Measuring progress toward Universal Health Coverage in Iran: two years after the implementation of the Health Transformation Plan
-
Zhaleh Abdi
,
Rezvaneh Alvandi
,
Bahar Haghdoost
,
Saharnaz Sazgarnejad
,
Elham Ahmadnezhad
,
Behzad Najafi
,
Iraj Harirchi
Abstract
Background and Objectives: One of the most important 2015-post agendas of countries’ health systems is achieving Universal Health Coverage (UHC), so the countries should monitor the taken activities. Ths study aimed to investigate the Universal UHC status two years after Health Transformation Plan in Iran.
Methods: Household Income and Expenditure Survey were used to estimate financial protection indicators in 2016. Estimation for service coverage index provided by international databases was applied at the country level. Indicators of financial protection and service coverage were evaluated in relation to each other using the World Health Organization joint levels assessment method, which indicates UHC attainment in terms of a plot with four zones. The relationship was estimated for the entire population, first quintile, and fifth quintile in 2000, 2017, and 2030.
Results: About 15.85% of households endured catastrophic health expenditures at the 10% threshold. Accordingly, Iran is on the border between zones 1 and 2 in 2017 in terms of achieving UHC and will move to zone 1 in 2030 with the current trend.
Conclusion: Iran did not attain UHC in 2000. It seems and has not achieved UHC in 2017 either. Even with improved service coverage, achieving UHC by 2030 may seem impossible with the current trends.
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26. Asadi-Lari, M., et al., Public health improvement in Iran—lessons from the last 20 years. Public health, 2004. 118(6): p. 395-402.
2. Hogan, D.R., et al., Monitoring universal health coverage within the Sustainable Development Goals: development and baseline data for an index of essential health services. The Lancet Global Health, 2018. 6(2): p. e152-e168.
3. Saksena, P., J. Hsu, and D.B. Evans, Financial risk protection and universal health coverage: evidence and measurement challenges. PLoS medicine, 2014. 11(9): p. e1001701.
4. Wagstaff, A., et al., Progress on catastrophic health spending in 133 countries: a retrospective observational study. The Lancet Global Health, 2018. 6(2): p. e169-e179.
5. Wagstaff, A., et al., Progress on impoverishing health spending in 122 countries: a retrospective observational study. The Lancet Global Health, 2018. 6(2): p. e180-e192.
6. Lozano, R., et al., Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 2018. 392(10159): p. 2091-2138.
7. Abdi, Z., R. Majdzadeh, and E. Ahmadnezhad, Developing a framework for the monitoring and evaluation of the Health Transformation Plan in the Islamic Republic of Iran: lessons learned. Eastern Mediterranean Health Journal, 2018. 24.
8. Akazili, J., et al., Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana. Global health action, 2017. 10(1): p. 1289735.
9. Kheirandish, M., et al., Impact of economic sanctions on access to noncommunicable diseases medicines in the Islamic Republic of Iran. Eastern Mediterranean Health Journal, 2018. 24(1).
10. Organization, W.H., Tracking universal health coverage: 2017 global monitoring report. 2017.
11. (IHME), T.I.f.H.M.a.E. Iran. 2019 April 17, 2019]; Available from: http://www.healthdata.org/iran.
12. OECD, Eurostat, and W.H. Organization, A System of Health Accounts 2011. 2017.
13. Xu, K. and W.H. Organization, Distribution of health payments and catastrophic expenditures methodology, 2005, Geneva: World Health Organization.
14. Ferreira, F. A richer array of international poverty lines. 2017 April 16, 2019]; Available from: http://blogs.worldbank.org/developmenttalk/richer-array-international-poverty-lines.
15. Statistical Center of Iran. Consumer Price Index. 2019 February 23, 2019]; Available from: https://www.amar.org.ir/.
16. worldometers and P.D. Department of Economic and Social Affairs. Iran population. 2019 February 23, 2019]; Available from: http://www.worldometers.info/world-population/iran-population/.
17. Zhaleh Abdi, et al., An analysis of financial protection before and after the Iranian Health Transformation Plan (Article in press) Eastern Mediterranean Health Journal.
18. Moghadam, M.N., V. Sadeghi, and S. Parva, Weaknesses and challenges of primary healthcare system in Iran: a review. The International journal of health planning and management, 2012. 27(2): p. e121-e131.
19. Verguet, S., et al., Is the sustainable development goal target for financial risk protection in health realistic? BMJ global health, 2017. 2(3): p. e000216.
20. Yazdi-Feyzabadi, V., et al., Prevalence and intensity of catastrophic health care expenditures in Iran from 2008 to 2015: a study on Iranian household income and expenditure survey. International journal for equity in health, 2018. 17(1): p. 44.
21. Aregbeshola, B.S. and S.M. Khan, Out-of-pocket payments, catastrophic health expenditure and poverty among households in Nigeria 2010. International journal of health policy and management, 2018. 7(9): p. 798.
22. Chhun, C., et al., Catastrophic payments and poverty in Cambodia: Evidence from Cambodia Socio-Economic Surveys 2004, 2007, 2009, 2010 and 2011. 2015: Cambodia Development Resource Institute.
23. Dorjdagva, J., et al., Catastrophic health expenditure and impoverishment in Mongolia. International journal for equity in health, 2016. 15(1): p. 105.
24. Rashad, A. and M. Sharaf, Catastrophic economic consequences of healthcare payments: effects on poverty estimates in Egypt, Jordan, and Palestine. Economies, 2015. 3(4): p. 216-234.
25. Van Doorslaer, E., et al., Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data. The lancet, 2006. 368(9544): p. 1357-1364.
26. Asadi-Lari, M., et al., Public health improvement in Iran—lessons from the last 20 years. Public health, 2004. 118(6): p. 395-402.
| Files | ||
| Issue | Vol 8 No 2 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jbe.v8i2.10415 | |
| Keywords | ||
| Financial Risk Protection Health Survey Health Transformation Plan Universal Health Coverage Sustainable Development Goals | ||
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How to Cite
1.
Abdi Z, Alvandi R, Haghdoost B, Sazgarnejad S, Ahmadnezhad E, Najafi B, Harirchi I. Measuring progress toward Universal Health Coverage in Iran: two years after the implementation of the Health Transformation Plan. JBE. 2022;8(2):170-180.
