Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Health Res Policy Syst. 2021 Jan 12;19(1):4. doi: 10.1186/s12961-020-00610-z.
Health financing systems have a key role in achieving universal health coverage (UHC) across the globe. However, little is known about how best to monitor health financing system progress towards UHC, especially in low- and middle-income countries. This is a protocol of a study that will aim to assess health financing system progress towards achieving UHC in Iran.
An explanatory mixed-method approach will be used in two phases. In the quantitative phase, the performance of the Iranian health financing system will be assessed using a well-established set of indicators to draw on progress over 5-year intervals starting in the year 2000 up to the present. Data will be extracted from the global health expenditure database using a specific form and will be classified in accordance with each indicator. A qualitative phase will then take place considering the Kutzin et al. framework and by using health financing progress matrices. The qualitative phase will consist of two successive stages; first, a descriptive overview on the major health coverage schemes along with key attributes of each scheme. This initial mapping will be the underlying background for the second stage. In the second stage, the matrices comprised of a series of questions and relevant to the core functions of health financing and cross-cutting options will be invested in enhancing the evaluation of the ongoing reforms or policies. In this phase, data will be collected by reviewing national policy documents and in-depth interviews with key informants who will be recruited using purposive sampling. Finally, a policy discussion with key stakeholders will be held in order to review and verify the consistency between the current health financing policy and UHC goals.
This study will provide a comprehensive image about the current status of the national health financing system progress towards achieving UHC in Iran. Such assessment will give detailed insight about the performance of the current financing system through identifying encountered challenges. Furthermore, some other defects in the design of the financing system are expected to appear. In all likelihood, the results will be fruitful enough to make informed decisions about interventions and policies in relation to UHC.
The study protocol has been approved by the Ethics Committee for Research at Tehran University of Medical Sciences. Informed consent will be obtained from all key informants and the data will be collected and transcribed anonymously in order to maintain utmost confidentiality. The results will be disseminated in peer-reviewed journals and presented in national and international conferences and meetings.
全球卫生融资系统在实现全民健康覆盖方面发挥着关键作用。然而，对于如何最好地监测卫生融资系统在实现全民健康覆盖方面的进展，特别是在中低收入国家，人们知之甚少。本研究旨在评估伊朗卫生融资系统在实现全民健康覆盖方面的进展。
本研究将采用解释性混合方法，分两个阶段进行。在定量阶段，将使用一套成熟的指标评估伊朗卫生融资系统的绩效，以评估从 2000 年开始到当前的 5 年间隔内的进展情况。数据将使用特定表格从全球卫生支出数据库中提取，并根据每个指标进行分类。然后将进行定性阶段，参考 Kutzin 等人的框架，并使用卫生融资进展矩阵。定性阶段将包括两个连续阶段；首先，对主要的健康覆盖计划以及每个计划的关键属性进行描述性概述。这一初步映射将是第二阶段的基础。在第二阶段，将对一系列与卫生融资核心功能和跨领域选项相关的问题组成的矩阵进行投资，以加强对正在进行的改革或政策的评估。在这一阶段，将通过审查国家政策文件和对通过目的性抽样选择的关键信息提供者进行深入访谈来收集数据。最后，将与利益攸关方举行政策讨论，以审查和核实当前卫生融资政策与全民健康覆盖目标之间的一致性。
本研究将提供伊朗在实现全民健康覆盖方面国家卫生融资系统进展的全面情况。这种评估将通过确定遇到的挑战，详细了解当前融资系统的绩效。此外，预计还会出现融资系统设计方面的其他一些缺陷。很有可能，研究结果将足以做出有关全民健康覆盖的干预措施和政策的知情决策。
本研究方案已获得德黑兰医科大学伦理委员会的批准。将从所有关键信息提供者处获得知情同意，并以匿名方式收集和转录数据，以保持最高机密性。研究结果将在同行评议的期刊上发表，并在国内外会议和会议上展示。
