Izadi Reyhane, Mohammadpour Mohammadtaghi, Sharifi Moslem, Khosravi Mohsen
Department of Health Services Management, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of).
School of Higher Education, Yasuj University of Medical Sciences, Gachsaran, Iran (the Islamic Republic of).
BMJ Open. 2025 May 24;15(5):e093310. doi: 10.1136/bmjopen-2024-093310.
The COVID-19 outbreak at the end of 2019 severely impacted global healthcare systems, especially primary healthcare services. This paper aimed to identify the implications derived from the strengths and weaknesses observed in Iran's primary healthcare (PHC) programmes during the pandemic.
This was a qualitative study conducted in 2021. 13 semistructured interviews were held with Iranian healthcare policymakers and executive managers, selected via snowball sampling, using the World Health Organization's analytical framework. Finally, a thematic analysis was conducted on the interview data.
The thematic analysis of the findings yielded five major themes: revision of healthcare financing, redefining education and research in primary healthcare, redefinition of primary healthcare, development of a new model for family medicine, and community engagement.
Addressing vertical inequality in Iran's healthcare system was delineated to be crucial. Meanwhile, multiple strategies including enhancing family physicians' knowledge and skills, decentralising decision-making, empowering them and involving communities in healthcare planning were presented to improve PHC and family medicine. Further empirical research is needed.
2019年末的新冠疫情严重冲击了全球医疗体系，尤其是基层医疗服务。本文旨在确定在疫情期间伊朗基层医疗（PHC）项目中观察到的优势和劣势所产生的影响。
这是一项于2021年开展的定性研究。通过滚雪球抽样法，选取伊朗医疗政策制定者和执行管理人员，运用世界卫生组织的分析框架进行了13次半结构化访谈。最后，对访谈数据进行了主题分析。
研究结果的主题分析产生了五个主要主题：医疗融资修订、重新定义基层医疗中的教育与研究、重新定义基层医疗、发展家庭医学新模式以及社区参与。
解决伊朗医疗体系中的纵向不平等被认为至关重要。同时，提出了多项策略，包括提高家庭医生的知识和技能、权力下放决策、赋予他们权力以及让社区参与医疗规划，以改善基层医疗和家庭医学。还需要进一步的实证研究。
