Designing an innovative primary health care for Iran's health system

Abstract

Introduction: Today, the primary strategy of countries to achieve universal health and elevate community health levels is Primary Health Care (PHC). With the advent of the twenty-first century, the necessity of these cares to respond to current issues and future needs has become more apparent. Therefore, the aim of this study is to identify necessary reforms and innovations and design an innovative model of primary healthcare in accordance with the conditions and requirements of Iran. Methodology: The present study is a mixed-methods study conducted between the years 2020 to 2023 at Tabriz University of Medical Sciences. Initially, a scoping review was conducted to examine innovative PHC features in leading countries. Then, through a qualitative study and in-depth interviews with 22 experts in primary healthcare, challenges of PHC in Iran were identified, along with suitable components for an innovative PHC system in Iran. Subsequently, using a multi-stage Delphi technique and expert panel, suitable components for innovation in primary health care and an appropriate innovative model for PHC in Iran were designed, and finally, the model's credibility was assessed and confirmed using appropriate criteria. Findings: According to the results of the scoping review, 106 articles were reviewed, and 55 innovations/improvements in primary healthcare in leading countries were identified. Additionally, the results of the qualitative study (objectives two and three) were categorized into six axes: strengths of PHC (drivers), barriers and challenges, considerations and assumptions necessary for change, evaluation and assessment process, organizations with roles in PHC, and necessary innovations/improvements for the primary healthcare system (38 innovations/improvements) in Iran. Finally, 28 innovations for PHC in Iran were extracted and finalized, categorized within the six building blocks framework of the World Health Organization, and then an innovative model of primary healthcare in Iran was designed in three levels: idea identification, idea incubator/maturation, and implementation of innovations. Conclusion: The study results indicate the need for a mechanism that continuously studies the PHC system and its surroundings, identifies the needs and expectations of the community and the health system, and generates innovative ideas. Additionally, an independent entity at the national level should be responsible for studying and supporting the operationalization of innovations. Keywords: Health system reforms, Innovation in primary health care, Innovative primary healthcare, Innovative model, six building blocks framework, Iran.