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. 2019 Sep 18;19(1):670.
doi: 10.1186/s12913-019-4505-3.

Policy analysis of the Iranian Health Transformation Plan in primary healthcare

Leila Doshmangir  1   2 , Esmaeil Moshiri  3 , Hakimeh Mostafavi  4 , Minoo Alipouri Sakha  5 , Abraham Assan  6   7
Affiliations

Policy analysis of the Iranian Health Transformation Plan in primary healthcare

Leila Doshmangir et al. BMC Health Serv Res. .

Abstract

Background: Health systems reform is inevitable due to the never-ending changing nature of societal health needs and policy dynamism. Today, the Health Transformation Plan (HTP) remains the major tool to facilitate the achievements of universal health coverage (UHC) in Iran. It was initially implemented in hospital-based setting and later expanded to primary health care (PHC). This study aimed to analyze the HTP at the PHC level in Iran.

Methods: Qualitative data were collected through document analysis, round-table discussion, and semi-structured interviews with stakeholders at the micro, meso and macro levels of the health system. A tailored version of Walt & Gilson's policy triangle model incorporating the stages heuristic model was used to guide data analysis.

Results: The HTP emerged through a political process. Although the initiative aimed to facilitate the achievements of UHC by improving the entire health system of Iran, little attention was given to PHC especially during the first phases of policy development - a gap that occurred because politicians were in a great haste to fulfil a campaign promise.

Conclusions: Health reforms targeting UHC and the health-related Sustainable Development Goals require the political will to improve PHC through engagements of all stakeholders of the health system, plus improved fiscal capacity of the country and financial commitments to implement evidence-informed initiatives.

Keywords: Health reform; Health transformation plan; Iran; Policy analysis; Primary health care; Universal health coverage.

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Conflict of interest statement

The authors declare that they have no competing interests.

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Conceptual interpretation of findings
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