Volume 14, Number 2 (9-2016)                   sjsph 2016, 14(2): 17-38 | Back to browse issues page


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Damari B, Vosough Moghaddam A, Rostami Gooran N, Kabir M J. Evaluation of the Urban Family Physician and Referral System Program in Fars and Mazandran Provinces: History, Achievements, Challenges and Solutions. sjsph. 2016; 14 (2) :17-38
URL: http://sjsph.tums.ac.ir/article-1-5381-en.html

1- MD-MFPH. Assistant Professor, Department of Social Determinant of Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
2- MD-FFPH. Assistant Professor, Health Sector Policy Coordination Group, Secretarait for Supreme Council of Health and Food Security, Ministry of Health and Medical Education,Tehran, Iran , a.vosoogh@gmail.com
3- MD. Assistant Professor, Intersectoal Health Policy Making Coordination Group, Secretarait for Supreme Council of Health and Food Security, Ministry of Health and Medical Education, Tehran, Iran
4- PhD. Assistant Professor, Community Medicine and Public Health Department, Golestan University of Medical Sciences, Gorgan, Iran
Abstract:   (3702 Views)

Background and Aim: The most important healthcare reform in Iran during the last decade has been implementation of the family physician and referral system in rural areas and small towns with a population of less than 20000. The program was expanded (as a pilot project), with small modifications, to rural areas of 2 provinces, namely, Fars and Mazandaran. This study was initiated to assess the achievements, challenges and weak points of the pilot project before deciding to expand it to other provinces.

Materials and Methods: This qualitative study was conducted in winter 2013. Data were collected using document desk reviews, semi-structured interviews with key informants, and focus-group discussions. Relevant family health policy makers, managers and service providers in the two provinces were invited to the meetings. The data were analyzed and categorized based on the content analysis method.

Results: The data showed that the family physician program is faced with several challenges regarding objectives; stewardship; service providing; and human, financial and information resources. It is to be noted, however, that the program has had achievements such as increased access to services, increased coordination among insurance organizations and medical universities, and organizing and managing health files.  

Conclusion: The program should not be expanded to other provinces before redesigning in order to assure that it is more complete and comprehensive and create commitment and adequate guarantee among stakeholders. It is essential that all the stakeholders agree on general and specific objectives of a 5-year program and prepare an operational plan for each specific objective. 

Full-Text [PDF 276 kb]   (1167 Downloads)    
Type of Study: Research | Subject: Public Health
Received: 2016/09/19 | Accepted: 2016/09/19 | Published: 2016/09/19

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