Department of Health Services Management, Faculty of Management and Medical Informatics, Kerman University of Medical Sciences, Center for Health Management Research, Kerman, Iran.
Int J Health Plann Manage. 2012 Apr-Jun;27(2):e121-31. doi: 10.1002/hpm.1105. Epub 2011 Oct 18.
While the primary healthcare (PHC) services in Iran were appropriate to the needs of the population in the late 1970s and 1980s, the changing burden of disease and shifting demand patterns have rendered the existing PHC system no longer suitable for meeting current and emergent needs. This has serious implications for the PHC system in Iran, which has clearly succeeded in addressing high levels of communicable diseases, maternal deaths and infant mortality, but appears less well prepared to address the emerging challenges of noncommunicable diseases (NCD). We conducted a systematic review of the available literature in the past 10 years related to the PHC system in Iran to assess its weaknesses and challenges. This paper categorizes PHC system weaknesses from the studied articles into two groups: (i) those related to the key functions of PHC, and (ii) others, which refer to health system weaknesses existing with the current PHC model. Iran can draw on international experience and evidence regarding interventions, which can be used to develop an effective and responsive PHC system designed to address current and emerging needs, in particular the NCD burden.
尽管伊朗的初级卫生保健(PHC)服务在 20 世纪 70 年代末和 80 年代符合人口需求,但疾病负担的变化和需求模式的转变使得现有的 PHC 系统不再适合满足当前和新出现的需求。这对伊朗的 PHC 系统产生了严重影响,该系统在解决传染病、孕产妇死亡和婴儿死亡率方面显然取得了成功,但似乎对解决非传染性疾病(NCD)带来的新挑战准备不足。我们对过去 10 年中与伊朗 PHC 系统相关的可用文献进行了系统回顾,以评估其弱点和挑战。本文将研究文章中的 PHC 系统弱点分为两类:(i)与 PHC 的主要功能相关的弱点,以及(ii)与当前 PHC 模式下存在的卫生系统弱点相关的其他弱点。伊朗可以借鉴国际经验和干预措施方面的证据,用于开发一个有效的、响应性的 PHC 系统,以应对当前和新出现的需求,特别是 NCD 负担。