How health transformation plan was designed and implemented in the Islamic Republic of Iran?

Following his inauguration in late 2013, President Rouhani aimed to boost quality and equity in thehealth care delivery system. To fulfill this aim, a set of interventions, called Health TransformationPlan (HTP), were implemented. So far, it has been a heated debate whether HTP breathes a spiritof a new reform. HTP has targeted long‑standing historical deficits of the Iranian health systemas well as urgent problems, both of which have been, to some extent, resolved. To decreaseOut‑Of‑Pocket (OOP) health expenditures, HTP has presented new financing mechanisms to expanda safety net to Iranian citizens fundamentally. HTP also encompassed interventions to overcomeproblems in the provision of health care by recruitment of health workforces, establishing newhealth facilities, and expanding primary health care to urban and peri‑urban areas. Furthermore,performance indicators including access, quality, and patient satisfaction have been affected. Giventhese changes, HTP is entitled to be a health system reform. However, a new agenda within HTP isrequired so that the Iranian health system can obtain better value for money that is to be spendingon it.