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Perceived Barriers to Implementing Sexual Health Programs from the Viewpoint of Health Policymakers in Iran: A Qualitative Study

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A Correction to this article was published on 09 April 2021

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Abstract

Introduction

Despite the fact that sexual and reproductive health has been considered key aspects of the individual’s wellbeing and social welfare, there are no adequate policies and programs to deal with sexual health, particularly among young people.

Methods

A qualitative study was conducted from February to December 2015. Twenty-five semi-structured in-depth interviews were conducted with health policymakers in Iran using a purposive sampling method. The qualitative data were analyzed using conventional content analysis with an inductive interpretive approach.

Results

The perceived barriers for sexual health programs generated by health-policymakers reside in three main domains: individual, structural, and socio-cultural. Under the domain of individual, the category of policymakers’ personal barriers comprises: “lack of knowledge,” “misperceptions,” and “stigma,” i.e., threat to their managerial positions. Under the domain of structural barriers, the category of “challenges in policy making processes” comprises: “the abstinence challenge/paradox of sexual health as a strategic goal,” “financial challenges,” “uncoordinated and unstable management of the program,” “challenges for data collection and planning,” and “lack of priority for sexual health.” Finally, under the domain of socio-cultural, the category of “conservative socio-cultural context, sexuality as a social taboo in Iranian society” emerged as a barrier for sexual health programs in Iran.

Conclusions

To introduce sexual health programs in a conservative society, health-policymakers must begin by advocating for sexual health, in order to create positive attitudes toward sexual heath as a component of human wellbeing, and then address social and cultural sensitivities by promoting greater dialogue.

Social and Public Policy Implications

Sexual health and sexual health needs are important aspects of life and warrant further research in Iran. Policy makers of the health system need to correct information of sexual health needs of people to health planning, and this clears barriers of sexual health planning in the health system of Iran.

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Availability of Data and Material

Data are available on request only, owing to privacy concerns and other restrictions.

Change history

Abbreviations

SRH:

Sexual and reproductive health

HIV/AIDS:

Human immunodeficiency virus infection and acquired immune deficiency syndrome

PWIDs:

People who inject drugs

DIC:

Drop in centers

MOHME:

Ministry of Health and Medical Education

MAXQDA:

MAX Qualitative Data Analysis (MAX is a name)

References

  • Alomair, N., Alageel, S., Davies, N., & Bailey, J. V. (2020). Factors influencing sexual and reproductive health of Muslim women: A systematic review. Reproductive Health, 17, 33.

    Article  Google Scholar 

  • Baraitser, P., & Wood, A. (2001). Precarious partnerships: barriers to multidisciplinary sex education in schools - a short communication. Health Education Journal, 60, 127–131.

    Article  Google Scholar 

  • Bhattacherjee, A. (2012). Social Science Research: Principles, Methods, and Practices. Scholar Commons.

  • Bostani Khalesi, Z., Simbar, M., & Azin, S. A. (2017). A qualitative study of sexual health education among Iranian engaged couples. African Health Sciences, 17, 382–390.

    Article  Google Scholar 

  • Ciarrochi, J., Mayer, J. D. (2007). Applying emotional intelligence: A practitioner’s guide. Psychology Press, 186–201.

  • Daviter, F. (2015). The political use of knowledge in the policy process. Policy Sciences, 48, 491–505.

    Article  Google Scholar 

  • DeJong, J., Jawad, R., Mortagy, I., & Shepard, B. (2005). The sexual and reproductive health of young people in the Arab countries and Iran. Reproductive Health Matters, 13, 49–59.

    Article  Google Scholar 

  • Ezeh, A., Bankole, A., Cleland, J., García-Moreno, C., Temmerman, M., & Ziraba, A. (2016). Reproductive, maternal, newborn, and child health: disease control priorities. The International Bank for Reconstruction and Development / The World Bank.

  • Esmaili, M. R., & Amiri, Z. (2016). The impact of shared leadership on talent management C. management studies in development & evaluation. Management Studies, 25, 47–64.

    Google Scholar 

  • Elmir, R., Schmied, V., Jackson, D., & Wilkes, L. (2011). Interviewing people about potentially sensitive topics. Nurse Researcher, 19, 12–16.

    Article  Google Scholar 

  • Friães dos Santos, J. P., Martins Pires, A. M., & Fernandes, P. O. (2018). The importance to financial information in the decision-making process in company’s family structure. Contaduría y Administración, Accounting and Management, 63, 35–36.

    Article  Google Scholar 

  • Frost, D. M. (2011). Social stigma and its consequences for the socially stigmatized. Social and Personality Psychology Compass, 5, 824–839.

    Article  Google Scholar 

  • Freud, S. (1913). Totem and Taboo.

  • Gheshlaghi, F., Dorvashi, G., Aran, F., Shafiei, F., & Montazeri Najafabadi, G. (2014). The study of Sexual satisfaction in Iranian women applying for divorce. International Journal of Fertility & Sterility, 8, 281–288.

    Google Scholar 

  • Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112.

    Article  Google Scholar 

  • Gruskin, S. (2008). Reproductive and sexual rights: Do words matter? American Journal of Public Health, 98, 1737.

    Article  Google Scholar 

  • Guba, E. G., & Lincoln, Y. S. (1994). Competing paradigms in qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of qualitative research (p. 105–117). Sage Publications, Inc.

  • Javadnoori, M., Latifnejad Roudsari, R., Hasanpour, M., Hazavehei, S. M. M., & Taghipour, A. (2012). Female adolescents’ experiences and perceptions regarding sexual health education in Iranian schools: A qualitative content analysis. Iran J Nurs Midwifery Res, 17, 539–546.

    PubMed  PubMed Central  Google Scholar 

  • Joulaei, H., Lankarani, K. B., & Shahbazi, M. (2012). Iranian and American health professionals working together to address health disparities in Mississippi Delta based on Iran’s health house model. Archives of Iranian Medicine, 15, 378–380.

    PubMed  Google Scholar 

  • Khalajabadi Farahani, F., & Cleland, J. (2015). Perceived norms of premarital heterosexual relationships and sexuality among female college students in Tehran. Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 17, 700–717.

    Article  Google Scholar 

  • Larson, J. E., & Corrigan, P. (2008). The stigma of families with mental illness. Academic Psychiatry, 32, 87–91.

    Article  Google Scholar 

  • Ministry of Health and Medical Education of Islamic Republic of Iran (MOHME). (2015). AIDS Progress Report on Monitoring of the United Nations General Assembly Special Session on HIV and AIDS. National AIDS Committee Secretariat.

  • Motamedi, M., Merghati-Khoei, E., Shahbazi, M., Rahimi-Naghani, S. H., Salehi, M., & Khalajabadi-Farahani, F. (2016). Paradoxical attitudes toward premarital dating and sexual encounters in Tehran, Iran: a cross-sectional study. Reproductive Health, 13, 102.

    Article  Google Scholar 

  • Motamedi, M., Merghati-Khoei, E., Salehi, M., Khalajabadi-Farahani, F., & Hajebi, A. (2016). Evaluation of sexual health programs in health system: Gap analysis. Isfahan University of Medical Sciences.

  • Moradi, G., Piroozi, B., Alinia, C., Akbarpour, S., Gouya, M. M., & Kazaerooni, P. A. (2019). Incidence, mortality, and burden of HIV/AIDS and its geographical distribution in Iran during 2008–2016. Iran Journal of Public Health, 48, 1–9.

    Google Scholar 

  • Noori, A., Rahimzadeh, Sh., Shahbazi, M., Moradi, G., Saeedi Moghaddam, S., & Shokoohi, M. (2016). The burden of HIV in Iran: Insights from the global burden of disease study 2010. Archives of Iranian Medicine, 19, 329–334.

    PubMed  Google Scholar 

  • Quinn, N., & Knifton, L. (2014). Beliefs, stigma and discrimination associated with mental health problems in Uganda: Implications for theory and practice. International Journal of Social Psychiatry, 60, 554–561.

    Article  Google Scholar 

  • Rahimi-Naghani, S., Merghati-Khoei, E., Shahbazi, M., Khalajabadi Farahani, F., & Motamedi, M. (2016). Sexual and reproductive health knowledge among men and women aged 15 to 49 years in metropolitan Tehran. The Journal of Sex Research, 53, 1153–1164.

    Article  Google Scholar 

  • Rashidi, H. B., Kiyani, K., & Shahbazi, S. S. (2015). Sexual health definition from the perspective of Iranian experts and description its components. Tehran University Medical Journal, 73, 210–220.

    Google Scholar 

  • Salo, N. (2009). The implications of knowledge management sustainability for leadership in an organization: An exploration and analysis of leadership theories and knowledge managment practices in Bangwita Flores. Indonesia. The Interdisciplinary Journal of NTT Development Studies, 1, 95–135.

    Google Scholar 

  • Sex Information and & Education Council of Canada (Sieccan). (2019). Canadian guidelines for sexual health education. Public Health Agency of Canada. Retrieved from ISBN: 978-0-662-48083-9, www.publichealth.gc.ca/sti.

  • Shariati, M., & Babazadeh., R., Mousavi, S. A., & Mirzaii-Najmabadi, K. . (2014). Iranian adolescent girls’ barriers in accessing sexual and reproductive health information and services: a qualitative study. The Journal of Family Planning and Reproductive Health Care, 40, 270–275.

    Article  Google Scholar 

  • Shirpak, K. R., Chinichian, M., Maticka-Tyndale, E., Ardebili, H. E., & Pourreza Ramenzankhani, A. (2008). A qualitative assessment of the sex education needs of married Iranian women. Sexuality Culture, 12, 133–150.

    Article  Google Scholar 

  • Singh, S., Darroch, E. J., & Ashford, D. L. (2014). ADDING IT UP: The cost and benefits of investing in sexual and reproductive health 2014. UNFPA, Guttmacher Institute. Retrieved from ISBN: 978-1-934387-18-4.

  • Smith, T., McNeil, K., Mitchell, R., Boyle, B., & Ries, N. (2019). A study of macro-, meso- and micro-barriers and enablers affecting extended scopes of practice: The case of rural nurse practitioners in Australia. BMC Nursing, 18, 14. https://doi.org/10.1186/s12912-019-0337-z.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tabrizi, J. S., Poursaghar, F., & Gholamzade, N. R. (2017). Status of Iran’s primary health care system in terms of health systems. Iranian Journal of Public Health, 46, 1156–1166.

    PubMed  PubMed Central  Google Scholar 

  • Taylor, A. W., Martin, G., Dal Grande, E., Swannell, S., Fullerton, S., Hazell, P., & Harrison, J. E. (2011). Methodological issues associated with collecting sensitive information over the telephone—Experience from an Australian non-suicidal self-injury (NSSI) prevalence study. BMC Medical Research Methodology, 11, 20.

    Article  Google Scholar 

  • Teimoori, V. (2012). A review of taboo in Iranian literature. Journal of Basic & Applied Sciences, 2, 7949–7955.

    Google Scholar 

  • Turan, J. M., Elafros, M. A., Logie, C. H., Banik, S., Turan, B., & Murray, S. M. (2019). Challenges and opportunities in examining and addressing intersectional stigma and health. BMC Med, 17.

  • WHO. (2004). Reproductive health strategy to accelerate progress towards the attainment of international development goals and targets. Geneva: World Health Organization.

    Google Scholar 

  • WHO. (2010). Developing sexual health programs: A framework for action. Geneva: World Health Organization.

    Google Scholar 

  • WHO. (2017). Sexual health and its linkages to reproductive health: an operational approach. Geneva: World Health Organization.

    Google Scholar 

  • Yari, F., Moghadam, Z., Parvizi, S., Nayeri, N., & Rezaei, E. (2015). Sexual and reproductive health problems of female university students in Iran: A qualitative study. Global Journal of Health Science, 7, 278.

    Article  Google Scholar 

  • Yarmohammadian, M. H., & Bahrami, S. (2006). Needs assessment in health and educational organizations health system planning needs assessment principles - Needs assessment patterns and techniques. Health Management, 20, 61–67.

    Google Scholar 

  • Yazdkhasti, M., Pourreza, A., Pirak, A., & Abdi, F. (2015). Unintended pregnancy and its adverse social and economic consequences on health system: A narrative review article. Iranian Journal of Public Health, 44, 12–21.

    PubMed  PubMed Central  Google Scholar 

  • Zelman, W. N., McCue, M. J., Millikan, A. R., & Glick, N. D. (2009). Financial management of health care organizations: An introduction to fundamental tools, concepts, and applications. John Wiley & Sons: Blackwell Publishing.

Download references

Acknowledgements

The authors are indebted to the members of the Ethics Committee of Isfahan University of Medical Sciences (reference: 393460). Our special thanks to Dr. Massoud Kamrava and J.M. Dormon for reviewing and editing the manuscript. We would like to express our gratitude to the study participants who shared their very personal information with us.

Author information

Authors and Affiliations

  1. Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

    Mahnaz Motamedi

  2. Department of Behavioral and Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA

    Mohammad Shahbazi

  3. Iranian Center of Addiction Studies (INCAS), Institution of Risk Behaviour Reduction, Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Effat Merghati-Khoei

  4. Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran

    Mehrdad Salehi

  5. Research Center for Addiction & Risky Behaviors (RECARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran

    Ahmad Hajebi

  6. Institute of Public Health, Heidelberg University, Heidelberg, Germany

    Shahrzad Rahimi-Naghani

  7. Aga Khan University, Karachi, Pakistan

    Safieh Shah

  8. Department of Population Health, Ministry of Health and Medical Education (MOHME), Midlife Health Office, Tehran, Iran

    Kianoush Kamali

  9. Department of Population & Health, National Population Studies and Comprehensive Management Institute, Tehran, Iran

    Farideh Khalajabadi-Farahani

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  1. Mahnaz Motamedi
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Contributions

MM designed and directed the study in all steps. MS, SS, and FK aided in analyzing work of the manuscript. MS, EM, and AH analyzed the data. KK and other authors discussed the results and commented on the manuscript.

Corresponding author

Correspondence to Farideh Khalajabadi-Farahani.

Ethics declarations

Ethics Approval

This study was approved by the ethical committee of the Isfahan University of Medical Sciences (reference: 393460). All participants were informed about the aim of the study and also were ensured about the confidentiality of their responses as well as voluntary participation, along with a verbal consent before the interviews were carried out.

Consent for Publication

All participants consented to the publication of this report before the interviews were carried out.

Competing Interests

The authors declare that they have no competing interests.

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The original version of this article unfortunately a mistake. The corresponding author should be Farideh Khalajabadi Farahani.

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Motamedi, M., Shahbazi, M., Merghati-Khoei, E. et al. Perceived Barriers to Implementing Sexual Health Programs from the Viewpoint of Health Policymakers in Iran: A Qualitative Study. Sex Res Soc Policy 19, 273–285 (2022). https://doi.org/10.1007/s13178-021-00540-7

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