Department of Healthcare Management, School of Management and Social Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran.
Department of Healthcare Management, School of Management and Social Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran and Health Economics policy Research Center, Tehran Medical Sciences Islamic Azad University, Tehran, Iran.
Int J Prison Health. 2020 Aug 17;16(4):373-388. doi: 10.1108/IJPH-01-2020-0008.
High quality health-care delivery is not only the governments' responsibility but also every prisoner's right. Health care in prison and, particularly, of Iranian prisoners is increasingly important topic because of the rising number of the prison population. This paper aims to explore health-care managers' perspectives and experiences of prisons and the barriers to health-care delivery in Iranian prisons.
DESIGN/METHODOLOGY/APPROACH: A qualitative research design was conducted in Iran from October 2018 to August 2019. The participants consisted of 51 health-care managers (50 men and one woman) from Iranian prisons. A combination of face-to-face (N = 42) and telephonic (N = 9) semi-structured interviews were used because of the geographical distribution of the respondents. The first part of the interview guide consisted of demographic characteristics, and the second part consisted of three main open ended-questions. Interviews were recorded and transcribed, and thematic descriptive analysis was used to interpret the data.
The barriers to health-care delivery in Iranian prisons were categorized into four main topics: human resources, financing, facilities and barriers related to the health-care delivery process. Data synthesis identified the following themes for barriers to human resources: barriers to human resources planning (with eight sub-themes); barriers to education (with three sub-themes); and motivational barriers (with seven sub-themes). Moreover, barriers to financing consisted of five sub-themes. The barriers to facilities consisted of barriers related to physical infrastructures (with two sub-themes) and barriers related to equipment (with six sub-themes). Finally, barriers to the health-care delivery process included the following themes: communication barriers (with six sub-themes); legal barriers (with five sub-themes); and environmental-demographic factors (with seven sub-themes).
ORIGINALITY/VALUE: Identifying the barriers to health-care delivery in Iranian prisons plays a critical role in the improvement of planning, decision-making and the health-care delivery process.
高质量的医疗保健服务不仅是政府的责任，也是每个囚犯的权利。监狱中的医疗保健，特别是伊朗囚犯的医疗保健，由于囚犯人数的增加，正成为一个日益重要的话题。本文旨在探讨卫生保健管理人员对监狱和伊朗监狱医疗服务提供障碍的看法和经验。
设计/方法/方法：2018 年 10 月至 2019 年 8 月，在伊朗进行了一项定性研究设计。参与者包括来自伊朗监狱的 51 名卫生保健管理人员（50 名男性和 1 名女性）。由于受访者的地理位置分布，采用了面对面（N=42）和电话（N=9）半结构化访谈相结合的方式。访谈指南的第一部分包括人口统计学特征，第二部分包括三个主要的开放式问题。访谈进行了录音和转录，并采用主题描述性分析来解释数据。
伊朗监狱医疗服务提供的障碍分为四个主要主题：人力资源、资金、设施和与医疗服务提供过程相关的障碍。数据综合确定了人力资源障碍的以下主题：人力资源规划障碍（有八个子主题）；教育障碍（有三个子主题）；和激励障碍（有七个子主题）。此外，资金障碍包括五个子主题。设施障碍包括与物理基础设施有关的障碍（有两个子主题）和与设备有关的障碍（有六个子主题）。最后，医疗服务提供过程的障碍包括以下主题：沟通障碍（有六个子主题）；法律障碍（有五个子主题）；和环境人口因素（有七个子主题）。
原创性/价值：确定伊朗监狱医疗服务提供的障碍对于改善规划、决策和医疗服务提供过程至关重要。
