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6 95/ & $ #!" 394 B ) C * ) )D E -3! +, 9 > <,- +8 (, =) 9 9; <,- +8 (, =) ( 0/44 (0/83) /33 (0/95) 2/4 (0/58) 0/9 (/23) 0/5 (0/3) 0/52 (0/8) 0/82 (0/3) 0/8 (0/8) 0/09 (0/29) /6 (/96) 0/24 (0/2) /39 (/39) 0/3 (0/32) 0/43 (/96) 2/23 (2/3) /26 (0/8) 0/2 (0/5) 0/3 (0/49) 2/6 (3/28) 0/6 (0) 0/6 (0/5) 2/4 (2/2) 0/63 (0/9) 0/6 (0/4) 0/3 (/3) 0/6 (0) H" \I#L \ 6 abl 9K $ 2 # ( ]L ( ',) ( 4M ' '4" 6) 4#D ik $- a $- j& = 9K 0/03 (0/03) 0/3 (0)!$- 48 NEL 6 /3 (0/52) 2/4 (3/28) K NEL L * HY 4K Y, L\ '4h4 Z HK 4- +* )$ ' k_!" " 4K Y 4 9= \C Y >M 4K `L 48 NEL 5 3G 4 L2 D K NEL '$!$- j H >M )* $- " 5#4 3 2 g M!D^'= 4!-$ H B 5#4 $- " >f & I )&G #L = \- '8!6 j Z6 j D '## 5 3G 4- (

7 ,- * )*+ /96 H ]Z # ]#! "!D ' g/ f >!# & 4- \5f I () EZM!D 4 6/ ZB $- " " $ & e 4- ( \-!` & (8) 6 2 -!$- " H#]K x/ L 4 '# i5 H$ x HY M e 4- '$ HK p!6 &` BL 5 4! L #C\ fm # >JL =!$- 4- '4K ZB L!$- " H$ 5 LB k_" (9) B ' H H$ -L 4- #!f (8) D " h Y!$- [ 4L x5 4# '!6 6,`$ c^ j 4 z[j! L tl!$- 4# +* )$ ( = 8 I 3 #!$-!6 j # tl 6/ 6* '4# 4 & $ 3af / # ]#! &!D 4 4 $- " - lf Y # ZD $- " (,"L '( -!$- = B! - 4 4( NL 5 g8b! )M f &` 5#4 (# 3G 4 ( '8! ` p 4!-$ > H 4- H$ x/ LK 8 $ -# # [! -$ > +Z!^,_6 $- " 4 ` $ 4K >E 4-6 \5f 4K 2$ 4- -* #!D a 4# H$ 5 L2 H" \I#L H$ LbL 2 " [! ` p H$ 5! 5 L! (4) EZM 5 6 Ew!` 4# p$ idj!$- = M! 4K 5 4 =, 9K j& = L\ # & Hf 4! Y&M 2=6 4K FtL!6 H$ 5 $- " 4 -#L ' - L K Z($ f6 8 '!" \5f j B$45 K! 5 4! - 8 L2 HK H$ 8 8 '4#D Y&M # (5) "\ D 4K 8!6 4! ( E j! H- #!$- 4 & I!6 = -! H$ ED ph- # j "!$- 6f 4 ^! H-Y " HY 8 (6) H,Y L{6 'H `$=! g " # 4 +Z!^ bl '[ 8 2C '!!"#$ L 8 " 4# +* )$ y 2 " 4# K 2 ' x#l " ]#L Y ZY!$- jl (6) $ 2,ƒD 4#Y 4K 4- \5f 4` HjEY 8 e 4K 2,Y ` 4#Y!6 f (6) H$ D6 $- " ' 4 8 L #!D 4 D J 6*,ZJL 5# m8 / 5 4` #C\ H$ 4#

8 9/ & $ #!" 394!6 'g#!6 5# > L 4$ o\ 2^,$ D H=( > ( # $ ( $- / H$ = 3 " Murray C, Frenk JA WHO framework for health system performance assessment Bulletin of the World Health Organization 2000, Movahedi M, Hajarizadeh B, Rahimi AD, Arshinchi M, Amirhosseini K, Motlagh MI, et al Trend and geographical inequality pattern of main health indicators in rural population of Iran Hakim Research Journal 2008, Rashidian A, Damari B, Larijani B, Vosoogh Moghaddam A, Alikhani S, Shadpour K, et al Health Observatories in Iran Iranian Journal of Public Health 203, Manenti A Health situation in Iran Medical Journal of The Islamic Republic of Iran 20, 25-5 Aghlmand S, Pourreza A Health Sector Reform Social Welfare 2005, Shadpour K Health sector reform in Islamic Republic of Iran Hakim 2006, 9-8 Damari B Challenges and directions of public health development in Iran from the viewpoint of provincial health deputies and health center SJSPH 205, Malekafzali H Primary Health case in Islamic Republic of Iran SJSPH 204, Javid N Assessment time and work Tehran danesh parvar, 2004 st editin,, Kahalzadeh A Methods time assessment and work measurement Tehran 5th ed Nashr daneshgahi, 2002, Westbrook JI, Duffield C, Ling L, Creswick C L How much time do nurses have for patients? a longitudinal study quantifying hospital nurses patterns of task time distribution and interactions with health professionals BMC Health $ aftl '##" 3G " H#,"+' f H$ 3G 4 ( 4 Y, L\ > I! 4 L\ HY D & ( ( " # - Services Research 20, Published online 20 Nov 24 doi 086/ Ali Ahmadi A Assessment work and time Tehran University of Science and Technology, 200, Yousefi M, Ahmadi M, Fazaeli S Staff Management Based On Performance Application Of A Work Measurement Model In Hospital Payavard 204, Asadi Laria M, Sayyari AA, Akbaric ME, Gray D Public health improvement in Iran lessons from the last 20 years Public Health 2004, Farahi Shahgoli J Assessment of personal need for health house in East Azarbaijan rural areas based on workloadavailable in eazphcptbzmedacir/uploads/26/cms/user/file/90//w orkloadpdf, Access date 30//206 6 Abbaszadeh A, Eskandari M, Borhani F Changing the Care Process A New Concept in Iranian Rural Health Care Asian Nursing Research 203, Nekoei Moghadam M, Sadeghi V, Parva S Weaknesses and Challenges of Primary Healthcare System in Iran A Review Int J Health Plann Mgmt 202, Javanparast S, Baum F, Labonte R,Sanders D, Heidari G, Rezaie S A policy review of the community health worker program in Iran Journal of Public Health Policy 20, Sadeghikho Sh, Yazdani Sh, Rahbar M, Ahmadi M Behvarzes viewpoints on their abilities in delivering health services Hakim Health Sys Res 204, 02-

9 Iranian Journal of Epidemiology Atumn 20; 3 (3) Original Article Work Measurement and Time Assessment of Health Centers in Saghez in 205 Parvareh M, Moradi G 2, Nouri B 3, Farzadfar F 4, Rezaei N 5 - MSc of Epidemiology, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran 2- Associate Professor of Epidemiology, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran 3- Assistant Professor of Biostatistics, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran 4- Associate Professor, Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical sciences, Tehran, Iran 5- MD, Non-communicable Diseases Research Center, Endocrinology & Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Corresponding author Moradi G, moradi_gh@yahoocom (Received October 206; Accepted 25 February 20) Background and ObjectivesIn order to determine the workload of health workers(behvarz), this research was conducted for work measurement and time assessment in rural health centers(health house) Methods This cross sectional study was conducted in 30 health centers during a routine working day in Saghez in 205 using the stop watch method The time and frequency of the processes were recorded in a checklist We estimated and compared spent, standard, expected and pessimistic time, and also the mean repetition for each process per day and month as the unit of time Results The mean real working time was about 55 minutes (33) per day, which was mostly (355 minutes) spent on the affairs of health volunteers Care for non-communicable diseases was the most frequent task with an average of 24 times per day In a month, family planning was undertaken more than other processes The time of most activities like mother care, elderly care, care for communicable and non-communicable disease was significantly lower than the expected and pessimistic times (P<005) Conclusion The time spent by health workers was low and unscheduled, particularly for important activities of primary health care It seems that it is necessary to revise the models and methods of service provision in health centers Efficient use of existing personnel, reducing unnecessary activities and adding more service packages according to the health system priority seem to be important requirements in the first level of health system Keywords Work measurement, Time assessment, Health system, Health workers, Primary health care, Iran

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