Health Financing Consequences of Implementing Health Transformation Plan in Iran: Achievements and Challenges

Doshmangir, Leila; Bazyar, Mohammad; Najafi, Behzad; Haghparast‐Bidgoli, Hassan

doi:10.15171/ijhpm.2019.18

Cited by 66 publications

(116 citation statements)

References 10 publications

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“…Iran has undertaken a number of important initiatives, particularly during the recent health sector reform (Health Transformation Plan) that began in 2014, to achieve healthcare for everyone by expanding universal health coverage (UHC) by 2025 [1][2][3][4]. As a result, the country has witnessed remarkable improvements in access to and coverage of healthcare services for all social classes, especially for the poor [5].…”

Section: Introductionmentioning

confidence: 99%

A roadmap for strengthening evidence-informed health policy-making in Iran: protocol for a research programme

Sajadi

Majdzadeh

Yazdizadeh

et al. 2019

Health Res Policy Sys

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Background: Many initiatives have been taken in the Islamic Republic of Iran to promote evidence-informed health policy-making (EIHP). However, these initiatives are not systematic. Since the implementation of EIHP is not consistent and the interventions in this regard are complex, a comprehensive plan could be a useful tool for employing initiatives to achieve and promote EIHP. Hence, this study aims to develop a roadmap for strengthening EIHP over a 3-year period in Iran. Methods: Nine projects will be conducted to define the roadmap for strengthening EIHP. These projects include two reviews and a stakeholder analysis to identify the factors that facilitate or hinder achieving EIHP. The next study will be a qualitative study to prioritise the challenges and outline the main causes. The following steps will be a review of reviews to extract global experiences on interventions used for strengthening EIHP and two qualitative studies to examine the adoption of these interventions and develop an operational plan for strengthening EIHP in Iran. The research will be completed through conducting two qualitative-quantitative studies to design a tool for measuring EIHP and assessing EIHP in Iran at baseline. Discussion: This national EIHP roadmap will surely be able to identify the gaps and bumps that might exist in the implementation plan for establishing EIHP and eliminate them as needed in the future. This roadmap can be a step in moving towards transparency and accountability in the health system and as thus towards good governance and improvement of the health system's performance. Although the plan can be a good model for developing countries and may promote the use of evidence in health policy-making, we should assume that there are some critical contextual factors that could potentially hinder the complete and successful implementation of EIHP. Thus, to enhance EIHP in these countries with a policy-making context that does not fully support the use of evidence, it is crucial to think about not only those interventions that directly address the EIHP barriers, but also some longterm strategies to make required changes in the context, both beyond and within the health system.

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Section: Introductionmentioning

confidence: 99%

A roadmap for strengthening evidence-informed health policy-making in Iran: protocol for a research programme

Sajadi

Majdzadeh

Yazdizadeh

et al. 2019

Health Res Policy Sys

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“…to the health sector: The health sector's share of government budget increased significantly following the implementation of HTP in 2014 18,42,48,49 . Given the current unilateral economic sanctions against Iran and the consecutive financial limits, serious concerns exist about the amount of financial resources allocated to the health sector as well as timely allocation of such resources, if any 21 .…”

Section: Sustainable Interventions To Allocate Enough Share Of the Gomentioning

confidence: 99%

Title of Manuscript: Health System Performance Towards Universal Health Coverage in Iran: A Comparative Panel Data Analysis

Sajadi

Goudarzi

Takian

et al. 2020

Preprint

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Abstract Background Building upon decades of continuous reforms, since 2014 under the banner of health transformation plan (HTP), Iran has been implementing various initiatives to strengthen its health system. Improving efficiency of the health system is fundamental to achieve better performance and reach universal health coverage (UHC). This article aimed to measure the efficiency and productivity changes in the Iranian health system during 2010-2015 in comparison with 36 selected other upper-middle income countries. Methods We used panel data to measure the variations in technical efficiency (TE) and total factor productivity (TFP) through an extended data envelopment analysis (EDEA) and Malmquist productivity index, respectively. General Government Health Expenditure (GGHE) per capita (International dollar) was selected as input variable. Service coverage of diphtheria, tetanus and pertussis; family planning; antiretroviral therapy; skilled attendants at birth; Tuberculosis treatment success rate; and GGHE as % of Total Health Expenditure (THE) were considered as output variables. The data for each indicator were taken from Global Health Observatory data repository and World Development Indicator database, for a period of six years (2010-2015). Results The TE scores of Iran’s health system were 0.75, 0.77, 0.74, 0.74, 0.97 and 0.84 in the period 2010-2015, respectively. TFP improved in 2011 (1.02), 2013 (1.01), and 2014 (1.30, generally). The overall efficiency and TFP increased in 2014. Changes made in CCHE per capita and GGHE/THE attributed to the increase of efficiency. ConclusionThere is a growing demand for efficiency improvements in the health systems to achieve UHC. While there are no defined set of indicators or precise methods to measure heath system efficiency, EDEA helped us to draw the picture of health system efficiency in Iran. Our findings also highlighted the essential need for targeted and sustained interventions, i.e. allocation of enough proportion of public funds to the health sector, to improve universal financial coverage against health costs aiming to enhance the future performance of Iran’s health system, ultimately. Such tailored interventions may be also useful for settings with similar context to speed up their movement towards improving efficiency, which in turn might lead to more resources to reach UHC.

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“…With the allocation of new funds, insurers play a major role in protecting patients [5]. Facilitating access to services for many people is a way for further promoting and enhancing justice and equity in health in Iran [6]. However, due to Iran's sanctions, many health sector activities that require financial exchanges and transactions are in many cases not possible [7].…”

Section: Introductionmentioning

confidence: 99%

Ensuring adequate health financing to prevent and control the COVID-19 in Iran

Behzadifar

Ghanbari

Bakhtiari

et al. 2020

Int J Equity Health

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On February 19 th 2020, the Iranian Ministry of Health and Medical Education (MoHME) has announced the first 2 cases of SARS-CoV-2, a novel emerging coronavirus which causes an infection termed as COVID-19, in Qom city. As such, the Iranian government, through the establishment of the "National Headquarters for the management and control of the novel Coronavirus", has started implementing policies and programs for the prevention and control of the virus. These measures include schools and universities closure, reduced working hours, and increased production and delivery of equipment such as masks, gloves and hygienic materials for sterile environments. The government has also made efforts to divulge high-quality information concerning the COVID-19 and to provide laboratories and hospitals with diagnostic kits and adequate resources to treat patients. However, despite such efforts, the number of cases and deaths has progressively increased with rising trends in total confirmed cases and deaths, as well as in new daily cases and deaths associated with the COVID-19. Iran is a developing country and its economic infrastructure has been hit hardly by embargo and sanctions. While developed countries have allocated appropriate funding and are responding adequately to the COVID-19 pandemics, Iran has experienced a serious surge of cases and deaths and should strive to provide additional resources to the health system to make healthcare services more accessible and to increase the fairness of that access. All relevant actors and stakeholders should work together to fight this disease.

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Health Financing Consequences of Implementing Health Transformation Plan in Iran: Achievements and Challenges

Cited by 66 publications

References 10 publications

A roadmap for strengthening evidence-informed health policy-making in Iran: protocol for a research programme

A roadmap for strengthening evidence-informed health policy-making in Iran: protocol for a research programme

Title of Manuscript: Health System Performance Towards Universal Health Coverage in Iran: A Comparative Panel Data Analysis

Ensuring adequate health financing to prevent and control the COVID-19 in Iran

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