Volume 19, Issue 3 (3-2022)
sjsph 2022, 19(3): 237-258 |
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Mosadeghrad A M, Heydari M, Esfahani P. Primary Health Care Strengthening Strategies in Iran: A Realistic Review. sjsph 2022; 19 (3) :237-258
URL: http://sjsph.tums.ac.ir/article-1-6061-en.html
URL: http://sjsph.tums.ac.ir/article-1-6061-en.html
1- 1- Ph.D. Professor, Department of Health Management and Economics, Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
2- 2- Ph.D. Student, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3- 3- Assistant Professor, Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran ,P.isfehani@gmail.com
2- 2- Ph.D. Student, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3- 3- Assistant Professor, Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran ,
Abstract: (3387 Views)
Background and Aim: The Primary Health Care (PHC) system is the most comprehensive, equitable and efficient way to promote people's health and social welfare by providing preventive, curative, rehabilitative and palliatvie services in a place close to where people live and work. Iran's PHC system faces challenges that limit its effectiveness and efficiency. The aim of this study was to identify strategies to strengthen Iran's PHC system.
Materials and Methods: A realistic review method was used in this research. Published articles on strategies to strengthen the PHC system between 1978 and 2019 were searched in eight databases and Google scholar search engine. Finally, 29 articles were found to be eligible for inclusion in this study; framework analysis was done using the MAXQDA-10 software.
Results: Twenty-nine strategies were identified for strengthening the PHC system. A well designed PHC system is one with the following characteristics: realistic goals and appropriate strategies equipped with necessary resources, organized in multidisciplinary teams that provide comprehensive and quality health services (intervention program), with strong governance and leadership, financing, work force, equipment and medicines, information systems and robust health services delivery processes and well adpated to the external environment (context). Such a PHC system will increase healthcare providers’ satisfaction and commitment, as well as the patients’ trust, participation and satisfaction (the mechanism) and, finally, promotes, restores, and maintains the people health (result).
Conclusion: A strong PHC system is a pre-requisite for strengthening a health system. Various strategies such as strengthening management and leadership, improving organizational structure and culture, improving the information system, empowering human resources and increasing population coverage can lead to an improved PHC system. Historical, social, cultural and economic factors affecting the health system should be considered in redesigning and stregtening a PHC system.
Materials and Methods: A realistic review method was used in this research. Published articles on strategies to strengthen the PHC system between 1978 and 2019 were searched in eight databases and Google scholar search engine. Finally, 29 articles were found to be eligible for inclusion in this study; framework analysis was done using the MAXQDA-10 software.
Results: Twenty-nine strategies were identified for strengthening the PHC system. A well designed PHC system is one with the following characteristics: realistic goals and appropriate strategies equipped with necessary resources, organized in multidisciplinary teams that provide comprehensive and quality health services (intervention program), with strong governance and leadership, financing, work force, equipment and medicines, information systems and robust health services delivery processes and well adpated to the external environment (context). Such a PHC system will increase healthcare providers’ satisfaction and commitment, as well as the patients’ trust, participation and satisfaction (the mechanism) and, finally, promotes, restores, and maintains the people health (result).
Conclusion: A strong PHC system is a pre-requisite for strengthening a health system. Various strategies such as strengthening management and leadership, improving organizational structure and culture, improving the information system, empowering human resources and increasing population coverage can lead to an improved PHC system. Historical, social, cultural and economic factors affecting the health system should be considered in redesigning and stregtening a PHC system.
Type of Study: Research |
Subject:
Public Health
Received: 2022/03/16 | Accepted: 2022/03/1 | Published: 2022/03/1
Received: 2022/03/16 | Accepted: 2022/03/1 | Published: 2022/03/1
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