فهرست نشریات علمی دسترسی آزاد ایران

BACKGROUND: According to the importance of health education (HE) in disease control andprevention and inadequacy of HE in the Iran’s health‑care system, clarifying the HE barriers isnecessary.OBJECTIVES: This study aimed to clarifying the comprehensive model of HE barriers of health‑caresystem in Iran.METHODS: This qualitative study was conducted in 2019. Twenty‑one health experts and physiciansat different levels of the health system, a former health deputy of the Ministry of Health, and 26community health workers (CHWs) were selected through purposive sampling. Data were collectedthrough semi‑structured individual interviews and group discussions and analyzed simultaneouslyby conventional content analysis.RESULTS: Five themes were extracted including individual barriers (most important categories:inadequate ability of CHWs in HE, poor motivational factors at individual level, and educator’s wrongbeliefs), interpersonal (most important categories: weakness of other health‑care providers in theeducation of CHWs, lack of proper understanding by health authorities of scientific and correct HE,inappropriate communication, unrealistic expectations from CHWs, problems with monitoring andsupervision, poor work commitment, and client‑related problems), organizational (most importantcategories: high workload of CHWs, problems related to educational resources, inappropriate attitudeof managers and officials, and inappropriate evaluation and monitoring), community (most importantcategories: not believing CHWs by people, people’s disinterest and lack of motivation in education,cultural problems, problems with the Internet and virtual social networks, and weak cross‑sectoralcooperation), and contextual barriers (most important categories: barriers related to universities,broadcasting, the nature of HE science, as well as gap between practical education and theory).CONCLUSION: Considering the multidimensional barriers such as individual, interpersonal,organizational, community, and contextual barriers, compiling and executing a comprehensivedocument with the participation of authorities, specialists, and service providers is recommended toremove barriers. This is in line with the Ottawa Charters’ “reorienting health services.”