Performance Challenges Faced by “Behvarzes” as Community Health Workers of Iran: A Systematic Review of Literature

Context: Iranian community health workers (known as behvarzes) have played an undeniable role in improving the status of rural recent decades. Therefore, this study aimed to identify performance challenges faced by behvarzes using a literature review. Methods: This systematic review searched Web Science, Scopus, Science Direct, Springer, PubMed, ProQuest, SID, and Magiran databases/search engines January 2020. There were 2 inclusion criteria, namely articles published English or Persian languages those after 2000. The search strategy resulted retrieval 1,472 primary articles, 16 which finally included study, their related contents entered into extraction tables. Then, identified categorized based on context, input, process, product (CIPP) model. Results: results recognized major 5 dimensions, including context (i.e., changes societal, cultural, demographical, epidemiological characteristics communities), input inadequate number behvarzes, insufficient competencies, limited resources), process increase healthcare complexity bahvarzes’ tasks managerial problems), output decrease quality, efficiency, accessibility, continuity, utilization, effectiveness services provided poor literacy population weak involvement affairs, emerging mental problems behvarzes), outcome low equity, urban-rural disparity diagnosis treatment diseases, dissatisfaction caregivers). Conclusions: revealed numerous important need effective intervention policymakers.