Barriers to engagement in non-communicable disease prevention and public health care programs in Iran: A qualitative...

Despite the presence of comprehensive primary healthcare networks in Iran, which provide essential services for managing non-communicable diseases (NCDs) in both rural and urban areas, there is limited engagement with these prevention and care services. This study explores the reasons behind low participation in NCDs prevention and care programs.

Qualitative study.

This multicenter phenomenological qualitative study was conducted across three health centers (Valiasr, Tehransar, and Olympics) in western Tehran. The study employed face-to-face semi-structured in-depth interviews using purposive snowball sampling to select healthcare workers. Data saturation was achieved after 18 interviews. The principal investigator confirmed comprehension of the presented concepts, and data credibility was evaluated using various criteria. Data analysis was performed using Colaizzi's seven-step method. All qualitative analyses were performed using MAXQDA (version 2020).

In total, 18 healthcare workers were interviewed. The findings revealed diverse challenges related to people, organizational deficiencies within health centers, and low motivation among healthcare workers. Challenges at the people level included prioritization of treatment over prevention services, economic difficulties, dissatisfaction with service quality, and lack of knowledge about NCDs prevention and care services. Organizational challenges included inadequate specialized services, single-shift operations at health centers, and registration issues within the National Electronic System. Additionally, burnout and low motivation were prevalent among healthcare workers.

This study highlights experiences that negatively impact NCD prevention and control efforts. Policymakers and health managers should consider these insights when planning strategies to enhance NCD services at health centers.