Patterns of Disease and Demographic Trends in the Nomadic Population of Southern Iran (Qashqai Tribe, 1973)

The planning and development d the health service depend on the needs of the population; their appreciation of the service, and bringing these needs to the attention of the health authorities by presenting demographic data and epidemiological investigations of morbidity and mortality of predominant diseases. On this basis a cross-sectional demography and morbidity survey of the Qaahqai Tribe of Southern Iran was conducted in 1973, with the following aims:- a) To describe the demographic features of population. b) To study the health problems, morbidity and the incidence of diseases, especially those that can be prevented. c) To determine the level of utilisation of existing health services and medical facilities. All these data are needed for justifying the plans for further development of health services for tribal populations. A sample of 3,214 households was chosen by random sampling and by using the list prepared by interviewing the heads of clans and subclans plus the statistics from Malaria Eradication Department, Iran. The study was carried out in two parts: namely, household survey for demography study and medical survey for morbidity study. While the household survey covered a de facto population of 16,939 persons in 2,929 households, the medical survey covered a population of 3,153 or 18.6 per cent of the total original sample population in the household survey. In addition, blood samples were collected randomly (about 40 per cent of persons medically examined), and this amounted to a total of 1,236 persons. This report presents the results obtained by the survey from the standpoint of demographic findings, tribal population structure is considered quite young, about 46.2 per cent of the population belong to the age group under 15 years, and 50 per cent to the group 15 to 64 years. The birth rate was 48.2 per 1,000 people, and the crude death rate 12.2 per 1,000. The infant mortality ratio was 143 per 1,000 live births. Other demographic findings were described in detail in the text of the thesis. Questions regarding attitudes towards family planning and ideal family size were asked, as one would expect, a large majority of respondents desired large families, and only 2.3 per cent of all married women under survey practised birth control. From the standpoint of health and morbidity survey, a number of definitions used for the state of health and disease were described in the text of the report. According to the survey, three categories, namely healthy, moderately healthy and apparently ill, were used. At the time of the survey it was found in primary diagnosis that 46.6 per cent of the population examined were ill. of which 37.1 per cent or 1,143 persons were moderately healthy, and 9. 5 per cent or 293 persons had apparent illness. The number of sick persons found by two different methods of diagnosis (primary and final diagnosis) differ because in laboratory findings some of the healthy persons were found to be ill, moreover, primary diagnosis was not carried out on 73 persons, some of whom were found to be ill when final diagnosis was done. The sickness rate was highest (83.5 per cent) among those aged 45 years and over, and lowest among infants (25.7 per cent). The sickness rate among males and females aged 15-44 years in final diagnosis was 62.3 per cent and 63. 5 per cent respectively. Our survey showed the rate of utilisation of existing health services by nomads to be very low. The population studies was found to be in need of health care. In some cases, urgent attention was needed. Demand for public health services is essentially simple and concentrated in a few categories of medical conditions and diseases. Most of the diseases and medical conditions are theoretically preventable, but under ideal conditions. Most of the defined medical conditions have a good prognosis, especially with treatment. The proposed plan for the development of health services for the tribal population is given in the text of the report. It is based on the auxiliary thams. The members will be selected from the same clans and will be trained and supervised by a static health centre.