Iran’s Hypertension and Diabetes Mellitus Surveillance System and Its Implementation Challenges: A Case Study of Tehran Uni- versity of Medical Sciences
Abstract
Introduction: Surveillance systems play a vital role in managing non-communicable diseases (NCDs). This study explores the
challenges encountered in the implementation of Iran's hypertension (HTN) and diabetes surveillance system, using Tehran
University of Medical Sciences (TUMS) as a case study.
Methods: This study employed a two-part approach, consisting of a literature review and an expert panel discussion. In the first
part, a literature review was conducted using PubMed and Google Scholar, encompassing studies published between 2000 and
2023 in both Persian and English. The objectives of this review were to: 1) investigate the history of diabetes and HTN surveillance
system and 2) identify implementation challenges of the surveillance system for these conditions. The sources included national
guidelines, health surveys, published reports, and academic papers. In the second part, five expert panel discussions (formal
focus groups) were conducted semi-structured with seven TUMS specialists. These sessions aimed to pinpoint the challenges
in implementing diabetes and HTN surveillance in Iran. Finally, data from both parts were analyzed using conventional content
analysis with an inductive approach and were categorized and coded using MAXQDA software to extract the key challenges in
implementing the surveillance system.
Results: The National HTN Prevention and Control Program was initiated in 1992 and later expanded its focus to include
individuals (both males and females) aged 30 and older in rural areas. In 2004, it merged with the National diabetes Prevention
and Control Program, which was established in 1991. This program primarily targeted high-risk individuals aged 15 to 39, as well
as those over 40 in selected pilot rural areas. Together, these programs now address both HTN and diabetes prevention through
the IraPEN program, launched in 2014. The analysis identified three main categories and eleven subcategories, resulting in a total
of 78 codes. The issues have been categorized into three areas: healthcare recipients (lack of public awareness and social issues),
healthcare system employees (staffing issues and inadequate training), and upper levels of the healthcare system (ineffective
policies, poor evaluation and monitoring, outdated facilities, weak management, insufficient data, and financial constraints).
Conclusion: The study identifies challenges within Iran's healthcare system that impede surveillance programs. To improve
outcomes, we should prioritize public education, provide better support for healthcare workers, and implement stronger
management practices. By adopting these changes, we can enhance the surveillance systems for HTN and diabetes.
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| Files | ||
| Issue | Vol 11 No 2 (2025) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/jbe.v11i2.20553 | |
| Keywords | ||
| Hypertension, Diabetes, Surveillance System, Challenges, Iran | ||
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