Unlike most beliefs, the Iranian healthcare system is one of the best globally despite the country undergoing instabilities due to unending revolutionary wars. Iran is also one of the most countries, with a significant percentage of its population living in rural areas. The country has managed to achieve equity healthcare accessibility, closing the urban-rural gap. This project will analyze Iranian healthcare, analyzing its areas of strengths and weaknesses. At the end of the paper, the author will recommend ways in which Iran can use to improve its healthcare system.
Introduction: Iran
Iran, also officially known as the Islamic Republic of Iran, is a country located in the Middle East. It is the second-largest country in the region, after Saudi Arabia. Its capital city is Tehran, which is also the largest in the country. Persians occupy the largest population of ethnicities. Other ethnic groups include Kurd, Arab, Turkmen and Azerbaijan. Notably, this paper project will focus on the Iranian healthcare system, and this segment provides background information that affects health in Iran.
Geographic Location
Iran is located in Western Asia. Many countries border it. Turkey and Iran border west, and Afghanistan east. In its south, it is bordered by the Persian Gulf and the Gulf of Oman. In its northern sides, there are Armenia and Azerbaijan (north-western border) and Turkmenistan (north-east).
Population
By 2019, the population in Iran was approximately 83,1834, 741. Persian ethnic group covers 61% per cent of this figure, marking the largest ethnic group in Iran.
Type of Government
Iran’s government is popularly known for dictatorship. As an Islamic state, the Supreme Leader holds the highest political and religious power. He acts as the commander in chief as he is the only one authorized to make decisions concerning the economy, military and politics. The Iranian president, who is democratically elected into office, is also subjected to the Supreme Leader’s authority. The current Supreme Leader is Ali Khamenei, who has held the position since 1989. Notably, Iran follows Sharia as the rule of law. Some of the laws have been termed hostile to minority groups like women, children and homosexuals.
Economic factors
Iran’s economy is mainly driven by the oil industry that is largely owned by the state. Other sectors that contribute to the Iranian economy is mining and partly agriculture.
Health Indicators in Iran
Birth Rate
The birth rate in Iran has been declining over the years. According to a current statistic by the Iranian Health Ministry, in 2021, the number of babies born each day has dropped y 1.6% per woman, leading to a 25% birth rate since the establishment of the Islamic Republic of Iran in 1979 (Lavasani, 2021). One of the factors causing a decrease in birth rate is urbanization and education, where most girls are allowed to pursue their education and careers instead of getting married.
Mortality Rate
There has been a decrease in the mortality rate in Iran. UNICEF (2020) attributes this success to a low child (under-five) mortality rate (See figure 1). The Iranian healthcare system has dedicated most of its resources to children under the age of five. Apart from the low child mortality rate, improvement in disaster management and prevention has also contributed to the low mortality rate in the country. For instance, the result finds of a study by Derakhshan and his colleagues (2019) indicated that drowning mortality cases in Iran had decreased from 1990 to 2015, with a record of only 903 fatalities in 2015.
Figure 1: Trends in under-five mortality rate in Iran. Retrieved from “Iran (Islamic Republic of Iran)” by UNICEF (2021). https://data.unicef.org/country/irn
Life Expectancy
According to World Health Organization (WHO) (2018), the male life expectancy in Iran is 74.6, and female is 76.9. coronary heart diseases, diabetes and hypertension, have been termed to be leading causes of death in Iran.
The Healthcare System in Iran
The Iranian healthcare system has improved since the establishment of the Islamic Republic of Iran. Despite its political instability over the years due to revolutionary wars, the Iranian constitution directs that quality healthcare is a paramount right to every Iranian (Mehrdad, 2009). Thus, the government and other stakeholders invest massively in the health sector, making it among the best globally. The Iranian healthcare system is basically divided into two pillars, public and private. The public healthcare sector is predominately controlled by the government. This aspect can be explained by the high population rate of approximately 84 million people (Mehrdad, 2009). This high population rate interprets to a higher demand for public-governmental services. Notably, this segment describes Iranian healthcare by providing an overview of access to healthcare, cost and quality of care under this system.
Access to Healthcare
The public sector of the Iranian government provides primary, secondary health sectors. Even though it dominates as the main healthcare provider, the private and NGO sector also play a pivotal role in ensuring health is accessible to every Iranian. Mehrdad (2009) explained that the private and the NGO sectors concentrate mostly on secondary and tertiary healthcare services. The good part about Iranian’s three health sectors/pillars (public, private and NGOs) is that they integrate to ensure quality provision of healthcare services.
Significantly, the adoption of Primary Health Care (PHC) in the Iranian healthcare system is the main reason access to healthcare has been improving over the years. Tabriz, Pourasghar and Nikjoo (2017) argued that the PHC program helped in solving the urban-rural health disparity to improve the health indicators. Iran is a highly populated country, with the cities being more populated than rural areas. Before the implementation of PHC, rural areas had limited to no chances of accessing healthcare services (Tabriz et al., 2017). Hospitals and health centres were scarce in the areas. However, with the help of the PHC program, health houses have been built in almost every village in Iran. These health houses are equipped with a Behvarz (“a multi-purpose health care worker who is set to serve 1200 people”) and basic hospital equipment (Tabriz et al., 2017). Notably, they (the health houses) have enabled fast interaction between villagers in rural areas and health care services. Furthermore, bigger villages have rural health centres, which are bigger than health centres and handle more complicated services because they are equipped with medical specialists (Tabriz et al., 2017). In summary, the health houses and health centres have improved healthcare accessibility in Iranian rural areas because people do not have to travel far to get health care services.
Cost of Health Care
The Iranian government has invested a lot in health care, increasing the expenditure on health per capita. A report by Macrotrends (2021) indicated that the Iran healthcare spending in 2018 was $484, marking a 1.24% increase from 2017, whose spending was $478. The reports insist that more expenditure increase on Iran healthcare will be witnessed due to the improving health care services. For instance, the government keeps building more health houses in the villages and equipping them with modern equipment and drugs.
As mentioned above, the public sector dominates in providing primary, secondary and tertiary health care services. Therefore, the cost of health care is cheap and affordable to Iranian from all social classes. The common insurance option in Iran is universal as most Iranian can access quality healthcare services without straining financially. They are expected to co-pay for their medical services with the government. Mehrdad (2009) explained that more than 90% of Iranians are insured. An excellent example is the Medical Service Insurance Organization, through which government pays for civil workers, students, and the less fortunate (Mehrdad, 2009).
Healthcare Delivery
Healthcare delivery in Iran is ranked as the best to the effort of ensuring high accessibility to healthcare services through the public sector. The PHC program focuses on primary health care services. The health houses and rural health centres in villages have made it easy for healthcare delivery in rural areas. Moreover, as Mehrdad (2009) explained, the health workforce in Iran is highly trained to fit the patient-based health care services.
Compare and Contrast: U.S. Healthcare System vs Iranian Healthcare System
Despite being countries from different geographical locations and cultures, the U.S. and the Iranian Healthcare system have several similarities and differences. The most important similarity is that both countries spend a lot on their healthcare systems, which are both among the best globally. The high expenditure in the U.S. healthcare system is attributed to the rapid advancement of technology and research in healthcare. The government is devoted to investing in discovering new forms of medicines and procedures. The same is the case in Iran, where the healthcare system largely focuses on accessibility. The government has invested a lot in ensuring that healthcare services are accessible to people in rural areas.
One major difference between the U.S. and Iranian healthcare systems is that the U.S. does not have a universal health insurance program like Iran. Importantly, the U.S healthcare model tends to favour private health insurance or to pay directly for the services. This model denies the government to pay insurance for its citizens. As a result of this model, healthcare service in the U.S. tends to be expensive. However, the vulnerable populations are covered under the Affordable Care Act (ACA). On the other hand, the Iranian healthcare model is highly focused on equity in accessing health; thus, it has universal health coverage, where the government pays for its citizens’ healthcare services.
Even though Iranian health care is one of the best globally, it still lags in lack of information in healthcare. Mehrdad (2009) argued that the Iranian healthcare system lacks an integrating health information system, which prevents systematic health analysis. This analysis is important in discovering aspects like customer satisfaction, which are necessary key performances indicators in measuring healthcare services. On the other hand, America’s healthcare system is highly advanced due to integrating technology in healthcare.
Major Health Problem in Iran
The major health problem in Iran is cardiovascular disease. A study by Saadat and his colleagues (2015) revealed that cardiovascular diseases were the leading causes of death in Iran. An unhealthy lifestyle has been attributed to this problem. Sadaat and his fellows (201) explained that Iranians who suffered from heart-related diseases were found to smoking, and had unhealthy habits and had minimum physical activity. Interestingly, this problem was seen to affect the ageing population more than the young people. Old people were discovered to smoke than young people. The best explanation for the prevalence of this issue in Iran is the uninformed public regarding the diseases and their causes. Another study by Sadeghi and his colleagues (2017) found that cardiovascular diseases were a major problem globally, with the developed countries affected the most. Unlike in developed countries like Iran, more youths than the elderly in developing countries suffered these diseases.
How Is Iran’s Healthcare System Equipped in Tackling Cardiovascular Diseases?
The Iranian healthcare system has put more effort into solving the cardiovascular disease problem. One of the efforts is the integration of medical education and service provision. This move has enabled the healthcare workers like the Behvarzs, who interact closely with the locals, to undergo training regarding the diseases while serving patients (Kamran et al., 2013). The benefit of integrating medical education with service provision enables the healthcare workers to be more informed about cardiovascular illnesses, enabling them to provide quality care to the locals.
Another important move has been introducing mental health services in primary health care (PHC). The Iranian health sector’s PHC program concentrated on services such as maternal care, pre-and neo-natal care, and vaccination (Lankarani et al., 2013). Recent studies have shown that mental unhealthiness is one of the leading causes of cardiovascular diseases. For example, stress can lead to hypertension, which in turn can cause a heart attack. The mental health services in primary care ensure that people live healthy psychologically (Lankarani et al., 2013).
The Problem of Cardiovascular Diseases: A Global Perspective
Cardiovascular diseases are slowly becoming a global issue, causing approximately10 a million deaths per year globally (CDC, 2021). These diseases are the major cause of premature death as people die silently. The symptoms are always hidden and gradually become deadly when not treated. Notably, cardiovascular diseases should be given global attention because they are expensive to treat and affect people from all economic grounds (CDC, 2021).
Recommendation to Improve Health Outcomes in Iran
Iran records one of the most positive health outcomes globally because of the PHC program. However, it still records high cases of cardiovascular diseases and other non-communicable diseases. As Mehrdad (2009) argued, Iran should invest in advance research regarding this problem. This method will enable its healthcare system to be informed about these diseases and adopt more effective ways of ensuring positive health outcomes.
References
CDC. (2020). Cardiovascular Diseases. Global Health Protection and Security. https://www.cdc.gov/globalhealth/healthprotection/ncd/cardiovascular-diseases.html
Derakhshan, P. et al. (2015). Trends in the drowning mortality rate in Iran. Injury Prevention, 26(4). https://injuryprevention.bmj.com/content/26/4/351
Lankarani, B. K., Alavian, M. S. & Peymani, P. (2013). Health in Islamic Republic of Ira, Challenges and Progress. Medical Journal of the Islamic Republic of Iran, 27(1):42-49
Lavasani, S. (2021, January 3). Iran’s fertility rate is alarmingly low. Teheran Times.
Macrotrends. (2021). Iran Healthcare Spending 2000-2021. https://www.macrotrends.net/countries/IRN/iran/healthcare-speding.
Mehrdad, R. (2009). Health System in Iran. International Medica Community. JMAJ, 52(1), 69-73.
Saadat, S. at al., (2015). The most important causes of death in the Iranian population; a retrospective cohort study. Emergency (Tehran). 3(1), 16-21. https://www/ncbi.nih.gov/pmc/articles/PMC4614603/#!po=31.6667
Sadeghi, M. (2017). Modelling the burden of cardiovascular disease in Iran from 2005-2025: The impact of democratic changes. Iranian Journal of Public Health. 46(4): 506-516.
Tabriz, S. J., Pourasghar, F. & Nikjoo, G. R. (2017). Status of Iran’s primary health care system in terms of health systems control knobs: A review article. Iran Journal of Public Health, 46(9), 1156-1166, https://www.ncbi.nlm.gov/pmc/articles/PMC5632316/#_ffn_sectitle
UNICEF. (Accessed on 2021, August 28). Iran (Islamic Republic of Iran).
