Development of the National Health policy with emphasis on PHC Dr. Gholamreza Heidari July/ 9/ 2012 PHA3

–A–Area: 1’648’000 km 2 –P–Population: Rural %21 Uraban%79 –P–Province: 30 –D–District: 300 –V–Village: I.R. IRAN Tehran Turkmenistan Afghanistan Pakistan Saudi Arabia Kuwait Iraq Azerbaijan Armenia Persian Gulf Oman Sea Caspian 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 Primary Health Care System in I.R.Iran was based on: Research based Standardized Integrated Coordinated Stratified Defined population oriented Client oriented Provider oriented Equipped with decision-making tools and techniques Affordable Flexible Decentralized Efficient Equitable Sustainable

The Structure of the Health System in Iran

Major Health Achievements

Trend of Demographic and Health Indicators in I.R.Iran

The causes of all deaths and YLL in provinces in I.R.Iran MI 15% CVA and other cerebral dis. 5.5% Related to length gestation & fetal growth 4.2% Respiratory & Cardiovascular disorders to the perinatal period 2% pneomonia 1.1% Percentage the Cause of death in provinces of YLL Cardiovascular disease 28% % Non intententional accidents 26.5% Antenatal disease. 4.8% 11% cancers 4.8% intentional accidents Respiratory disorder 4.5% Transport accidents 17.3% 3.3% burn cancer of Stomach 2% leukemia 1.7% Pulmonary cancer 1% suicide 3.2% violence 1.6%

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

 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. The policies implemented

 High Council for Health Chair by the President  And secretary of Health Minister Other Departments in High Health Council  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 Leadership for Healthy People 2010 through the 5-year Development Plan

Thank You for Your Kind Attention