انقلاب اسلامی سال 1979 در ایران بر عدالت اجتماعی به عنوان ستون توسعه تأکید کرد. اقدامات اساسی در جهت دسترسی عادلانه و همگانی به خدمات بهداشتی و درمانی و با کیفیت بالا با ایجاد وزارت بهداشت ، درمان و آموزش پزشکی (وزارت بهداشت) و تأسیس شبکه مراقبت های بهداشتی اولیه درسراسر کشور در سال 1985 آغاز شد. سیستم سلامت در ایران با تغییرات مداوم در سیاست ها روبرو بوده است (یعنی تحولات ساختاری و رویه ای). از آن زمان و با وجود جنگ تحمیلی 8 ساله با عراق و تحریم های ناعادلانه مداوم علیه این کشور ، پیشرفت قابل ملاحظه ای در سیستم سلامت حاصل شده است که منجر به سلامت بهتر جمعیت و خودکفایی در آموزش نیروی کار بهداشتی؛ پیشرفت در بهداشت عمومی و علوم پزشکی؛ تأسیس و گسترش موسسات بهداشتی و درمانی در مناطق با هدف تقویت عدالت در دسترسی به خدمات درمانی مورد نیاز صورت گرفته است

مقاله ای با عنوان 

So Near, So Far: Four Decades of Health Policy Reforms in Iran, Achievements and Challenges 

در مجله

Arch Iran Med

به چاپ رسیده است که روند سیاست های چهل سال اخیر در نظام سلامت ایران را نشان می دهد. برای مشاهده متن کامل مقاله روی لینک زیر کلیلک نمایید

Abstract

The Islamic revolution of 1979 in Iran emphasized social justice as a pillar for development. The fundamental steps towards universal equitable access to high-quality healthcare services began with the creation of the Ministry of Health and Medical Education (MoHME) and the nationwide establishment of primary healthcare (PHC) network in 1985. Now, in the 40th anniversary of the Islamic revolution, the history of health system development in Iran is characterized by constant policy changes; i.e. structural and procedural transformations. Ever since and despite the imposed 8-year war with Iraq and continuous unfair sanctions against the country, noticeable progress has been achieved in the health system that has led to better population health including among others: self-sufficiency in training health workforce; advances in public health and medical sciences; establishment and expansion of health facilities within the hard-to-reach areas aiming to enhance equity in access to needed healthcare services; domestic production of most medicines and medical equipment; and meaningful expansion of health insurance coverage. These have led to admirable improvement in public health indicators; i.e. maternal mortality, child mortality, life expectancy, and vaccination coverage. Despite achievements, there still remain challenges in health financing, protecting the public against high expenditure of medical care, establishment of referral system and rationalization of service utilization, provision of high quality healthcare services to all in need, and conflict of interest in health policy making, all of which may hinder the goal to reach “universal health coverage”, identified as the main goal of the health system in Iran by 2025. Recently, the MoHME began structural and functional reforms to boost societal efforts and enhance intersectoral collaboration to address social determinants of health, improve actions for prevention and control of non-communicable diseases and other social health problems. Drawing upon the World Health Organization (WHO)’s “six building blocks” model, this article presents an analytical description of the main health policy reforms during the last four decades after the Islamic revolution in Iran, divided by each decade. Learning from the historical reforms will create, we envisage, a better understanding of health system developments, its advances and challenges, which might in turn contribute to better evidence-informed policy making and sustainable health development in the country, and perhaps beyond.

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