Achievement of the WHO Goals in Iran’s Health Care System. Results From a Scoping Review

Background: Health systems are required to examine achievement of the goals based on appropriate frameworks. Assessment of health system in a country provides an opportunity to address the main mission through recognizing new needs and resolving existing gaps. Then this review study examines Iran’s health systems achievement of the goals set by the World Health Organization’s conceptual framework. Methods: This scoping review was conducted based the methodological framework of Arksey and O’Malley in 2021. A structured search of the international data bases including Web of Science, Scopus, PubMed/Medline and Persian databases such as SID, Magian and Iran doc was conducted. Keywords of “health, Iran, system” along with “burden diseases”, “responsiveness” and “financial protection” were used separately for each dimension of health promotion, accountability and fair financial participation. Appropriate Persian words were also used equivalent to English ones. Retrieved articles were analyzed using qualitative synthesis. Results: Data extracted of articles categorized in the three categories including “Health” (with sub-categories of epidemiologic and population transitions), “Responsiveness” and “Fair financing and financial risk protection”. Synthesis of data revealed that the profiles of diseases has been changed over recent decades in Iran, which has resulted from epidemiologic and population transitions. In terms of responsibility of health system, services provided have not fulfilled clients’ expectations. Regarding financial protection, synthesis of data showed that people face high costs, with a high rate of out-of-pocket payment by the public. Conclusions: The results of this study show that Iran’s health system is not yet reached the goals determined by the framework of the World Health Organization. Fundamental reform is required in the health care system.