Reduction and elimination solutions of informal payment in Iran's health system
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Article Type:
Research/Original Article (دارای رتبه معتبر)
Abstract:
Background
Informal payments can cause delayed access to health care services, forcing people to sell their properties for cost of treatment; and as a result, they lose trust in the health system. Considering the importance of this issue, this study was conducted in 2016 to identify solutions to reduce and eliminate informal payments in Iran’s health system.

Methods
Initially, solutions to reduce informal payments were extracted by reviewing resources and searching Persian and English-language databases including Science direct, PubMed, Scopus, Medline, ISC, Magiran, SID using the following keywords: informal payments, under the table payment, bribes, gratitude payment, and informal payments/fees. Then, Iranian context specific solutions were obtained by performing semi-structured interviews with 19 individuals, who were aware of the problem. Next, the identified strategies were confirmed using Delphi technique and with the participation of 50 experts.

Results
Various solutions were identified and confirmed to reduce or eliminate informal payments in Iran’s health system, which are divisible in different economical fields, such as payments to providers based on performance, religious leaders’ fatwa (sociocultural), disclosing the offenders’ names (legal-political), and using family doctor system (structural).

Conclusion
The proposed solutions can be used by policymakers and managers in the health sector to manage informal payments. Careful identification of health care providers and recipients’ motivations and needs can be effective in recognizing and eliminating this phenomenon.
Language:
English
Published:
Medical Journal Of the Islamic Republic of Iran, Volume:31 Issue: 1, Winter 2017
Pages:
915 to 922
magiran.com/p1823858  
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