The ‘Health Transformation Plan’ in Iran: A policy to achieve universal health coverage in slums and informal settlement areas

Abstract

Universal health coverage (UHC) is one of the strategies that health decision‐ and policy‐makers worldwide are implementing to guarantee a good health status to everyone. Living in slums is characterized by several issues, including homelessness and malnutrition, environmental challenges, lack of sanitation and access to safe, healthy drinking water, waste disposal problems, widespread social disruptions, job insecurity, feelings of dissatisfaction and inadequacy. In Iran, the ‘Health Transformation Plan’ (HTP), despite its weaknesses, has had good effects on the health level of people living in slums, ensuring insurance coverage and reducing many economic, social and cultural problems, with a dramatic decline in out‐of‐pocket expenditures. Good governmental financial support and an adequate revision of the initial packages of health services and provisions have resulted in a higher access rate to healthcare. The HTP has been, indeed, a major step towards reaching UHC in Iran. If policy‐ and decision‐makers can further improve the present situation and provide more and better‐quality services to these people, it can be expected that health indicators in suburbs will be significantly improved. Researchers should monitor the impact of HTP and examine its effects on health indicators, specifically among particularly vulnerable groups such as children, women and the elderly.

Effectiveness of interventions to contain out‐of‐pocket‐expenditure in lower‐middle income countries: A systematic review and synthesis

“…Previous evidence has highlighted a reduction in healthcare expenditure through improving care quality by preventing treatment complications and readmissions. 6 Conversely, an incoherent result was reported in a systematic review in the magnitude and direction of association between the costs incurred during treatment and the quality of care provided. 70 Change in physician's behaviour causing limiting drug prescription, diagnostic, and lab test, preventing early discharges and improving patient-physician communication on healthcare cost can reduce the healthcare expenditure.…”

“…Such consequences of OOPE often induce intractable stress on the household's economic security 3,4 . This has narrated the policymakers to implement various financial protective interventions, at national and subnational levels to curb the despicable repercussions of OOPE 5,6 . Health policy researchers have evaluated the effectiveness of such interventional strategies, sans space and time 5,7–11 .…”

“…3,4 This has narrated the policymakers to implement various financial protective interventions, at national and subnational levels to curb the despicable repercussions of OOPE. 5,6 Health policy researchers have evaluated the effectiveness of such interventional strategies, sans space and time. 5,[7][8][9][10][11] However, it is a debatable phenomenon as findings on the effectiveness of OOPE reduction strategies are inconsistent and inconclusive.…”

The role of Iran's context for the development of health technology assessment: challenges and solutions

“…Expanding health insurance coverage has been a crucial component of the health transformation plan [ 28 ]. The government has increased the number of people covered by the public health insurance system and introduced supplementary insurance plans for those who can afford to pay more for healthcare services [ 29 ]. These measures have helped reduce the financial burden on patients and ensure that more people have access to healthcare services [ 30 ].…”

Social determinants of health inequity in Iran: a narrative review

“…Hence, this infrastructure helped the health system to minimize the harm of pandemic on SDH inequity by providing home-to-home screening and registering the health status of all Iranians in a system to make available future treatment and health support [ 8 ]. Moreover, after implementation of Health Transformation Plan in Iran to reduce regional health inequity [ 38 ], the number of hospital beds and other related facilities elevated dramatically. This facilitated the management of hospitalized bed need in district level at the COVID-19 pandemic period [ 39 ].…”