In the new public health, the concept of “social functioning”
has received particular attention as both a social health asset
and a determinant of physical and mental health, in despite
the fact that the concept primarily derived from the works
of sociologists and psychiatrists. Seeking care for nonpsychotic
mental disorders as a consequence of problematic
social relationships was one of the first reasons of paying attention
to the concept of social roles and similarly, social functions.
Several countries, especially developed, and international organizations
have made attempts to develop their special indicators
of social function. Most of them have integrated
social functioning indicators into their health programs such
as Americans’ healthy people 2020 program; OECD (Organisation
for Economic Co-operation and Development) framework
of monitoring health; framework of CIHI (Canadian Institute
for Health Information).
A recently developed framework
for monitoring social well-being in Iran, has considered ‘social functioning’ as a main component but there is no detailed
indicators to monitor social functioning.
In Iran, as a middle-income country, with rapid social, cultural,
and political changes, and improvement in social function was
increasingly emphasized by government and policy-makers in
recent twenty years, following the evidence-based reports of
diminishing trend of social health and capital and increasing
trend of social problems such as drug abuse, violence, depression,
relationship and family breakdown. The last report
of global burden of diseases study regarding Iran situation,
which estimated burden of 289 diseases with 67 risk factors,
ranked drug use, intimate partner violence, and children
sexual abuse as 10th, 13th, and 16th risk factor, respectively;
and ranked major depressive disorder, anxiety disorder, drug
abuse disorder, self-harm, and interpersonal violence as 4th,
10th, 12th, 23th, 25th of diseases, respectively. In addition
the trend of divorce and sexual dysfunction among Iranian
spouses has been increasing during recent decades. Taken together, the weight of problems with social aspect
in Iranian health system is dramatic. Iran Supreme-leader has
recently alarm and concern at the impact of social problems
and emergent need for governmental interventions. For this
reason, policy-makers in different organizations such as Ministry
of State, Ministry of Social Affairs and especially Ministry
of Health (MOH) made several attempts to deal with the problems.
Establishment of Social Health Unit in MOH, conducting
the first round of “Iranians’ social health survey”, and implementing
provincial community-based initiatives to reduce social
problems were a number of good illustrations.
Following the mentioned attempts, Social Health Unit of MOH
decided to develop an evidence-based conceptual framework
and indicators to monitor social functioning as a major aspect
of social health in national and provincial level since there is
no a consensus among sociologists and public health scientists
on the concept of social functioning. Indeed, developed
indicators would be a valuable instrument in hands of policymakers
in different levels to make most effective and efficient
attempts. Therefore, the aim of our study was to contribute to
this growing area by exploring framework of social functioning,
and develop and prioritize indicators through a consensus-building
approach.
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