1 Nursing Care Research Center, Iran University of Medical Sciences, Iran, Law School, Flinders University, Australia

2 Professor, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

3 Assistant Professor of Pediatrics, Department of Pediatrics, Ali Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran


INTRODUCTION: Iran’s Health System Reform Plan (HSRP) were initiated in public and hospitals
affiliated to Medical Sciences Universities in June 2015. The purpose of the present paper is to
provide a critical analyse of the HSRP and its outcomes.
METHODS: The study was carried out as a review critical analyse in 2019. The pertinent articles
were searched for in Science Direct, PubMed, Ovid, and Google Scholar using keywords “health
sector,” “reform plan,” “health system reform,” “health services,” “health care system,” and “Iran.”
Published articles in scientific national and international journals in Persian and English language,
of which the full‑texts were available, were entered into the study. Finally, from a total of 75 articles
obtained, 45 studies were carefully reviewed.
RESULTS: Several factors, which impact in the success of Iran’s HSRP such as social‑economic and
political outlooks, lack of official information and a comprehensive management system, in addition
to failure to extend continuous performance control, economic sanctions against Iran. Other factors
are limitations on financial transactions between Iran and the rest of the world due to the sanctions,
relying merely on a few instructions, and negligence of the required infrastructures. In terms of
advantages of the plan, relative decrease in patient’s share in medical expenses, improvement of
emergency wards, and relative decrease in the rate of C‑section operations are notable.
CONCLUSION: Better implementation of Iran’s HSRP entails the provision of resources and facilities
such as stable and adequate resources, proper management of available resources, payment
mechanisms reform, attracting, and facilitating private sector’s participation.


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