Critical Analysis of Corruption in Iran's Health Care System and Its Control Strategies

Context: according to the corruption perceptions index (CPI) 2018, Iran ranked 148 among 183 countries. This position shows the crucial importance of considering corruption and its negative effect on Iran and its health care system. In this review, we aimed to shed the light on corrupt practices in Iran’s health care system and recommend some practical strategies to combat them. Evidence Acquisition: This is a narrative review based on Vian's conceptual model of corruption in the health sector to evaluate and analyze corruption in Iran's health system. Review of the literature and documents without any time limitation were conducted in several databases including PubMed, Scopus, Web of Science, Google Scholar, and Farsi sources including Iran Medex, scientific information database )SID(, and Magiran, and also the official websites of the Ministry of Health and news agencies. Results: Unfortunately, to the best of our review, there is less published evidence about the extent and types of corruption in Iran's health system. Based on Vian’s model, reviewed literature revealed that Iran's health system is prone to corruption. This system is monopolistic and self-authorized, low transparent and accountable, and required law enforcement in many areas. Evidence to clarify the situation of citizen voice was not found. Conclusions: Based on this study, evidence shows corruption in financing, service provision, and resource generation of Iran's health system. It could affect not only performance of this system but also its responsiveness and effectiveness. To combat, Iran should apply multiple strategies such as; improving good governance, strengthening legal system over the health system, reducing monopoly and discretion stepwise and manageable, enhancing community participation, and finally updating ethics codes in the health system.

A framework of a health system responsiveness assessment information system for iran

BACKGROUND

Responsiveness assessment of health system with the quality information is the key in effective evidence-based management of the health system.

OBJECTIVES

This qualitative study defines the necessary components required for the health system responsiveness assessment information system (HS-RAIS).

MATERIALS AND METHODS

This study was conducted based on mixed-methods approach and by using Delphi technique (29 participants in first round and 25 participants in second round) and semi-structured interviews in Iran 2013. The participant selection strikes a balance between being able to provide valid data, and increasing representative's leverage. The final framework for HS-RAIS was extracted from in-depth interviews with ten key informants.

RESULTS

We followed these recommendations and developed a framework in 10 components including: minimum datasets, data sources, data gathering, data analysis, feedback and dissemination, legislative needs, objectives of health system responsiveness assessment, repetition period, executive committee and stewardship.

CONCLUSIONS

This framework provides useful information for decision-making at all levels about assessment of health system.