Health system profile - Islamic Republic of Iran - What is GIS - World ...

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Health Systems Profile- Islamic Republic of Iran Regional Health Systems Observatory- EMRO Planned changes to private sector organization As indicated in section 4.3.4 the private sector is expanding rapidly and the government is generally supportive. It has been encouraging the subordinate organizations, like universities of medical sciences to outsource support services and purchase different service from the private sector. However, such initiatives are still in their pilot phase and efforts are being made to consolidate the results and improve the process. 4.4 Overall Health Care System Organization of health care structures For delivering the PHC an elaborate network of facilities has been established. That is, Health Houses, which constitute the basic building blocks for health network, are the first point of contact by health system with the community in rural areas. Each of this facility is ideally run by a male and a female community health worker – Behvarz. Male Behvarz is responsible for vaccination and environmental health promotion, while female Behvarz provides maternal and child health care (MCH) and family planning services in the target communities. This network of health houses is supported by Rural Health Centers (2361 in total) staffed by technicians and administrative personnel working under a physician. In urban areas, the Urban Health Centers provide ambulatory care. Health posts, which are static health facilities, provide vaccination and MCH services. The role of Behvarz, as outreach workers in rural areas is assumed by Women Health Volunteers in urban areas. However, their function is mainly limited to the provision of health education and advocacy for family planning. This network of urban and rural PHC facilities is supported for referrals by District Hospitals. These general hospitals located in cities have specialties: physician, general surgeon, pediatrician and gynecologist, although many of these hospitals have more specialties. In big cities, which are also district headquarters, provincial hospitals provide tertiary care. The PHC network is administered by District Health Centers (DHC) – one in each district, and affiliated to this is a Behvarz Training Centre. The Universities of Medical Sciences, at least one in each province, play an important role both in medical education and provision of health services. That is, the Chancellor of the University, as Executive Director of provincial health services is in charge of all DHCs and hospitals. They in turn report to the MoH&ME. Table 4.2: Estimated Number of Health Care Facilities in Iran (2002) Type of service Types of Facilities Estimated Number Out-patient/ Primary Health Care Services Health Houses 17,300 Health Posts 300 Rural Health Centers 2,400 Urban Health Centers 1,900 Private Solo GPs 25,000 Private Polyclinics 900 In-patient Care Government and Social Security Organization Hospitals 600 23
Health Systems Profile- Islamic Republic of Iran Regional Health Systems Observatory- EMRO Support Services Pharmacies 6,200 Source: Iran National Health Account Report, 2002 Radiology Centers 1,100 Laboratories 1,700 Table 4.3: Distributions of Hospital Beds in Iran (2001) Ownership Number of Beds % Ministry of Health and Medical Education 76,167 69.8 Social Security Organization 11,663 10.7 Other Government Hospitals 4,149 3.8 Private Hospitals (Non-Profit) 3.544 3.2 Private Hospitals (For-Profit) 12,619 11.6 Private Teaching Hospitals 1,010 0.9 Total 109,152 100% Source: Iran National Health Account Report, 2002 Brief description of current overall structure While the primary health care is almost the sole responsibility of the MoH & MoE, a number of other ministries and organizations provide secondary and tertiary care, mainly to their employees and their families. These include the armed forces, major banks, oil companies, railways, municipalities, and government run not for profit organizations. 24
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