Challenges of Health System Reform Plan in Bushehr: A Qualitative Study

The health system reform plan was implemented by the Ministry of Health and Medical Education in accordance with the Fourth and Fifth Development Plan Acts in order to achieve public health coverage. Despite achieving many successes in the pursuit of the objectives of the plan, it has faced challenges. The purpose of the study was to determine the challenges of health system reform plan in the centers of affiliated to Bushehr University of Medical Sciences.

This study was conducted with qualitative content analysis approach. A total of 38 healthcare providers were selected from centers affiliated with Bushehr University of Medical Sciences by purposive sampling method. Data was collected from semi- structured interviews in six focus group discussions, and analyzed simultaneously with data collection. Data accuracy and rigor were confirmed in various ways.

The three main categories of decreased satisfaction, infrastructure problems, and management system weaknesses emerged after analyzing 860 initial codes. Decreased satisfaction emerged from primary satisfaction and dissatisfaction subcategories; infrastructure problems emerged from ambiguities in upstream laws, weaknesses in policy making and building culture of change, and lack of comprehensive coverage, and the management system weaknesses emerged from weaknesses in planning, weakness in human resource management, and weaknesses in supervisory practices.

It appears that the main challenges included financial problems, rapid implementation and failure to consider the less-favored cities in the implementation of the plan. In order to quickly revive the plan and achieve its positive and beneficial goals, it is recommended to revise the plan and take effective measures, especially in solving infrastructure and management problems.