Barriers of health equity in the Iranian health system from the medical ethics viewpoint

Journal of Medical Ethics and History of Medicine · 7 authors, 7 centres

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TL;DR

This qualitative study used semi-structured interviews with 30 health experts in Iran to identify barriers to health equity in accessing care.

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This qualitative study conducted 30 semi-structured interviews with health managers, economists, ethicists, and medical experts in Iran from June 2018 to March 2019. Using purposive sampling and content analysis, the researchers identified 44 barrier codes categorized into two themes: micro factors and macro factors. These were further grouped into five sub-themes: cultural, financial, geographical, social, and religious barriers. Key findings included differences in individual perceptions and health literacy as cultural barriers, inadequate insurance coverage as a financial barrier, and inequality in resource distribution as a geographical barrier.

STUDY TYPE

other

SPECIALTY

public health

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100% · A

ORIGINAL PAPER

PMC10151731

Barriers of health equity in the Iranian health system from the medical ethics viewpoint

Journal of Medical Ethics and History of Medicine

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ABSTRACT

In order to lessen health inequalities, the obstacles to health equity will need to be identified. This study aimed at investigating the barriers to access to health-care services from the medical ethics point of view. Data were collected through a qualitative study by performing semi-structured interviews. Purposive sampling was used to recruit participants involved in health provision and/or management. Content analysis was done using MAXQDA software. Overall, 30 interviews were conducted. The content analysis of the interviews identified two themes including “micro factors” and “macro factors”, five sub-themes including “cultural, financial, geographical, social and religious barriers”, and 44 codes. Based on our findings, differences in individuals’ perceptions, cultural control, religious beliefs and social stigmas create cultural barriers. Financial barriers consist of the financial connection between service recipients and service providers, insurance premiums, and inadequate coverage of health-care services. The most important geographical barriers identified in our study were differences in urbanization, inequality in various geographical areas, marginalization, and inequality in resource distribution. Finally, differences in the level of income, education and occupational diversity were among the social barriers. Given the wide range of barriers to access to health-care services, a comprehensive plan covering various dimensions of health equity should be implemented. To this end, innovative and progressive strategies emphasizing the principles of equity and social equality should be developed.

CITATION EXPORT

Davoud Nezamoleslami, Efat Mohamadi, Bagher Larijani et al.. Barriers of health equity in the Iranian health system from the medical ethics viewpoint. Journal of Medical Ethics and History of Medicine. (2022). https://doi.org/10.18502/jmehm.v15i14.11570

AUTHORS

7 · 7 CENTRES

Davoud Nezamoleslami, Efat Mohamadi, Bagher Larijani, Alireza Olyaeemanesh, Masoumeh Ebrahimi Tavani, Roya Rashidpouraie, Fataneh Sadat Bathaei

1 PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran.
3 Professor, Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, Iran.
4 Professor, Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran; National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran.
5 Assistant Professor, Group of Quality Improvement, Monitoring and Evaluation, Center for Health Network Management, Deputy for Public Health, Ministry of Health & Medical Education, Tehran, Iran.
6 Researcher, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
7 Researcher, Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.