Assessing Experiences of Outsourcing Urban Health Posts: Facilities and Services Offered in Publicly Owned and Outsourced Health Posts in Tehran University of Medical Sciences

The expansion of public sector capacity in public health is difficult due to legal limitations and limited financial and staff resources. Outsourcing services to the private sector provides opportunity to provide health services to public. This study aimed to assess and compare the capacity and services in publicly run and outsourced urban health posts. This cross-sectional study was carried out in all health posts affiliated to the university. Data were collected using a 26-items questionnaire and were analyzed using the univariate analyses. Among 74 health posts، 48 health posts (64. 9%) were outsourced and 26 (35. 1%) were managed by the public sector. Medical doctors managed 43. 7% and midwives 45. 8% of the outsourced health posts. Midwives managed 73. 0% and health officers 23. 0% of the public sector posts. 61. 5% and 77. 1% of the outsourced and publically managed health posts were located in appropriately structured buildings. Over 92% of the clients walked to the health posts. On average، public health posts covered 8954 individuals and outsourced health posts covered 12158 individuals. No differences were observed in health program related knowledge of the staff in two centers. Supervision approaches has a direct effect on behaviors of the private sector. Since the supervisors mostly noted the physical structure and standards of equipments، these had adequate standards. There were no differences between public and private health posts in health care indices and those services that had been provided by similar staff from the two health post groups.