Iran's Primary Health Care Challenges in Realizing Public Health Coverage: A Qualitative Study

 Despite many advances in health, health systems still do not meet all the needs of communities. Countries at the 2018 Astana Summit agreed to strengthen primary health care (PHC) in order to achieve universal coverage of health (UHC). This study aimed to identify the challenges of the PHC system in Iran and to provide practical solutions to overcome them.

 This qualitative study was conducted using interviews and document reviews. Interviews were made with decision makers, executive and academic experts, PHC executives and experts. National and international documents were examined in the field of health. The WHO building blocks framework was used to encode the data. The data were analyzed by deductive content analysis using MAXQDA 12 software.

 Due to changing health needs of people, PHC system in Iran today faces challenges why so the centralized structure does not have the flexibility to deal with changes. The private sector plays a minor role in providing services. There is no coordination between levels of service delivery and parallel systems have emerged. Despite the scarcity of resources, there are problems in the planning and equitable distribution of resources.  Information systems are not yet complete.  University curricula are not in harmony with PHC and as a result human resources are unable to respond to job requirements.

In order to improve the health of the country and in line with international commitments as well as the need to reach the UHC, it must prioritize existing challenges and strategies, implement practical and tailor-made reforms while using the experiences of other countries to enhance PHC.