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This study aims to investigate the effect of the Diamond Justice model on self-efficiency with the mediating role of job stress among the staff of Qazvin hospitals affiliated with Qazvin University of Medical Sciences. This study is a cross-sectional descriptive-analytical study conducted among the staff of Qazvin hospitals affiliated with Qazvin University of Medical Sciences in 2020.

Sampling was performed using the structural equation method. Data collection tools included three sections: demographic information, justice and self-efficiency questionnaire and job stress questionnaire. Data were finally analyzed using SPSS software version 26 and AMOS version 23 at a significance level of 0.05.

The structural equation model’s standard estimation coefficients show that all existing paths are at a significant level. Finally, the regression analysis showed that justice is inversely related to stress level (ß = −0.185, p = 0.015). Justice is directly related with self-efficiency (ß = 0.282, p < 0.001).

Justice, stress and self-efficacy have been measured in various studies among health workers. However, a fitting model showing these three variables’ interaction was necessary. Therefore, this study tries to conceptualize the multifaceted relationships of the components of these concepts by presenting a model.

In the time of the COVID-19 crisis, many physical, psychological and spiritual difficulties are imposed on the front line staff and overshadow their rights, resilience and retention. In addition, the loss of this important organizational resource imposes huge costs on the system. The purpose of this study is systemic review of the influential factors, policies and strategies applied to defend the rights of health-care staff and improve the resilience and retention of health system human resources in the COVID-19 crisis.

This systematic review was conducted in 2021. Data were collected by keyword search in Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID and Irandoc databases until December 2021. In addition, the quality of the studies was evaluated by three experts using the Strobe checklist. The analysis used in this study to categorize the results was thematic analysis.

Factors that cause tension and injustice to employees and also strategies to overcome it and increase their resilience were classified into general categories according to their nature. Factors included factors related to safety, economic and financial, staff characteristics, crisis management characteristics, organizational climate and working conditions. Existing strategies also fall into four categories of physical, psychological and spiritual health promotion strategies; organizational climate and work environment; education and empowerment and economic and financial.

This study is a systematic review of the factors that affect the health workforce rights and resilience of health-care personnel during the COVID-19 crisis. On the other hand, the policies and strategies used in different countries to overcome the difficulties and increase the resilience and retention of health workers have been summarized and can be used in other crises.

It can be said that the most important function of the health system is to provide health-care services. This directly affects society’s health and justice. To the best of the authors’ knowledge, this study is the first study that has meta-analyzed the percentage of health services utilization among Iranians to answer this question “How much is the percentage of health-care services utilization in Iran?”

This study is a systematic review and meta-analysis conducted in 2020. The literature review was done by searching the databases of Google Scholar, Scopus, PubMed, Web of Science, Science Direct, SID, Magiran and Irandoc from January 2010 to August 2020. Pooled utilization percentage (UP) was estimated by STATA 15 through random-effects meta-analysis with 95% confidence interval. The I² statistic was used to investigate the possibility of heterogeneity of articles (I² ≥ 50% indicate heterogeneity). A forest plot was applied to report the results. A funnel plot exploited due to publication bias assessment.

Approximately 22% of the reviewed articles have been done at the national level of Iran. Most studies have examined the utilization of outpatient and inpatient services. Based on the random effects method, the pooled value of UP was obtained at 47.82%, (95% CI: 39.33–56.31). Also, the pooled percentage of utilization was statistically significant (Test of UP = 0, Z = 456.44, p = 0.000).

Policymakers can improve the level of utilization from health services by expanding universal coverage, expanding insurance coverage and removing direct and indirect barriers.

To the best of the authors’ knowledge, this is the first systematic review and meta-analysis on health services utilization in Iran that completely considers the utilization rate in all health services and states the practical solutions to cope with utilization deficiencies and barriers.