Future Development Through the Past: Analysis of Financing Dimension of Iran’s Health Transformation Plan

Article type
Authors
Doshmangir L1, Najafi B2, Mostafavi H3, Moshiri E4
1Health Services Management Research Center, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz
2Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz
3Shahid Beheshti University of Medical Sciences, Tehran
4Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan
Abstract
Background:
On 15 Jun 2014, a significant reform called Health Transformation Plan (HTP) started in Iran to achieve Universal Health Coverage by 2025. To implement HTP, significant funding was allocated to the Ministry of Health and Medical Education (MoHME). However, before HTP, the budgeting model used for healthcare funding was affected by global oil prices, fluctuation in the exchange rates, and economic sanctions.

Objectives:
This study aimed to analyze the future of HTP in light of potential financial barriers and challenges.

Methods:
We reviewed published and unpublished documents from social media, national policy-making organizations, including MoHME, parliament, medical universities, and some other related organizations. We also conducted face-to-face interviews with key informants, including health policymakers at different levels of the health system, health researchers, health insurance officers, and faculty members. Data were analyzed using both deductive and inductive approaches.

Results:
Unsustainability in financial resources and continuing in the allocation of Gross Domestic Product (GDP) to the HTP is a challenge in continuing this policy reform. Also, the bureaucratic procedures in allocation and distribution of funds, discrepancy between health insurance funds and affiliated units of MoHME, especially Medical Sciences Universities (MSU), the lack of purchaser-provider split, inappropriate payments and compensation mechanisms, and dependence of MSU on individual revenues are the main challenges that threaten the future of HTP in Iran.

Conclusions:
Given the current situation, where the country's funding resources are often unpredictable, it seems that such funding challenges will lead to poor HTP results. Having a holistic view, adopting and implementing evidence-informed policies and future-based strategies can prevent unexpected consequences.

Patient or healthcare consumer involvement:
No patient or healthcare consumer was involved in the study.