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Khankeh, Hamid Reza, Bagheri Lankarani, Kamran, Zarei, Nooshin, Joulaei, Hassan. (1400). Three Decades of Healthcare System Reform in Iran from the Perspective of Universal Health Coverage: A Macro-Qualitative Study. سامانه مدیریت نشریات علمی, 46(3), 198-206. doi: 10.30476/ijms.2020.84023.1342
Hamid Reza Khankeh; Kamran Bagheri Lankarani; Nooshin Zarei; Hassan Joulaei. "Three Decades of Healthcare System Reform in Iran from the Perspective of Universal Health Coverage: A Macro-Qualitative Study". سامانه مدیریت نشریات علمی, 46, 3, 1400, 198-206. doi: 10.30476/ijms.2020.84023.1342
Khankeh, Hamid Reza, Bagheri Lankarani, Kamran, Zarei, Nooshin, Joulaei, Hassan. (1400). 'Three Decades of Healthcare System Reform in Iran from the Perspective of Universal Health Coverage: A Macro-Qualitative Study', سامانه مدیریت نشریات علمی, 46(3), pp. 198-206. doi: 10.30476/ijms.2020.84023.1342
Khankeh, Hamid Reza, Bagheri Lankarani, Kamran, Zarei, Nooshin, Joulaei, Hassan. Three Decades of Healthcare System Reform in Iran from the Perspective of Universal Health Coverage: A Macro-Qualitative Study. سامانه مدیریت نشریات علمی, 1400; 46(3): 198-206. doi: 10.30476/ijms.2020.84023.1342

Three Decades of Healthcare System Reform in Iran from the Perspective of Universal Health Coverage: A Macro-Qualitative Study

Iranian Journal of Medical Sciences
مقاله 6، دوره 46، شماره 3، مرداد 2021، صفحه 198-206    اصل مقاله (702.65 K)
نوع مقاله: Original Article(s)
شناسه دیجیتال (DOI): 10.30476/ijms.2020.84023.1342
نویسندگان
Hamid Reza Khankeh1، 2؛ Kamran Bagheri Lankarani3؛ Nooshin Zarei4؛ Hassan Joulaei* 3
1Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
2Emergency and disaster research center, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
3Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
4Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
چکیده
Background: The healthcare system in Iran has undergone several reforms to achieve the objectives of universal health coverage (UHC). Some reforms have delivered positive benefits, however, still many challenges remain. Hence, the current study assessed the progress and outcomes of these reforms over the past three decades.
Methods: The present nationwide macro-qualitative study was conducted in Iran during 2016-2017. Data were collected through 32 in-depth interviews with 30 high-ranking policymakers and healthcare providers at the national and provincial levels to identify their experiences and perceptions of the reforms. The data were analyzed using the constant comparative analysis method.
Results: Analysis of the interview data resulted in two main themes, six categories, and 18 sub-categories. The extracted themes were adverse situational context and the chaotic healthcare system. The results showed that the Iranian healthcare system reforms could be characterized as incoherent and passive, and that these were the main reasons for not achieving the objectives of UHC reforms. It was revealed that the implemented reforms lacked a comprehensive approach and at times were counterproductive. Moreover, the situational context adversely hindered the successful implementation of the reforms.
Conclusion: Despite many efforts to improve the Iranian healthcare system through reforms, the situational context and organizational factors have prevented achieving the main objectives. Iran’s health policymakers should consider a phased implementation of small-scale reforms based on a comprehensive master plan that takes social, political, and economic factors into account. This approach would minimize potential risks and encourages the cooperation of the main stakeholders.
کلیدواژه‌ها
Delivery of health care؛ Interview؛ Qualitative research؛ Iran
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