software.

The average age of patients with cancer was 61.81 in men and 55.93 in women. Between 2012 and 2022, the ten most common cancers were skin, stomach, breast, bone marrow, malignant neoplasm, prostate, colon, lung, bladder, and brain. Skin cancer (10.6%), breast cancer (8.0%), and bone marrow cancer (7.9%) were the most common cancers in both sexes. Skin cancer (13%) was more common in men, and breast cancer (19.8%) was more common in women. The result of the Cochran-Armitage test showed no significant linear trend in cancer incidence in the rural districts of Asadabad during the study years (P > 0.05).

Given the prevalence of skin, stomach, breast, bone marrow, malignant neoplasm, prostate, colon, lung, bladder, and brain cancers in Asadabad County, the development, organization, and implementation of a comprehensive cancer control program should be the top priority in health policy. Therefore, it is necessary to conduct analytical studies to identify the causes of the disease and solve related problems.

The seventh peak represented the latest surge of the coronavirus disease 2019 (COVID-19) pandemic in Iran, predominantly characterized by Omicron subvariants. Due to the complex interplay of various factors contributing to COVID-19 mortality, employing an advanced statistical technique such as principal component regression (PCR) allows for the categorization and evaluation of these variables while improving predictive accuracy and mitigating issues such as multicollinearity often encountered with traditional regression methods.

In this cross-sectional study, data from 8994 patients were extracted from the Medical Care Monitoring Center (MCMC) of hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, covering the period from July to September 2022. Principal component logistic regression was employed to identify significant factors associated with patient mortality. Data analysis was done using SPSS software at a significance level of 0.05.

The mean age of participants was 50.87 ± 28.30 years. Statistically significant associations were found between several variables including drug use, COVID-19 test results, high fever, respiratory distress, decreased level of consciousness, gastrointestinal symptoms, intubation status, oxygen saturation (PO2) levels, chronic blood diseases, and histories of hypertension (HTN), cancer, and diabetes with patient mortality (P < 0.05). In the regression model, the components of respiratory factors and underlying factors increased the chance of death by 62% and 15%, respectively, with confidence intervals (CIs) of 1.41-1.86 and 1.01-1.30, respectively. Besides, the components of intubation and temperature increased the chance of death by 2.47 times with a CI of 2.10-2.89 (P < 0.05).

Identifying risk factors is essential for healthcare providers to recognize vulnerable patient subpopulations, enhance the quality of care, prioritize treatment interventions, and effectively allocate resources.

Food preservatives have an important role in food industry and are widely used in many products. Sorbic acid and its salts lead to maintaining the quality and improving the shelf life of food by preventing the growth of microorganisms and preventing chemical and enzymatic changes. However, health organizations involved in monitoring food products have set permitted limits for the use of these compounds in food industry. Due to probable high usage and long-term application of preservatives such as sorbic acid and its derivatives, they may have adverse effects on human health.

The present study is a systematic review of the measured amount of sorbic acid and its derivatives in different foods in Iran. In the following, the extracted measured amounts of sorbic acid and its derivatives were compared with the permitted amount mentioned in the Iran National Standard Organization (INSO) and Codex Alimentarius Commission (CAC).

Literature reviews showed that most of the examined products were in an illegal state in terms of sorbic acid content in INSO. According to INSO, the highest rate of non-compliance with the appropriate concentration range was related to dairy and bakery products. Since the food standard limit of INSO is stricter than CAC, the products that were within the permissible limits set by CAC were included in a larger share. It should be mentioned that the limits of some food products in CAC were not define.

In general, in this study, it was found that the amounts of sorbic acid and its derivatives were not within the range approved by the INSO in many food products. But they were within the CAC limit. Nevertheless, continuous monitoring of preservatives in food, specifically in highly consumed food products, is suggested.

Crimean-Congo Hemorrhagic Fever (CCHF) is an acute viral disease caused by a virus of the genus Nairovirus, transmitted primarily through the bites of infected ticks. Due to its high mortality rate and prevalence in various regions worldwide, particularly in Iran, different aspects of the disease warrant more detailed investigation. In this narrative review, data collection was performed through comprehensive searches of scientific databases, including PubMed, Web of Science, Scopus, and ScienceDirect, as well as Persian databases such as the Scientific Information Database (SID), the National Journals Database (Magiran), and Civilica. The search employed both Persian and English keywords, including “Crimean-Congo fever,” “Crimean-Congo hemorrhagic fever,” “Nairoviruses,” “Prevalence,” “Epidemiology,” “Distribution,” “Vectors,” “Tick,” “Control,” and “Iran,” using both individual and advanced combined search strategies, covering the period from 1969 to December 2024. The findings indicate that the incidence of CCHF in Iran has risen in recent years, with cases reported from all 31 provinces. Sistan and Baluchestan and Khorasan Razavi Provinces have reported the highest number of cases. The disease shows peak prevalence during the warm seasons, particularly from mid-spring to mid-summer, coinciding with heightened tick activity, and is more frequently observed in men due to occupational exposure. Individuals such as butchers, livestock farmers, and those who handle livestock or infected patients are at high risk, especially in rural areas. Among the 37 tick species identified in Iran, 11 are infected with the CCHF virus. The highest number of CCHF-infected tick species has been reported in Hamedan Province. Hyalomma marginatum and Hyalomma anatolicum have been documented as the primary vectors of CCHF.Given the current status of CCHF in Iran and the influence of environmental and social factors in recent years, the establishment of comprehensive programs focusing on prevention, education, and public awareness is crucial to reducing the prevalence and controlling the spread of this disease.

Dengue fever is one of the most common mosquito-borne diseases worldwide. The aim of this study was to investigate the knowledge, attitude, and practices (KAP) of health center employees in Kerman, Iran, regarding dengue fever.

This cross-sectional study was conducted among the employees of health centers in Kerman using a standardized four-part questionnaire in 2022. The first part of the questionnaire focused on demographics, the second on knowledge, the third on attitudes, and the fourth on personnel practices regarding dengue fever. The data were analyzed using descriptive statistics and SPSS software.

A total of 301 individuals participated in the present study. According to the results, 10.1% of the participants were physicians, 62.5% were healthcare employees, 14.5% were environmental and occupational health employees, and 12.8% were managers working in the health centers. The mean knowledge score of the study population was 6.56 ± 2.61. A positive correlation was found between the knowledge score, attitude score, and practice score (P = 0.001). The mean attitude score of the study population was 7.23 ± 1.14, which was positively correlated with age, work experience, knowledge score, and practice score (P < 0.05). The mean practice score of the study population was 6.05 ± 1.74, which showed no significant relationship with demographic variables; however, a positive correlation was observed between the practice score and age, work experience, knowledge score, and attitude score.

The results indicated that the knowledge, attitude, and practice scores of health center employees in Kerman were at an average level. It is recommended that education and re-education on dengue fever be implemented among health center employees, as they are the first line of education and disease prevention.

The advancements in communication and information technology have brought about significant changes in the provision of healthcare services, including speech-language therapy. In this regard, telehealth has recently emerged as an accessible and effective method. The present study aims to identify the challenges of providing online speech-language therapy services in Iran from the perspective of speech-language pathologists.

This qualitative study was conducted from 2021 to 2022. Snowball sampling was used to select 14 speech-language pathologists (10 females and 4 males) with a mean age of 29 years and at least one year of experience in providing online services during the COVID-19 pandemic. Data were collected using semi-structured interviews, conducted individually by audio and video calling on messaging apps (WhatsApp and Skype). Data analysis was done using the thematic data analysis method.

Six themes emerged: Lack of educational/professional guidelines (lack of academic training related to the provision of online speech therapy services, and absence of clear guidelines for conducting online speech therapy), socio-cultural issues (interference of work with personal life, and informality of online sessions), communicational/interactional challenges (lack of face-to-face interaction with patients, slow internet speed for communication and data transmission, poor video quality in Iranian apps, distraction and increased inclination of children to play with phones, filtering of foreign messaging apps, inadequate internet coverage in some rural and urban areas, and lack of specialized and official apps for online service delivery), financial barriers (inability of some families to afford internet packages and suitable phones, unwillingness of some families to pay high fees for online speech therapy, and unclear pricing for online speech therapy services), decreased quality of patient assessment/treatment (inability to correctly implement certain therapeutic techniques, inaccurate assessment of children, incorrect diagnosis of speech-language disorders, lack of accurate recognition of the child’s abilities, failure to hold group therapy sessions, the use of diagnostic and therapeutic tools, and increased fatigue and burnout for therapists and families), and lack of supervision over therapy sessions (involvement of non-professionals in online therapy, and neglect of patient rights).

Various structural, professional, cultural, and ethical barriers can hinder the delivery of online speech-language therapy services in Iran. Providing educational programs in medical universities, developing essential guidelines to protect the rights of therapists and patients, designing specialized and efficient apps, and establishing proper communication infrastructure can facilitate the online provision of these services in Iran.

Stroke is the second leading cause of death and a major cause of disability worldwide. Determining the quality of life of patients and its dimensions can help treatment staff, patients' caregivers, and patients themselves in choosing effective treatment methods to improve their health. The purpose of this study is to investigate the quality of life and its affecting factors in stroke patients in Iran using a systematic review and meta-analysis.

In this study, relevant articles on the quality of life in stroke patients in Iran were extracted from the domestic and international databases of Magiran, Medlib, SID ISI, PubMed, Scopus, without a time limit. After extraction and quality assessment using the STROBE checklist, article data were entered into comparative tables. Heterogeneity was assessed using the I² index and Cochrane’s Q-test. Analyses were performed using Comprehensive Meta-Analysis software.

After searching for articles based on inclusion and exclusion criteria, 19 articles were included in the final analysis. The findings of the present study showed that out of 19 studies, the highest mean total score for patients' quality of life was 191.26, and among the physical, social and mental health dimensions of stroke patients' quality of life, the highest mean score was related to the physical health dimension (87.5). Meta-analysis using a random-effects model showed the mean quality of life score for stroke patients in Iran was 90.4 (95% confidence interval).

Quality of life in stroke patients is positively correlated with rehabilitation interventions, increased income, social support, marriage, e-learning, Sertaline use, mental exercises and education. Negative correlations were observed with depression, fear of falling and hypertension. Therefore, while paying attention to the importance of these factors, education and continuous care for these patients are emphasized.

Hamadan Province, located in western Iran, covers 20,000 square kilometers and has a population of 1.7 million. The onset of COVID-19 and the cessation of public gatherings significantly affected air quality. This study aimed to examine the air quality in Hamadan Province over two years prior to the COVID-19 outbreak, during the pandemic, and after its resolution.

This research adhered to ethical standards. Daily air quality data were obtained from five monitoring stations. After validation, the data were analyzed during the three aforementioned periods. Descriptive results were presented as means and standard deviation, and parameters were evaluated using SPSS software with the Post Hoc Bonferroni tests.

During the COVID-19 period, the average concentrations of CO2, O3, and PM10decreased compared to pre-COVID-19 levels, while PM2.5, SO2, and CO concentrations increased. After COVID-19, the average concentrations of NO2, O3, and SO2decreased compared to the COVID-19 period, conversely,PM10and CO concentrations increased, with PM2.5maintaining a stable average concentration. The highest averageconcentrations of NO2and O3occurred in summer, CO in autumn, and SO2in winter.

The mandatory lockdown during the COVID-19 period significantly impacted the air quality of the province. The subsequent ban on Mazut fuel in power plants and industrial units also had a notable effect on air quality. Therefore, traffic control and the simultaneous prohibition of Mazut fuel are recommended to improve air quality in this province.

Grand Round is one of the methods of medical education in the hospital environment, which is conducted as a discussion on patients in the presence of a group of specialists and students of different medical departments. This study was conducted to review the history of medical grand rounds research in Iran in order to evaluate its efficiency, new methods, advantages and challenges.

This study used a systematic review in accordance with PRISMA standards and evaluated the role of Grand Round in medical education. PubMed, EMBASE, Scopus, Web of Science databases as well as FarsiSID.ir, Elmentnet and Magiran databases were searched using specific terms. Two referees independently reviewed the articles based on the entry criteria and resolved the differences through discussion. Quality and bias were assessed using the MMAT tool. Thematic codes extracted from the responses guided the qualitative synthesis of evidence.

In this study, 15 articles were examined. Medical students experience challenges in the quality of teaching grand rounds compared to faculty and residents, potentially influenced by gender differences or stages of medical education. Acknowledging these disparities is critical to effective educational strategies, especially in the Grand Round context. Adapting to challenges such as the COVID-19 pandemic, it is recommended that virtual group discussions be implemented to increase student satisfaction and knowledge transfer during Grand Rounds. Despite the strengths of bedside grand rounds, managing the lack of evidence-based issues and clinical decision-making is critical to increasing the overall quality of grand rounds.

The current review study showed that in order to increase the productivity of medical grand rounds, there is a need to plan to increase the interaction and involvement of all educational members and learners in a group; Also, to increase the quality of meetings, it is necessary to present discussions based on scientific evidence.

The environmental and health hazards posed by microplastics (particles < 5 mm) have raised significant concerns in contemporary society. This study investigates the quantity, types, and forms of microplastics present in ready-to-use compost from urban and agricultural green spaces in Isfahan City, Iran, in 2023.

In this study, we analyzed the frequency, types, and morphological characteristics of microplastics in ready-to-use compost sourced from urban and agricultural green spaces in Isfahan City. We employed various methods, including sieving, Fenton digestion, flotation based on density with saturated salt, and filtration, to separate microplastic particles. A stereo microscope was utilized to count and characterize their shapes, while Fourier transform infrared (FTIR) spectroscopy was used to identify the types of polymers present.

The study revealed an average of 36145.8 ± 7395.1 microplastic particles per kilogram of compost. Microplastics measuring between 1000 and 5000 µm constituted the highest frequency, accounting for 78% of the total. Five types of polymers were identified in the ready-to-use compost: polyethylene terephthalate (PET), polypropylene (PP), polyethylene (PE), polystyrene (PS), and polyvinyl chloride (PVC), with PET being the most prevalent at 28.7%. Microplastics were observed in various forms, including fibers, foam, fragments, and films, with fibers being the most common form, comprising 60% of the total.

The concentration of microplastics in ready-to-use compost from urban and agricultural green spaces in Isfahan City is comparable to levels found in other studies conducted within the country; however, it is notably higher than those observed in countries where organic materials are properly segregated. Due to the lack of standardized limits for microplastics in compost, making international comparisons is challenging. The choice of methodologies for sampling, separation, identification protocols, measurement, and the establishment of permissible limits significantly influences study outcomes. Hence, it is crucial to establish standardized methods to ensure consistency and accuracy in assessing microplastics in compost.

As medical education continues to evolve, it is essential to analyze the trends and patterns of research collaboration in this field. This study aims to examine the evolving body of research on electronic medical education, with a specific focus on publications by Iranian researchers.

This study employed a bibliometric approach to analyze the research publications of Iranian authors in the field of medical e-learning, as indexed in the Web of Science database. Data was collected from 2005 to 2024 and analyzed using bibliometrix R in January 2024.

This analysis encompassed 270 articles from 135 sources, with an average age of 4.85 years and an average of 9.393 citations per article. The dataset included 9689 references and 533 keywords. Among the 1033 authors, each article had an average of 4.61 co-authors, indicating a lack of international collaboration. Tehran, Shiraz, Mashhad, and Iran University of Medical Sciences were the most prolific institutions. The limited collaboration network suggests a decentralized research community.

This bibliometric study highlights the significant impact of the COVID-19 pandemic on medical education research, particularly in Iran. While the study identifies a substantial increase in research output, it also reveals a limited degree of domestic and international collaboration among Iranian researchers. The findings underscore the need for stronger collaborative efforts to advance the field of virtual medical education.

In light of the profound transformations occurring within health systems and the forthcoming challenges that lie ahead, it is highly imperative to address the matter of governance. Consequently, the objective of the present study is to detect the governance elements that comprise the health system in universities of medical sciences in Iran.

This qualitative research was developed using the content analysis method. The statistical population consisted of experts, professionals, managers, and specialists affiliated with Iran's Ministry of Health and medical sciences universities. The data collection process involved conducting semi-structured interviews with 24 experts, including managers and professionals in this field who were selected using the targeted sampling method and maximal diversity. To analyze the interview data, the inductive content analysis technique was applied.

Eight main components were identified, including independence and self-reliance, administrative system health, organizational agility, meritocracy, human capital development, social capital development, health orientation, and infrastructure development.

The challenges in the way of achieving the goals of the health system in the current governance model of the health system in Iran can be studied based on 8 components, and in the future interventions, they can be considered to create and strengthen a flexible structure in line with dynamism and effective innovation and reducing dependence on governmental resources.

Universities play a key role in training skilled professionals and advancing knowledge. Nursing schools must educate nurses with scientific expertise, clinical skills, and leadership abilities. This study aimed to compare the Master’s programs in Community Health Nursing in Iran and the University of Washington in the U.S. to identify strengths and areas for improvement.

This descriptive-comparative study was conducted in 2023 using the Bereday model (description, interpretation, juxtaposition, and comparison). The comparative analysis examined the curricula of the Master’s in Community Health Nursing from Iran’s Ministry of Health, Treatment, and Medical Education and the University of Washington’s School of Nursing and Public Health.

The analysis revealed that Iran’s program, with 32 credit units, emphasizes practical skills and family-centered care, offering stronger training workshops. In contrast, the University of Washington’s flexible 60-credit program prioritizes social justice and applied research.

The findings suggest that while Iran’s Community Health Nursing program has strengths, such as skill-based training, it requires greater curricular flexibility, enhanced research orientation, and the integration of health equity conceptsAdopting lessons from the University of Washington in leadership and technology could lead to more competent nurses. These changes would be a fundamental step in improving the quality of community-based care.

Medication errors pose a significant threat to patient safety in healthcare settings. This study aimed to determine the prevalence and types of medication errors among intensive care unit (ICU) nurses in Iran through a systematic review and meta-analysis.

Electronic databases, including PubMed, Scopus, Web of Science, Science Direct, SID, and Magiran, were searched for studies on medication errors among ICU nurses up to February 2025. A manual search of references from primary and review studies was also conducted. Studies were limited to Persian and English languages. Bias assessment was performed using the Newcastle-Ottawa Scale. Data analysis was conducted using Comprehensive Meta-Analysis software (version 3).

A total of 19 observational studies were selected and included in the study. The results of the meta-analysis showed that the prevalence of medication errors among intensive care unit nurses was 64.8% (95% confidence interval [CI]: 0.54-0.74, P<0.05). The prevalence of incorrect dosage, incorrect injection rate, incorrect time of administration, and incorrect medication were 15.6% (95% CI: 0.08-0.27, P<0.05), 18.5% (95% CI: 0.08-0.37, P<0.05), 11.8% (95% CI: 0.08-0.15, P<0.05), and 9.5% (95% CI: 0.05-0.16, P<0.05), respectively. Publication bias was not observed in the study (P=0.49).

The high prevalence of medication errors among ICU nurses in Iran highlights an urgent need for intervention. Proper nurse training, adoption of advanced technologies, improved working conditions, and enhanced communication can significantly reduce medication errors in hospitals.

The rate of animal bites in Golestan Province, Iran, is alarmingly high, placing a significant burden on the country's healthcare system. Kalaleh City is one of the cities of Golestan Province and the rate of animal bites needs to be investigated. Therefore, this study was designed and conducted to determine the epidemiological characteristics of animal bites in Kalaleh City from 2016 to 2020.

In this cross-sectional study, 3838 animal-bitten cases that were registered in the electronic system of the rabies prevention department of the health center were included in this study. Data were analyzed using descriptive statistics in SPSS software.

The mean and standard deviation (SD) of the subjects’ age was 27.07 ± 19.27 years. The total incidence rate in these five years was 654 per 100000 population. 72.4% of the bitten people were men, and 86.3% were villagers. In terms of animals, 89.5% of bites were by dogs and 7% by cats. In terms of bite season, it was 26.2% in spring and 26.6% in summer. In terms of job distribution, 31.7% were students.

The average incidence rate of animal bites during the study period was 654 per 100000 individuals. Most of the people bitten were villagers and men. The bites have been significant among students, children, and farmers. Interventions to reduce the incidence rate in this city seem necessary.

Effective management of healthcare waste is crucial for preventing the dissemination of pathogens and safeguarding public health. This study aimed to evaluate the medical waste management practices in educational hospitals of Khoy City, Iran.

This descriptive cross-sectional study was conducted in 2021. Data were collected using a structured questionnaire that included inquiries regarding the types and quantities of waste generated, as well as the processes involved in the collection, transportation, and disposal of chemical, pharmaceutical, and infectious waste. The assessment focused on three hospitals affiliated with Khoy University of Medical Sciences, with 466 active beds. In light of the coronavirus disease 2019 (COVID-19) pandemic during the study period, one hospital designated specifically for patients with COVID-19, along with two hospitals operating under standard conditions, were selected as the study population considering the number and variety of wards and the diversity of waste produced.

Waste management practices in the studied hospitals demonstrated compliance rates of 95.66% and 98.33% in the stages of segregation and transportation, respectively. The stages of temporary storage and decontamination showed moderate compliance, with approximately 75% adherence to established standards. The average total waste generated by the hospitals was 1505.9 ± 31.6 kg/day, with infectious waste comprising the largest portion at 67.2%. In contrast, chemical and pharmaceutical waste represented a minimal share of 0.5% of the total waste produced.

The results indicated a significant increase in the generation of infectious waste following the outbreak of COVID-19. Additionally, decontamination and sanitary disposal of chemical and pharmaceutical waste require increased attention and enhanced oversight.

Sustainable development entails a meaningful integration of economic, social, and environmental goals with human well-being, without harming the capacities of future generations to meet their needs. Good governance mechanisms are crucial for fostering sustainable development, which in turn contributes to creation, maintenance, and promotion of individuals and communities’ health. This study aims to provide a comprehensive definition of governance and its components, with a focus on health, and provide an overview of the challenges and opportunities of good governance and sustainable health development in Iran.

This is a review study. We considered all published articles in Scopus and PubMed in Farsi and English, regardless of time limit until September 22, 2023.

According to the World Bank, governance includes "traditions and institutions" by which authority is established in a country. So far, many frameworks, models and components have been introduced for governance. For health system studies, the five-component model of governance, which was first introduced in 2018, is one of the most widely used models. Participation, accountability, rule of law, equity and equality, transparency, corruption control, effectiveness and efficiency are among the recurring components of governance in different models. Besides, the improving trends in indicators such as the Neonatal Mortality Rate, Infant Mortality Rate, Under-Five Mortality Rate, Maternal Mortality Rate, and human development indices represent opportunities for good governance in Iran. Conversely, the increasing trends in deaths caused by accidents, deteriorating air quality, soil pollution and erosion, unemployment, and inflation have been posing challenges to good governance in the country. Moreover, several factors have hindered the promotion of good governance in Iran’s health system. These include the lack of an efficient monitoring and evaluation system, inadequate transparency and accountability, insufficient participation of relevant stakeholders, weak management of conflicts of interest and corruption, insufficient coordination and cooperation between and within departments, inadequate use of scientific information and solid evidence in policies, and fragile acceptance of  good governance concept as a fundamental value.

It appears that the health system needs to implement the principles of good governance in order to successfully respond to the needs and expectations of the people. We suggest that, while creating an enabling environment for the effective implementation of good governance in line with the sustainable development goals, managing conflict of interest situations in the health system, transparency, and the use of institutional approach need be used to create executive structures and the necessary tools for monitoring and evaluating these measures. We advocate these items to be placed on the policy makers’ agenda.