presentation of the genetic counseling network in the welfare organization of iran

the importance of genetic and congenital factors which cause many diseases and disabilities is obvious with a glance at the facts and figures in the world. in iran, like many other middle eastern countries, certain factors exist that worsen the situation such as: 1. high percentage of consanguineous marriages, 2. high incidence and prevalence of hemoglobinopathies (b-thalassemia & g6pd-d), 3. a social preference for childbearing up to older ages, 4. insufficient public health programs and facilities regarding this issue, 5. expensive genetic counseling services in governmental or non-governmental sectors, 6. insufficient public knowledge about the causes and possible preventive measures for genetic and congenital diseases or disabilities. this comprehensive program is planned with the aim of implementing a genetic counseling network. in other words, the goal is providing easily available quality genetic counseling services with reasonable costs for the whole population in the country. the general goal of this comprehensive program is to decrease the incidence and prevalence of genetic and congenital disabilities. for implementing this program, the network has gradually expanded with about 128 genetic counseling centers throughout the country. the first level is counseling centers in smaller cities the intermediate level is counseling centers in the capital city of each province, and the highest level is the state commission of genetics in tehran. the referral centers are located in the capital cities of 9 provinces including tehran, tabriz, hamedan, yazd, shiraz, mashhad, rasht, ahvaz and esfehan. these provinces are the head of 9 regional offices in the country. the staff in smaller cities consist of a general physician along with a professional nurse, midwife or geneticist and in the provincial capital cities a specialist along with a general physician and one professional nurse, midwife, or geneticist. the staff in the provincial referral centers consist of at least 2 specialists and 2 - 3 general physicians with years of experience. the members of the state commission of genetics are about 10 specialists (pediatrician, clinical geneticist, cytogeneticist, molecular geneticists and other specialists such as neurologists, etc). the network has gradually expanded since the year 1997 and now we have 132 governmental and private genetic counseling centers throughout the country. these centers have been offering services to approximately 400,000 clients until now. in these years, about 900 genetic counselors have been trained by the state welfare organization. in some of the provinces such as tehran, there are 15 centers and in some provinces such as north khorasan, there is only 1 center. the mean number of counseling centers in each province is at least 2-3. because of the importance of preventing genetic and congenital disorders and the need for genetic counseling centers in iran, the genetic counseling network was designed and founded in 1997. the genetic counseling network which has an important role in preventing the genetic and congenital disorders offers good quality low-cost easily available services to population at risk.