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Evaluation of programs and determining its challenges to improve and implement reforms is essential in a healthcare system. A primary healthcare program was conducted since 1984 in Iran and faces various challenges after several decades of its life. The aim of this study is to evaluate Iran's primary healthcare program and determine its challenges and weaknesses. In the present systematic review study, the published articles related to Iran's primary healthcare were searched and collected from Iranian databases (SID, Magiran, Noormags and Irandoc) and international databases (Pubmed, Scopus, Web of Knowledge and Google Scholar). The Iranian grey literature was also explored. In total, from 336 papers identified, 25 papers were deemed relevant after the step-by-step review of articles and removal of non-related articles. The results of this study show that primary healthcare in Iran has different challenges and weaknesses. Most of these challenges and weaknesses relate to the structure and process of primary healthcare. The Iranian primary healthcare system has achieved many successes in community health promotion, but today, because of social, economic, political and environmental changes, it does not meet the needs of the people; therefore, this system requires structural reforms.

Background: Social issues have short- or long-term as well as positive or negative effects on health systems. Identifying and analyzing events and trends help managers to make the vision and strategic planning. The purpose of this study is to identify the social trends and their impacts on the future of the Iranian health system. Methods: Focus group discussion (FGD) was used to collect the data in 2017--18. The participants were selected through purposive sampling and the snowball method. The discussions were all written and recorded with the consent of the participants. A qualitative content analysis was used to analyze the data. Results: The participants believed that the most important social trends affecting future of health system in Iran are increase health literacy, demographic transition, nutritional pattern, migration and urbanization, marginal settlement, rising unemployment, and increased usage of personal cars. Conclusions: The increase in health problems, healthcare costs, and mortality because of social behaviors and trends are considered as threats to the health system. Therefore, policymakers should reduce their negative effects by taking into account and focusing on these trends and making appropriate plans.

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IntroductionIn order to improve health, hospital sources such as beds and staffing should be properly allocated and used. The aim of this study is reallocation of Shafa hospital beds in Kerman using a goal-programming model.MethodsThis study was an applied cross-sectional study, which used the goal programming model and software WinQSB to optimize bed allocation. By review of the literature and interviews with experts, the constraints in beds allocation were identified, and using the collected data the desired model was designed.ResultsHospital beds were redistributed based on the constraints of the goal-programming model and objectives. The results showed that there was a shortage of beds in departments such as burns, GICU, HICU, cardiac surgery, emergency, and orthopedics, and excess of beds in the ear, nose, and throat (ENT), ophthalmology, and neurology departments.ConclusionIt is anticipated that the optimal allocation of hospital beds, regarding hospital activity indicators, can lead to greater justice in the provision of services and a better distribution of resources.