A qualitative assessment of the Iraqi primary healthcare system

With the limited availability of empirical and documented knowledge about the Iraqi primary healthcare (PHC) system, this study aimed to identify the main problems facing the Iraqi PHC system and the priorities for change. A qualitative study based on a self-administered questionnaire survey involving 46 primary care managers, public health professionals and academics was conducted in Erbil, Iraq. The questionnaire addressed participants' views on positive aspects, problems, priorities and barriers to change of the PHC system through seven open questions. The qualitative data analysis comprised thematic analysis. The survey revealed significant impediments to delivering PHC services, including problems in organization and management of the system, shortage of and poor quality of medications, and inadequate or uneven distribution of manpower and expertise. Priorities for improving the primary healthcare system included reorganization of the services and leadership involving adoption of family practice and regulation of public-private practice, placing emphasis on prevention and health education, and provision of continuing professional training and development. The enormous problems facing the system might signal the need for important and comprehensive improvements based on more in-depth assessment.