Seyed Rahim Safavi Mirmahalleh, Mohammad Rahim Ramazanian, Mahmoud Moradi, Mostafa Ebrahimpour Azbari,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Health status is undeniably one of the most critical indicators of social development and progress. Providing healthcare poses a significant challenge for human life, and managing the healthcare supply chain is of strategic importance. The aim of this research is to analyze and compare the results of meta-synthesis with thematic analysis in identifying the risks of the pharmaceutical industry's supply chain.
Methods: This research follows a qualitative approach, utilizing both meta-synthesis and thematic analysis to identify supply chain risks in the pharmaceutical industry. In the first step, a meta-synthesis and systematic review of related studies over the past twenty-three years were conducted, identifying one hundred articles, which were refined to twenty-six key articles for the research. In the next step, risks specific to Iran's pharmaceutical supply chain were identified through thematic analysis and semi-structured interviews with experts, using targeted sampling. Finally, the results from these two approaches were compared and analyzed.
Results: The meta-synthesis approach identified ten general supply chain risks in the global pharmaceutical industry. Similarly, the thematic analysis approach identified ten specific supply chain risks in Iran's pharmaceutical industry. Six risks were common to both approaches: low quality of raw materials, complexity and incompatibility of information systems, supply of foreign currency and financial payments, transportation and insurance issues, increase in the price of raw materials, and unavailability of medicines. These common risks are critical for both the global and Iranian pharmaceutical supply chains.
Conclusion: Stakeholders in Iran's pharmaceutical supply chain (including hospitals) should prioritize managing these six common risks to improve supply chain performance. Additionally, they should focus on the four unique risks identified through thematic analysis specific to Iran's pharmaceutical supply chain, applying appropriate control measures and activities.
Alireza Rahimi,
Volume 24, Issue 2 (9-2025)
Abstract
Background and purpose: Pre-hospital Emergency Medical Services (EMS) play a pivotal role in managing life-threatening conditions. However, evidence suggests that the Iranian EMS system faces multifaceted challenges across human, managerial, and infrastructural dimensions. This study aimed to conduct a comprehensive meta-synthesis to identify and analyze the challenges characterizing pre-hospital EMS in Iran, based on research evidence published between 2014 and 2025.
Methods: This study employed a meta-synthesis approach utilizing the seven-step framework by Sandelowski and Barroso (2006). A systematic search of major domestic and international databases using relevant keywords yielded 414 initial records. Following a rigorous screening process based on inclusion/exclusion criteria and quality appraisal, 25 articles were selected for the final analysis. Data were synthesized and categorized using thematic analysis.
Results: The findings revealed that the challenges facing the Iranian pre-hospital EMS can be categorized into six main themes: human resources, logistics and infrastructure, organizational and managerial barriers, socio-cultural issues, and educational deficits. A deeper analysis highlighted the multifaceted and intertwined nature of these obstacles. The results indicate that these challenges do not exist in isolation but are interconnected within a complex network of cause-and-effect relationships.
Conclusion: The findings confirm that the challenges within Iran's emergency system mirror global trends and overlap significantly with issues reported in other low- and middle-income countries (LMICs). Addressing these problems requires a holistic and systemic approach that simultaneously targets human, logistical, organizational, and socio-cultural dimensions, while ensuring system preparedness for potential accidents and disasters.
