Which Interventions should be Included in National Health System Assessment Framework? Selecting Essential Interventions Based on Effective Coverage Approach

Author(s):

Vahideh Sadeghi*, Ali Jannati, Homayoun Sadeghi-Bazargani and Ali Imani

Background: Coverage of population with essential health services should be regulated into any local framework for monitoring progress towards UHC. Aim: The present study was conducted to find out the essential health care interventions in Iran UHC monitoring system.

Methods: 23 experts participated in this study. Semi structured questionnaires were completed and data were analyzed using quantitative content analysis. Findings: Interventions in each following level were extracted reflecting Iranian health system priorities; Promotion services: modifying non-communicable diseases risk factors, training and counseling regarding sexual and mental health, prevention of smoking and substance abuse and promotion of safety and traffic culture. Preventive care: diabetes and hypertension screening, prenatal and antenatal care, HIV/Aids and hepatitis screening, breast, cervical and lung cancer screening, prevention of osteoporosis and DPT and Tetanus immunization. Treatment: treatment of diabetes and hypertension, mental disorders, HIV/Aids, cardiovascular disease, upper respiratory infections; surgical treatments for trauma and accidents, arthritis and disc, hospital care for prematurity and smoking cessation. Rehabilitation services: rehabilitation of cardiovascular diseases, cancer, trauma and accidents, musculoskeletal disorders and mental illnesses. Prevalence rate, mortality, disease related complications, and burden of disease were among the most frequent criteria for selecting essential interventions.

Conclusion: Selecting the optimal set of interventions is generally the starting point of the designing an assessment framework. Every country based on their health needs as well as epidemiology and demographic situations needs to create measures to assess coverage of essential interventions selected based on logical criteria.