Iran Country Brief
Community Health: Policy and Implementation Landscape Mapping in the Middle East and North Africa Region 2024
Highlights
Country Context
The Islamic Republic of Iran is located in the Middle East and is a country with a rich cultural history. It has one of the world's largest oil and gas reserves and has sustained growth amidst rising geopolitical tensions. It has an ethnically diverse population of more than 87 million and shares borders with seven countries. Iran has a robust health system that has contributed significantly to reducing child and maternal mortality, increasing life expectancy.
Despite progress, challenges such as the rise in non-communicable diseases, urbanization, and gaps in urban health care delivery have prompted reforms. One such reform is the Family Physician Programme (FPP), which was initially launched in 2004 and served to shift the first point of contact to the family physicians team. This programme was expanded to include urban areas six years later and has since been expanded again in 2024. The programme was significant in increasing public access to health service and in improving community health outcomes. Other reforms have worked towards expanding insurance coverage, reducing patient cost-sharing, enhancing health benefits, improving service purchasing efficiency, institutionalizing public participation in health, and launching the Health Transformation Plan.
Overview of Community Health
Following the Islamic Revolution and the adoption of the Alma Ata Declaration, Iran restructured its community health in alignment with primary health care (PHC) principles. The Iranian PHC system was established to improve access to health care for the disadvantaged and reduce the gap between health outcomes in urban and rural areas. Central to this aim was the establishment of Health Houses in rural and sparsely populated areas staffed by community health workers (CHWs) known as Behvarzes (rural area) and Moraghebe-Salamat (urban area). Working at the community level, these health workers deliver comprehensive primary health care services, including for maternal and child health and the management of communicable and non-communicable diseases. Health houses serve a population of about 1,000-1,500 and health posts average around 12,500 persons. According to figures from 2022, there are 18,242 health houses, 5,489 health posts and 5,517 comprehensive health centres (of which 2,723 are urban and 2,794 are rural) across the country.
