Strategies for Improving the Financing of Family Medicine Program: Evidence from Iran

Overview

Journal Health Sci Rep

Specialty General Medicine

Date 2024 Jan 11

PMID 38204751

Authors

Mohammad Javad Kabir

Sajad Moeini

Alireza Heidari

Affiliations

Soon will be listed here.

Abstract

Background And Aims: The impact of health financing on the performance of the entire health system, including access, quality, and efficiency of healthcare, has been emphasized in the Astana Declaration, and the need to strengthen primary healthcare (PHC) and policy integration has been emphasized. After about two decades, the family medicine (FM) program in Iran is still facing great challenges. The aim of this study is to explore strategies for strengthening financing of the FM program in Iran, a vital component of PHC.

Methods: A qualitative study was conducted in 2021. Purposeful sampling was used to select 34 policymakers, managers, and experts from various levels of the Ministry of Health, Iran universities of medical sciences, plan and budget organization of Iran, and health insurance organization in Iran. Thirty-four semistructured interviews were conducted to collect data, which were analyzed by content analysis.

Results: Through the analysis of interviews, our study has identified five strategies (identification and management of sustainable resources, pooling of sustainable resources, modeling of service provision, payment system model and its implementation process, and FM management structure), and 13 actions for strengthening financing of the FM program in Iran.

Conclusion: Our study has identified five strategies and 13 actions for strengthening the financing of the FM program in Iran. These strategies and actions should be considered by policymakers during the review of the FM program in Iran. Without implementation of the suggested strategies and action, allocated resources may be wasted.

Citing Articles

Strategies for improving the financing of family medicine program: Evidence from Iran.

Kabir M, Moeini S, Heidari A Health Sci Rep. 2024; 7(1):e1813.

PMID: 38204751 PMC: 10776829. DOI: 10.1002/hsr2.1813.

References

Vosoogh Moghaddam A, Damari B, Alikhani S, Salarianzedeh M, Rostamigooran N, Delavari A . Health in the 5th 5-years Development Plan of Iran: Main Challenges, General Policies and Strategies. Iran J Public Health. 2013; 42(Supple1):42-9. PMC: 3712611. View

Faghihi M, Farshad A, Biglari Abhari M, Azadi N, Mansourian M . The components of workplace violence against nurses from the perspective of women working in a hospital in Tehran: a qualitative study. BMC Womens Health. 2021; 21(1):209. PMC: 8136170. DOI: 10.1186/s12905-021-01342-0. View

Reich M, Harris J, Ikegami N, Maeda A, Cashin C, Araujo E . Moving towards universal health coverage: lessons from 11 country studies. Lancet. 2015; 387(10020):811-6. DOI: 10.1016/S0140-6736(15)60002-2. View

Kraef C, Kallestrup P . After the Astana declaration: is comprehensive primary health care set for success this time?. BMJ Glob Health. 2019; 4(6):e001871. PMC: 6861067. DOI: 10.1136/bmjgh-2019-001871. View

Takian A, Rashidian A, Doshmangir L . The experience of purchaser-provider split in the implementation of family physician and rural health insurance in Iran: an institutional approach. Health Policy Plan. 2015; 30(10):1261-71. DOI: 10.1093/heapol/czu135. View

Danaei G, Farzadfar F, Kelishadi R, Rashidian A, Rouhani O, Ahmadnia S . Iran in transition. Lancet. 2019; 393(10184):1984-2005. DOI: 10.1016/S0140-6736(18)33197-0. View

Mackintosh M, Channon A, Karan A, Selvaraj S, Cavagnero E, Zhao H . What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries. Lancet. 2016; 388(10044):596-605. DOI: 10.1016/S0140-6736(16)00342-1. View

Verguet S, Hailu A, Eregata G, Memirie S, Johansson K, Norheim O . Toward universal health coverage in the post-COVID-19 era. Nat Med. 2021; 27(3):380-387. DOI: 10.1038/s41591-021-01268-y. View

Oleszczyk M, Svab I, Seifert B, Krzton-Krolewiecka A, Windak A . Family medicine in post-communist Europe needs a boost. Exploring the position of family medicine in healthcare systems of Central and Eastern Europe and Russia. BMC Fam Pract. 2012; 13:15. PMC: 3368769. DOI: 10.1186/1471-2296-13-15. View

10.

McPake B, Hanson K . Managing the public-private mix to achieve universal health coverage. Lancet. 2016; 388(10044):622-30. DOI: 10.1016/S0140-6736(16)00344-5. View

11.

Lal A, Erondu N, Heymann D, Gitahi G, Yates R . Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage. Lancet. 2020; 397(10268):61-67. PMC: 7834479. DOI: 10.1016/S0140-6736(20)32228-5. View

12.

Behzadifar M, Behzadifar M, Heidarvand S, Gorji H, Aryankhesal A, Taheri Moghadam S . The challenges of the family physician policy in Iran: a systematic review and meta-synthesis of qualitative researches. Fam Pract. 2018; 35(6):652-660. DOI: 10.1093/fampra/cmy035. View

13.

Rakic S, Djudurovic A, Antonic D . Financial sustainability strategies of public primary health care centres in the Republic of Srpska, Bosnia and Herzegovina. Int J Health Plann Manage. 2021; 36(5):1772-1788. DOI: 10.1002/hpm.3262. View

14.

Bazyar M, Yazdi-Feyzabadi V, Rashidian A, Behzadi A . The experiences of merging health insurance funds in South Korea, Turkey, Thailand, and Indonesia: a cross-country comparative study. Int J Equity Health. 2021; 20(1):66. PMC: 7913450. DOI: 10.1186/s12939-021-01382-w. View

15.

Dargahi H, Darrudi A, Zalvand R . Family Medicine Program in Iran: SWOT Analysis and TOWS Matrix Model. Iran J Public Health. 2019; 48(6):1140-1148. PMC: 6635346. View

16.

Hanson K, Brikci N, Erlangga D, Alebachew A, De Allegri M, Balabanova D . The Lancet Global Health Commission on financing primary health care: putting people at the centre. Lancet Glob Health. 2022; 10(5):e715-e772. PMC: 9005653. DOI: 10.1016/S2214-109X(22)00005-5. View

17.

Doshmangir L, Shirjang A, Assan A, Gordeev V . Iranian primary health care network: challenges and ways forward. Prim Health Care Res Dev. 2023; 24:e1. PMC: 9884526. DOI: 10.1017/S1463423622000354. View

18.

Takian A, Rashidian A, Kabir M . Expediency and coincidence in re-engineering a health system: an interpretive approach to formation of family medicine in Iran. Health Policy Plan. 2010; 26(2):163-73. DOI: 10.1093/heapol/czq036. View

19.

Bazyar M, Rashidian A, Kane S, Mahdavi M, Akbari Sari A, Doshmangir L . Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran. Int J Health Policy Manag. 2016; 5(4):253-8. PMC: 4818990. DOI: 10.15171/ijhpm.2016.12. View

20.

Graneheim U, LUNDMAN B . Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004; 24(2):105-12. DOI: 10.1016/j.nedt.2003.10.001. View