Regional disparities in the distribution of healthcare workers: evidence from Iran, Chaharmahal and Bakhtiari province

Inequality trends in the distribution of healthcare human resources in eastern Iran

Background

Inequitable distribution of human resources in healthcare is one of the main obstacles to improve any health system. This study aimed to evaluate inequalities in the distribution of human resources in healthcare in South Khorasan Province, Iran.

Methods

We have investigated three types of health staff (i.e. nurses, general practitioners, and specialists) from 2013 to 2018. Data were collected from the annual reports of the Statistical Centre of Iran. The Gini coefficient and time trend regression were applied to measure the inequality.

Results

The distribution of specialists and general practitioners were the highest and lowest inequality, respectively. Inequalities in the distribution of nurses and specialists have decreased from 2013 to 2018, while the Gini coefficients of the general practitioners have increased from 0.31 to 0.38. According to the regression analysis, inequality in the distribution of nurses and specialists was decreasing over the time; however, the decline was only significant for specialists. While the coefficient B for general practitioners is positive, this indicates raised inequality, but the observed increase was not significant.

Conclusions

This study revealed that Iran, similar to several other low- and middle-income countries, is with faced the challenge of inequitable distribution of human resources in healthcare, which in turn indicates the necessity of reforms at national and regional levels to address inequalities in the distribution of healthcare human resources, particularly in South Khorasan Province. Hence, the main policy recommendation is to focus on continuous monitoring and evaluation of resource allocation in South Khorasan Province to reduce inequalities.

Cytotoxic Activity of Thirteen Endemic and Rare Plants from Chaharmahal and Bakhtiari Province in Iran

Chaharmahal and Bakhtiari Province is one of the most important endemism states of the flora of Iran with a considerable plant species diversity. In the present study, the cytotoxic activity of 13 plant species grown in Chaharmahal and Bakhtiari have been evaluated on prostate (PC-3), breast (MCF-7), liver (HepG2), ovary (CHO), and melanoma (B16-F10) cancer cell lines. The cytotoxicity and apoptotic activity of methanol extracts was evaluated using resazurin reagent and flow cytometry of PI stained cells, respectively. Methanol extracts of Dionysia sawyeri, Stachys obtusicrena and Cicer oxyodon on CHO cell line (p <0.05) and D. sawyer and Linum album on B16/F10 cell line (p <0.05) showed significant cytotoxic effects and increased apoptosis. It is generally suggested that the plant extracts with low IC50 values are likely to be used as anti-cancer compounds in reducing cancer progression in scientific studies.