Developming National Framework for Assessment of Effective Coverage of Health System Interventions in Iran towards Universal Health Coverage

Abstract

Abstract Introduction: Delivering health interventions through a range of services is the main task of health systems. Accurate measurement of such an effort is, therefore, an essential input into tracking performance, decision-making processes and good policy formulation. Recently, international health organizations have introduced effective coverage against other commonly used measurements and monitoring indicators to assess the performance of health systems, and have recommended countries to provide a national performance assessment framework based on this metric. The present study was designed and implemented to provide a national framework for assessing effective coverage of health services in Iran. Methods: This study is a type of research in health system including a combination of review and qualitative methods for developing the framework and quantitative methods for measuring the effective coverage of interventions planned based on the objectives of the study. In addition, about ten cross-sectional sub studies were conducted with especial design and methodology and related analyzes to measure the effective coverage of selected interventions. Results: Develoed framwork based on study results included up to thirty priority interventions in Iran in four areas of promotion to rehabilitation, interventions selection criteria, and meausurement strategies for assessing three components of effective coverage for each intervention. In the practical phase of the study that was assessing the effective coverage of selected interventions, the results indicated a low coverage of health interventions, especially in promotion and prevention area. Conclusions: With the ongoing epidemiological transition in Iran, major emphasis should be placed on the coverage of non-communicable diseases and accidents along with communicable diseases. With regard to the effective coverage framework, this emphasis is necessary in three areas including identifying population in need of services, the provision of services to them and then ensuring the effectiveness of the services provided. In order to achieve each of these goals, data and information system proper to the type of interventions should be designed and implemented and, based on the assessment results, policies and action plans should be formulated