The barriers to achieve financial protection in Iranian health system: a qualitative study in a developing country

Background: The move to universal health coverage and consequently health promotion is influenced by political, socio-economic and other contextual factors in a country. Iran, as a developing country with an upper-middle national income, has developed policies to achieve universal health coverage through financial protection. This study aims to investigate barriers to develop financial protection as a requirement to achieve universal health coverage.Materials and Methods: This qualitative study was conducted using 20 in-depth interviews with experts in social welfare, health insurance and financing. The framework analysis method was used to analyze the data.Results: The results have been categorized in three major themes that were extracted from ten sub-themes. The major themes included the political, social and economic context of the country, the context and structure of healthcare system and dimensions of UHC.Conclusion: Achieving financial protection as a long-term objective should be considered as a priority among Iranian policy makers that requires an inter-sectoral collaboration with a defined in-charge body. Health policy makers in Iran should develop a more comprehensive benefits package for diseases and health conditions with catastrophic consequences. They also should develop a plan to cover the poor people.Keywords: Universal Health Coverage, Financial Protection, Catastrophic Health Expenditures, Impoverishing Health Expenditure

Economic Value of Life in Iran: The Human Capital Approach

Background: The human life value is among the most important challenges of the health economic evaluation. This limitation has reduced the feasibility of applying the cost-benefit method in evaluations of health interventions and policies. Using the human capital approach and discounted value of future earnings, the present study calculated the human capital of different age groups. Methods: The required data were obtained using “income and expenditures of Iranian households” data in 2015 from the Statistical Center of Iran, which included the information on 19380 urban households. Results: According to the calculation of human capital, the maximum value of a statistical life year in the high-income group was related to the age group of 30-34 yr old (223,286 US$ equals to 9378 million Iranian Rials). The lowest value in all three groups of high, medium and low income is related to the age group of 85 and older. In addition, the economic value of statistical life year for men has been calculated as higher than that of women, however, in older age groups, the human capital of both genders have been converging. Conclusion: The economic value of life for young people aged between 20 to 30 yr was higher than other demographic groups. The findings of the research help to provide a more accurate base for the cost-benefit analysis of health and social policies. Considering the economic value of the statistical life for different age groups may change policy priorities in areas related to health and life of human beings

Cancer incidence in Iran in 2014: Results of the Iranian National Population-based Cancer Registry

Background: We aimed to report, for the first time, the results of the Iranian National Population-based Cancer Registry (INPCR) for the year 2014. Methods: Total population of Iran in 2014 was 76,639,000. The INPCR covered 30 out of 31 provinces (98 of total population). It registered only cases diagnosed with malignant new primary tumors. The main sources for data collection included pathology center, hospitals as well as death registries. Quality assessment and analysis of data were performed by CanReg-5 software. Age standardized incidence rates (ASR) (per 100,000) were reported at national and subnational levels. Results: Overall, 112,131 new cancer cases were registered in INPCR in 2014, of which 60,469 (53.9) were male. The diagnosis of cancer was made by microscopic confirmation in 76,568 cases (68.28). The ASRs of all cancers were 177.44 and 141.18 in male and female, respectively. Cancers of the stomach (ASR = 21.24), prostate (18.41) and colorectum (16.57) were the most common cancers in men and the top three cancers in women were malignancies of breast (34.53), colorectum (11.86) and stomach (9.44). The ASR of cervix uteri cancer in women was 1.78. Our findings suggested high incidence of cancers of the esophagus, stomach and lung in North/ North West of Iran. Conclusion: Our results showed that Iran is a medium-risk area for incidence of cancers. We found differences in the most common cancers in Iran comparing to those reported for the World. Our results also suggested geographical diversifies in incidence rates of cancers in different subdivisions of Iran