Communicable Diseases Surveillance System in Iran: Strengths and Weaknesses 30 Years Following its Implementation

Communicable diseases are one of the main health problems in Iran. This study aimed at demonstrating the progress of communicable diseases management in more than 30 years of its implementation and pointing out its strengths and weaknesses, as well.

This interview-based study using content analysis method was conducted in 2014. Data were collected through deep interviews. Fifteen interviews were conducted with all experts and health system managers at Iran’s communicable diseases management center. The collected data were analyzed using the principles suggested by Strauss and Corbin. 

The establishment of the communicable disease surveillance system was a revolution in the health system of Iran. The strengths of the system are as follows: network-based and integrated health services, well-organized and knowledgeable personnel, national and international supports, strategic and operational plans, and expanded programs of immunization. On the other hand, its weaknesses mentioned by the participants were: disease-based case definition, poor public awareness, poor inter-sectoral collaboration and coordination, insufficient resources, delayed or no notifying target diseases, lack of district laws or incomplete implementation of legislation, failure to provide feedback or ignoring for the results of the analysis, and lack of performance evaluation.

Although the implementation of the communicable diseases surveillance system was a huge achievement in the health system of Iran, however, it needs more improvements based on the present situation. Revision of the rules, restoration and strengthening of the existing structure, the use of modern information and communication technologies, and the establishment of the monitoring and evaluation system are helpful to increase its success.