Challenges and strengths of implementing urban family physician program in Fars Province, Iran
نویسندگان
1 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Health Managers Development Institute (HMDI), Ministry of Health and Medical Education
2 Health Managers Development Institute (HMDI), Ministry of Health and Medical Education, Secretariat of Supreme Council for Health and Food Security, Ministry of Health and Medical Education, Tehran, Iran
3 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences
4 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences
doi
چکیده
BACKGROUND: Family physician (FP) is one of the best strategies to reform health system andpromote population health. Due to the different context, culture, and population, implementing thisreform within cities would be more challenging than in rural areas. This study aimed to assess thechallenges and strengths of Urban FP Program in Fars Province of Iran.MATERIALS AND METHODS: It was a qualitative study using framework analysis for collecting andinterpreting data. The participants included health policy‑makers, top managers, and involved healthstaff selected through purposive and snowball sampling. Participating in the program or workingas a physician in urban areas were among inclusion criteria. Three focus groups with experts aswell as the content analysis of national documents were also performed. The research tool was asemi‑structured interview guide. Interviews and focus groups were recorded and transcribed wordby word. The framework of triangle for data analysis and the content was analyzed using MAXQDA2010 software.RESULTS: The participants’ mean age was 44.9 ± 6.4 years, with a mean work experience of13.2 ± 7.4 years. The transcripts revealed six themes and 17 subthemes. The emerging themesincluded three challenges and three solutions as following: social problems, financial problems, andstructural problems as well as resistance reduction, executive meetings, and surveillance.CONCLUSION: Resolving staff shortage, decreasing the public resistance, and eliminatingunnecessary referrals were among the strategies used by Fars, during FP implementation. Tobe successful in implementing this program, the required perquisites such as infrastructuresand culture growth must be undertaken. The current study suggests the establishment of theelectronic health record to improve the pace and quality of service provision as well as reducingviolations.
