Achieving universal health coverage; implementation of the ‘supporting physician retention in deprived areas’ programme in Iran

From the WHO’s perspective, trained and motivated healthcare workers can promote community access to essential health services in deprived areas; this could also help achieve the millennium development goals. The concentration of healthcare workers in the capital has caused a lack of them in deprived areas and made delivering services difficult in almost all rural and underdeveloped areas. So, one of the main concerns of all health systems is planning to attract and keep physicians in underprivileged areas. The number of retained physicians has tripled. 24/7 coverage of specialised medical services in the hospital has been provided. People’s access to health care has improved. Dispatching of patients to other cities’ hospitals for essential medical services has been minimised by providing it locally. Illegal payments have been eliminated. This practice study aims to present Iran’s Universal Health Coverage approach to addressing the lack of access to physicians in deprived areas through the ‘supporting physician retention in deprived areas’ programme and demonstrate its outcomes from 2014 to 2016. This national programme is designed to improve people’s access to high-quality health services and reduce out-of-pocket payments at hospitals in underdeveloped areas. The number of retained physicians has tripled. 24/7 coverage of specialised medical services in the hospital has been provided. People’s access to health care has improved. Dispatching of patients to other cities’ hospitals for essential medical services has been minimised by providing it locally. Illegal payments have been eliminated. The programme began by ranking all the cities in the country based on socioeconomic indicators. Then, 302 regions in 30 provinces of Iran were selected and classified into four groups. Finally, each group’s incentive package was defined, consisting of a combination of fixed and performance-oriented payments. This programme has obtained the following achievements in the deprived areas: The number of retained physicians has tripled. 24/7 coverage of specialised medical services in the hospital has been provided. People’s access to health care has improved. Dispatching of patients to other cities’ hospitals for essential medical services has been minimised by providing it locally. Illegal payments have been eliminated.