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Developing Iranian sub-national primary health care measurement framework: a mixed-method study
Ramin Rezapour1, Ardeshir Khosravi2, Mostafa Farahbakhsh3
1Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Summary
This study developed the Iranian sub-national Primary Health Care (PHC) Measurement Framework (PHCMF) with 100 KPIs. This comprehensive tool aids decision-makers in assessing and improving PHC performance at the sub-national level.
Area of Science:
- Health Services Research
- Public Health Policy
- Healthcare Management
Background:
- Strong Primary Health Care (PHC) is crucial for achieving desired health outcomes.
- Effective decision-making for PHC reforms requires robust scientific tools.
- This study addresses the need for a sub-national PHC performance measurement framework.
Purpose of the Study:
- To develop a sub-national framework for Primary Health Care (PHC) performance measurement in Iran.
- To adapt the World Health Organization (WHO) conceptual framework for PHC measurement to a sub-national context.
- To provide a scientific tool for guiding PHC policy and reform.
Main Methods:
- A mixed-method and qualitative approach was employed.
- The framework development involved literature reviews, national document analysis, and expert consultations.
- The Delphi technique was utilized for finalizing Key Performance Indicators (KPIs).
Main Results:
- The Iranian sub-national PHC Measurement Framework (PHCMF) was finalized, comprising 100 KPIs.
- The KPIs are categorized into three components: Health systems determinants, Service Delivery, and Health system objectives.
- Most KPIs focused on the output domain (24 KPIs), with fewer on input and process (9 KPIs).
Conclusions:
- The developed PHCMF is a comprehensive tool for assessing PHC systems.
- It covers all operational levers and key aspects of PHC performance.
- The framework serves as a practical instrument for evaluating and enhancing sub-national PHC in Iran.
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