Azami Saeid Reza, Hosseini Seyed Mojtaba, Alimohammadzadeh Khalil, Jafari Mehrnoosh, Bahadori Mohammad Karim
Department of Health Services Management, School of Management , North Tehran Branch, Islamic Azad University, Tehran, Iran.
Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2021 Dec 28;35:180. doi: 10.47176/mjiri.35.180. eCollection 2021.
Despite regulations to facilitate the purchase of medical equipment, the process is now faced with severe challenges due to the sanctions. This study focuses on the effects of the international sanctions on the process of procuring capital medical equipment in the Iranian health system. A qualitative study using a content analysis approach was designed to investigate the effects of the international sanctions on capital medical equipment from January 2018 to June 2019. The data were gathered through 32 face-to-face, semi-structured interviews according to an interview guide. All the interviews were transcribed verbatim and analyzed accordingly. Thematic analysis with an inductive approach was employed for analyzing the data. After a comprehensive analysis of open codes, two themes and 9 sub-themes were formulated. Based on our findings, the challenges facing the Iranian health sector during international sanctions included: "procurement of capital medical equipment" (with 6 sub-themes: Capital medical equipment suppliers, Monetary and interbank transactions, Suppliers and importers of the capital medical equipment, The process of procurement of capital medical equipment, Healthcare providers and Service receivers) and "repairing and after-sales services of capital medical equipment," (with 3 sub-themes: Software and spare parts dependent repair, Specialized human resources dependent repairing and after-sales services). Even though the sanction has made Iranian scientists and technicians capable of re-engineering and producing some of the medical equipment and accessories, the study confirms the adverse effects of sanctions on the quality and quantity of medical equipment procurement, hence, delivering adequate and on-time medical services. In many cases, for money transfer issues, international companies were not sure they could have their money back if they sold the facilities to Iran. Fear of losing the US market was the other main consideration for the international companies.
尽管有相关规定促进医疗设备的采购，但由于制裁，这一过程目前面临严峻挑战。本研究聚焦于国际制裁对伊朗卫生系统中购置大型医疗设备过程的影响。设计了一项采用内容分析法的定性研究，以调查2018年1月至2019年6月国际制裁对大型医疗设备的影响。根据访谈指南，通过32次面对面的半结构化访谈收集数据。所有访谈均逐字转录并据此进行分析。采用归纳法进行主题分析以分析数据。在对开放编码进行全面分析后，形成了两个主题和9个子主题。根据我们的研究结果，伊朗卫生部门在国际制裁期间面临的挑战包括：“大型医疗设备的采购”（有6个子主题：大型医疗设备供应商、货币和银行间交易、大型医疗设备的供应商和进口商、大型医疗设备的采购过程、医疗服务提供者和服务接受者）以及“大型医疗设备的维修和售后服务”（有3个子主题：依赖软件和备件的维修、依赖专业人力资源的维修和售后服务）。尽管制裁使伊朗科学家和技术人员有能力重新设计和生产一些医疗设备及配件，但该研究证实了制裁对医疗设备采购的质量和数量产生的不利影响，从而影响了提供充足和及时的医疗服务。在许多情况下，由于资金转移问题，国际公司不确定如果将设备卖给伊朗能否收回资金。对失去美国市场的担忧是国际公司的另一个主要考虑因素。
