Academic journal article Iranian Journal of Public Health

What Must Be the Pillars of Iran's Health System in 2025? Values and Principles of Health System Reform Plan

Academic journal article Iranian Journal of Public Health

What Must Be the Pillars of Iran's Health System in 2025? Values and Principles of Health System Reform Plan

Article excerpt


Background: Preparing long term reformatory plan for the health system, like other macro plans, requires guiding principles which is according to the values, and as a bridge, connect the ideals and values to the goals. This study was designed with the purpose of explaining the values and principles of health system, and as a pre -requisite to compilation of Iran's health system reform plan at 2025.

Method: The document of values and principles of health system reform plan for 2025 was developed by reviewing the literature and receiving the opinions of senior experts of health system, and was criticized in focus group discussion sessions of experts and decision makers.

Results: The values of Iran are: dignity of human, the right to maximum attainable level of health, comprehensive health, equity and social cohesion. The principles of this health system include: institutionalizing the ethical values, responsiveness and accountability, equitable access (utilization), prevention and health promotion, community participation, inter-sectoral collaboration, integrated stewardship, benefit from innovation and desired technology, human resources promotion and excellence and harmony.

Conclusion: Based on the perception of cultural and religious teachings in Iran, protecting of human dignity and human prosperity are the ultimate social goal. In this sense, health and healthy humans, in its holistic concept (physical, mental, social health and spiritual) are the center and development in any form should lead to the human prosperity in a way that each of the individuals could enjoy the maximum attainable level of health in its holistic meaning and in a faire manner.

Keywords: Health system, Value, Principle, Iran


Over the years, the health system of Iran has undergone many changes. One of the most important and effective changes was developing primary health care system across the country, which was designed forty years ago based on the health status of the society (high burden of infec-tious and communicable diseases) (1) and was im-plemented after the revolution because of the so- cial condition of the society and the idealist and equity seeking spirit of people (2).

Integration of medical education in the health ser-vice providing system and formation of the Minis-try of Health and Medical Education was another major change during these three decays after revolution(3). Currently the health system of Iran has two main characteristics, firstly, it is network based and secondly, the health services providing system has been integrated into educational system. The above transformation and investment in pri-mary health care system in the form of health net-works in the last 30 years, was the cause of a significant progress in health indicators of Iran, in a way that the life expectancy increased from 46.7 years in the year 1981 to 72 years in the year 2007, and non-communicable diseases were controlled effectively (4). Also this reorganization was the reason that Iran achieved a desirable level of maternal and child mortality indicators of millen-nium development goals (5).

On the other hand, demographic and epidemiological transitions along with the socio-economic condition, resulted in serious challenges for health systems in all developing countries(6, 7), including Iran, and emphasize the need for review of the health system and health programs (8). Weakness in equitable access to health care, con-trol of increasing cost of services and financial protection of customers, comprehensive and effi-cient care systems and proper stewardship are among the challenges of health systems, especially in developing countries (9).

This group of problems has been continued due to the reasons like lack of consensus of policy makers about the solutions, insufficient financial resources and low motivated human resources (10). Based on the studies, the dispersion in opi-nions of policy makers have been recognized as one of the important factors (11). …

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