HEARTS & MINDS

Iran 2013 | HEALTH & EDUCATION | VIP INTERVIEW

Dr. Marzieh Vahid Dastjerdi, Minister of Health and Medical Education, on reforms to the healthcare system, medical expenses, and lowering infant mortality rates.

What key reforms are being carried out to enhance the healthcare system?

Strategies taken by the Ministry of Health and Medical Education for the development of healthcare services include designing and building a clear healthcare network that will perform basic sanitary functions. Some of the fundamental principles of developing such a network include prioritizing preventative treatments, increasing services in rural areas, and better distributing resources to the vulnerable parts of society, while also prioritizing and balancing services for inpatients and outpatients. It is also necessary to create a good private-public balance while also promoting decentralization in order to create independent healthcare networks. Designing and implementing basic healthcare services is in line with the Alma Ata Declaration, and the expansion of services is demanded by the public. Services demanded include dental and mental health services and preventative services for non-contagious diseases. We also aim to expand fair accessibility to service providers by choosing the right technology for maximum efficiency in the system, providing primary health care (PHC) for the majority of people, especially in rural and deprived areas, and improving living conditions in rural areas while promoting self-directed health care (SDH) in order to improve public health.

What role does medical education play in the healthcare system?

By combining medical education and healthcare delivery, we can create a broad context of service delivery that makes a shorter and more widespread training program possible. Due to this combination, an education system based on the community is provided that will better serve the needs of the healthcare sector. This expansive package automatically guarantees high-quality healthcare services. With the integration of medical education into service delivery complete, a number of other actions have been taken, including training manpower on the basis of the system's requirements, performing the necessary tasks for the codification of training programs, and carrying out the required interactions in order to make sure faculty members conduct research.

“We are working on integrating medical education into primary care systems."

How will healthcare costs evolve over the coming years?

In line with communicated policies regarding health care and the requirement of a family practitioner in urban areas under clauses A and D of Article 32 and Clause A of Article 35 of the Fifth Development Plan, the Ministry of Health and Medical Education is required to implement the family practitioner plan and the urban referral system, which will have a direct impact on health costs. An increase in health costs can be divided into two sections: necessary and unnecessary. For the necessary increase in costs, the required actions affecting policymaking and legislation have been taken, such as the Fifth Development Law. By managing the entrance and use of new technologies and also by implementing strategies such as the family practitioner plan, we have been trying to control the increase of costs that are unnecessary and irrational.

What steps has the Ministry of Health and Medical Education taken in order to lower the infant mortality rate?

The Ministry of Health and Medical Education has taken many steps in order to decrease the infant mortality rate. A newborn health program covering the first 28 days will also feature preconception care for women at risk due to old age or chronic diseases, and referral mechanisms directed toward specialized care. We will also carry out the implementation of a grading program for prenatal services, which will have four key dimensions, including assessing health defects in pregnant women on a primary care level and their referral to specialized care when needed; the effective management of consultancy and transportation of endangered mothers and newborns to higher levels of health care if necessary; the standardization of beds in specialized care sections for endangered mothers and specialized care for newborns; and the enhancement of IT infrastructure and the hospital care quality improvement program. We are also working on designing and implementing service packages and several care systems to improve the quality of hospital care with a greater focus on the primary care level, including newborn resuscitation services, healthy newborn services, critical care for endangered newborns, developmental care services for newborns, prenatal care, and infection control in specialized care sections for newborns. Child health programs will also include a combined healthy child care system, comprising of efforts to reduce the risk of incidents, promote breast feeding, monitor the growth of nutritious eating programs and developmental care, and care for those with sight and hearing disorders as well as supply vaccinations and referrals when necessary. A combined care system for sick children will also feature standard controls and cures for infectious respiratory conditions as well central nervous system disorders, diarrhea, vomiting, growth and nutrition disorders, fevers, paroxysm, coma, shock, and referrals when necessary. A child mortality monitoring system will also assess the causes of death among children. The main goals of the children's health program include enhancing and promoting breast feeding in Iran, especially raising awareness and improving staff skills in case breastfeeding problems arise, raising awareness and improving staff skills when it comes to caring for healthy children as well as sick children, and improving a family's ability to care for sick children and promote healthy eating. We aim to decrease the mortality rate of children under six years of age by means of controlling contagious and non-contagious diseases. The program's strategies include enhancing the continuity of breastfeeding programs; expanding integrated care systems for children under six years old; providing standard healthcare services to healthy children and extending programs to the private sector; enhancing the prevention of accidents in children and raising awareness of preventable deaths; introducing a child nurturing program aimed at spiritual growth and lower crime and child abuse; enhancing the process of providing, distributing, and prescribing medical equipment; overviewing and completed programs related to enhancing and expanding the death registration for children between 0 and 59 months; and intervening based on the results. It will also focus on improving and empowering referrals and follow-up systems in child healthcare programs at various network levels. Taking into account the importance of the child mortality index, for the purpose of monitoring child deaths and calculating the death index as well as analyzing the causes of death, special information systems have been developed by the Ministry of Health and Medical Education. With the help of this system, we can analyze child mortality rates and also assess interventions made for the improvement of child health. Through broad activities in the expansion of basic healthcare coverage during the 1980s and their continuity, as well as creating the family practitioner plan in 2005 in rural areas and urban areas with less than 2,000 people, our country has made exceptional progress in decreasing the mortality rate among children.

What is the Ministry of Health and Medical Education's plan to decrease health expenses from 50%?

According to clause B of Article 34 of the Fifth Developmental Plan, the Supreme Leader has stated that expenses paid by the public must reduce to 30%. The Ministry of Health and Medical Education, with the help of the Ministry of Cooperatives, by means of the legal context of this law has the implementation of the family practitioner plan and the referral system on its agenda. The plan is to increase the practitioner payroll on a per capita basis and increase the share of insurance in health-related expenses, thus decreasing expenses paid by people.

What steps has the Ministry of Health and Medical Education taken in order to raise awareness of personal health?

Based on clauses A and C of Article 37 from the Fifth Development Plan, which forbids the advertisement of harmful products, the Ministry compiles an annual public list. We are also working on integrating medical education into primary care systems, enhancing instructors' skills in consultancy and public education, and taking a broad range of actions to gain the cooperation of other organizations in order to raise popular awareness about personal health. We also research, plan, and assess the processes, train and empower staff, carry out public relations exercises on the expansion of healthy environments, introduce new educational and electronic technologies, and use volunteer forces as health messengers to educate people.

© The Business Year - October 2012