فهرست نشریات علمی دسترسی آزاد ایران

BACKGROUND AND AIM: Considering that the Qom University of Medical Sciences was a pioneerto implement the health system reform (HSR) in the domain of health services and the lack of astudy that has addressed the challenges and strategies to promote the HSR in the health domain,this study was designed to explain the structural challenges and its solutions in the health domainof the HSR in the city of Qom, Iran, 2017.MATERIALS AND METHODS: This study was a qualitative research. The health managers, thehealth‑care providers, and the recipients of health services referring to the health centers in Qom werethe participants in this study who were selected using the convenience sampling method. The datawere collected using individual interviews and with the guidance of a semi‑structured questionnaire.Collected data were analyzed by the qualitative content analysis method with an inductive approach.After extracting the challenges of the HSR in the health domain through a qualitative approach, thesechallenges were prioritized through Delphi’s technique in terms of relevance and resolving strategies.RESULTS: From the perspective of the study participants, the structural challenges of HSR in thehealth domain in order of importance and priority included problems due to the SIB system, defects inthe instructions, the disruptions caused by multitasking, poor service coverage, incomplete health‑carepackages, and the shortage of resources.CONCLUSION: According to the findings of this study, we hoped that the HSR in the health areacan be improved to increase its success by modifying the guidelines and the coverage of services,modifying the SIB system, providing requires resources, completing the service packages, andsolving the multitasking problem.