Background: Refugees’ access to quality healthcare services might be compromised, which can in turn hinder universal health coverage (UHC), and achieving Sustainable Development Goal (SDG), ultimately. Objective: This article aims to illustrate the status of refugees’ access to healthcare and main initiatives to improve their health status in Iran. Methods: This is a mixed-method study with two consecutive phases: qualitative and quantitative. In the qualitative phase, through a review of documents and semi-structured interviews with 40 purposively-selected healthcare providers, the right of refugees to access healthcare services in the Iranian health system was examined. In the quantitative phase, data on refugees’ insurance coverage and their utilization from community-based rehabilitation (CBR) projects were collected and analyzed. Results: There are international and upstream policies, laws and practical projects that support refugees’ health in Iran. Refugees and immigrants have free access to most healthcare services provided in the PHC network in Iran. They can also access curative and rehabilitation services, the costs of which depend on their health insurance status. In 2015, the government allowed the inclusion of all registered refugees in the Universal Public Health Insurance (UPHI) scheme. Moreover, the mean number of disabled refugees using CBR services was 786 (±389.7). The mean number of refugees covered by the UPHI scheme was 112,000 (±30404.9). Conclusion: The United Nations’ SDGs ask to strive for peace and reducing inequity. Along its pathway towards UHC, despite limited resources received from the international society, the government of Iran has taken some fundamental steps to serve refugees similar to citizens of Iran. Although the initiative looks promising, more is still required to bring NGOs on board and fulfill the vision of leaving no one behind.
Purpose This study aims to explore the challenges of providing primary health care (PHC) to Afghan immigrants in Tehran as an important global human right issue. Design/methodology/approach In this exploratory study, a total of 25 purposively selected PHC providers, including physicians, psychologists and midwives, were approached for face-to-face, semi-structured interviews, lasting 30 min on average. Thematic analysis was used to analyze the data. Findings The most common challenges of providing PHC to Afghan immigrants were categorized at individual, organizational and societal levels. Communication barriers and socioeconomic features emerged at the individual level. The organizational challenges included mainly the lack of insurance coverage for all immigrants and the lack of a screening system upon the immigrants’ arrival from the borders. At the societal level, the negative attitudes toward Afghan immigrants were causing a problematic challenge. Research limitations/implications The main limitation was the possibility that only health-care professionals with particular positive or negative perspectives about immigrants enter into the study, because of the voluntary nature of participation. Practical implications Findings can help policymakers adopt evidence-informed strategies for facilitating PHC provision and improving the access to health care in immigrants as a global human right concern. Social implications This study alerts about undesirable consequences of certain attitudes and behaviors of the society toward immigrant health. Originality/value To the best of the authors’ knowledge, this is one of the first studies conducted in PHC centers in Tehran Province that explores the challenges of providing PHC to Afghan immigrants.
INTRODUCTION: The performance of the emergency department (ED) as one of the main parts of hospitals, have a great impact on the performance of the whole-hospital. In Iran, the official education program of this discipline was started in 2001 and has expanded in most medical universities. Given the unprecedentedness of emergency medicine (EM), there are limited studies about this specialty. Thus, this study aims to explore the status, role, and performance of Iranian EM specialists. MATERIALS AND METHODS: This qualitative study was conducted using content analysis of 19 semi-structured interviews with EM specialists and key informant. Purposive sampling was conducted, and some teaching and nonstate hospitals in different geographic regions of Tehran city were selected. Conducting interviews continued until reaching the data saturation. Thematic analysis was employed. Extracted themes were reviewed and confirmed by some of the participants. RESULTS: The study results were categorized within five main themes; included the role of ED from EM specialists' viewpoint, EM specialists' viewpoint on their discipline, performance of EM specialists (including medical, managerial, and economic performance), and role of EM specialists in patient satisfaction; and opportunities and challenges of EM specialists. CONCLUSION: Overall, the study findings highlighted the effectiveness and positive medical, managerial and economic impacts of EM in Iran, inside and beyond hospitals. However, the study addressed significant opportunities some solvable challenges in educational, professional and economic domains, and interdisciplinary relationships. Further studies are recommended for comprehensive exploring viewpoint of other disciplines and stakeholders.
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