Although Mental Health Program has been adopted as one of the components of the primary Health care program in Iran since 1989 its cost effectiveness has not yet been evaluated in any form. The purpose of the present study was to evaluate the cost-effectiveness of mental health program regarding the treatment of epileptic patients in the Kurdestan province.

In order to achieve the above goal in a case-contrl study, 92 epileptic patients who were under the coverage of mental health program in PHC (Case group) were compared in terms of sex, occupation, age, annual inpatient and outpatient contacts, days staying in hospital, as well as mean of annual cost and benefits per patients.

The findings ndicated that differences in age, sex, occupation, mean of days staying in the hospital andmean of inpatient contacts between the two groups were not statistically significant, but means of outpatient contacts, annual cost and benefit per aptient contacts, and mean of annual cost per patient was smaller than that for the control group.

The findings of the present study provides convincing evidence regarding the positive effects of theintegrated mental health program in Iran in increasing outpatient contacts and decreasing cost, as well as improving cost-benefit dimensions in the care of epileptic patients.

The aims of the present study were to assess the level of stress in hospital managers, to determine the sources of stress among hospital managers, and to evaluate the impact of stress on their job performance and, also to identify the relationship between some of the mamagers' personal characterisitcs and their level of stress. To achieve the above objectieves, it was decided to include all of the hospital mamagers (n=79) from Fars and Khozestan provinces in Iran in the study. However only 53 of them agreed to participate and complete the required questionnaires. The fingins revealted that 58% of the mamagers experienced high levels of stress. The rates were 51% and 70% for Fars and Khozestan provinces, respectively. When they were separated according to the type of hospital they managed, i.e. public or private, the percentages were 11.1% and 68.2% respectively. The findings revealed that the ten following factors were the top ranking sources of stress for the mamagers: 1- inflation and high cost of living. 20 Physical condition of working environment, fatigue and work. Related accidents 3- Competitors' success. 4- Difficult to deal with personnel at work. 5- Difficulty of job. 6- Having great responsibility for recovery of patients. 7- Number of tasks that need to be done simulaneously. 8- Shortage of recreational facilities. 9- Low salary. 10- Negative attitude of the community. Based on the above analysis most of the factors causing stress were work related. The rsults also indicated that stress had reduced the mamagers' morale, motivation, quality of their work and had also a negative impact on their baility for effective decision making process.

  The purpose of the present study was to evaluate the effectiveness of volunteer women in changing the health knowledge and practice of families that were under the coverage of urban health centres in Tehran (south area), Sanandaj and Shahr-e-Kord. This study was a quasi-experimental research. In each area one centre with volunteers programme was selected as experimental and a centre without such programme was selected as control centre. The experimental and control centres were matched in terms of social and economical levels of population they served. Subjects were 400 married women (aged 15 to 49), their children (aged 1 to 4) and infants (aged 12 to 18 months). Data were collected through interview and questionnaire. In the experimental centres before providing this service the subject's knowledge of health issues and their health practice were measured. After the completion of the programme, samples were selected from both experimental and control centres. Pre-test and post-test measures in the two groups were compared. The results showed that this programme ted to a significant increase in the knowledge and practice of the experimental groups in the south area of Tehran. These changes were also seen in Sanandaj and Shahr-e-Kord but were not statistically significant. In terms of the functioning of the mothers with children aged 14 years old only those in the south area in Tehran showed significant improvement. No significant changes in the functioning of the mothers in Sanandaj and Shahr-e-Kord were noted. Although some improvement in terms of child care is demonstrated by mothers in south Tehran but findings of other regions do not indicate any noticeable change.

Abstract

Objectives:Over ten years has passed since the integration of Mental Health Program into the Na-tion’s Primary Health Care system (PHC), yet its management thus far has not been assessed.The objective of this project was to evaluate the management performance of Mental Health Program in the PHC of Khuzestan province based on four dimensions of planning,organization,administra-tion, and control.

Method:This was a descriptive-comparative and a practical study. The instrument to collect data was the five point scale Likrette ranking the responses from very much to very little. The popula-tion sample was 108 managers at various levels of mental health program in PHC of Khuzestan pro- vince.77 of these managers volunteered to take part in the research. 8 were the heads of health care districts 13 were mental health care specialists and 56 were general practitioners in charge of the health treatment centers in rural areas under the auspices of Mental Health Program.Data were ana- lyzed by descriptive statistics and Fisher exact test.

Findings: The managers performed at a medium level across all four abovementioned dimensions. Comparison of the mean scores indicated that control and supervision were the strongest and admi- nistration was the weakest dimensions. Planning and organization were ranked respectively the se- cond and the third. A significant difference was noted on the dimension of organization between the participants in the study at different levels of management such difference was not indicated on other dimensions.

Results:There is a gap between the ideal and the actual conditions of mental health program manage- ment in PHC of Khuzestan province.