full of uniqueness. sitting on the first page. o sitting on the first page, it is there. look on the other side of the fence, the pleasure of visiting is there. o seat of the first row, justice. stand up, you are the burden of trust, stand up, stand in the first row, the first row, the first row, the first row, the line of service, your stronghold, your stronghold, this is the table and there is hope for you, on the other side of the table, there is a martyr in your eyes, in the name of god

, the most merciful, the most merciful. greetings to you, fellow countrymen, ladies and gentlemen, welcome to the first row. we always talk about prevention, which is the introduction to treatment, and that if we think about prevention of treatment , we will reduce the treatment costs, or we will not find any need to spend in the treatment phase at all. over the past forty years, as a result of paying attention to these preventions, the life expectancy has increased from about 50 years to about 75 years . welcome, mr. doctor, thank you very much. hello, i am at your service, dear viewers, we are at your service. well

, we will start with a report prepared by my colleagues , and then we will answer our questions . risk of heart, kidneys and liver are at risk put diabetes is one of the most common diseases in the world, and in fact, after cardiovascular diseases and cancer , it is the fourth or fifth cause of death among non-communicable causes . change in lifestyle , weight gain, low movement, change in diet and high consumption of prepared foods in the lives of statistical people.

diabetes is increasing day by day. 11 of our population over 25 years old are now suffering from diabetes, unfortunately 75% of these people only know about their own disease . it is the disease of 76-year-old mohsen who has been suffering from diabetes for a long time. he had diabetes before and because he did not have proper control, he got diabetic foot ulcer. in our country , more than 7 million people over the age of 25 are suffering from diabetes. one person in the world is suffering from diabetes. well, dr. farshidi, tell me about the treatment of diabetes and blood pressure, how does this happen and when did it start ? if you remember, we started a program called the family program in may

, its family-oriented health program. there were cities with more than 20,000 people, but we are actually in cities with less than 20,000 people our people and villages have a system called active care which is done by our health center or our health center. unfortunately, in cities with more than 20,000 people, this possibility and reach of people was a little low, so we sought this by providing the family health program and the arja system. that we can have an active follow-up by creating proper access for people and training health care workers specifically for this work. our art is to find people before they get sick. we have two groups of people . he knows he has diabetes

dona has high blood pressure as long as diabetes and high blood pressure do not have any complications. well, this time is well diagnosed and treatable, and i will show you the effect of the treatment. therefore , when we came and started this project and gradually expanded the population. we had, especially now that since the first of december, we have increased the 9 million people covered by the family health program to 20 million people in 182 cities, we have defined a campaign that the main goal of this campaign is actually to improve health literacy, that is , our main goal that from this program and i really thank sadasima as a program the tone of the voice that can convey these messages to the people is what we are pursuing and today if we talk about blood pressure or diabetes screening

, in fact our goal is beyond this. let's go. now, the two things that are lacking in the cities and that is the completion of electronic health records, we want to increase some coverage in the city, but why did we choose high blood pressure and why diabetes, these two are two very important factors in the majority of deaths and the trends that we are witnessing now in the treatment costs our treatment system is being tolerated. now, more than 88% of our deaths are caused by non-communicable diseases, the heart is cancer , and diabetes and

high blood pressure are 423%. this is directly related to coronary heart disease. how many risk factors do we have ? we know high blood pressure, we have diabetes , we have obesity, we have high blood fat, these were felt. the greatest impact on mortality and complications means that we are not only talking about reducing heart and stroke mortality with proper control of high blood pressure and diabetes, but also the complications of these. what complications does high blood pressure have for us? a heart attack may not lead to death, but when a heart attack occurs when a part of the insulation of the heart is destroyed, the heart will fail . you will have to live with heart failure for years as one of the complications of high blood pressure . if diabetes occurs, you will develop kidney failure. in addition to what i have told you, amputation, we have just seen the diabetic foot ulcer in my report, this can

easily lead to amputation and cause a leg to be amputated every second in the world due to diabetic foot ulcer, while if we can we can definitely treat before this happens at all, i will not go into the treatment section, what are the side effects and how much should we spend, if we can only do something for a heart failure, at least he can live his life, we live an active life , we will get over it, if he survives, he can at least live his life, how much should we spend when we say that because of diabetes and high blood pressure, a person can end up in a dialysis machine, which means he will lose his kidneys. well, i don't think it's painful even for us to imagine that he has to go 3 days a week in the morning to be connected to a dialysis machine. now let's do the next psychological problems

the different physical effects it can cause, it causes blindness in some people, it causes problems, yes , the same thing happens, blood pressure and diabetes are closely related, wherever your blood flows , the effects of this, high blood pressure and diabetes , have their effects. therefore, blindness, cerebral palsy, all organ palpitations, and these things happen. now we have the problem , so we said that we have a patient who you know. in this report, you said that a significant percentage of people do not know whether they have diabetes or not. our goal is first. this is to say that high blood pressure is important, this is the first goal of diabetes importantly, this is the first goal. after this, let's say, well, dear sir, in the past 6 months, in the past year, you have controlled your blood pressure , you have controlled your blood sugar once, this is important for us , we have a whole lot of other things, but these two are important because

we can diagnose them in time. with proper treatment, fortunately, fortunately, both cases are in the early stages , even drug treatment may not be needed. by regulating physical activity, regulating food consumption, it means that we can completely treat and reduce salt . appropriate physical activity. have fruits and use less foods that are now canned in various forms most of them are high in salt, so it is easy to get high blood pressure. in order to start the treatment of high blood pressure , it is better to spend two to three months on non-drug treatments. they will definitely work if there is a good cooperation. maybe we are less to average medicine. it is important for us to find these two

. i will show hazrat ali a graph. yes, if we come, say that i think my colleagues have this ready . if we show this graph, you can show it to me, but if we look at hazrat ali yes, we can see these columns if we look at them, if i control 25% of the population and its pressure. yes, i will have this. in terms of stroke, now my 25% will be 55. this is something that has been proven to work in different countries, and if i control 75% , i will have a reduction of more than half in stroke. the same thing happens with kidney failure. the same thing happens to heart attack and to diabetes and high blood pressure , so it is worth reading this. take it to the camera again because i think my colleagues failed to

show the graphs on the screen in any of these 3 columns that we we can see the effect of this page on high blood pressure, its control reduces stroke, heart attack, and kidney failure, that is, we have all three cases , and we can easily perform ablution. 22 to 23 percent have high blood pressure. about 31 of our 30-year-olds have high blood pressure. well, these 30% who have high blood pressure, how many percent of them know that they have high blood pressure , 60, so of those 30, 60% of them know that they have high blood pressure, well , of the 60% who know, how many percent of them know that they have high blood pressure now that they know. they are taking medicine

they are taking 57 out of 60 and 57. well, now they are taking medicine. is our blood pressure under control? it means that he is taking medicine and following his diet, and his blood pressure is not higher than 120 over 80. we call this 24% control, so those who are under control are very numerous. the number is low, so we have to work on each of these, that is to say, high blood pressure, it is important to go to the level of this, yes, i will follow it , we have to work, how does this happen? we have a population. today , we have a type of population, a population that is under the cover of the house our health is a population that is covered by our mobile teams, 97 of our population is in the village with a health house, now we have 54% of the country over the age of 1, we say that if we are over the age of 18, we should take all of them at least once.

our work is easier day by day, because now most of our health centers know their high blood pressure patients, now they have to do this once again in the month and a half that we have this program or follow up . kenan is taking this medicine, there is control , there is no control. we have such a population in you in our urban areas, we have 40 million people, and we have to take blood pressure in more than 18 of these halls. all of our centers have 28,25,000 physical spaces , such as health centers, health centers, and health centers, which are fixed spaces that are ready to be attended 70,000 health workers, these are only the workers who are in the ministry of health and are ready for people to visit or take their blood pressure at least once for 18 years and

those who are over 40 years old , fasting blood sugar may be checked once in these people. if they are not satisfied, they will be given time to express and this blood sugar is checked, if our blood pressure is high, the same previous program with health recommendations on what to do to avoid high blood pressure is acceptable . these will continue well. well, now this model that you have, this method that you have, is the method that you have to reach the people's ears, tell them many times to be informed whether it reaches their ears or not. in any case, there are new methods, including texting, yes, and you can very easily access the database of people's mobile numbers, people over 18 years old, men over 40 years old separately, with the cooperation of mobile phone operators and send text messages when sms

come on, for me, you can refer to some place for this issue, or it's better to refer to another place. well, i take this message much better and feel that i was taken seriously. yes, i will probably take it more seriously myself. very good point. you mentioned that before we send that message, the nation should find this awareness in any way . before the message, it is important for the radio station, which i thank , but for the message, we now have a very good relationship with the first company. very nice karen and we have a program that send one million text messages a day with a link in each text message we have electronics in these text messages that can be sent, god willing, this will be operational from next saturday, december 10th

, and so you are doing this. you can open this link, there is a series of information there, you will be asked, and the party can have some, for example, blood pressure measurement at home, if he has diabetes, and if he has already been tested, he can enter a statement through himself , enter his national code and this goes directly to where it resides in that base of my health the health care provider is present, the health care provider, when he sees a patient with diabetes or high blood pressure in an active form in continuous follow-up programs, this work will definitely be done, and we have 9 million people in the family health program, which i thank the budget program organization for by providing proper credit, we have the possibility to have this increase in population, and since ardi behesht , when we started, we have now reached 9 million, and since december 1, 11 million have been added, and from december 15, 20 million

people will be included in family health with the cooperation that the organization of the sheep and for the sake of the country, having us take care of it has a direct relationship with the population, that is, the population in the family health program, he knows his health care provider. every 1,500 people have a health care provider. this population used to be more than this. we have reduced it with the program that we have now . this means that my caregiver should look for healthy people, sick people should look for people who do not know they are sick, and before we find complications , we should look for 2 risk factors now, which are really very important for us, very important. diabetes and hypertension are so important worldwide. let's not think that the countries that are financially heavy now very good, it is not possible to control 100 in

european countries, the statistics are very good, 70-75% of people need to control their blood pressure, which means it is hard work. but with the creation of this potential that the care provider can actively follow up, if the party does not come to call him, he should go to his house and follow up, with what motivation should he do this? the appropriate budget for launching various services, which is that, well , you have seen the budgets, but the thing that has been answered and followed in the world for a long time is that health people have found a connection with the benefits of insurances, using the benefits of insurances, in fact, in order not to have to pay the treatment costs later, the insurance pays both the prevention costs and also takes care of it and follows you. you came to arrange such a mechanism and

establish a relationship between these. we are now saying that because of the gender of dr. it is far from being able to reach a place where a caregiver really comes to the point you say, even in our house when we reduced the population, our blocks have 300 people, which means a health team in a block of 30 people. it is located not so far away, the effective distance between a house and a health center should be less than an hour, so that besides this, we are not satisfied with only diabetes and high blood pressure . literacy is health, it means that i, as a citizen, know that there is a place, if they go to raigan , what we are doing now is free. in addition to this , if a disease is found, i go to the health center and find a disease in me, high blood pressure, that's enough, then

the referral system will come up, that is, from this system at one o'clock. we would like to say that the hospitals that are included in this program will be provided to the people who are referred through the same thing that you mentioned, the issue of insurance is raised, right now 95% of the costs are covered, and those who are from this part no, i am at the stage of treatment. look at the countries whose health systems are insurance-based. of course, we have other models in the world , those that are insurance-based because the benefits of insurance require it. the family doctor is actually responsible for prevention, because he knows that if now don't prevent it for its own benefit through less insurance it will be ensured that this will happen now in your prevention, finally, or it has to happen or in another way

, probably, you should put this benefit for him to take care of his health, for him to take care of our family. the health insurance sector is completely involved in this program, even a part of the health insurance system, the doctors who are working right now are working under the title of family doctors, and they are connected to these health care providers in our system. to create the feeling that i i have to spend time for my own health and for my own health i have to go to the centers that the government provided the budget for. . where is our flock? our problem is that we have very good communication in the villages. the coverage is very good. cities, fortunately

, the situation of villages is better here, that is, they are benefiting more from government services. this is good news, of course. but in any case, problems like this are more connected with urbanization and industrial life. and when did you get this disease when you served in a city like tehran and other big cities, these problems are probably there. it should be more, better, but you say that there is no such coverage here, the corner is very low, the folder is below 15 %, yes, now the small cities have a bit better coverage, but we are coming to the big cities , there is little coverage in tehran, why is there no such coverage, or are the people really unaware for example , there is a center 23 kilometers away from my house that provides these services . then i said that this is the primary service that we started . now we call blood pressure different types of cancers. that we can prevent it, we can detect it, the same thing is happening with the samplings that are done for cancer, for

breast cancer and for colon cancer, we are doing it, we are doing it, we are doing it in our community health centers, so either people don't know or we do. we don't show the facilities properly, for example, we are now trying to create access to people in this family health plan, if these messages are very popular. it means that these messages come regularly in different topics so that i know that there is a health center near my house and that it offers these services to me. and if i take these services, i will be harmed myself. probably, this level of coverage will increase from 15%. definitely, at some point , we will have to go in such a way that we will let people know that the health care provider we hired is an expert. this nursing expert must

establish a very good relationship based on trust with the people, with the comprehensive one that he said, the center is at the center of these relationships, so that we recognize this health care provider as our health advisor, even for things other than seeing patients now. let's call and ask or through virtual systems to be able to have this care. if it is strengthened, we will go to include other low coverage in this program. certainly, the goal of the ministry of health is that by the end of the year, we will have 20 million people in the population above 20 thousand people, 33 million people in the population that we have now, that is 55 millions of our population should be covered and, god willing , the entire country will be covered by the family health program from april to next year , so this is your prediction. that until next may all people will be covered, god willing , our cities with over 20,000 people and 35 million by the end of the year, 20 million over the population over 20

the population that is now in the villages and cities is below 20,000 people, that is, by the end of the year, we have taken 55 million people under the folder, and you, the executive bodies of the organizations' offices , can also expand this level of coverage through these, because every now, the employees who are at work, if you take action through that department of that ministry, that organization , you can find them very easily, and no one will mind that they are sitting at work. someone should come here and, for example, take a test from him and go . this is what you mentioned at the beginning of our program, which means expanding the information program and going to the people. let's show them our health centers, let's introduce them. this is possible in one year, two years, three years, but after that what should happen, the same as we said, the insurance companies are still working, they say, i will pay your insurance when that

referral form is submitted . if it happens, it means that you go to the service that we have prepared for you, use this service , do not prevent your appointment and wait until you get sick, then maybe the discussion about treatment , insurance is under the burden of mr. thab basij's coverage , you are also using the capacity of basij. in this story, like what happened about polio we had set aside the first week and the second week for the internal discussions of the universities to strengthen themselves and adjust their communication plans . god willing, from 15th of december, everyone's intervention means the presence of all those who can be involved in some way . last week, there was an information regarding the campaign of the governors coming to work in the cities, but we still haven't started basij or the red crescent or anywhere in diatelbane

, which are few in number . the scandal that is taking place well, right now, the implementation has not yet started at the stage where people can come. it has already started . i said now that we will be sending text messages from december 10th . it can be done on saturday now. the patch now means that it informs that the spaces we have now, we said we have 25,000 spaces , you must follow the queue for people to come, if a center has the capacity to check 50 people a day for diabetes, 100 people, it will definitely create a crowd. yes, but your capacity should last this long these capacities should be ready, the infrastructure should be ready. since 15th of december, we have said that a public notification like other spaces, especially for big cities like

tehran, will be open for food outside our centers and will be accepted by the owners. in the next steps, what other diseases are going to be identified in the health survey or are they going to be screened for blood lipids? we have a plan now . the discussion of cerebral strokes and heart attacks has entered the phase of cancer there are at least three types of cancer that we can easily do this in our department . it is very easy. many times, only with the education you give to the family, the person himself can find some of these symptoms and refer to us. we are in this section, as well as various other discussions

in non-contagious communication, especially god willing, the work that is being done will continue, and is this a sub-section of the family health plan, for which we designed the family health plan, and this part of the family health program is actually in fact family health is a program that we expect in the future to provide adequate coverage of all our health services through this program. when the patient's health is fully established, the relationship that is established between the caregiver and the population, and the relationship between the caregiver and our doctor is established, then there will always be a discussion about our family doctor, this is the family medical team that can transfer services through referral let's see a report on the second level, which is the therapeutic level, about the health of the family.