Communicable Diseases Surveillance System in I.R.Iran: Strengths and Weaknesses of 30 years implementation

Background: Communicable diseases was one of the main problems in I.R.Iran. This study aimed to show the progress of communicable diseases management in more than 30 years of implementation and point out strengths and weaknesses as well. Methods: This study was carried out on an interview-based qualitative study using content analysis in 2014. Data was collected by deep interviews. Fifteen interviews were conducted with all experts and health system managers who were engaged in running the communicable disease surveillance system and present at the Iran’s communicable diseases management center at the time of study. The collected data was analyzed using the principles suggested by Strauss and Corbin. Results: Establishment of the communicable disease surveillance system was a revolution in health system of Iran. There was many strengths such as, network-based and integrated Health services, well organized and knowledgeable personnel, national and international supports, strategic and operational plan, and expanded program of immunization. Weaknesses mentioned by participants were, disease based case definition, Insufficient public awareness, Poor inter-sectorial collaboration and coordination, insufficient resources, delayed or not notifying target diseases, not enforcing the law or incomplete implementation of legislation, failure to provide feedback or disregard for the results of the analysis, lack of performance evaluation. Conclusions: Although implementation of communicable diseases surveillance system was a big achievement in health system of Iran, but need more improvement according to current situation. Revision of the rules, restoration and strengthening of the existing structure, the use of modern information and communication technologies, and the establishment of the monitoring and evaluation system will help to increase its success.