Exploring Current Iran’s Primary Healthcare System: Challenges and Solutions

2020 ◽  
Author(s):  
Ahmad Shirjang ◽  
Leila Doshmangir ◽  
Abraham Assan
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Primary Healthcare ◽  
Health Care Services ◽  
Care Delivery ◽  
Health Needs ◽  
New Public Health ◽  
Public Health Challenges ◽  
Consistent Manner

Abstract Background: Since 1980s, establishing Primary Healthcare (PHC) network in Iran to promote health care delivery and population’s health, the PHC system has experienced various achievements and changes. This study aimed to explore current PHC in Iran focusing on challenges and solutions.Methods: Documentary review and interviews were used to collect qualitative data. The interviews were conducted with 26 stakeholders in various levels of the health system including health policymakers, academics, health managers and staffs are expert in public health and the PHC. National upstream documents including the Five Year Development Plans, General Health Policies, and the Iran’s 20 year national vision were reviewed. Data analysis was done using deductive content analysis assisted by MAXQDA 12 software. Results: Although Iranian PHC has enjoyed significant successes, it does not match with the changing populations’ health needs especially during the last years. The current workforce cannot respond to new public health challenges, health data are not collected and analyzed in a consistent manner, modern appropriate technologies in the PHC are not used and electronic service delivery are not provided yet. PHC financial difficulties and the current rigid structure of the health system cannot satisfy the new emerging needs of the population.Conclusion: Given the challenges and the new health needs, the current PHC structure and services should use the private sector involvement for better respond to the public health needs and flexible structure and services while dealing with the changes. The workforce needs to be updated, and the referral system should be established for providing the health care services based on FP plan.

scholarly journals A MOOC to disseminate key concepts related to the future challenges of the French health system

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C You ◽  
V Lissillour ◽  
A Lefébure
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Health Care Professionals ◽  
Decision Makers ◽  
Teaching Staff ◽  
New Public Health ◽  
New Public ◽  
Wide Range ◽  
Public Health Challenges

Abstract Background The increase of life expectancy creates critical health needs that developed countries health systems have to deal with. They are also confronted to persistent health inequalities. A common vision of these issues may not be shared by the health care professionals, decision-makers and citizens. In the context of the launch of new public health laws in France, the French School of Public Health (EHESP) decided to offer a MOOC entitled “Public Health and Health System: transition and transformation” (2019). Objectives The MOOC intends to raise awareness and increase understanding of public health challenges. It is designed for a wide audience of professionals, decision-makers and citizens in the French speaking world. The content was designed by a multidisciplinary team of academics from the EHESP (N = 50) and a network of health professionals (N = 21). The 6 modules address major themes of the recent health policies, e.g. social and territorial inequalities in health, health care security, health pathways, innovation or health democracy. Results Over the course of 6 consecutive weeks, almost 7800 people have enrolled in this e-learning. They are provided with short teaching videos (109 capsules of 4-5’) and webinars, have access to a number of supplementary reading material and a variety of self-assessment. Active learning is enhanced via forum involving peers and teaching staff. The full course represents around 20 hours of teaching. So far, completion rate has attained 13% which compares well with usual rate for MOOCs. Participants include a wide range of professionals, students and citizens from 87 different countries (72% from France) and 50% had a master or higher degree. The overall satisfaction rate is 98%. Conclusions This MOOC attracted the attention of a wide and diverse audience regarding the major public health issues. Some public health agencies have expressed interest in implementing the MOOC into their professional development program of their staff. Key messages Health system reforms are constantly implemented to face new public health challenges. A multidisciplinary MOOC can help raise awareness and understanding of the issue being addressed by new policies.

Quality improvement of health care in Iraq

2018 ◽  
Vol 1 (1) ◽  
pp. 1-5
Author(s):  
Abdulghani Alsamarai Alsamarai ◽  
Alaa Bashir
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Public Health Care ◽  
High Morbidity ◽  
Quality Health Care ◽  
Record System ◽  
Control Programs ◽  
Inappropriate Use

Iraqi health care experts documented that hundreds of patients die each year because of hospitals failures to adhere consistently to standard procedures of safe and effective medical care. The routine hospital care improvement is public health imperative. High quality health care [safe, effective, patient – centered, timely, equitable and efficient] is should be provided for all population. Unfortunately, the growing literature and health care professions documents a serious problem in health care delivery in Iraq, for example: Unnecessary surgery: Such as increased numbers of cesarean section with time; increasing numbers of operation for appendectomy (most of them in is later found to be normal).; High morbidity and mortality following surgery.; Inappropriate use of medications.; Inadequate prevention of diseases.; Avoidable exacerbation of chronic conditions, Malpractice, lack of accreditation and licensing system, malpractice in private pharmacy, drugs irrational use, absence of referral system, short consultation time, no consistent medical record system, no clinical standards in health care providing, fail to maintain sanitation in public health care services, non existence of quality control programs in hospital and health care centers, and non effective diseases prevention and control programs

Health System Reform in Mexico: A Critical Review

2007 ◽  
Vol 37 (3) ◽  
pp. 515-535 ◽  
Author(s):  
Asa Cristina Laurell
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Security ◽  
Health System ◽  
Care Delivery ◽  
Public Health Care ◽  
System Reform ◽  
Managed Competition ◽  
Health System Reform ◽  
Social Security Institute

Last year Lancet published a series of articles on Mexico's 2004 health system reform. This article reviews the reform and its presentation in the Lancet series. The author sees the 2004 reform as a continuation of those initiated in 1995 at the largest public social security institute and in 1996 at the Ministry of Health, following the same conceptual design: “managed competition.” The cornerstone of the 2004 reform—the voluntary Popular Health Insurance (PHI)—will not resolve the problems of the public health care system. The author assesses the robustness and validity of the evidence on which the 2004 reform is based, noting some inconsistencies and methodological errors in the data analysis and in the construction of the “effective coverage” index. Finally, some predictions about the future of PHI are outlined, given its intrinsic weaknesses. The next two or three years are critical for the viability of PHI: both families and states will face increasing difficulties in paying the insurance premium; health infrastructure and staff are insufficient to guarantee the health package services; and the private service contracting will further strain state health ministries' ability to strengthen service supply. Moreover, redistribution of federal health expenditure favoring PHI at the cost of the Social Security Institute will further endanger public health care delivery.

scholarly journals Beyond Public Health Emergency Legal Preparedness: Rethinking Best Practices

2013 ◽  
Vol 41 (S1) ◽  
pp. 13-16 ◽  
Author(s):  
Jennifer A. Bernstein
Keyword(s):  
Public Health ◽  
Best Practices ◽  
Health System ◽  
Public Health System ◽  
The Public ◽  
New Public Health ◽  
New Public ◽  
Public Health Challenges ◽  
Core Elements ◽  
Health Laws

It has now been 10 years since the framework for public health legal preparedness was put forth as a model to meet new public health challenges in the 21st century. Public health legal preparedness is defined as the “attainment by a public health system of specified legal of standards essential to the preparedness of the public health system.” The framework has continued to develop over time and four core elements have emerged to make up the basis for public health legal preparedness. The four core elements are: (1) laws and legal authorities; (2) competency in using laws effectively and wisely; (3) coordination of legally based interventions across jurisdictions and sectors; and (4) information on public health laws and best practices.

scholarly journals Clinicians’ experience of providing care: a rapid review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maha Pervaz Iqbal ◽  
Elizabeth Manias ◽  
Laurel Mimmo ◽  
Stephen Mears ◽  
Briony Jack ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Services ◽  
Care Delivery ◽  
Grey Literature ◽  
Clinical Work ◽  
Models Of Care ◽  
Rapid Review ◽  
Measurement Tools ◽  
Clinician Experience

Abstract Background Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progressed in relation to provider experience. This review aims to explore this knowledge gap by capturing evidence of clinician experience, and how this experience is defined and measured in the context of health system change and innovation. Methods A rapid review of published and grey literature review was conducted utilising a rapid evidence assessment methodology. Seventy-nine studies retrieved from the literature were included in the review. Fourteen articles were identified from the grey literature search and one article obtained via hand searching. In total, 94 articles were included in the review. This study was commissioned by and co-designed with the New South Wales, Ministry of Health. Results Clinician experience of delivering health care is inconsistently defined in the literature, with identified articles lacking clarity regarding distinctions between experience, engagement and work-related outcomes such as job satisfaction. Clinician experience was commonly explored using qualitative research that focused on experiences of discrete health care activities or events in which a change was occurring. Such research enabled exploration of complex experiences. In these contexts, clinician experience was captured in terms of self-reported information that clinicians provided about the health care activity or event, their perceptions of its value, the lived impacts they experienced, and the specific behaviours they displayed in relation to the activity or event. Moreover, clinician’s experience has been identified to have a paucity of measurement tools. Conclusion Literature to date has not examined clinician experience in a holistic sense. In order to achieve the goals identified in relation to value-based care, further work is needed to conceptualise clinician experience and understand the nature of measurement tools required to assess this. In health system application, a broader ‘clinician pulse’ style assessment may be valuable to understand the experience of clinical work on a continuum rather than in the context of episodes of change/care.

scholarly journals Public Health Challenges and Priorities for Kazakhstan

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Altyn Aringazina ◽  
Gabriel Gulis ◽  
John P. Allegrante
Keyword(s):  
Public Health ◽  
Health Care ◽  
Population Health ◽  
Public Health Practice ◽  
Health Impact ◽  
Health Concern ◽  
Health Care Reforms ◽  
New Public Health ◽  
Public Health Challenges ◽  
Health And Economic Development

The Republic of Kazakhstan is one of the largest and fastest growing post-Soviet economies in Central Asia. Despite recent improvements in health care in response to Kazakhstan 2030 and other state-mandated policy reforms, Kazakhstan still lags behind other members of the Commonwealth of Independent States of the European Region on key indicators of health and economic development. Although cardiovascular diseases are the leading cause of mortality among adults, HIV/AIDS, tuberculosis, and blood-borne infectious diseases are of increasing public health concern. Recent data suggest that while Kazakhstan has improved on some measures of population health status, many environmental and public health challenges remain. These include the need to improve public health infrastructure, address the social determinants of health, and implement better health impact assessments to inform health policies and public health practice. In addition, more than three decades after the Declaration of Alma-Ata, which was adopted at the International Conference on Primary Health Care convened in Kazakhstan in 1978, facilitating population-wide lifestyle and behavioral change to reduce risk factors for chronic and communicable diseases, as well as injuries, remains a high priority for emerging health care reforms and the new public health. This paper reviews the current public health challenges in Kazakhstan and describes five priorities for building public health capacity that are now being developed and undertaken at the Kazakhstan School of Public Health to strengthen population health in the country and the Central Asian Region.

scholarly journals Clinicians’ Experience of Providing Care: A Rapid Review

2020 ◽  
Author(s):  
Maha Pervaz Iqbal ◽  
Elizabeth Manias ◽  
Laurel Mimmo ◽  
Stephen Mears ◽  
Briony Jack ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Services ◽  
Care Delivery ◽  
Grey Literature ◽  
Clinical Work ◽  
Models Of Care ◽  
Rapid Review ◽  
Measurement Tools ◽  
Clinician Experience

Abstract Background Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progressed in relation to provider experience. This review aims to explore this knowledge gap by capturing evidence of clinician experience, and how this experience is defined and measured in the context of health system change and innovation.Methods A rapid review of published and grey literature review was conducted utilising a rapid evidence assessment methodology. 79 studies retrieved from the literature were included in the review. 14 articles were identified from the grey literature search and one article obtained via hand searching. In total, 94 articles were included in the review. This study was commissioned by and co-designed with the New South Wales, Ministry of Health.Results Clinician experience of delivering health care is inconsistently defined in the literature, with identified articles lacking clarity regarding distinctions between experience, engagement and work-related outcomes such as job satisfaction. Clinician experience was commonly explored using qualitative research that focused on experiences of discrete health care activities or events in which a change was occurring. Such research enabled exploration of complex experiences. In these contexts, clinician experience was captured in terms of self-reported information that clinicians provided about the health care activity or event, their perceptions of its value, the lived impacts they experienced, and the specific behaviours they displayed in relation to the activity or event. Moreover, clinician’s experience has been identified to have a paucity of measurement tools. Conclusion Literature to date has not examined clinician experience in a holistic sense. In order to achieve the goals identified in relation to value-based care, further work is needed to conceptualise clinician experience and understand the nature of measurement tools required to assess this. In health system application, a broader ‘clinician pulse’ style assessment may be valuable to understand the experience of clinical work on a continuum rather than in the context of episodes of change/care.

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