Aim: This study aimed to explore the current challenges of Iran’s Iranian Primary Health Care (PHC) network and possible ways forward. Background: PHC network was established in 1985. It remains a core instrument of health care delivery. However, it faces several challenges that can threaten its effective functioning. Methods: We conducted face-to-face semi-structured interviews with 26 key stakeholders. We used the deductive content analysis approach. World Health Organization’s health system framework guided our analyses. Data were analysed using MAXQDA software. To enhance data triangulation, we reviewed PHC national related plans, bylaws, and national and international published reports. Findings: PHC network experiences financial challenges and fails to respond fully to the emerging population’s needs due to unfair distribution of resources and a lack of community health workers for PHC and a sustainable financing model for PHC. Furthermore, the insurance package is not well integrated into the PHC network system. Policy interests and resource commitments for innovative, preventive, and health promotion initiatives are lacking. Innovative, preventive, and health promotion initiatives should become the highest priority for policymakers. Well-trained community health professionals, active community participation, private sector engagements and active involvement of non-government organisations are fundamental for a well-functioning PHC network in Iran, especially to foster the delivery of evidence-based initiatives.
Background and Objectives: Rural family physician is one of the strategic reforms in Iranian health system. It has been implemented since 2005 with the aim of improving people's access to health services. Despite its pivotal role in health system programs, the program has not progressed according to its original policies. Therefore, in this study, we aimed to identify the challenges of the rural family physician to provide solutions to these problems. Material and Methods: The present study is in the field of qualitative studies. This was done by interviewing and reviewing the documentation. The sampling was purposive and the documents were systematically selected. In-depth semi-structured interviews were conducted with 26 key informants. Data were analyzed using MAXQDA software by content analysis method. Results: After more than a decade of practicing family physician, the program still faces a number of key challenges in the areas of leadership and governance, financing, service providers, training and making culture, customer behavior, and monitoring and evaluation. Most of the program's challenges are related to leadership and governance, such as the negligible role of the private sector in service delivery, politicians are not justified about the program, and failure to anticipate the infrastructure required for the program. Conclusion: Given the importance and key role of the family physician in the field of health and completing primary health care (PHC), especially the effective role in achieving UHC, with proper planning, appropriate and practical interventions should be designed and implemented to remove barriers and enhance the family physician program.
Background: Since 1980s, establishing Primary Healthcare (PHC) network in Iran to promote health care delivery and population’s health, the PHC system has experienced various achievements and changes. This study aimed to explore current PHC in Iran focusing on challenges and solutions.Methods: Documentary review and interviews were used to collect qualitative data. The interviews were conducted with 26 stakeholders in various levels of the health system including health policymakers, academics, health managers and staffs are expert in public health and the PHC. National upstream documents including the Five Year Development Plans, General Health Policies, and the Iran’s 20 year national vision were reviewed. Data analysis was done using deductive content analysis assisted by MAXQDA 12 software. Results: Although Iranian PHC has enjoyed significant successes, it does not match with the changing populations’ health needs especially during the last years. The current workforce cannot respond to new public health challenges, health data are not collected and analyzed in a consistent manner, modern appropriate technologies in the PHC are not used and electronic service delivery are not provided yet. PHC financial difficulties and the current rigid structure of the health system cannot satisfy the new emerging needs of the population.Conclusion: Given the challenges and the new health needs, the current PHC structure and services should use the private sector involvement for better respond to the public health needs and flexible structure and services while dealing with the changes. The workforce needs to be updated, and the referral system should be established for providing the health care services based on FP plan.
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