Successful implementation of general health policies in the Islamic Republic of Iran: barriers and mechanisms

Amiri, Mohammad; Tavana, Ali Mehrabi

doi:10.26719/emhj.18.009

Cited by 9 publications

(6 citation statements)

References 19 publications

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“…Accordingly, several studies have concluded that a comprehensive national action plan for the implementation of GHP is necessary. [ 43 44 45 ]…”

Section: Discussionmentioning

confidence: 99%

Reviewing the national health services quality policies and strategies of the Iranian health system: A document analysis

Maleki,

Fallah,

Aryankhesal

et al. 2023

Int J Prev Med

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Background: High-quality health care is an important component of efforts to reach Universal Health Coverage (UHC). Given this pivotal fact, poor quality of care is a significant bottleneck in the endeavors of Iran to UHC. This study was part of a broader qualitative study and aimed to provide supplementary data about the documents related to the National Quality Policies and Strategies (NQPS) health services in the health system of Iran to determine the degree of alignment with the World Health Organization (WHO) approach for NQPS, and to track change and development over time. Methods: This document analysis was performed following the READ approach for systematic document analysis in health policy research. Furthermore, qualitative content analysis following parallel forms of the mixed analysis in which the textual material proceeded with different inductive and deductive content-analytical procedures simultaneously, applying the WHO practical approach for NQPS, was selected. Results: The 15 included records that met the inclusion criteria were released in the post-Islamic Revolution period. The Ministry of Health was found as the most responsible authority for publishing the NQPS among the other authorities. Furthermore, 67% of NQPS was aligned with the goals and priorities of a broader national plan or policy. Contradictions, variations, and ambiguities were also found in the literature circumstances of the NQPS. There was no NQPS concentrated on the entire pathway of care in the Iranian health system, which developed according to the WHO approach for NQPS. Conclusions: Qualitative analysis of the current NQPSs based on the eight inter-dependent elements and critical supplements, the technical perspective of broad stakeholders, community engagement, and steady commitment of policymakers are our recommendations for future efforts towards having NQPS.

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“…Accordingly, several studies have concluded that a comprehensive national action plan for the implementation of GHP is necessary. [ 43 44 45 ]…”

Section: Discussionmentioning

confidence: 99%

Reviewing the national health services quality policies and strategies of the Iranian health system: A document analysis

Maleki,

Fallah,

Aryankhesal

et al. 2023

Int J Prev Med

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“…10 One of the major aims of the HTP is to increase the financial risk protection among Iranian population, particularly the poor and vulnerable, which was endorsed by national general health policies by 2025. 11 The HTP extended basic health insurance coverage to approximately 10 million people, increasing those covered from 83.2% of the population to 93.2%. 12 According to SDG1, countries are committed to end poverty in all forms and dimensions by 2030 by implementing necessary measures and interventions.…”

Section: Highlightsmentioning

confidence: 99%

“…As in many other countries, the recent health reforms in Iran are guided by the concept of UHC 10 . One of the major aims of the HTP is to increase the financial risk protection among Iranian population, particularly the poor and vulnerable, which was endorsed by national general health policies by 2025 11 . The HTP extended basic health insurance coverage to approximately 10 million people, increasing those covered from 83.2% of the population to 93.2% 12…”

Section: Introductionmentioning

confidence: 99%

The impact of health reform on poverty estimates in Iran: Implications for monitoring the first goal of Sustainable Development Goals

Ahmadnezhad

Daştan²,

Alvandi

et al. 2023

Health Planning & Management

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Introduction Iran launched a series of health reforms called Health Transformation Plan (HTP) in order to improve financial protection and access to health care in 2014. This study aimed to investigate the extent of impoverishment due to out of pocket (OOP) payments during 2011–2016 and to assess the implications of health expenditures to overall national poverty rate before and after the HTP implementation, with a focus on monitoring the first Sustainable Development Goals (SDGs). Methods The study relied on data from a nationally representative household income and expenditure survey. Two measures of poverty were estimated in this study: the prevalence (poverty headcount) and the intensity of poverty before and after OOP health payments (poverty gap). Proportion of the population fell into poverty due to OOP spending for health care from total poor population calculated for 2 years before and after the HTP implementation using three poverty lines suggested by the World Bank for global poverty comparison ($1.90, $3.2 and $5.5 per day in 2011 purchasing power parity (PPP) $). Results Our results indicate that the incidence of impoverishing health expenditures has remained relatively low during 2011–2016. At the 2011 PPP $5.5 daily poverty line, the average incidence rate at the national level was 1.36% during the period. The percentage of population impoverished due to OOP health expenditures increased after HTP implementation, irrespective of the poverty line used. However, the proportion of individuals that pushed further into poverty decreased after HTP implementation. It was estimated that around 12.5% of total poor population fell below poverty line due to paying OOP payments in 2016. Conclusion Although health care costs are not major causes of impoverishment in Iran, the relative impact of OOP spending for health is not negligible. To attain SDG 1, pro‐poor interventions that aim to reduce the burden of OOP payments should be advocated and implemented with an inter‐sectoral approach.

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“…Meanwhile, in Iran, community-based geriatric services, as well as the policy of providing integrated services, have quantitative and qualitative defects especially in implementation process [ 24 ]. The most important obstacles to the implementation of general health policies in Iran were the lack of formulated strategies, poor management, lack of a comprehensive national action plan, minimal information infrastructure, and insufficient funding [ 25 ]. Consequently, due to the difference in health and support system policies especially for older adults in Iran compared to other countries, the levels of functional status or ability to perform basic and instrumental activities of daily living can be different in older adults, therefore, the results in other countries may not be generalizable to Iran.…”

Section: Introductionmentioning

confidence: 99%

Predictors of basic and instrumental activities of daily living among older adults with multiple chronic conditions

Jafari-Koulaee,

Mohammadi,

Fox

et al. 2024

BMC Geriatr

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Background Understanding the predictors of functional status can be useful for improving modifiable predictors or identifying at-risk populations. Researchers have examined the predictors of functional status in older adults, but there has not been sufficient study in this field in older adults with multiple chronic conditions, especially in Iran. Consequently, the results of this body of research may not be generalizable to Iran. Therefore, this study was conducted to determine the predictors of functional status in Iranian older adults with multiple chronic conditions. Methods In this cross-sectional study, 118 Iranian older adults with multiple chronic conditions were recruited from December 2022 to September 2023. They were invited to respond to questionnaires inquiring about their demographic and health information, basic activities of daily living (BADL) and instrumental activities of daily living (IADL), depression and cognitive status. The predictors included age, gender, marital status, education, number of chronic conditions, and depression. Descriptive and analytical statistical tests (univariate and multiple regression analysis) were used to analyze the data. Results The majority of participants were married (63.9%) and women (59.3%). Based on the results of the multiple regression analysis, age (B=-0.04, P = 0.04), depression (B=-0.12, P = 0.04), and IADL (B = 0.46, P < 0.001) were significant predictors for functional status in terms of BADL. Also, marital status (B=-0.51, P = 0.05), numbers of chronic conditions (B=-0.61, P = 0.002), and BADL (B = 0.46, P < 0.001) were significant predictors for functional status in terms of IADL. Conclusion The findings support the predictive ability of age, marital status, number of chronic diseases, and depression for the functional status. Older adults with multiple chronic conditions who are older, single, depressed and with more chronic conditions number are more likely to have limitations in functional status. Therefore, nurses and other health care providers can benefit from the results of this study and identify and pay more attention to the high risk older adult population.

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Successful implementation of general health policies in the Islamic Republic of Iran: barriers and mechanisms

Cited by 9 publications

References 19 publications

Reviewing the national health services quality policies and strategies of the Iranian health system: A document analysis

Reviewing the national health services quality policies and strategies of the Iranian health system: A document analysis

The impact of health reform on poverty estimates in Iran: Implications for monitoring the first goal of Sustainable Development Goals

Predictors of basic and instrumental activities of daily living among older adults with multiple chronic conditions

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