Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Daneshgah Street, 5165665811, Tabriz, Iran.
Department of Family and Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
J Health Popul Nutr. 2023 Mar 16;42(1):19. doi: 10.1186/s41043-023-00356-8.
This study defines futures myocardial infarction landscapes and proposes a few policy options to reduce the burden of cardiovascular diseases using the scenario development method. We identified the effective drivers of myocardial infarction by reviewing the literature and completed the returned list with "experts" opinions. The results were classified using the STEEP (Social, Technological, Environmental, Economic, and Political) framework. We plotted the critical uncertainties in a two-dimensional ranking of "effect" and "uncertainty" levels. Eleven drivers with uncertainty and high potential impact were selected and categorized into three groups: Political Development, Access to health services, and Self-Care. Scenarios were developed, and 3 scenarios (optimistic, pessimistic, and possible) were selected based on scoring. For each scenario, policy options were formulated. Utilizing the capacity of Non-Governmental Organizations and charities and strengthening restrictive and punitive legislation was chosen as policy options for addressing possible scenarios. Building infrastructure and improving prevention services, designing and regenerating curative infrastructure were selected as optimal strategies for addressing issues related to the optimistic scenario. Strengthening restrictive and punitive legislation related to community health and population empowerment were proposed as critical policy options for health improvement regarding the pessimistic scenario. Increasing people's participation, strengthening infrastructure and punitive policies can be effective in Myocardial infarction mortality prevention policies in Iran.
本研究使用情景发展方法定义未来心肌梗死的前景，并提出了一些减少心血管疾病负担的政策选择。我们通过回顾文献确定了心肌梗死的有效驱动因素，并通过“专家”意见完成了返回列表。结果使用 STEEP（社会、技术、环境、经济和政治）框架进行分类。我们在“影响”和“不确定性”水平的二维排名中绘制了关键的不确定性。选择了具有不确定性和高潜在影响的 11 个驱动因素，并将其分为三组：政治发展、获得卫生服务和自我保健。制定了情景，并根据评分选择了三个情景（乐观、悲观和可能）。对于每个情景，都制定了政策选择。利用非政府组织和慈善机构的能力，并加强限制性和惩罚性立法，被选为应对可能出现的情景的政策选择。建立基础设施和改善预防服务、设计和再生治疗性基础设施被选为应对与乐观情景相关问题的最佳策略。加强与社区健康和人口赋权相关的限制性和惩罚性立法，被提议作为改善悲观情景下健康的关键政策选择。加强基础设施和惩罚性政策，提高人们的参与度，可有效预防伊朗的心肌梗死死亡率。
