Analysis of the Situation and Challenges of Strategic Purchasing in order to Achieve Universal Health Coverage in Iran

Background and Objectives: Strategic purchasing of health care services is one of the major issues contributing to the enhancement of the performance and reform of healthcare systems across the globe. Traditional (passive) purchasing suffers from serious weaknesses, such as low efficiency in the health care system, lack of targeted resources, Resource inefficiency, and unfair access to services. To solve these problems, the World Health Organization has introduced strategic purchasing as the main activity to improve the performance of healthcare systems. In light of the aforementioned issues, the present study aimed to investigate the challenges and problems of strategic purchasing in the health sector.   Methods: For the purpose of the current qualitative study, the upstream laws and policies in the field of strategic shopping in Iran were initially investigated to gather the needed information. In the next step, 25 health policymakers were interviewed about the challenges of strategic purchasing and the implemented measures. The data were analyzed in MAXQDA software (version10) using content analysis.   Results: Assessing the current situation, strategic purchasing was classified into 5 dimensions, 21 them, and 57 sub-thems. The most important issues among the findings included governance with the highest frequency of 62% and the health information system with a frequency of 47%. Analyzing the research findings, 52 challenges were identified and examined.   Conclusion: Despite all the benefits of strategic purchasing, its effectiveness depends on the successful implementation and effective cooperation of all stakeholders. In addition, strategic purchasing might need to be tailored to the circumstances of each country and the needs of that community. Therefore, the establishment of the needed infrastructure and tackling the presented challenges are indispensable for the optimal implementation of strategic purchasing in our country.