The Study of Barriers and facilitators of providing services in Participatory and Public Health Facilities Covered by Tehran University of Medical Sciences: A Qualitative Study

This study is a qualitative study that was conducted at Tehran University of Medical Sciences with the aim of identifying obstacles and facilitators of providing services at participatory sites covered by Tehran University of Medical Sciences. Experts were interviewed, the implementation was carried out, and the indexing process was performed on all interviews. All coding subjects and topics as well as the charts table were completed. Then, based on the conceptual structure form, indexing and data analysis were done. The process was positive toward the experience. The most important facilitators were the private sector, job creation, transparent guidelines, specific credits for payments, and experiences from other countries. Some of the main obstacles were inadequate physical space, shortage of manpower, lack of physician placement, weariness of equipment, delayed payments to founders, insufficient salaries for staff, strict supervision of staff oversight and attention to quantity rather than service quality, insurance and taxes. The policy of small government, the privatization of services to the private sector, and supervision by the state system has led to a positive attitude of managers towards participatory bases. In addition, the ineffectiveness of government personnel from other countries has led to the creation of participatory bases successfully. The financial and administrative constraints in purchasing, constructing, and repairing state civil-engineering units and reducing employment capacity are also due to the transfer of participatory bases. Furthermore, bases were dissatisfied with low job security and low salaries.