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3.2. Health, Education and Recreation 3.2.1. Health statistics The overall improvement in health care and delivery of health services over the last 20 years has been one of the main reasons for the progress in human development in the Islamic Republic of Iran. The expansion of health facilities, particularly primary health care, has greatly contributed to a longer life expectancy that is one of the three components of the human development index (HDI). Life expectancy in Iran increased as much from 1988 to 1997 as it did in the three previous decades because of the provision of public health services. Figure 1 shows the growth in life expectancy for men and women between 1988 and 1997. Life expectancy in Iran stood at 61.1 years in 1988 had risen to 69.5 years in 1997. For Gilan provinces, it is 67.4 years, which is more than the national average in Gilan and less in Golestan and Mazandaran provinces
Trend of life expectancy in I.R. of Iran, 1988 The most important factor in increasing life expectancy over the past 10 years was the decline in the mortality rate among children under five years from 85.3 per 1,000 live births in 1988 to 37.3 per 1,000 live births in 1997. Other factors contributing to longer life expectancy included a decline in infant and maternal mortality. Cardiovascular diseases and cancer are now the main causes of death while the spread of AIDS and tuberculosis is beginning to cause alarm. According to Iranian constitutional law, good health is a basic right and the government is obliged to provide the facilities needed to make this right a reality. At the macro level, the health network is the foundation of the country’s healthcare system. The principle underlying it is the reduction of disparities among different groups, particularly people in poor and rural areas and those who are vulnerable, notably women and children. Accordingly, the expansion of the health network as a decentralized system was adopted down to the district level. Its organizational structures is shown in Figure ?. Urban and Rural Health Centers and Health Houses meet the primary health care needs of people in the community they serve. Health Houses are the health care facilities closest to the people and provide primary health care in villages. Specialized care is provided by university-affiliated hospitals in provincial capitals. The creation of the health network means that 100% of the urban population and around 85% of the rural population now have access to primary health care. The parallel expansion of a universal health insurance system has been another major factor in improving the public’s health, as has the growth in the number of doctors. In 1988, there were 49.9 doctors per 100,000 people in Iran. This had increased to 107.9 by 1997. As the government scales down its presence in the economy, however the private sector is expected to play a greater role in providing health care services special medical services in particular. Reproductive health, immunization, prevention and control of endemic illnesses and treatment of endemic diseases are among the special services being provided by the PHC in recent years.
Nutritional Safety A sound diet is a leading factor in good health. An examination of households and individual’s comparing food security and health reveals their nutritional status in both quantitative and qualitative terms. According to the latest data available, from 1991-1995, a typical Iranian consumed 128 kg of bread, 44.2 kg of rice, 7.7 kg of cereals, 25.5 kg of sugar, 171 kg of vegetables and fruits 41 kg of various kinds of meat and eggs, 61 liters of milk and dairy products, and 14.2 kg of fats. This diet amounts to 2,665 kilocalories of energy, 73.8 grams of protein, 616 milligrams of calcium, 31.4 milligrams of iron, 603 micrograms of vitamin A, one milligram of riboflavin and 90.4 milligrams of vitamin C - 120% of the recommended dietary allowance. The only deficiencies are in riboflavin (75% of the body’s requirement) and particularly in rural areas where the deficiency is very severe vitamin A. Other Iranians are getting their basic need and more. These data could be extended to cover coastal provinces as an indicator of the nutritional index, because specific data are not available for this region. Nevertheless, it should be mentioned that the per capita consumption of fresh vegetables, rice and fish meat is more than the country’s average. In addition, rural people consume less meat and fruits than city dwellers. In Tables ? and ? summary of health indices according to the coastal provinces is presented. Improvement of national public health in the last 20 years has been a leading factor in the human development growth indices in the Islamic Republic of Iran. Expansion of health facilities, particularly primary healthcare, has greatly contributed to longer life expectancy that is one of the three components of the human development index (HDI). Life expectancy in Iran increased as much from 1988 to 1997 as it did in the three preceding decades, because of the provision of public health services. Figure 1 shows the upward trend in life expectancy for men and women between 1988 and 1997. Life expectancy in Iran that stood at 61.1 years in 1998 had risen to 69.5 years in 1997. For Gilan province, it is 67.4 years, which is higher than the national average. The figure for Gilan is lower than in the other two provinces under consideration.
Trend of Life Expectancy in I.R. of Iran--1988 The most important factor in increasing life expectancy over the past decade has been the decline in the mortality rate among children under five years of age from 85.3 per 1,000 live births in 1988 to 37.3 per 1,000 live births in 1997. Other contributing factors included a decline in infant and maternal mortality. Cardiovascular diseases and cancer are now the main causes of death while the spread of AIDS and tuberculosis are becoming sources of genuine concern. According to the Iranian Constitution, good health is a basic right. The government is obliged to provide the facilities needed to make this right a reality. At the macro level, the national health network is the foundation of the country’s healthcare system. The major principle underlying the systems’ policy is the reduction of disparities among different income and social groups, particularly people in poor and rural areas and those who are vulnerable, notably women and children. Consequently, the expansion of the health network as a decentralized system was adopted down to the district level. Its organizational structure is shown in Figure ?. Urban and Rural Health Centers and Health Houses meet the primary health care needs of people in the community they serve. Health Houses are the health care facilities closest to the people and provide primary health care in villages. Specialized care is provided by university-affiliated hospitals in provincial capitals. The creation of the health network has meant that 100% of the urban population and around 85% of the rural population now have access to primary health care. The parallel expansion of a universal health insurance system has been another major factor in improving public health, as has the growth in the number of doctors. In 1988, there were 49.9 doctors per 100,000 people. This increased to 107.9 by 1997. As the government scales down its presence in the economy however, the private sector is expected to play a greater role in providing health care services, special medical services in particular. Reproductive health, immunization, prevention and control of endemic illnesses and treatment of endemic diseases are included in the special services provided by the PHC in recent years.
Nutritional Safety A sound diet is a leading factor in good health. A study of the relationship between household and individual food security and health reveals their nutritional status in both quantitative and qualitative terms. According to the latest data available, from 1991 to 1995, a typical Iranian consumed 128 kg of bread, 44.2 kg of rice, 7.7 kg of cereals, 25.5 kg of sugar, 171 kg of vegetables and fruits 41 kg of various kinds of meat and eggs, 61 liters of milk and dairy products, and 14.2 kg of fats. This diet amounts to 2.665 kilocalories of energy, 73.8 g of protein, 616 mg of calcium, 31.4 mg of iron, 603 micrograms of Vitamin A, one mg of riboflavin and 90.4 mg of Vitamin C - 120% of the recommended dietary allowance. The only deficiencies are in riboflavin (75% of the body’s requirement) and particularly in rural areas where the deficiency is very severe, Vitamin A. Other Iranians are getting their basic needs and more. This data can be juxtaposed on the coastal provinces as an indicator of the nutritional index, as specific data are not available for this region. But it should be mentioned that the per capita consumption of fresh vegetables, rice and fish meat is more than the country’s average. In addition, the rural population consumes less meat and fruits than city dwellers. In Table ?, a summary of health indices according to the coastal provinces are presented in addition to Table ? that outlines food security in selected areas. 3.2.2. Environmental health A precondition for human development is the creation of a safe and healthy environment, undertaken in the specific context of efforts to protect and improve public health. In the human development approach, environmental protection is the basis of sustainable human development. In the face of challenges posed by unbridled economic growth, the need to treat the various environmental dimensions of development has emerged as a major national issue. This is of special importance in the northern provinces, where the environment is both fragile and burdened with rapid human development. The fast population growth over the last 20 years has dramatically changed the composition of urban and rural populations, resulting in accelerated urbanization. This progress has harmed the environment in a number of ways, particularly in large cities. These adverse effects are readily observable in many areas of quality of life indices including air and water characteristics, human settlements, noise levels, energy consumption, communications and the state of natural resources. The outstanding threat to the environment is the urban population that has doubled in 20 years from 17.85 million to 23.24 million. In the same period, the number of cities and towns leaped from 375 to 616. This increase has naturally hindered the adoption of measures to protect the urban environment. The resulting deficiencies are most clearly noticeable in relation to water pollution in coastal areas, especially rivers that pass through populated and industrial areas. The most conspicuous example of this phenomenon is the Zarjab River that enters the Anzali lagoon and carries the pollution load of numerous factories and towns (particularly the city of Rasht), into this water body. Many other rivers also empty their pollution loads into the Caspian Sea. Because insufficient attention has been given to the environmental impact of water-borne effluent, implacable urbanization and the industrialization associated with it have become the leading threats to the environment of the Caspian region in urban and industrial centers. It is estimated that there are 500 and 473 large industrial units in Mazandaran and Gilan provinces respectively. Many of these facilities are constructed in close proximity while some industrial regions have hundreds of factories. The Rasht Industrial Center is the leading example in this respect. Although government policy in recent years has been to move factories to the outskirts of urban areas in order to reduce industrial pollution and increase environmental health, the implementation of this scheme faces a series of obstacles. The increasing volume of toxic industrial effluent continues to be a significant environmental concern for the region. A brief description of the comprehensive nature of the pollution problem is discussed in the relevant chapters. 3.2.3. Social welfare system 3.2.4. Student population at various level 3.2.5. Literacy 3.2.6. Environmental education Education is arguably the cornerstone and outstanding single element in human development. The expansion of knowledge paves the way to a magnification of human choices, thus providing improved standards of living through greater access to employment opportunities, enhanced health and healthcare. Learning also affords a better understanding of our environment and surroundings. This cluster of closely connected factors has prompted the government of Iran to underscore the qualitative growth of education over the last two decades. Two of the most important indicators in the improvement of human development levels in Iran from 1988 to the present were the improvement of the adult literacy rate from 57.1% to 75.5% and the increase in the combined school enrolment ratio from 65.6% to 75%. Accordingly, the gross enrolment ratio at the secondary level went up from 52.7% to 77.5% (15.2%) and at the tertiary level jumped from 6.89% in 1988 to 18.17% in 1997. The principal impetus for this expansion was largely due to efforts for furthering education and employment opportunities. On the other hand, the ratio at the primary level declined from 122.5% in 1988 to 119.2% in 1997.(Table ?) According to Table 1, in 1976, the total number of students nationwide was about 18.5 million. In the coastal provinces, the figure was about 1.9 million, or some 10% of the national figure. The highest number of students is registered in Mazandaran province (43%) then Gilan (34%) and finally Golestan (23%). According to provincial population statistics, the ratio of students to population size is 29.l5% in Gilan, 31% in Mazandaran and 30% in Golestan which are all within a similar range. For the entire coastal region, this figure is 30.5%. Over the last 20 years, the country’s population has doubled but the number of students has increased 2.5 times. Comparing this figure to the 5.2 times for the corresponding period of 1956 to 1976, a reduction in the ratio of students to the population increase rate is noticeable but it is estimated that the present rate would be more or less stable in the coming years. At the tertiary level (universities and colleges) there is a significant increase in the number of universities and institutions of higher education.. The growing involvement of the private sector in this area explains the situation. Another important reason for the rise in enrolment at the tertiary level is that attainment of higher education is widely perceived to have economic advantages. In the coastal provinces alone there are 120,842 students or 19% of the population. More than 51% of the aggregate attend private institutions. For the country these figures are 1.99 and 51% respectively. Disregarding Tehran province, Mazandaran ranks third (5.2%) nationwide in the number of students pursuing higher degrees. In the last 10 years establishing fisheries, marine and environmental science courses has increased. Today in all these provinces there are several private and governmental colleges and universities providing such education. The main institutions are Gilan University (environment); Tarbiat Moalem University in Noor-Mazandaran (providing courses in marine biology, fisheries and environmental sciences at the MSc. and Ph.D levels; Azad University in Lahijan- Gilan (offering fisheries and environment courses at the B.Sc. and M.Sc. level; Azad University in Babulsar – Mazandaran (offering B.Sc. fisheries courses); Gorgan University – Golestan (fisheries and environmental sciences at the B.Sc. and M.Sc. levels). There are also at least four vocational high schools in the northern provinces that provide courses in fisheries navigation, marine engineering (marine engines), commercial navigation and marine electronics and communication. In 1997, the Islamic Republic of Iran’s education index stood at 0.75 compared with 0.85-0.99 in countries with higher levels of human development, indicating there remains substantial room for improvement. All measures to increase literacy and boost enrolment at different educational levels would improve Iran’s education index and, as a corollary, raise its level of human development. A comparison between men and women’s educational status is also important from a human development perspective. From 1988 to 1997. The adult literacy rate for women rose from 46.3 % to 67.0% while the rate for men increased from 67.1% to 81.9%. It is worthy of note that although the age composition of the population indicates more men having an opportunity to become literate, women have shown a greater interest in literacy. Table ? which outlines female enrolment indices at various education levels, reveals that the index for the number of female students in higher education increased from 100 (the base figure) in 1988 to 322 in 1996. In the same period, the index for female secondary enrolment rose to 189, and the index for female primary enrolment went up to 125. In 1988, 60.5% of students were concentrated in urban areas with the remainder in rural areas. Of all the enrollees covered by the Literacy Movement, 56.8% were in urban and 43.2 in rural areas. In 1996, of the I.R. Iran’s 26 provinces, Tehran and Sistan and Baluchestan had the highest and lowest adult literacy rates, 84.7% and 48.0% respectively. In 1998 the figures for Gilan, Mazandaran and Golestan provinces stood at 79.2%, 80.8% and 76.97%. For the entire region the average is 78.98%.
3.2.7. Community activities Social and Cultural Activities In the Islamic Republic of Iran, besides formal public institutions such as schools and universities, there are non-governmental institutions that impact on the society’s educational environment. Cultural centers such as libraries, cinemas, theaters, cultural and art complexes, mosques, and other sports and entertainment facilities are among these institutions. This also includes mass media such as radio and television, press and other print media. All make an impression on the country’s educational environment. Thus, it is important to assess the role of these institutions and mass media in public education.
Libraries Available data indicate that there were 486 public libraries in Iran in 1988. Growing at an annual average rate of 10%, the number of public libraries in 1997 has more than doubled to 1,147. In the Caspian coastal provinces, there are 114 public libraries with more than half a million books, in excess of 1.5 million users, and 72,857 regular members (about 55% women) annually. The expansion of public libraries has played a remarkable role in improvement of the country’s educational indicators, particularly for guidance and high school students. For students who have no suitable place to study at home, expansion of the public library system will meet an important need.
Cinemas Cinemas, theaters and other cultural and art centers have also played an important role in creating an improved educational environment and contributed to human development. The quantitative expansion of programs offered by such centers is an indication of their impact on learning and education. However, according to available data, the number of cinemas has not increased significantly: There were 260 in 1988 and only 295 in 1996. In the coastal provinces, there are 53 cinemas, mostly in Gilan and Mazandaran provinces.
Cultural Centers The establishment of cultural and art complexes was one of the initiatives launched by the government. In 1997, 70 cultural and arts centers and 36 cultural houses were active in the country’s urban and rural areas. Apart from these centers, there is also cultural centers and youth clubs in almost all cities. These venues provide a unique atmosphere for youths to spend their leisure time as well as to participate in cultural activities through attending different classes and courses, such as painting, singing, music, carpet weaving, theater, etc. In 1998, there were at least 44 cultural centers in the coastal provinces.
Mass media The country’s mass media have also played an important role in creating a live educational atmosphere. Television programs produced in the country registered an average annual growth rate of 22.9% from 1989 to 1997. Production of radio programs by IRIB (Islamic Republic of Iran Broadcasting) recorded an average annual growth of 22.9% from 1989 to 1997. Production of radio programs by IRIB made a gigantic leap from 45,530 hours in 1989 to 146,019 hours in 1997. The northern Caspian provinces have also benefited from this development process during the last 10 years. The whole region is under the umbrella of radio broadcasting services from national and local programs. There are 20 radio stations in the region and five radio channels that broadcast 11,481 hours of local programs on different subjects, mainly focused on moral issues, entertainment, and information on science and technology. **maps (p.46, p.24) The number of print media grew at an average annual rate of 23.8%, with the highest increase in dailies at 27.5% and the lowest in monthlies at 19.3%. Momentous social developments, a higher level of public awareness, and government support in the recent years were the primary factors for the remarkable growth of the print media. More than 40 local publications are being published in the coastal provinces. From 1994 to 1997, the print media circulation grew at an average of 20.6% annually, which indicates an impressive increase of the print media on rising awareness of the region’s different social groups, particularly the youth. It is foreseen that in the coming years, the press will have an even stronger impact on public education and advancement of human development.
Sports and historical places In 1998, it is estimated that 2,047 sport centers were operating in the Caspian provinces. The range of sports activities is quite wide and includes: football, volleyball, basketball, swimming, boxing, wrestling, table tennis, gymnastics, weight lifting, track and field and martial arts Football, swimming and wrestling are the most popular. The private and governmental sport centers include stadiums, gymnasiums, pools, and open playgrounds. The coastal provinces enjoy several historical monuments and ancient places including holy places, mosques, castles, bridges, public baths, palaces, minarets, caravanserais, historical buildings, tombs, etc. It is estimated that about one million people visit these sites every year.
Site seeing and tourist attractions: The coastal provinces have a unique climatic condition, with relatively a mild weather and lots of rain. These factors make the area green with a dense tree cover that creates many beautiful and interesting places for people living there, as well as for domestic and foreign tourists. The most important attractions of these provinces are the beach resorts that extend along the entire Caspian coastline. These locations attract thousands of people every year. These areas accommodate people in a large number of villas along the resort areas. Some of the important resort beaches are: Mazandaran province: Khazar-Abad, Mahmood-Abad, Nour, Alamdeh, Nowshahr, Abbas-Abad, Nashtarood, Tonekabon, Katalem, and Sadat-Mahaalleh Gilan Province: Astara, Anzali, Rudsar, In these resorts, swimming and boating are very popular sports, especially during late spring and summer (May-September) In figure… , the location of the main tourist attractions sites are presented. In Table…., some important statistics have been provided. |
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