Transcript Health System in Islamic Republic of Iran

Development of the National Health
policy with emphasis on PHC
• Dr. Gholamreza Heidari
• July/ 9/ 2012 PHA3
– Area:
•
1’648’000 km2
– Population:
•7496172
Caspian
Sea
•Rural %21
•Uraban%79
– Province:
•
30
Tehran
I.R. IRAN
– District:
•
300
– Village:
•
65000
Oman Sea
Primary Health Care
Experience in Iran
Background:
 1972: West Azerbaijan research project on
PHC
 1977: Government accepted the concept of
PHC network
 1979: Broad programming for Health System
Development based on PHC
 1981: Preparation of master plans for
countrywide expansion of PHC network
 1985: Establishment of prototype district PHC
networks approved by the parliament
The Structure of the Health System in Iran
Ministry of Health
and
Medical Education
University of the
province
School
of .............
Director of District
Health Network
District
Health Center
Teaching
Hospital
District
General Hospital
Behvarz
Training Center
Rural
Health Center
Urban
Health Center
Maternity
Facility
Health
House
Health
House
Health
Post
Health
House
Health
House
Health
Post
Health
Post
Health
Post
Major Health Achievements
Trend of Demographic and Health Indicators
in I.R.Iran
1986
1991
1996
2012
Population (million)
49.4
55.8
60
7496172
Urban population
54.3%
57%
61%
%71
Under 15
45.3%
44.3%
39.5%
24.3%
64 and over
3%
3.4%
4.4%
6.5
Male life expectancy
58.5
62.4
68
71
Female life expectancy
59.2
63.2
70
73.17
NMR
21
19
16
12
IMR
51
33
26
18
U5MR
70
42
33
22
MMR
140
54
37.4
22
Annual PGR
3.2
2.7
1.56
1.3
The causes of all deaths and YLL
in provinces in I.R.Iran
%17.3 Transport accidents
3.3%
burn
Percentage
the
Cause of death in provinces
of YLL
%28% Cardiovascular disease
cancer of Stomach
1.7%
leukemia 26.5% Non intententional accidents
%1
Pulmonary cancer
11%
cancers
2%
3.2%
1.6%
suicide
violence
4.8% .
4.8%
%4.5
Antenatal disease
intentional accidents
Respiratory disorder
15%
MI
CVA and other
5.5% cerebral dis.
Related to length
gestation & fetal growth 4.2%
Respiratory & Cardiovascular
disorders to the
perinatal period
2%
1.1%
pneomonia
Consequences
•
Increase frequency of non communicable
diseases
– Injuries
– traffic accidents
– cardiovascular daisies
– …
•
Challenges in Equity and equality in health
due to
– Increase the needed health expenditures
– Decrease the ability of pubic funds to support
people
– Increase the risk of induced demands and out of
packet payments
What are the Challenges for the health
care systems in the last decades?
•
•
•
•
Demographic transition
Epidemiologic transition
New expectations of the clients
Entering new expensive diagnostic and
intervention technologies
• Changing socioeconomic environment
SO
Our Plans
The policies implementedHealth market regulation
Family physician and referral system
Human resource policy for health
More integrated medical education to health
system
Construct out come-based education on the
basis of new health needs
Accessibilities
Expand insurance plans for the basic needs
The policies implemented
 Regulation of health technology on the basis
of the available resources
 Priority of prevention in resource allocation
 Priority of ambulatory care to hospitalization
 Control of entering expensive health technologies
 Health finance strategy




Using public funds like as insurance plans
Benefit packages
More performance based payment mechanism
Taxation on tobacco products, 10% for domestic
products & 20% for imported
 10% energy subsidies saving goes to Health
program .
Leadership for Healthy People 2010
through the 5-year Development Plan
 High Council for Health Chair by the President
 And secretary of Health Minister
Other Departments in High Health Council
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


Ministry of Agriculture
Ministry of Interior
Ministry of Culture and Guidance
Ministry of Public Highway and Transport
Ministry of Education
Management and Planning (Vice President)
Ministry of Welfare and social security
Ministry of Economy