* :ﻪﺒﺗﺎﮑﻣ سردآ دﺎﺑآ مﺮﺧ
، هﺎﮕﺸﻧاد مﻮﻠﻋ ،ﯽﮑﺷﺰﭘ ا ﻞﻣاﻮﻋ تﺎﻘﯿﻘﺤﺗ ﺰﮐﺮﻣ ﺖﻣﻼﺳ ﺮﺑ ﺮﺛﻮﻣ ﯽﻋﺎﻤﺘﺟ
.
ﺖﺴﭘ :ﮏﯿﻧوﺮﺘﮑﻟا
ﯽﺘﺳﺎﯿﺳ ﻪﺻﻼﺧ :ناﺮﯾا رد ﯽﺘﺷاﺪﻬﺑ ﻪﮑﺒﺷ مﺎﻈﻧ دﻮﺒﻬﺑ
2
ﯽﺑﺎﻬﺷ ﺪﯿﻌﺳ ،
1ﺮﻓ يداﺰﻬﺑ ﻢﺜﯿﻣ يرﺎﯿﺘﺨﺑ ﺪﺣا ،
يرذآ ﺪﻤﺻ ،
3ﺴﺣا ﺮﻔﻌﺟ ﺪﯿﺳ ،
4هداز نﺎ ،
5ﺮﻓ يداﺰﻬﺑ دﻮﻌﺴﻣ
1 *
1 - ﻣ ﯽﻋﺎﻤﺘﺟا ﻞﻣاﻮﻋ تﺎﻘﯿﻘﺤﺗ ﺰﮐﺮﻣ ناﺮﯾا ،دﺎﺑآ مﺮﺧ ،نﺎﺘﺳﺮﻟ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﺖﻣﻼﺳ ﺮﺑ ﺮﺛﻮ
2 - ناﺮﯾا ،زاﺮﯿﺷ ،زاﺮﯿﺷ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﺖﻣﻼﺳ يراﺬﮔ ﺖﺳﺎﯿﺳ تﺎﻘﯿﻘﺤﺗ ﺰﮐﺮﻣ
3 - ناﺮﯾا ،ناﺮﻬﺗ ،ناﺮﻬﺗ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﺖﻣﻼﺳ رد ﺖﻟاﺪﻋ تﺎﻘﯿﻘﺤﺗ ﺰﮐﺮﻣ
4 - ﺎﺘﺳرﺎﻤﯿﺑ ﺖﯾﺮﯾﺪﻣ تﺎﻘﯿﻘﺤﺗ ﺰﮐﺮﻣ ﺮﯾا ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﯽﻧ
ناﺮﯾا ،ناﺮﻬﺗ ،نا
5 - ناﺮﯾا ،ناﺮﻬﺗ ،ناﺮﯾا ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ،ﯽﮑﺷﺰﭘ ﯽﻧﺎﺳر عﻼﻃا و ﺖﯾﺮﯾﺪﻣ هﺪﮑﺸﻧاد
هرود / ﻪﺘﻓﺎﯾ 24
هرﺎﻤﺷ / 3
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/ ﻞﺴﻠﺴﻣ 93
:ﻪﻟﺎﻘﻣ ﺖﻓﺎﯾرد 6
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ﻪﻣﺪﻘﻣ :
) ﺖﻣﻼﺳ ﻪﯿﻟوا يﺎﻫ ﺖﺒﻗاﺮﻣ Primary health care (PHC)
يﺎﻫ ﺖﺒﻗاﺮﻣ ﻪﺋارا و ﻦﯿﻣﺎﺗ شور ﻦﯾﺮﺘﻬﺑ ﺪﻧاﻮﺗ ﯽﻣ ( ﺑ
ﯽﺘﺷاﺪﻬ
ﺟﻮﺗ مﺪﻋ .ﺪﺷﺎﺑ يا ﻪﻌﻣﺎﺟ ﺮﻫ رد ﺖﻣﻼﺳ ﺢﻄﺳ ءﺎﻘﺗرا و ﯽﺑﺎﯿﺘﺳد ياﺮﺑ هار ﻦﯾﺮﺗﺮﺛﻮﻣ و ﻦﯾﺮﺗﺪﻣآرﺎﮐ و هدﻮﺑ داﺮﻓا ﻪﻤﻫ ياﺮﺑ ﻪﺑ ﻪ
وPHC
ﻣ و ﻒﻠﺘﺨﻣ يﺎﻫ يرﺎﻤﯿﺑ ﺶﯾاﺰﻓا زا ﺐﺒﺳ ﺪﻧاﻮﺗ ﯽﻣ ﺖﯿﻔﯿﮐ ﯽﺑ ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ ﻫ ترﺎﺴﺧ ﺚﻋﺎﺑ و هﺪﺷ يا ﻪﻌﻣﺎﺟ ﺮﻫ رد ﺮﯿﻣ و گﺮ
يﺎ
.ددﺮﮔ يرﻮﺸﮐ ﺮﻫ ياﺮﺑ يدﺎﯾز يدﺎﺼﺘﻗا يﺪﺟ ترﻮﺻ ﻪﺑ
ﺒﻗاﺮﻣ ﻪﮑﺒﺷ .ﺖﻓﺮﮔ راﺮﻗ يﺪﺟ ﻪﺟﻮﺗ درﻮﻣ بﻼﻘﻧا زا ﺪﻌﺑ ناﺮﯾا ردPHC يﺎﻫ ﺖ
ﺪﯾدﺮﮔ دﺎﺠﯾا رﻮﺸﮐ ﺮﺳاﺮﺳ رد ﯽﺘﺷاﺪﻬﺑ .
ﺎﺑ ﻪﻌﺳﻮﺗ و هﺪﺷ ﺮﺘﻤﮐ ﺮﯿﻣ و گﺮﻣ ﻞﻠﻋ ،ناﺮﯾا ﯽﻣﻼﺳا يرﻮﻬﻤﺟ ردPHC
زا ﯽﺷﺎﻧ تﻮﻓ ﺑ
يﺎﻫ يرﺎﻤﯿ
.ﺖﺳا ﻪﺘﻓﺎﯾ ﺶﻫﺎﮐ ناﺮﯾا رد نﺎﻤﯾاز و يرادرﺎﺑ تﻼﮑﺸﻣ و رادﺮﯿﮔاو دﻮﺟو زا ﯽﺷﺎﻧ هدﺮﺘﺴﮔ يﺎﻫدروﺎﺘﺳد دﻮﺟو ﺎﺑ
ﺮﯾا ردPHC لﺎﺳ رد ﺎﻣا ،نا
.ﺖﺳا هﺪﺸﻧ نا ﺖﯾﺪﻘﺗ و يزﺎﺳزﺎﺑ ﻪﺑ ﯽﻓﺎﮐ ﻪﺟﻮﺗ ﺮﯿﺧا يﺎﻫ ا و ﺎﻫﺮﻬﺷ رد هداﻮﻧﺎﺧ ﮏﺷﺰﭘ ياﺮﺟا مﺪﻋ ،ﯽﻓﺎﮐ ﯽﻟﺎﻣ ﻊﺑﺎﻨﻣ دﻮﺒﻧ
ﺷ ا تﻻﺎﮑ ﯽﯾاﺮﺟ
ﺎﻬﻧآ ﻪﻗﻼﻋ ﻦﺘﺷاﺪﻧ و ﺖﺷاﺪﻬﺑ ﺶﺨﺑ رد نﺎﯾﻮﺠﺸﻧاد شزﻮﻣآ ﻪﺑ ﻪﺟﻮﺗ مﺪﻋ ،ﯽﻧﺎﺴﻧا يوﺮﯿﻧ دﻮﺒﻤﮐ ،هداﻮﻧﺎﺧ ﮏﺷﺰﭘ رد يﺮﯿﮔدﺎﯾ ﻪﺑ
ﯿﻟﺎﻌﻓ يﺎﻫ ﺖ
هزﻮﺣ ﻦﯾا تﻼﮑﺸﻣ ، يرادا و يرﺎﺘﺧﺎﺳ
ا رد ناراﺬﮔ ﺖﺳﺎﯿﺳ .ﺪﺷﺎﺑ ﯽﻣ دﻮﺟﻮﻣ يﺎﻫ ﺶﻟﺎﭼ ﯽﺧﺮﺑ ﻼﺳ يﺎﻫ ﺺﺧﺎﺷ ءﺎﻘﺗرا ياﺮﺑ ناﺮﯾ
ﺖﻣ ﺶﻫﺎﮐ ،
يدورو رد ﺮﺘﺸﯿﺑ يراﺬﮔ ﻪﯾﺎﻣﺮﺳ ﺪﻨﻣزﺎﯿﻧ ﯽﻟﺎﻣ دوﺪﺤﻣ ﻊﺑﺎﻨﻣ ﺮﺗ ﺐﺳﺎﻨﻣ هدﺎﻔﺘﺳا و ،ﺎﻫ نﺎﺘﺳرﺎﻤﯿﺑ ﻪﺑ نارﺎﻤﯿﺑ و ﺪﻨﺘﺴﻫPHC
ﺑ ﻪﺑ ﻪﺟﻮﺗ ﺎ
ﺎﮐ رد ﯽﻤﻬﻣ ﺶﻘﻧ ﺪﻧاﻮﺗ ﯽﻣ ﻪﮑﺒﺷ ﻦﯾا ﺖﯾﻮﻘﺗ ﻪﺑ ﺮﺘﺸﯿﺑ ﻪﺟﻮﺗ ﺪﺳر ﯽﻣ ﺮﻈﻧ ﻪﺑ ،دراد دﻮﺟو ﺶﺨﺑ ﻦﯾا رد ﻪﮐ ﯽﺑﻮﺧ يﺎﻫ ﺖﺧﺎﺳﺮﯾز ﻨﯾﺰﻫ ﺶﻫ
ﻪ
ﯾﺎﺟ و ﻪﺘﺷاد ﺎﻫراﻮﻧﺎﺧ يﺎﻫ .ددﺮﮔ اﺮﺟا ﻪﻌﻣﺎﺟ رد ﯽﺘﺳرد ﻪﺑ ﺰﯿﻧ نآ يﺎﻫدﺮﮐرﺎﮐ و هداﻮﻧﺎﺧ ﮏﺷﺰﭘ هﺎﮕ
هژاو ﺪﯿﻠﮐ يﺎﻫ :ي
ﻪﯿﻟوا يﺎﻫ ﺖﺒﻗاﺮﻣ ﺖﻣﻼﺳ يراﺬﮔ ﺖﺳﺎﯿﺳ ،ناﺮﯾا ،ﺖﻣﻼﺳ
.
هﺪﯿﮑﭼ
ﻪﻣﺪﻘﻣ
ﯽﺘﻣﻼﺳ ﯽﺳﺎﺳا و ﻢﻬﻣ قﻮﻘﺣ زا ﻪـﺑ ﺪﯾﺎﺑ و هدﻮﺑ دﺮﻓ ﺮﻫ
ﯽﺘـﺷاﺪﻬﺑ تﺎﻣﺪﺧ ﯽـﺳﺮﺘﺳد دﻮـﺧ زﺎـﯿﻧ درﻮـﻣ ﯽﻧﺎـﻣرد–
ﺪﺷﺎﺑ ﻪﺘﺷاد )
1 ( . لﺎﺳ رد 1978 ﻗاﺮﻣ ﺎﺗآﺎﻤﻟآ ﻪﯿﻣﻼﻋا رد ﺖـﺒ
) ﻪﯿﻟوا ﯽﺘﺷاﺪﻬﺑ يﺎﻫ Primary health care (PHC)
ﺢﻄـﺳ ءﺎـﻘﺗرا رد ﻢـﻬﻣ رﺎﯿـﺴﺑ ﻒـﻄﻋ ﻪﻄﻘﻧ ﮏﯾ و ﯽﻓﺮﻌﻣ ( .ﺪـﺷ بﻮﺴﺤﻣ نﺎﻬﺟ رد ﺖﻣﻼﺳ PHC
ﯽـﺳﺎﺳا ﻪـﯾﺎﭘ ﮏـﯾ
ﯽـﻣ بﻮـﺴﺤﻣ ﻻﺎـﺑ ﺖـﯿﻔﯿﮐ ﺎﺑ ﯽﺘﺷاﺪﻬﺑ يﺎﻫ ﻢﺘﺴﯿﺳ ياﺮﺑ ددﺮﮔ ) 2 ( . ﺖـﺒﻗاﺮﻣ ﻪـﺋارا و ﻦﯿﻣﺎـﺗ شور ﻦﯾﺮﺘﻬﺑ ﺪﻧاﻮﺗ ﯽﻣPHC
ﻦﯾﺮﺗﺮﺛﻮـﻣ و ﻦﯾﺮﺗﺪـﻣآرﺎﮐ و هدﻮـﺑ داﺮﻓا ياﺮﺑ ﯽﺘﺷاﺪﻬﺑ يﺎﻫ يا ﻪـﻌﻣﺎﺟ ﺮـﻫ رد ﺖﻣﻼﺳ ﺢﻄﺳ ءﺎﻘﺗرا و ﯽﺑﺎﯿﺘﺳد ياﺮﺑ هار ﺪﺷﺎﺑ ) 3 ( . ار دﺮـﻓ ﮏـﯾ ﯽﺘـﺷاﺪﻬﺑ يﺎﻫزﺎﯿﻧ ﺪﻧاﻮﺗ ﯽﻣPHC
فﺮـﻃﺮﺑ ﺖﺳا ﯽﻋﺎﻤﺘﺟا و ﯽﺣور ،ﯽﻤﺴﺟ ﺖﻣﻼﺳ ﻞﻣﺎﺷ ﻪﮐ ار يرﻮـﺤﻣ دﺮـﻓ ،يرﻮـﺤﻣ رﺎـﻤﯿﺑ ﺮـﺑ ﻪﯿﮑﺗ يﺎﺟ ﻪﺑ و هدﻮﻤﻧ رد ﺖﻟاﺪـﻋ ﺶﯾاﺰـﻓا و ﻖﻘﺤﺗ ياﺮﺑ .ﺪﻫد ﯽﻣ راﺮﻗ ﻪﺟﻮﺗ درﻮﻣ ،ﺐﺳﺎﻨﻣ ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ ﻪﺑ ﯽﺳﺮﺘﺳد ﺖﻟود
يور ﺪـﯾﺎﺑ ﺎـﻫ
ﻪﯾﺎﻣﺮــﺳ نازرا و ﺖــﯿﻔﯿﮐﺎﺑPHC ﺪــﻨﻨﮐ يراﺬﮔ
) 4 (.
مﺪــﻋ
ﻪﺑ ﻪﺟﻮﺗ ﺪـﻧاﻮﺗ ﯽـﻣ ﺖﯿﻔﯿﮐ ﯽﺑ ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ وPHC
ﺮـﻫ رد ﺮـﯿﻣ و گﺮـﻣ و ﻒـﻠﺘﺨﻣ يﺎﻫ يرﺎﻤﯿﺑ ﺶﯾاﺰﻓا ﺐﺒﺳ ﺮـﻫ ياﺮـﺑ يدﺎـﯾز يدﺎﺼﺘﻗا يﺎﻫ ترﺎﺴﺧ و هﺪﺷ يا ﻪﻌﻣﺎﺟ ﺪـﺷﺎﺑ ﻪﺘـﺷاد ﺮـﺑ رد يرﻮﺸﮐ )
5 ( . ﺢﻄـﺳ ﻦﯿﺘـﺴﺨﻧPHC
تﺎﻣﺪـﺧ ﺪﻨﻧاﻮﺗ ﯽﻣ و هدﻮﺑ ﺖﻣﻼﺳ مﺎﻈﻧ ﮏﯾ رد داﺮﻓا سﺎﻤﺗ ﺪﻨﻨﮐ ﺖﻓﺎﯾرد ار دﻮﺧ زﺎﯿﻧ درﻮﻣ ﯽﻧﺎﻣرد ﯽﺘﺷاﺪﻬﺑ )6
( ﻒﯿﻃ .
،ﻒـﻠﺘﺨﻣ يﺎـﻫ يرﺎﻤﯿﺑ ﺎﺑ طﺎﺒﺗرا رد تﺎﻣﺪﺧ زا يا هدﺮﺘﺴﮔ ـﻋﺎﺑ و هداد ﻪـﺋارا ار ﯽـﺸﺨﺒﻧاﻮﺗ و يﺮﮕﻟﺎـﺑﺮﻏ ،ﺎـﻬﻧآ نﺎﻣرد ﺚ
ددﺮﮔ ﯽﻣ ﺖﻣﻼﺳ يﺎﻫ ﺺﺧﺎﺷ دﻮﺒﻬﺑ و ﻆﻔﺣ )
7 ( .
مﺎﻈﻧ ﮏﯾ ﺖﻣﻼﺳ
تﺎﻣﺪﺧ ﻪﺋارا ﺎﺑ رد عﻮﻨﺘﻣ
ﯽـﻣPHC
ﻪـﺑ ﺖﻣﻼﺳ دﻮﺒﻬﺑ رد يﺪﻨﻤﺷزرا و ﺮﺛﻮﻣ يﺎﻫدروﺎﺘﺳد ﺪﻧاﻮﺗ ﺪـﺷﺎﺑ ﻪﺘﺷاد لﺎﺒﻧد )
8 ( ﮏـﯾ دﻮـﺟو ﺎـﺑ ،ﯽـﺘﻬﺟ زا . PHC
ﻪـﺑ ﺖﻣﻼـﺳ مﺎﻈﻧ رد دوﺪﺤﻣ ﯽﻟﺎﻣ ﻊﺑﺎﻨﻣ زا ناﻮﺗ ﯽﻣ ﺪﻣآرﺎﮐ ﻧد يﺎﻫرﻮـﺸﮐ زا يرﺎﯿﺴﺑ .دﻮﻤﻧ هدﺎﻔﺘﺳا ﻪﻨﯿﻬﺑ ترﻮﺻ ﺎـﺑ ﺎـﯿ
ياﺮﺟا رد ﯽﮔرﺰﺑ و ﺪﻨﻤﺷزرا يﺎﻫ ﺖﯿﻘﻓﻮﻣ ﺪﻨﺘﺴﻧاﻮﺗPHC
ﺪﻨﺷﺎﺑ ﻪﺘﺷاد ﺖﻣﻼﺳ يﺎﻫ ﺺﺧﺎﺷ ءﺎﻘﺗرا )
9 ( ﺪـﯿﻣا ﺶﯾاﺰﻓا .
يرﺎـﻤﯿﺑ يﺮﮕﻟﺎـﺑﺮﻏ ،نﻮﯿﺳﺎﻨﯿﺴﮐاو يﻻﺎﺑ ﺶﺷﻮﭘ ،ﯽﮔﺪﻧز ﻪﺑ ﯽـﻨﮐ ﻪـﺸﯾر ،ﻢﻟﺎـﺳ بآ ﻪﺑ ﯽﺳﺮﺘﺳد ﺶﯾاﺰﻓا ،ﻒﻠﺘﺨﻣ يﺎﻫ زا ﺮﻄﺧ ضﺮﻌﻣ رد يﺎﻬﻫوﺮﮔ و نﺎﻧز ﺖﻣﻼﺳ ﻪﺑ ﻪﺟﻮﺗ و ﻪﻠﺑآ يﺎﻫدروﺎﺘﺳد دﻮﺑPHC
) 10 ( لﺎﺳ رد . 2018
ﻪـﯿﻣﻼﻋا رد ،
ﺖﯾﻮﻘﺗ ياﺮﺑ ﯽﻧﺎﻬﺟ شﻼﺗ ﻪﻧﺎﺘﺳآ ﯽـﻫار ناﻮﻨﻋ ﻪﺑ ارPHC
يﺎـﻫ ﺖـﺒﻗاﺮﻣ ﻢﺘـﺴﯿﺳ ﯽﮔدﺎـﻣآ و ﯽﯾﻮﮕﺨﺳﺎﭘ دﻮﺒﻬﺑ ياﺮﺑ دﺮﮐ ﺎﯿﺣا ﺎﻫرﻮﺸﮐ ﯽﺘﺷاﺪﻬﺑ )
11 (.
ناﺮﯾا ردPHC راﺮـﻗ يﺪـﺟ ﻪـﺟﻮﺗ درﻮـﻣ بﻼﻘﻧا زا ﺪﻌﺑ ناﺮﯾا ردPHC
ﺖﻓﺮﮔ و ﻗاﺮﻣ ﻪﮑﺒﺷ دﺎﺠﯾا رﻮﺸﮐ ﺮﺳاﺮﺳ رد ﯽﺘﺷاﺪﻬﺑ يﺎﻫ ﺖﺒ
ﺪــﯾدﺮﮔ ) 12 ( رد و ﯽﻧﺎــﻣرد ﯽﺘــﺷاﺪﻬﺑ ﺰــﮐاﺮﻣ ﺎﻫﺮﻬــﺷ رد .
ﻪﺑ وﺮﯿﻧ ﮏﯾ ﻂﺳﻮﺗ ﺖﺷاﺪﻬﺑ يﺎﻫ ﻪﻧﺎﺧ ﺎﻫﺎﺘﺳور مﺎﻧ
،زرﻮﻬﺑ ﺑ ﻪ
تﺎﻣﺪﺧ ﻪﺋارا و نﺎـﺳآ ﯽـﺳﺮﺘﺳد ﺪـﻨﻧﺎﻣ ﯽﻠﺋﺎـﺴﻣ .ﺪـﻨﺘﺧادﺮﭘ
اﺪﻬﺑ ﺮﺑ ﺮﺛﻮﻣ ﯽﮕﻨﻫﺮﻓ ﻞﺋﺎﺴﻣ ﻪﺑ ﻪﺟﻮﺗ ،ﯽﯾﺎﯿﻓاﺮﻐﺟ ﺮﯿﮔاﺮﻓ ،ﺖﺷ
،ﯽﻧﺎــﺴﻧا يوﺮــﯿﻧ و تﺎﻣﺪــﺧ ﻢــﺠﺣ ﻦﯿــﺑ ﺐــﺳﺎﻨﺗ دﻮــﺟو ﺢﻄﺳ و عﺎـﺟرا ﻢﺘﺴﯿﺳ ﻖﯾﺮﻃ زا تﺎﻣﺪﺧ ﻪﺋارا ، تﺎﻣﺪﺧ يﺪﻨﺑ نﺎـﻧآ يﺎـﻫ ﯽﻫﺎﮔآ ﺢﻄﺳ ءﺎﻘﺗرا و ﺺﺼﺨﺘﻣ نﺎﻨﮐرﺎﮐ شزﻮﻣآ
ﻪﻣﺎﻧﺮﺑ ﻦﯾا ياﺮﺟا رد رﻮﻣ
ﺖﻓﺮﮔ راﺮﻗ ﺪﯿﮐﺎﺗ د )
13
، 14 ( .
يﺎﻫ ﺖﯿﻘﻓﻮﻣ ناﺮﯾا ردPHC
ﯽﻣﻼـﺳا يرﻮﻬﻤﺟ رد ﺖﻣﻼﺳ مﺎﻈﻧ و ﯽﮑﺷﺰﭘ ﺖﻓﺮﺸﯿﭘ ﺎﺑ يرﺎـﻤﯿﺑ زا ﯽـﺷﺎﻧ تﻮـﻓ و هﺪﺷ ﺮﺘﻤﮐ ﺮﯿﻣ و گﺮﻣ ﻞﻠﻋ ،ناﺮﯾا ﻪـﺘﻓﺎﯾ ﺶﻫﺎـﮐ نﺎـﻤﯾاز و يرادرﺎـﺑ تﻼﮑـﺸﻣ و رادﺮﯿﮔاو يﺎﻫ رد ﺮــﯿﯿﻐﺗ ﺐــﺟﻮﻣ ،ﯽﺘﺷاﺪــــﻬﺑ تﺎــــﻣﺪﺧ ﺶﯾاﺰــﻓا .ﺖــﺳا ﮔﺮـــﮔد و ﺮـــﯿﻣ و گﺮــﻣ ﺐﯿــﮐﺮﺗ يرﺎﻤﯿﺑ زوﺮـﺑرد ﯽﻧﻮ
ﺎـﻫ
ﺖـﺳا هﺪـﺷ )
15 ( ﺶﻫﺎـﮐ ،هﺪـﺷ مﺎـﺠﻧا تﺎـﻌﻟﺎﻄﻣ سﺎـﺳاﺮﺑ .
گﺮﻣ رد ﯽﻣﻮﻤﻋ ﻪﻫد رﺎﻬﭼ ﯽﻃ ناﺮﯾا رﻮﺸﮐ رد نﺎﮐدﻮﮐ ﺮﯿﻣو
ﺖﺳا ﻪﺘﺷاد دﻮﺟو ﺮﯿﺧا شﺮﺘﺴﮔ.
ﻪـﺑ ﺮـﺠﻨﻣ ﯽﻣﻮﻤﻋPHC
ﻫﺎﮐ هﺪـﺷ ﻢـﻫ لﺎـﺳ ﺞﻨﭘ ﺮﯾز نﺎﮐدﻮﮐ ﺮﯿﻣ و گﺮﻣ ناواﺮﻓ ﺶ يﺮﯿﮕﻤـﺸﭼ ﺪـﺷر ،بﻼـﻘﻧا زا ﻞﺒﻗ نارود ﻪﺑ ﺖﺒﺴﻧ ﻪﮐ ﺖﺳا
ﺖﺳا ﻪﺘﺷاد ).
16 ( مرﺎـﻬﭼ ﻪـﻫد رد ﻪـﮐ ﺖـﺳا ﯽﻟﺎﺣ رد ﻦﯾا
،ﯽﻣﻼﺳا بﻼﻘﻧا PHC
ﺶﺷﻮﭘ يﺎﻘﺗرا ﺎﺑ 100
ﺖﯿﻌﻤﺟ رد %
و يﺮﻬﺷ ا ﺶﯿﺑ ز 94 هدﻮـﺑ هاﺮﻤﻫ رﻮﺸﮐ ﯽﯾﺎﺘﺳور ﺖﯿﻌﻤﺟ %
ﺖﺳا ﻦـﺴﮐاو ﺶـﺷﻮﭘ ،ﯽـﻠﻠﻤﻟا ﻦﯿـﺑ يﺎﻫ شراﺰﮔ سﺎﺳا ﺮﺑ. ) (ﻪﻓﺮـــﺳ هﺎﯿـــﺳ و زاﺰـــﮐ ،يﺮـــﺘﻔﯾد ) ﻪـــﻧﺎﮔ ﻪـــﺳ يﺎـــﻫ
(Diphtheria, tetanus and pertussis (DPT) رد
لﺎــﺳ 2021 ﻪــﺑ 99
% ، ﮏﺧﺮــﺳ يﺎــﻫ ﻦــﺴﮐاو ﺶــﺷﻮﭘ ،
) نﻮﯾروا و ﻪﺠﺧﺮﺳ Measles, mumps and rubella
(MMR) (
100
% ب ﺖــﯿﺗﺎﭙﻫ ﻦــﺴﮐاو لوا زد ﺶــﺷﻮﭘ و
100
% ﺮـﯾز كدﻮﮐ گﺮﻣ ناﺰﯿﻣ ﻦﯿﻨﭽﻤﻫ .ﺖﺳا ﻪﺘﻓﺎﯾ ﺶﯾاﺰﻓا
دوﺪﺣ ﻪﺑ لﺎﺴﮑﯾ 10
ﻪﺘﻓﺎﯾ ﺶﻫﺎﮐ هﺪﻧز ﺪﻟﻮﺗ راﺰﻫ ﺪﺻ ﮏﯾ رد
دوﺪـﺣ ﻪـﺑ ﻪـﻌﻣﺎﺟ ﺢﻄـﺳ رد ﯽﮔﺪﻧز ﻪﺑ ﺪﯿﻣا ﻦﯿﮕﻧﺎﯿﻣ و ﺖﺳا 77 دﻮـﺒﻬﺑ هﺪـﻨﻫد نﺎـﺸﻧ ﻦـﯾا و ﺖـﺳا ﻪـﺘﻓﺎﯾ ﺶﯾاﺰـﻓا لﺎﺳ
ﻫ ﻪﻫد رد ﺖﻣﻼﺳ تﺎﻣﺪﺧ يﺎﻫدروﺎﺘـﺳد .ﺪـﺷﺎﺑ ﯽﻣ ﺮﯿﺧا يﺎ
شﺮﺘـﺴﮔ و ﻪﻌـﺳﻮﺗ ﻪﻄـﺳاو ﻪﺑ يا هدﺮﺘﺴﮔ ناﺮـﯾا ردPHC
ﻒـﻠﺘﺨﻣ يﺎﻫ ﺖﻟود يﺪﺟ مﺰﻋ هﺪﻨﻫد نﺎﺸﻧ ﻪﮐ هﺪﺷ ﻞﺻﺎﺣ ﺖـﺳا هدﻮـﺑ ﺖﻣﻼـﺳ ءﺎـﻘﺗرا ياﺮـﺑ ناراﺬـﮔ ﺖﺳﺎﯿﺳ و )
17 ( .
لﺎـﺳ رد ﻪـﮐ ﺪـﻧدﻮﺑ كﺮﺘـﺸﻣ ﯽﻓاﺪـﻫا هراﺰـﻫ ﻪﻌﺳﻮﺗ فاﺪﻫا 2000 ﻦـﯾا رد .ﺖـﻓﺮﮔ ترﻮـﺻ ﻖـﻓاﻮﺗ ﺎﻬﻧآ ﻪﺑ نﺪﯿﺳر ﺮﺳ ﺮﺑ ﺎـﻫ ﺖﺳﺎﯿﺳ ،دﻮﺧ ﺪﻬﻌﺗ سﺎﺳا ﺮﺑ و ﺎﻫرﻮﺸﮐ زا يرﺎﯿﺴﺑ ﺎﺘﺳار مﺎـﺠﻧا نآ فاﺪـﻫا ﻪـﺑ نﺪﯿـﺳر ياﺮـﺑ ﯽـﻔﻠﺘﺨﻣ يﺎﻫ ﻪﻣﺎﻧﺮﺑ و دﻮــﺟو ﻪــﺑ ﻪــﺟﻮﺗ ﺎــﺑ .ﺪــﻧداد ﺮــﯿﻣ و گﺮــﻣ ،ناﺮــﯾا ردPHC
ﻪـﺑ ﯽـﺳﺮﺘﺳد و ﻪﺘﺷاد يﺮﯿﮕﻤﺸﭼ ﺶﻫﺎﮐ ناردﺎﻣ و نﺎﮐدﻮﮐ ﺎﺳ ﯽﻧﺪﯿﻣﺎﺷآ بآ يﺎﻬﻟﺎـﺳ ﯽﻃ ﺎﺘﺳور و ﺮﻬﺷ رد ﻢﻟ
2000 ﺎـﺗ
2015 ﺖﺳا ﻪﺘﺷاد ﯽﯾﻻﺎﺑ ﺶﯾاﺰﻓا )
18 ( .
ﺎﻫ ﺶﻟﺎﭼ ،اﻮـﻫ ﯽﮔدﻮـﻟآ ،يﺪﻨﻤﻟﺎﺳ يﻮﺳ ﻪﺑ رﻮﺸﮐ ﻊﯾﺮﺳ ﺖﮐﺮﺣ داﺪـﻌﺗ ﺶﯾاﺰـﻓا ،رﺎـﻤﯿﺑ ﺪـﯿﻟﻮﺗ ﺶﯾاﺰـﻓا و رﻮﺤﻣ نﺎﻣرد هﺎﮕﻧ
ﻪﺘﮑـﺳ و ﯽـﻗوﺮﻋ و ﯽﺒﻠﻗ ،ﯽﻧﺎﻃﺮﺳ نارﺎﻤﯿﺑ زا ﯽـﺷﺎﻧ ﻪـﮐ ﺎﻫ
ﺪـﻨﻗ ،تﺎﯿﻧﺎﺧد فﺮﺼﻣ ﺶﯾاﺰﻓا ﻪﻠﻤﺟ زا ﯽﯾﺎﻫرﻮﺘﮐﺎﻓ ﮏﺴﯾر ﻪﯾﺬﻐﺗ ﺮﻘﻓ و ﮏﻤﻧ و ﻪـﺑ ﯽﻓﺎﮐ ﻪﺟﻮﺗ مﺪﻋ ،ﺖﺳا يا
وPHC
ﻣ دﻮﺒﻧ ياﺮﺟا مﺪﻋ ،ﯽﻓﺎﮐ ﯽﻟﺎﻣ ﻊﺑﺎﻨ ﻪـﻣﺎﻧﺮﺑ
هداﻮﻧﺎـﺧ ﮏـﺷﺰﭘ
رد ﯽﯾاﺮﺟا تﻻﺎﮑﺷا و ﺎﻫﺮﻬﺷ رد آ ياﺮﺟا
ن يوﺮـﯿﻧ دﻮﺒﻤﮐ ، ﺶــﺨﺑ رد نﺎﯾﻮﺠــﺸﻧاد شزﻮــﻣآ ﻪــﺑ ﻪــﺟﻮﺗ مﺪــﻋ ،ﯽﻧﺎــﺴﻧا
ﻦﯾا يﺎﻫ ﺖﯿﻟﺎﻌﻓ يﺮﯿﮔدﺎﯾ ﻪﺑ ﺎﻬﻧآ ﻪﻗﻼﻋ ﻦﺘﺷاﺪﻧ و ﺖﺷاﺪﻬﺑ تﻼﮑـﺸﻣ ،هزﻮـﺣ
،يرادا و يرﺎﺘﺧﺎـﺳ ﺰـﮐﺮﻤﺗ
رد ﻢﯿﻤـﺼﺗ
يﺮـﯿﮔ رد ﺎـﻫ
، PHC ﺎـﺳ رﺎﺘﺧ ﺐـﺳﺎﻨﻣﺎﻧ نﺎﮔﺪـﻨﻫد ﻪـﯾارا
ﺖﻣﺪﺧ رد ﻪـﺑ ﺖـﺧادﺮﭘ مﺎـﻈﻧ رد ناواﺮـﻓ تﻻﺎﮑﺷا ،ﺎﻫﺮﻬﺷ
،ﯽﻧﺎـﺴﻧا يوﺮـﯿﻧ ﺐـﺳﺎﻨﻣﺎﻧ ﻊـﯾزﻮﺗ ،تﺎﻣﺪـﺧ نﺎﮔﺪﻨﻫد ﻪﯾارا ،ﺎـﻫ ﺖﺧﺎـﺳﺮﯾز ﻪـﺑ ﻪـﺟﻮﺗ نوﺪﺑ ﻒﻠﺘﺨﻣ يﺎﻫ ﻪﻣﺎﻧﺮﺑ ياﺮﺟا ،ﯽﺗﺪـﻣ زا ﺪـﻌﺑ ﺎـﻬﻧآ ﯽﺷﻮﻣاﺮﻓ و ﺎﻬﻧآ زا ﺐﺳﺎﻨﻣ ﯽﺑﺎﯾزرا مﺪﻋ ــﻫ ناﺮــﺤﺑ رد ﺺﺨــﺸﻣ يﺎــﻫ ﺖــﺳﺎﯿﺳ دﻮــﺒﻧ ﺪــﻨﻧﺎﻣ ﯽﯾﺎ
COVID-19 و ﯽﺣاﺮﻃ ،
ياﺮﺟا ﻪـﺟﻮﺗ نوﺪﺑ يﺎﻫ ﻪﻣﺎﻧﺮﺑ
نﺎـﻤﻫ ﺎـﯾ ناﺪـﯿﻣ رد ﯽﯾاﺮﺟا يﺎﻫوﺮﯿﻧ تاﺮﻈﻧ ﻪﺑ )
Street-
level bureaucrats
رد ( رﺎﺘﺧﺎﺳ ،PHC
ﯽﺘﻨﺳ
، PHC
،ﺮـﺛا ﻢـﮐ و ﯽﯾاﺪﺘﺑا يﺎﻫ ﻞﯿﻠﺤﺗ و ﺐﺳﺎﻨﻣ يرﺎﻣآ مﺎﻈﻧ دﻮﺒﻧ دﺪﻌﺗ ﺰﮐاﺮﻣ ﻪﯾارا تﺎﻣﺪـﺧ رد ﺎﻫﺮﻬـﺷ و ﯽﮕﻨﻫﺎـﻤﻫﺎﻧ ﻦﯿـﺑ
ﺸﺨﺑ ﯽ و نورد ﯽﺸﺨﺑ زا ﻦﯾﺮﺘﻤﻬﻣ رد دﻮﺟﻮﻣ يﺎﻫ ﺶﻟﺎﭼ
ﺪﺷﺎﺑ ﯽﻣ ناﺮﯾاPHC )
14
، 19 ( .
ﺎﻫرﺎﮐ هار رد ﻢﺸﭼ زاﺪﻧا ﺖﻣﻼﺳ لﺎﺳ رد ناﺮﯾا 1404
ﺪﯾﺎﺑ رﻮﺸﮐ
ياراد ﻪﻧﻻدﺎﻋ ﻦﯾﺮﺗ و ﻪﻌﺳﻮﺗ ﻪﺘﻓﺎﯾ ﻦﯾﺮﺗ مﺎـﻈﻧ ﺖﻣﻼـﺳ رد
ﺢﻄﺳ ﻪﻘﻄﻨﻣ ﺪـﺷﺎﺑ يﺎـﻫ ﺶﻟﺎـﭼ ﻪـﺑ ﻪـﺟﻮﺗ ﺎـﺑ ور ﻦـﯾا زا .
ﺖــﺳﺎﯿﺳ ﺪــﯾﺎﺑ ﺶــﺨﺑ ﻦــﯾا رد يﺪــﺟ تﻼﮑــﺸﻣ و دﻮــﺟﻮﻣ ﻦـﯾا رد يراﺬـﮔﺮﺛا و يﺪـﺟ تﺎﻤﯿﻤـﺼﺗ ناﺮﯾﺪـﻣ و ناراﺬﮔ ا ﺶﺨﺑ فاﺪﻫا ﻪﺑ ﺎﺗ هدﺮﮐ لﺎﻤﻋ 1404
ﻦـﯾا زا .ﻢﯿﺑﺎـﯾ ﺖﺳد
ﻦـﯾا رد تﺎﺣﻼـﺻا دﺎـﺠﯾا ياﺮـﺑ ﺮـﯾز يﺎﻫرﺎﮐ هار ﯽﺧﺮﺑ ور ﮔ ﯽﻣ دﺎﻬﻨﺸﯿﭘ ﺶﺨﺑ :ددﺮ
- ﯽﯾادزﺰﮐﺮﻤﺗ زا
ﺮـﯾز ﻪـﺑ ﻪﺟﻮﺗ وPHC يﺎـﻫ ﺖﺧﺎـﺳ
ياﺮﺑ ﯽﻠﺤﻣ و ﯽﻣﻮﺑ ﺮﺘـﺸﯿﺑ ﺖﮐرﺎـﺸﻣ و تﺎﻣﺪﺧ ﻪﺋارا دﻮﺒﻬﺑ
ياﺰﺟا ﻪﻤﻫ ﺎﻫ يﺮﯿﮔ ﻢﯿﻤﺼﺗ ردPHC
- مﺎﻈﻧ ﻞﯿﻤﮑﺗ ـﻋﻼﻃا
تﺎ ﺰـﮐﺮﻤﺘﻣ ﻪﻧﺎﻣﺎـﺳ دﺎـﺠﯾا و ﻪـﺑ
رﻮﻈﻨﻣ يﺎﻫ ﺖﯿﻟﺎﻌﻓ ﻪﻤﻫ رد هدﺎﻔﺘﺳا PHC
- فﺎﻄﻌﻧا دﺎﺠﯾا ياﺮـﺑ ﺶـﺨﺑ ﻦـﯾا يﺮﯾﺬﭘ
ﯽﯾﻮﮕﺨـﺳﺎﭘ ﻪـﺑ
تاﺮﯿﯿﻐﺗ ﺪﻨﻧﺎﻣ ﯽﻧﺎﻬﺟ يﺎﻫ ﺶﻟﺎﭼ و ﯽﻄﯿﺤﻣ COVID-19
- يﺪﺟ حﻼﺻا مﺎﻈﻧ
ﺎـﺑ ﺖـﺳﺎﯿﺳ ﻦـﯾا ياﺮـﺟا و عﺎـﺟرا
هدﺮﺘﺴﮔ ﯽﻧﺎﺳر عﻼﻃا و شزﻮﻣآ - راﺮﻘﺘﺳا مﺎﻈﻧ ـﺳا ﺎـﺑ ﯽـﻤﻠﻋ ﺖﯾﺮﯾﺪـﻣ يوﺮـﯿﻧ زا هدﺎﻔﺘ
ﯽﺘﺷاﺪﻬﺑ تﺎﻣﺪﺧ ﻪﻨﯿﻣز رد ﻪﺑﺮﺠﺗ ﺎﺑ و هﺪﯾد شزﻮﻣآ ﯽﻧﺎﺴﻧا ﯽـﺑ و رﻮـﺤﻣ نﺎـﻣرد هﺎﮔﺪﯾد ﺎﺑ ناﺮﯾﺪﻣ زا هدﺎﻔﺘﺳا ﺶﻫﺎﮐ و ﺶﺨﺑ ﻦﯾا رد ﻪﺑﺮﺠﺗ
- دﻮﺒﻬﺑ ِﺎـﻘﺗرا و يوﺮـﯿﻧ ﯽﻧﺎـﺴﻧا ز ﻪـﻤﻫ رد ﻣﯿ
ـﻨ يﺎـﻫ ﻪ
ﺎﺑ ﻂﺒﺗﺮﻣ PHC
- ﻊﺑﺎﻨﻣ ﺶﯾاﺰﻓا ﯾو ﻪﺟﻮﺗ ﺎﺑ ﺪﯾﺪﺟ ﻊﺑﺎﻨﻣ ﻖﯾرﺰﺗ و ﯽﻟﺎﻣ
هﮋ
ﺘﺧﺎﺳ ﻂﺳﻮﺗ رﻮﺸﮐ رد يراﺬﮕﻧﻮﻧﺎﻗ يﺎﻫرﺎ
- دﺎﺠﯾا يﺎﻬﺘﺻﺮﻓ ﺐﺳﺎﻨﻣ
ﯽﺻﻮﺼﺧ ﺶﺨﺑ ﺶﯾاﺰﻓا و رد
ﻪﯾارا تﺎﻣﺪﺧ رد PHC
- رد ﯽــﯾاﺮﺟا يﺎــﻫ ﻪــﻣﺎﻧﺮﺑ ﯽﺑﺎــﯾزرا ﺎــﺑ رﻮــﺸﮐPHC
زور ﻪﺑ و ﯽﻤﻠﻋ يﺎﻫرﺎﯿﻌﻣ زا هدﺎﻔﺘﺳا - ﺪـﻬﻌﺗ شﺮـﮕﻧ ﺮـﯿﯿﻐﺗ و ﺮﺘـﺸﯿﺑ نﺎـﻣرد زا ﺎـﻫ ﺖـﻟود
يرﻮﺤﻣ ﺖﺷاﺪﻬﺑ ﻪﺑ يرﻮﺤﻣ - حﻼﺻا رﺎﺘﺧﺎﺳ ﯽﻧﺎﻣزﺎﺳ PHC رد ﺖﻬﺟ ﺶﯾاﺰﻓا
،ﺮﺤﺗ
دﻮﺒﻬﺑ و ﯽﯾارﺎﮐ رد ﯽﻧﺎﺳر ﺖﻣﺪﺧ
يﺎﺘﺳار ﯽﯾﻮﮕﺨـﺳﺎﭘ ﻪـﺑ
ﺖﯾﻮﻟوا ﺎﻫ و يﺎﻫزﺎﯿﻧ ﯽﺳﺎﺳا
- ﻪـﺑ ﯽـﯾاﺮﺟا رﻮـﻣا يﺎﻫ ﺖﯿﻟﺎﻌﻓ ﻦﯾﺮﺗ ﯽﺳﺎﺳا يراﺬﮔاو ﺮﺘـﺸﯿﺑ ترﺎﻈﻧ و ﺖﯾﺮﯾﺪﻣ لﺎﻤﻋا ،ﯽﮑﺷﺰﭘ مﻮﻠﻋ يﺎﻬﻫﺎﮕﺸﻧاد
ﺎﻫ نﺎﺘﺳا ﺖﻣﻼﺳ يارﻮﺷ ﻪﺑ - ﯽــﻠﺤﻣ ضراﻮــﻋ يﺎــﻫ ﺖــﯿﻟﺎﻣ ﺬــﺧا يﺎﻫﺪــﻣآرد و
ﺎﻬﻧﺎﻣزﺎــﺳ يرادﺮﻬــﺷ ﺪــﻨﻧﺎﻣ ﯽﯾ ﻊﯾﺎﻨــﺻ و تﺎــﺠﻧﺎﺧرﺎﮐ ،ﺎــﻫ
مﺎـﻈﻧ و بﻮـﻠﻄﻣ يا هﻮﯿـﺷ ﻪﺑ صﺎﺼﺘﺧا و ﯽﻄﯿﺤﻣ هﺪﻨﯾﻻآ ﻪﺑ ﺪﻨﻣ PHC
- رﺎﺘﺧﺎـﺳ ﻦﯾوﺪـﺗ و يﺮﮕﻧزﺎـﺑ ﺖﺌﯿﻫ ﻞﯿﮑﺸﺗ ﺎـﺑPHC
نﺎﮔﺪـﻨﯾﺎﻤﻧ و ،ﯽـﻠﺤﻣ ،ﯽـﺳﺎﯿﺳ ،ﯽﻫﺎﮕﺸﻧاد نﺎﮔﺮﺒﺧ رﻮﻀﺣ ﺖﯾﻮﻟوا زا ﮏﯾﮋﺗاﺮﺘﺳا ﺖﺧﺎﻨﺷ ياﺮﺑ ﯽﺻﻮﺼﺧ ﺶﺨﺑ و مدﺮﻣ ﮐ ،دﻮـﺟﻮﻣ يﺎﻫ ﺶﻟﺎﭼ و ﺎﻫ و يزﺎـﺳ هدﺎـﺳ ،يزﺎـﺳ ﮏـﭼﻮ
درﻮـﻣ ﯽﻧﺎـﺴﻧا يوﺮﯿﻧ و ﯽﺴﯾﺮﺗﺎﻣ دﺮﮑﯾور ﺎﺑ رﺎﺘﺧﺎﺳ ﯽﺣاﺮﻃ و يﺰـﯾر ﻪـﻣﺎﻧﺮﺑ زﺎـﯿﻧ درﻮـﻣ يﺎـﻫ ترﺎـﻬﻣ و ﺶـﻧاد ﺎـﺑ زﺎﯿﻧ
ﯽﻠﻣ ﺖﯾﺮﯾﺪﻣ - تﺪـﻣﺪﻨﻠﺑ ﺪﯾد ﺎﺑ ترازو ﮏﯾﮋﺗاﺮﺘﺳا ﻪﻣﺎﻧﺮﺑ ﻦﯾوﺪﺗ ﻪـﮐ
دﻮﺑ ﺪﻫاﻮﺧ هار ﻦﯾا رد ﻊﻣﺎﺟ ماﺪﻗا ﻦﯿﻟوا رﻮﺘﺳد رد زﺎﺑ ﻦﺘﻓﺮﮔ راﺮﻗ رﺎﮐ
ﯽﺳﺪﻨﻬﻣ ) ناﺮﯾا ردPHC
Agenda setting reengineering PHC in Iran (
،ﺖﻣﻼﺳ يراﺬﮔ ﺖﺳﺎﯿﺳ رد دﺮﺑرﺎﮐﺮﭘ يﺎﻫ لﺪﻣ زا ﯽﮑﯾ ﯽـﺳرﺮﺑ ﻪـﺑ ﻪـﮐ ﺖـﺳا ،ناﺪـﮕﻨﯿﮐ ﻪـﻧﺎﮔﺪﻨﭼ تﺎﻧﺎﯾﺮﺟ لﺪﻣ
رﻮﺘﺳد رد ﯽﮕﻧﻮﮕﭼ هدﺎﻔﺘﺳا ﺎﺑ ﺖﺳﺎﯿﺳ ﮏﯾ ﻦﺘﻓﺮﮔ راﺮﻗ رﺎﮐ
نﺎـﯾﺮﺟ ﻪﺳ زا :
هار) ﺖـﺳﺎﯿﺳ نﺎـﯾﺮﺟ ،ﻞﮑـﺸﻣ نﺎـﯾﺮﺟ ﻞـﺣ
دزادﺮـﭘ ﯽﻣ (ﯽﺳﺎﯿﺳ هدارا) ﯽﺳﺎﯿﺳ نﺎﯾﺮﺟ و (ﻞﮑﺸﻣ )
20 (.
ﻦﯾا سﺎﺳا ﺮﺑ ﻢﯿﻫاﻮﺧ ﯽﻣ رﻮﺘﺳد رد ﺖﯿﻌﺿو ،لﺪﻣ
راﺮﻗ رﺎﮐ
حﻼﺻا و ﺖﯾﻮﻘﺗ ﻦﺘﻓﺮﮔ .ﻢﯿﻨﮐ ﯽﺳرﺮﺑ ار ناﺮﯾا ردPHC
ﺖـﯿﻤﻫا ﺎﺑ زا ﯽﮑﯾ ﺪﻧاﻮﺗ ﯽﻣ ﺐﺳﺎﻨﻣ ﺖﺷاﺪﻬﺑ و ﺖﻣﻼﺳ .دﻮـﺷ بﻮـﺴﺤﻣ ﻪـﻌﻣﺎﺟ ﺮـﻫ ﺖﻓﺮﺸﯿﭘ رد ﺮﺛﻮﻣ ﻞﻣاﻮﻋ ﻦﯾﺮﺗ ﺎـﯾ و ﯽـﻧاور ،ﯽﻤﺴﺟ ﻪﮑﻨﯾا زا ﻢﻋا ﻪﻌﻣﺎﺟ رد ﺖﻣﻼﺳ ناﺪﻘﻓ ﺪﺷﺎﺑ ﯽﻋﺎﻤﺘﺟا يدﺪﻌﺘﻣ ﺐﻗاﻮﻋ ﺪﻧاﻮﺗ ﯽﻣ
ﻪﺘـﺷاد هاﺮـﻤﻫ ﻪﺑ
هزور ﺮـﻫ نﺎـﻬﺟ ﺮﺳاﺮﺳ رد .ﺪﺷﺎﺑ 8000
ﺖـﻠﻋ ﻪـﺑ كدﻮـﮐ
دوﺪﺣ ،نﻮﯿﺳﺎﻨﯿﺴﮐاو نداﺪﻧ مﺎﺠﻧا 7000
ﻢـﮐ ﺖﻠﻌﺑ كدﻮﮐ
دوﺪﺣ و ﯽﻣ لﺎﻬﺳا زا ﯽﺷﺎﻧ نﺪﺑ ﯽﺑآ 6000
ﺖﻠﻋ ﻪﺑ كدﻮﮐ
ﯽﺴﻔﻨﺗ يﺎﻫ ﺖﻧﻮﻔﻋ ﺪـﻧﺮﯿﻣ ﯽـﻣ
ﻦـﯾا ﻪـﺑ ﻊـﺿو ﻪـﭽﻧﺎﻨﭼ و
نﻮـﯿﻠﯿﻣ ﺎـﻫ ﺪـﺻ هﺪـﻨﯾآ يﺎﻬﻟﺎﺳ رد ،ﺪﻨﮐ اﺪﯿﭘ ﻪﻣادا ﺐﯿﺗﺮﺗ دﻮﮐ نﺎﮐ نﺎﺟ و ﺪﻨﻫد ﯽﻣ ﺖﺳد زا ار دﻮﺧ ﯽﺿراﻮﻋ رﺎﭼد ﺎﯾ
نﻮﭽﻤﻫ ﯽـﻣ ﯽـﻧاور و ﯽﻤـﺴﺟ ﯽﻓﺎـﮐﺎﻧ ﺪـﺷر و ﻪﯾﺬﻐﺗ ءﻮﺳ و نﺎـﮐدﻮﮐ ﺮـﯿﻣ و گﺮـﻣ زا ناﻮـﺗ ﯽـﻣ ﻪـﮐ ﯽﻟﺎﺣ رد .ﺪﻧﻮﺷ
شﺮﺘـﺴﮔ ﺎـﺑ ﺎـﻫ يرﺎﻤﯿﺑ ﻦﯾا زا ﯽﺷﺎﻧ يﺎﻫ ترﺎﺴﺧ PHC
دﻮﻤﻧ يﺮﯿﮔﻮﻠﺟ رد ﻪـﮐ يا ﻪـﻔﻗو ﯽـﺑ يﺎـﻫ شﻼﺗ ﻢﻏﺮﯿﻠﻋ.
ﻼﺳ ﺢﻄﺳ ءﺎﻘﺗرا ياﺮﺑ ناﺮﯾا زﻮـﻨﻫ ﺎـﻣا ﺖﺳا هﺪﺷ مﺎﺠﻧا ﺖﻣ
ﻪـﮐ دراد دﻮـﺟو يدﺎـﯾز ﯽﺘـﺷاﺪﻬﺑ يﺎﻫ ﺶﻟﺎﭼ و تﻼﮑﺸﻣ ) ﻞﮑﺸﻣ ﻞﺻا دﻮﺟو ﻪﺑ هرﺎﺷا Problem
دراد ( ) 17 ( .
و ﯽﻧﺎـﻣرد ،ﯽﺘـﺷاﺪﻬﺑ ،ﯽﺸﻫوﮋﭘ ،ﯽﺷزﻮﻣآ تﺎﻣﺪﺧ ﻪﺋارا ﯽﻧﺎـﺴﻧا يﺎﻬـﺷزرا و لﻮـﺻا ﺮـﺑ ﯽﻨﺘﺒﻣ ﺖﻣﻼﺳ ﯽﺸﺨﺒﻧاﻮﺗ -
ﯽﻣﻼــﺳا ﻪــﻌﻣﺎﺟ رد نآ يزﺎــﺳ ﻪــﻨﯾدﺎﻬﻧ و ،
دﺮــﮑﯾور ﻖــﻘﺤﺗ
،ﻦﯿﻧاﻮــﻗ ﻪــﻤﻫ رد ﻢﻟﺎــﺳ نﺎــﺴﻧا و ﻪــﺒﻧﺎﺟ ﻪــﻤﻫ ﺖﻣﻼــﺳ ﺖـﯾﺎﻋر ﺎـﺑ تارﺮـﻘﻣ و ﯽـﯾاﺮﺟا يﺎﻬﺘﺳﺎﯿﺳ ندﻮـﻤﻧ ﺪـﻣآزور
ﻪﻣﺎﻧﺮﺑ ﯽﺘﺷاﺪﻬﺑ يﺎﻫ ،
حﺮﻃ ياﺮﺑ ﺖﻣﻼﺳ ﺖﺳﻮﯿﭘ ﻪﯿﻬﺗ يﺎﻫ
ﻪﻌﺳﻮﺗ نﻼﮐ ،رﻮﺤﻣ
نﺎـﻣرد ﺮـﺑ يﺮﯿﮕـﺸﯿﭘ ﺖﯾﻮﻟوا ،
ﺶﻫﺎـﮐ
ﯽﮔدﻮﻟآ و تاﺮﻃﺎﺨﻣ ﺪﯾﺪﻬﺗ يﺎﻫ
ﺮـﺑ ﯽـﻨﺘﺒﻣ ﺖﻣﻼﺳ هﺪﻨﻨﮐ
ﯽﻤﻠﻋ ﺮﺒﺘﻌﻣ ﺪﻫاﻮﺷ ،
هﺮـﻬﺑ و ﯽﯾاﺬـﻏ ﺖـﯿﻨﻣا ﻦﯿﻣﺄﺗ يﺪـﻨﻣ
،ﯽﻓﺎـﮐ و بﻮـﻠﻄﻣ ،ﻢﻟﺎـﺳ ﯽﯾاﺬﻏ ﺪﺒﺳ زا مدﺮﻣ دﺎﺣآ ﻪﻧﻻدﺎﻋ ياﻮﻫ و بآ ﻢﻟﺎﺳ
تﺎﻧﺎﮑﻣا ، هدروآﺮﻓ و ﯽﻧﺎﮕﻤﻫ ﯽﺷزرو
يﺎـﻫ
و ﯽــﻠﻣ يﺎﻫدراﺪﻧﺎﺘــﺳا ﺖــﯾﺎﻋر ﺎــﺑ هاﺮــﻤﻫ ﻦــﻤﯾا ﯽﺘــﺷاﺪﻬﺑ ﻪﻘﻄﻨﻣ يﺎﻫرﺎﯿﻌﻣ ﯽﻧﺎﻬﺟ و يا
، ﻢﯿﻤﺼﺗ ﺞﯾوﺮﺗ ماﺪﻗا و يﺮﯿﮔ
ﻪﺘﻓﺎﯾ ﺮﺑ ﯽﻨﺘﺒﻣ ،ﺖﻣﻼـﺳ يﺎﻬﺘﺒﻗاﺮﻣ رد ﯽﻤﻠﻋ و ﻦﻘﺘﻣ يﺎﻫ
ﻦﯾوﺪﺗ ﺎﺑ تﺎﻣﺪﺧ و شزﻮﻣآ ﯽﺑﺎﯾزرا ،ﺎﻫﺎﻤﻨﻫار و ﺎﻫدراﺪﻧﺎﺘﺳا
يروﺎﻨﻓ ﺢﻄﺳ مﺎﻈﻧ راﺮﻘﺘﺳا ،ﺖﻣﻼﺳ يﺎﻫ ﺖـﯾﻮﻟوا ﺎـﺑ يﺪﻨﺑ
يﺮﯿﮕـﺸﯿﭘ و ﺖﻣﻼﺳ ءﺎﻘﺗرا تﺎﻣﺪﺧ مﺎـﻈﻧ رد ﺎـﻬﻧآ مﺎـﻏدا و
ﯽﮑـﺷﺰﭘ مﻮﻠﻋ شزﻮﻣآ ،
ﺖـﺧادﺮﭘ مﺎـﻈﻧ حﻼـﺻا ﺮـﺑ ﯽـﻨﺘﺒﻣ
و ﻪـﻧﻻدﺎﻋ ﺪـﻣآرد دﺎـﺠﯾا ،ﯽﯾآرﺎـﮐ ﺶﯾاﺰﻓا ،دﺮﮑﻠﻤﻋ ﺖﯿﻔﯿﮐ هﺰﯿﮕﻧا ﺐﯿﻏﺮﺗ ﺖﺒﺜﻣ يﺎﻫ
ﻪـﺟﻮﺗ و تﺎﻣﺪـﺧ نﺎﮔﺪـﻨﻨﮐ ﻪﺋارا
ﻖﻃﺎـﻨﻣ رد يﺮﯿﮕـﺸﯿﭘ و ﺖﻣﻼﺳ ءﺎﻘﺗرا يﺎﻬﺘﯿﻟﺎﻌﻓ ﻪﺑ صﺎﺧ موﺮــﺤﻣ رد ﺐــﺳﺎﻨﻣ يﺎــﻫ ﺖــﺳﺎﯿﺳ دﻮــﺟو زا يا ﻪــﺷﻮﮔ ،
ﻪﻌﺳﻮﺗ يﺎﺘﺳار دﻮـﺟو ﻪـﺑ هرﺎـﺷا ﻪـﮐ ﺖﺳا ناﺮﯾا ردPHC
ﺖﺳﺎﯿﺳ ﻞﺻا ) يراﺬﮔ
Policy دراد ( ) 21 (.
ﮏـﯾ ناﻮﻨﻋ ﻪﺑ ﺖﻣﻼﺳ مﻮﻬﻔﻣ دﺎﻌﺑا ﯽﮔدﺮﺘﺴﮔ و تاﺮﯿﯿﻐﺗ ﺎـﺳ رد نآ يزﺎـﺳ ﻢﻫاﺮﻓ ﺮﺑ راﺬﮔﺮﯿﺛﺄﺗ نﺎﮐرا و ﯽﻧﺎﮕﻤﻫ ﻖﺣ ل
ﻦﺘـﺷاد ﺮـﻈﻧ رد ﺎـﺑ ﻖـﯿﻗد يﺎﻫ يﺰﯾر ﻪﻣﺎﻧﺮﺑ موﺰﻟ ﺮﯿﺧا يﺎﻫ رد .ﺖـﺳا هدﺮـﮐ ناﺪﻨﭼود ار ﺎﻫ ﺺﺧﺎﺷ و فاﺪﻫا ،ﺎﻫ ﺖﯾﻮﻟوا نﻮﻨﮐﺎﺗ ،ناﺮﯾا 6
ﯽﮕﻨﻫﺮﻓ و ﯽﻋﺎﻤﺘﺟا ،يدﺎﺼﺘﻗا ﻪﻌﺳﻮﺗ ﻪﻣﺎﻧﺮﺑ
و ﺐﯾﻮـﺼﺗ ﺲـﻠﺠﻣ و ﺖـﻟود يرﺎـﮑﻤﻫ ﺎﺑ ﻪﻟﺎﺳ ﺞﻨﭘ ترﻮﺻ ﻪﺑ ﻮﺗ درﻮـﻣ ﺎﻬﻧآ رد ﯽﻧﺎﻣرد و ﯽﺘﺷاﺪﻬﺑ ﻞﺋﺎﺴﻣ ﻪﮐ هﺪﺷ اﺮﺟا ﻪـﺟ
ﯽـﭘ ناﻮـﺗ ﯽﻣ ﺎﻫ ﻪﻣﺎﻧﺮﺑ ﻦﯾا ﯽﺳرﺮﺑ ﺎﺑ ﻪﺘﺒﻟا .ﺖﺳا ﻪﺘﻓﺮﮔ راﺮﻗ ﺖـﯿﻤﻫا و ﺶـﻘﻧ ﻪـﺑ هﮋـﯾو ﻪـﺟﻮﺗ ،نﺎـﻣز روﺮﻣ ﻪﺑ دﺮﺑ PHC
دﻮـﺟو نآ ﯽـﺳﺪﻨﻬﻣزﺎﺑ ياﺮﺑ ﯽﺼﺨﺸﻣ ﻪﻣﺎﻧﺮﺑ و ﻪﺘﻓﺎﯾ ﺶﻫﺎﮐ ﺪـﻨﻧاﻮﺗ ﯽـﻣ ﺎﺘـﺳار ﻦﯾا رد ﯽﻤﻬﻣ يﺎﻫ نﺎﻣزﺎﺳ .ﺖﺳا ﻪﺘﺷاﺪﻧ
ﺪﻨﻨﮐ ﺶﻘﻧ يﺎﻔﯾا ﻪﻠﻤﺟ زا .
ﯽﻣﻼـﺳا يارﻮـﺷ ﺲـﻠﺠﻣ ﻪـﮐ
ﺎـﺑ
ﺟو ﻪـﮐ ﺖﺳا ﻪﺘﺴﻧاﻮﺘﻧ ،ﻢﻬﻣ رﺎﯿﺴﺑ يراﺬﮔ ﺖﺳﺎﯿﺳ هﺎﮕﯾﺎﺟ دﻮ
رد ﯽﺒﺳﺎﻨﻣ يﺎﻫ ﺖﺳﺎﯿﺳ 10
ﻢـﻬﻣ ﻦـﯾا ياﺮـﺑ ﻪﺘـﺷﺬﮔ لﺎﺳ
ﺶـﺨﺑ شﺮﺘﺴﮔ ﺮﺑ نآ ﺰﮐﺮﻤﺗ هﺪﻤﻋ ﻪﻧﺎﻔﺳﺎﺘﻣ و ﺪﯾﺎﻤﻧ ﺐﯾﻮﺼﺗ نﺎﺘـﺴﮕﻨﻫﺮﻓ رد .ﺖـﺳا هدﻮـﺑ ﺎـﻫ نﺎﺘﺳرﺎﻤﯿﺑ ﻪﻌﺳﻮﺗ و نﺎﻣرد تﺎﻣﺪـﺧ ﻪـﺋارا ﻪﮑﺒـﺷ مﺎـﻈﻧ ﺖـﯾﻮﻘﺗ ﺮـﺑ ﺪﯿﮐﺎﺗ ﯽﮑﺷﺰﭘ مﻮﻠﻋ ﻪﻌﻣﺎﺟ و ﺖﻣﻼﺳ دﻮـﺟو ،ﯽﮑـﺷﺰﭘ شزﻮﻣآ ندﺮﮐ رﻮﺤﻣ
دراد ،
ﺖـﺳﺎﯿﺳ يﻮـﺳ زا ﺮـﻣا ﻦـﯾ ﻪـﺑ ﯽﻬﺟﻮـﺗ ﺪﺳر ﯽﻣ ﺮﻈﻧ ﻪﺑ ﺎﻣا ﺮـﺒﻫر ﻪـﻗﻼﻋ و ﺪـﯿﮐﺎﺗ ،ﻦﯿـﺑ ﻦـﯾا رد ﺎـﻣا .ﺖﺳا هﺪﺸﻧ ناراﺬﮔ تﻮﻗ ﻪﻄﻘﻧ ،ﯽﻧﺎﻣرد و ﯽﺘﺷاﺪﻬﺑ ﻪﮑﺒﺷ ﺖﯿﻤﻫا درﻮﻣ رد بﻼﻘﻧا ﯽﻣﺎـﺣ ﮏـﯾ ناﻮـﻨﻋ ﻪـﺑ نﺎـﺸﯾا ،ﺖﺳا ﺪﻨﻤﺷزرا رﺎﯿﺴﺑ و هدﻮﺑ اﻮﺧ ،ﻢــﻬﻣ رﺎﯿــﺴﺑ ﯽــﺳﺎﯿﺳ ﺖــﯾﻮﻘﺗ و يزﺎــﺳزﺎﺑ رﺎﺘــﺳ
ــﺷ ﻪﮑﺒ
ﺪﻧﺪﺷ ﺖﺷاﺪﻬﺑ ﺎﺗ
ﺮﺘـﺸﯿﺑ ﺖﻣﻼـﺳ ءﺎﻘﺗرا ﺪﻫﺎﺷ ﺮﺘﻤﮐ ﻪﻨﯾﺰﻫ ﺎﺑ
.ﻢﯿﺷﺎﺑ ﻪﻌﻣﺎﺟ ﯽـﺳﺎﯿﺳ ﻞـﺻا دﻮـﺟو ﻪﺑ هرﺎﺷا دراﻮﻣ ﻦﯾا ﻪﻤﻫ
) ندﻮﺑ Politics دراد (
) 22 (.
حﺮـﻃ ﺪـﻨﻧﺎﻣ ناﺮـﯾا ﺖﻣﻼـﺳ مﺎـﻈﻧ رد تﺎﺣﻼﺻا ياﺮﺟا ﺶﯾاﺪـﯿﭘ ،ب ﺖﯾﺎﭙﻫ هدﺮﺘﺴﮔ نﻮﯿﺳﺎﻨﯿﺴﮐاو ،ﺖﻣﻼﺳ لﻮﺤﺗ
COVID-19 رد ﯽﺘـــﺷاﺪﻬﺑ ﻪﮑﺒـــﺷ ﮓـــﻧرﺮﭘ ﺶـــﻘﻧ و
ياﺮـﺟا ﻖﯾﺮﻃ زا يرﺎﻤﯿﺑ دراﻮﻣ ﺶﻫﺎﮐ و لﺮﺘﻨﮐ ،يﺮﯿﮕﺸﯿﭘ ﺎــﺻﻮﺼﺨﻣ و ﻒــﻠﺘﺨﻣ يﺎــﻫ ﻪــﻣﺎﻧﺮﺑ
"
نﻮﯿــﺳﺎﻨﯿﺴﮐاو مﺎــﺠﻧا
هدﺮﺘــﺴﮔ COVID-19
يﺎــﻫ ﺖــﺴﺗ هدﺮﺘــﺴﮔ مﺎــﺠﻧا ،
نﺎـﻧآ يﺎﻫ هداﻮﻧﺎﺧ و نارﺎﻤﯿﺑ شزﻮﻣآ و يﺮﯿﮕﯿﭘ ،ﯽﺼﯿﺨﺸﺗ رﻮﺘــﺳد و هﮋــﯾو ﻪــﺟﻮﺗ و ﯽﻧﺎﻤﯿﻠــﺳ ﺪﯿﻬــﺷ حﺮــﻃ ﻖــﯾﺮﻃ زا ياﺮﺑ يﺮﺒﻫر ﺖﯾﻮﻘﺗ و يزﺎﺳزﺎﺑ
ﺷ ﺖـﺷاﺪﻬﺑ ﻪﮑﺒ ﺪـﻧاﻮﺗ ﯽـﻣ
) ﺖــﺻﺮﻓ هﺮــﺠﻨﭘ ﮏــﯾ Window of opportunity
(
زﺎﺑ ياﺮﺑ ار ﺐﺳﺎﻨﻣ ﯽﺳﺪﻨﻬﻣ
ﻪـﺑ .ﺪﻨﮐ ﻢﻫاﺮﻓ ناﺮﯾا ردPHC
،ﻻﺎـﺑ رد هﺪـﺷ ﻪـﺘﻔﮔ يﺎﻫرﺎﯿﻌﻣ دﻮﺟو ﻢﻏﺮﯿﻠﻋ ﺪﺳر ﯽﻣ ﺮﻈﻧ ﺖــﯾﻮﻘﺗ و ﯽــﺳﺪﻨﻬﻣزﺎﺑ زﻮــﻨﻫ ﺎــﻣا رﺎــﮐ رﻮﺘــﺳد ردPHC
ياﺮـﺟا مﺪـﻋ و ﺖـﺳا ﻪﺘﻓﺮﮕﻧ راﺮﻗ ناﺮﯾا رد ناراﺬﮔ ﺖﺳﺎﯿﺳ ) ﺖﻣﻼـﺳ ﯽﻧﺎﮕﻤﻫ ﺶﺷﻮﭘ ﻪﺑ ﯽﺑﺎﯿﺘﺳد ﺮﺑ ﺪﻧاﻮﺗ ﯽﻣ ﺮﻣا ﻦﯾا
Universal health coverage (UHC) راﺬــﮔﺮﺛا (
.ﺪﺷﺎﺑ
يﺮﯿﮔ ﻪﺠﯿﺘﻧ
يﺎـﻫ ﺺﺧﺎـﺷ ءﺎـﻘﺗرا ياﺮـﺑ ناﺮـﯾا رد ناراﺬﮔ ﺖﺳﺎﯿﺳ هدﺎﻔﺘﺳا و ﺎﻫ نﺎﺘﺳرﺎﻤﯿﺑ ﻪﺑ نارﺎﻤﯿﺑ يدورو ﺶﻫﺎﮐ ،ﺖﻣﻼﺳ يراﺬـﮔ ﻪﯾﺎﻣﺮـﺳ ﺪـﻨﻣزﺎﯿﻧ ﯽﻟﺎـﻣ دوﺪـﺤﻣ ﻊﺑﺎـﻨﻣ ﺮﺗ ﺐﺳﺎﻨﻣ رد ﺮﺘﺸﯿﺑ
يﺎـﻫ ﺖﺧﺎـﺳﺮﯾز ﻪـﺑ ﻪـﺟﻮﺗ ﺎـﺑ و ﺪﻨﺘﺴﻫ PHC
ﺮﻈﻧ ﻪﺑ ،دراد دﻮﺟو ﺶﺨﺑ ﻦﯾا رد ﻪﮐ ﯽﺑﻮﺧ ﻪـﺟﻮﺗ ﺪﺳر ﯽﻣ
رد ﯽـﻤﻬﻣ ﺶـﻘﻧ ﺪـﻧاﻮﺗ ﯽـﻣ ﻪﮑﺒـﺷ ﻦـﯾا ﺖـﯾﻮﻘﺗ ﻪﺑ ﺮﺘﺸﯿﺑ هداﻮﻧﺎﺧ ﮏﺷﺰﭘ هﺎﮕﯾﺎﺟ و ﻪﺘﺷاد ﺎﻫراﻮﻧﺎﺧ يﺎﻫ ﻪﻨﯾﺰﻫ ﺶﻫﺎﮐ .ددﺮﮔ اﺮﺟا ﻪﻌﻣﺎﺟ رد ﯽﺘﺳرد ﻪﺑ ﺰﯿﻧ نآ يﺎﻫدﺮﮐرﺎﮐ و
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Improving the primary healthcare in Iran: A policy brief
Behzadifar M1, Shahabi S2, Bakhtiari A3, Azari S4, Ehsanzadeh SJ5, Behzadifar M1*
1.Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran 2.Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
3.Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran 4.Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
5.School of Health Management & Information Sciences, Iran University of Medical Sciences, Tehran, Iran, [email protected]
Received: 2022/12/27 Accepted: 2023/1/6
Abstract
Background: Primary healthcare (PHC) is the best method to provide primary healthcare for the people, and is the most efficient and effective way to achieve and improve a high level of health in any society. Failure to pay attention to PHC and low-quality health services can lead to an increase in various diseases, and consequently a higher number of death toll in any society, which would cause economic damages. PHC in Iran received a lot of attention after the revolution in 1979. In PHC, a healthcare network was established throughout the country. With the development of PHC in the Islamic Republic of Iran, the causes of death have decreased, and the death due to infectious diseases, pregnancy, and childbirth problems have also decreased. Despite the vast achievements of PHC in Iran, in recent years, enough attention has not been paid to its reconstruction and consecration. Lack of sufficient financial resources, non-implementation of family doctors in cities and executive problems in family doctors, lack of human resources, lack of attention to the education of students in the health sector, their lack of students’ interest in learning the activities of this field, and structural and administrative problems are some of the existing challenges. Results of the present study suggest that policymakers in Iran need to invest more in PHC in order to improve health indicators, reduce patient admissions to hospitals, and make more appropriate use of limited financial resources. Using the infrastructure that already exists in this sector and strengthening the network of PHC play an important role in reducing household expenses; also, the position of the family doctor and its functions can be properly implemented in the society.
Keywords: Primary healthcare, Iran, Health policy.
*Citation: Behzadifar M, Shahabi S, Bakhtiari A, Azari S, Ehsanzadeh SJ, Behzadifar M. Improving the primary healthcare in Iran: A policy brief. Yafte. 2022; 24(3):72-80.
