Strategies to improve the structure of primary health care in the villages of Iran: a qualitative study

Background
Low-quality Primary Health Care (PHC) services reduce the effectiveness of care and public confidence in the health system.

Objectives
This study aimed to provide strategies to improve the structure of primary health care in the villages of Iran.

Material and methods
The present study was a two-part qualitative study (comparative review, interview with experts) on improving provision of rural primary health care. Australia, Canada, the United States, the United Kingdom, Kazakhstan, Thailand, and Iran, based on the six regional divisions of the World Health Organization, were approached with a specific approach to PHC. In-depth semi-structured interviews were conducted with 25 experts in PHC. Samples were selected by purposive sampling and snowball sampling. Data analysis was performed using MAXQDA 20.

Results
The results of the qualitative study after identifying the gap in the findings of the comparative study showed that four main components and fourteen sub-components (1 – evidence-based planning (transparency in decision-making, needs assessment); 2 – the role of organizations, institutions, and people (strong participation); 3 – access (access to information, geographical access); 4 – managerial approach (strengthening managerial thinking, empowering rural caregiver, management of human resources, statistics and information management, financial and payment management, equipment, physical resources management, organization, effective monitoring and supervision, empowerment of health school educators and staff experts)) were effective in improving the structure of PHC in the villages of Iran.

Conclusions
With evidence-based planning, strong participation of organizations, institutions and people, access, and strengthening the management approach, one can effectively improve the structure of PHC in rural areas.