Ghiasi Kanishka, Mosadeghrad Ali Mohammad, Dargahi Hossein, Jaafaripooyan Ebrahim
International campus, School of Public Health, Department of Health Management, Policy and Economics, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Health Res Policy Syst. 2025 Jun 10;23(1):75. doi: 10.1186/s12961-025-01336-6.
Migrant health has emerged as a critical global public health issue, necessitating effective policies to address the needs of this vulnerable population. Iran, hosting over 4.5 million migrants - many undocumented - faces significant challenges in ensuring equitable healthcare access. Despite existing policies, implementation gaps persist, exacerbating health disparities. This study analyzes Iran's migrant health policies, identifies challenges and proposes effective solutions.
This qualitative study involved semi-structured interviews with 38 stakeholders, including policymakers, managers, healthcare providers, migrant health experts and migrants themselves, selected through purposeful and snowball sampling. Data were triangulated with a review of 15 policy documents. Guided by the Integrated Policy Analysis Framework, the study focused on four phases: preparation, formulation, implementation and evaluation. Data analysis followed Ritchie and Spencer's framework analysis method, ensuring systematic categorization and thematic interpretation.
The analysis generated 49 codes, grouped into 10 sub-themes and four main themes aligned with the policy analysis framework. Key findings revealed persistent challenges across all phases: (1) policy preparation was hindered by the absence of a formal governance structure, such as the lack of a specific committee within the Ministry of Health and Medical Education for migrant health policies, and insufficient stakeholder involvement; (2) policy formulation suffered from selective health priorities, significant data gaps and the exclusion of undocumented migrants from legal coverage; (3) policy implementation faced financial constraints, insurance disparities and systemic barriers, including e-prescription requirements tied to Iranian IDs; and (4) policy evaluation lacked formal mechanisms for monitoring and assessment, highlighting the need for standardized metrics and accountability frameworks.
Addressing migrant health in Iran requires a multi-faceted approach that prioritizes stakeholder engagement, robust data collection and inclusive implementation strategies. Establishing dedicated committees, improving data accuracy and ensuring equitable access to health services are critical steps. By implementing these recommendations, Iran can enhance health outcomes for migrants, promote public health and foster social cohesion. This study provides a foundation for evidence-based policy reforms to address the unique health needs of migrant populations.
移民健康已成为一个关键的全球公共卫生问题，需要制定有效的政策来满足这一弱势群体的需求。伊朗接纳了超过450万移民——其中许多人没有合法身份——在确保公平获得医疗保健方面面临重大挑战。尽管有现有政策，但实施差距依然存在，加剧了健康不平等。本研究分析了伊朗的移民健康政策，识别挑战并提出有效解决方案。
这项定性研究包括对38名利益相关者进行半结构化访谈，这些利益相关者包括政策制定者、管理人员、医疗服务提供者、移民健康专家以及移民自身，通过目的抽样和滚雪球抽样选取。数据与15份政策文件的审查结果进行了三角验证。在综合政策分析框架的指导下，该研究聚焦于四个阶段：准备、制定、实施和评估。数据分析遵循里奇和斯宾塞的框架分析方法，确保系统分类和主题解读。
分析产生了49个编码，分为10个子主题和与政策分析框架一致的四个主要主题。主要研究结果揭示了各阶段持续存在的挑战：（1）政策准备受到缺乏正式治理结构的阻碍，例如卫生和医学教育部内缺乏针对移民健康政策的特定委员会，以及利益相关者参与不足；（2）政策制定存在选择性的健康优先事项、重大数据缺口以及将无证移民排除在法定覆盖范围之外的问题；（3）政策实施面临财政限制、保险差异和系统性障碍，包括与伊朗身份证挂钩的电子处方要求；（4）政策评估缺乏正式的监测和评估机制，凸显了对标准化指标和问责框架的需求。
解决伊朗的移民健康问题需要采取多方面的方法，优先考虑利益相关者的参与、强大的数据收集和包容性的实施策略。设立专门委员会、提高数据准确性以及确保公平获得医疗服务是关键步骤。通过实施这些建议，伊朗可以改善移民的健康结果、促进公共卫生并增强社会凝聚力。本研究为基于证据的政策改革提供了基础，以满足移民群体独特的健康需求。
