Summary of major healthcare challenges in Iran

HealthyIran is my first weblog created on December 25, 2006. I'd like to have your opinions on pros and cons of healthcare system in Iran. I try to write in brief but to the point.

I would like you to comment on the major challenges of healthcare in Iran, summarized as follows:


1- Healthcare delivery at primary (preventive) level is totally public and seems to be very efficient. Currently, more than 40,000 Behvarz (Community Health Workers) are working with the system. The system provides a number of basic level free of charge healthcare (mainly preventive) with rural people all over the country.

2- Higher level outpatient healthcare is in private sector and totally unregulated. This causes people to pay out of their pocket for healthcare. In fact, some 65% of healthcare expenditure is coming from people's pocket.

3-Inpatient care is mainly provided by governmental hospitals; however, 20-30% of hospitals are in private sector. Most of private hospitals are located in large cities like Tehran, Isfahan, Mashad, Shiraz, and Tabriz.

4-Ministry of Health and Medical Education supervises 40 Medical Universities. Medical university in each province is the core unit for local health policy making and supervising healthcare at provincial level.

5-Since the year 2005 the Ministry of Health has started a national program on referral healthcare delivery in outpatient care. Recruited General Practitioners are working as family physician and considered as gate keeper of the system.

6-The cost of healthcare is rapidly increasing.

7-Cardiovascular disease, Road traffic accidents, cancers, and addiction are conditions with the highest burden in the country . Other words, they are the main cause of mortality and morbidity. Like other (developing ) countries , and with increasing age, degenerative mental disorders (dementia) are increasing in Iran. Depression, and psychotic disorders are diseases with very high morbidity in the coutnry.

8-AIDS is increasing and is becoming a major challenge for the health system.

9- Micronutrient deficieny is commonplace while average weight of the population is on the increase.

10- Tuberculosis, malaria, brucellosis, and other infectious diseases have a patchy pattern and are endemic in parts of the country.


11-Health insurance policies are not efficient. More than 90 percent (and according to self-reported estimates at least 75%) of the population are covered by at least one type of health insurance plan. Less than one percent of the health insurance policies are private. Supplementory health insurance plans are only for a limited number of people working in high class formal sector.

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