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Background and objective:
Qualitative paradigms are developed based on different social phenomena and study of such phenomena by those who have experienced it. In the field of health sciences, application of these methodology and development of related paradigms for analysis of complex and culturally-relevant phenomena can be of great importance in multi-faceted promotion of public health. The aim of the current study is to discuss different aspects of such phenomena with the primary objective of illumination and illustration, analysis, presentation, prediction, and management ofthem.
Methods:
This essay focuses on design and implementation of qualitative research based on critical analysis of the existing body of literature as well as the  xperiences of the author in the field of health systems theorization.
Results:
Evidence-based approach to healthcare has provided the necessarybasic framework for design and implementation of different studies. Most studies are  esigned and carried out based on a positivism paradigm with the primary goal of illuminating facts with potential of practical application. However, as  ealth and health-related subjects are culturally sensitive, intuitive, and complex, their in-depth analysis and full conception constitutes the initialstage in design and development of corrective intervention measures. Qualitative paradigm and related methodologies can provide an excellent platform for in-epth analysis and conceptualization of health-related phenomena through description and analysis of human experiences. Ultimately, when the phenomena are problem-oriented, complex, process-dependent, and related to cultural background and mores of the society,they can be employed for formulation of  vidence-based interdisciplinary theories. Theories formed through such processes candepict a clear picture of health phenomena which may assist scholars and experts in field for design and development of appropriate approaches to health and health-related issues with favorable outcomes.
Conclusion:
Comprehensive and clear depiction of theorizing studies may lead to design and implementation of culturally-appropriate interventions which will not only  ead to multifaceted promotion of public health, but also results in enhancement of social health of the nation. Moreover, through formation of  nterdisciplinary theories and evaluation of peoples’ reactions to challenging situation in healthcare, the necessary foundation for development of demand-oriented health services will be formed.

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Abstract
The planning and timely implementation of health policies and the provision for necessary healthcare by the officials in charge will help resist and overcome our enemies whilst working under the harsh conditions imposed by sanctions on Iran; this in turn will help attain long-term stability, develop the healthcare system, and strengthen national security. The initiatives to be implemented to this end are based upon the health policies rendered during the Iraq-Iran War that were based on pursuing a defensive stance inherent to Islamic culture and prevalent in the Iranian society. In this commentary the views on policies and options to consider and pursue in provision of healthcare and related issues advocated by the permanent members of the Academy of Medical Sciences, are presented; thus reflecting their commitment and their experience in regard to the aforementioned issues.

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Background and aim: Assessment of general healthcare policies and   appraisal  of  the role and  effectiveness of these policies as well as their strengths and weaknesses are important. The  aim of this study was to present a model to assess the parameters of the general healthcare policy of Iran.
Method: This qualitative study was undertaken in 2018  to identify appropriate parameters by which to assess the  general Healthcare policies.  To this end first a list of appropriate  assessment indicies  were identified  via review of the literature at hand.   Then with consideration of the selection criteria the list was truncated.  Ultimately, the relevant  parameters  were selected.
Results: A total of 345 indices or parameters were first identified and selected;   then  based on the selection criteria   65 parameters were chosen. After gathering  the opinions of specialists  57 parameters for quantitative assessment of Healthcare policies were chosen.  In the end the final selection of  the  quantitative healthcare  policies were presented as a group. 
Conclusion: The  pattern of indices and parameters proposed can function  as an effective and appropriate tool used to  assess advancement or deterioration of the goals listed  in the current healthcare   policy.  Although this  pattern has its weaknesses and shortcomings relative to proposed parameters and methods of assessment, it   however appears to be a good place to start;   because important interventions taken in Healthcare  and  health policy are not ascertained     there  is nothing at hand to show whether  or not these intervention were correct or incorrect.

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Background and Aim: In order for implementation of announced general health policies, the first step is to explain the various dimensions of each policy for the policymakers.   In this regard the Academy of Medical Sciences of the Islamic Republic of Iran in accordance with the 14 –article policies sought to explain  16 studies  related to articles in this document. This study was designed and conducted to merge the  mentioned  interventions of the various articles in this policy document.
Method: This qualitative study was done in 2018. Interventions which  had priority were explained  and the announced policies were selected and were merged and classified by the teams using qualitative analysis   based on  the health policy framework.
Results: A total of 149 interventions were selected to implement in healthcare policies;  these interventions were merged into 5 groups and were presented. There were 46 structural interventions, 55   outcomes interventions,  39 practical interventions, 9 content interventions and 23 behavioral interventions.
Conclusion: In conclusion interventions in health policy showed that the acquisition of financial resources should be provided as “fee-for-services” and structured upon a “referral framework” to improve the quality of healthcare rendered. 

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Background: Stewardship ,one of the most dominant functions of the health system is emphasized in the “General Health Policies Document” (GHPD) announced by the supreme leader of the Islamic Republic of Iran. Given that stewardship is a multi-dimensional concept with several different definitions, it needs clarification based on the aforementioned criteria in the GHPD. The purpose of this study was to identify and assess the concept of stewardship and its role functions.
Methods: This study was a scoping review. For this purpose, reliable Persian and English-language databases were systematically reviewed without time limitation. The various definitions of stewardship, its functions and duties, as well as its role in achieving health goals are summarized.
Results: According to the findings, stewardship is defined  differently  and different functions and tasks are stated for it; but their common point is the concept of unbiased orientation to provide community benefits rather than individual or group benefits.
Conclusion: Review of the stewardship concept revealed that its main function is to envision the health system and define the limitations and boundaries that affect the health system and ascertain that it works properly. In fact, as stated  in the  GHPD, the role of stewardship in the health system is one of governance and is not transferable. It is in line with the general health policy document.
 
 

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Background and Aim: Article 8 of  the General Health Policy Document   refers to promotion and improvement of  quality and safety of justice-focused services, emphasizes accountability and transparent information, effectiveness, efficiency and productivity  of health networks in accordance with the system of ranking and referral. The purpose of this study was to determine the most important indicators and interventions that can be done.
Methods: This study was conducted using descriptive and qualitative methods. In order to extract the indicies, texts and documents were reviewed and interviews and expert meetings were used to determine the interventions. The data were analyzed using the framework analysis with consideration of the health system framework.
Results: This study extracted five main indicators relating to Article 8 of the General Health Policy. Then, for the implementation of this article, 19 interventions in the resource production, payment, organizing rules and regulations and behavior were proposed.
Conclusion: Article 8 of the General Health Policy focuses on two categories of quality and safety of comprehensive health services. In order to improve the quality and safety of services which two important sources namely, health policymakers and managers are required to make a continuous effort for planning using the indicators and interventions mentioned.
 
 

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Abstract
Background and Aim: Overall health policies are one of the major macroeconomic policies that are designed to dynamize the health systems and socialize health plans. The research project "Observation of the Implementation of the Article 11 of General Health Policies" aimed at explaining this policy, formulate the implementation program, defined necessary interventions and determine its monitoring indicators.
Method: In this study, a variety of library, documentary, qualitative and descriptive studies were used in different stages. At the expert panels, the various issues and concepts of this policy were identified. Scientific information about these topics was collected in a review study. Stakeholders were identified through documentary reviews and interviews with experts and program managers. General objectives, strategic objectives, strategy, short-term goals and interventions were defined in expert panels. Focus group discussions were used for gathering complementary information about the plan and in process interventions. In priority interventions were proposed by considering national plans and policies.
 Discussion: The findings of this study provide health authorities the needed information to implement Article 11 of the general health policies and to monitor it. These achievements are presented in another paper. The methodology of this project is presented here. By this methodology it was tried to define information needed, monitoring indicators and in-priority indicators with considering optimal use of resources.  The method could prevent of duplication of formulation and implementation of operational programs and could provide a good model for researchers, planners and executives.

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Abstract
Background and aim:  Article 14 of the General Health Policy Document refers to changing the research strategy in accordance with national innovation system, become leader in science, technology and services in medical sciences, and also become center of excellence in medical services for south-west of Asia and Muslim world. The purpose of this study was to draw different conceptual and implantation models.
Methods: This study was conducted by using descriptive and qualitative methods. For designing the models, text and documents were reviewed and expert panels were used. Data were analyzed using framework analysis.
 Result and conclusion: Since article 14 consist of three different sections, one of the most important prerequisite for implementation is a suitable conceptual model. This study proposed four conceptual model. In accordance, one implementation model also proposed. According to internal conditions in the country (institution, economy, politics, etc.) one of the models can be selected. It is also possible to move from one model to another, with changing the environment.

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Aim: This article presents 40 years of experience in the process of developing primary healthcare. It also addresses the opportunities and challenges ahead and outlines the roadmap for the future.
Method: A literature review was undertaken, recording, documenting and using available scientific resources.
Results: Positive points and opportunities at the onset, and especially in the first decade after the revolution were noted. Training medical technicians, evidence based policymaking, need-based education, simple statistical system, international organization support, formulation of a roadmap for quantitative and qualitative development of the program considering  ecological conditions of each region, use of the quantitative scientific capacity of medical universities to exploit human resources and improve services rendered, proper guidance and supervision were undertaken. This led to a significant improvement in health indicators, particularly in reducing maternal and child mortality rate, eradication and elimination or control of communicable diseases, decreasing total fertility rate and increasing life expectancy.
Shortcomings and challenges included failure to implement family medicine planning , failure to organize the whole referral system, lack of timely change in structure and implementing programs based on community needs. Lack of full use of information technology in the statistical system, change in approaches and management with changing governments and managers, lack of public participation programs and weakness in cross-sectoral partnerships necessitate further planning .In this regard, suggestions are presented as a roadmap for future development of the healthcare system.
Conclusion: Primary healthcare was established through research in the Islamic Republic of Iran and it grew by commitment and planning, especially in rural villages; however, it needs serious reconstruction in order to preserve what has been achieved.

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Background and Objectives: The United Nations has an extensive and diverse structure;  thus, it is involved in numerous activities worldwide. This article briefly describes some of them.
Methods: The data and documents were collected   using library studies and the UN website.
Results: The active institutions of the United Nations can be divided into two sections: 1- Institutions directly related to health and 2- Institutions indirectly related to healthcare. Organizations and funds officially providing services in the first section include: The World Health Organization (WHO), United Nations Children's Fund (UNICEF), United Nations Population Fund (UNFPA) and United Nations Educational National and Cultural Organization (UNESCO). In addition to these agencies, two other newly established international agencies are of  mention namely  the Global Fund to Fight AIDS, Tuberculosis and Malaria and Joint the United Nations Program on HIV and AIDS (UNAIDS). The second section assesses  organizations such as the United Nations Development Program (UNDP), UN Refugee Agency (UNHCR), United Nations Environment Program (UNEP), International Labor Organization (ILO), World Trade Organization (WOT), Organization for the Prohibition of Chemical Weapons (OPCW), the Food and Agriculture Organization (FAO), and World Food Program (WFP).
Conclusions: In this brief review, the structure and some of the more important activities of UN agencies involved in Development of Primary Health Care In Iran are discussed.

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Background and Aim: The Islamic Revolution sought the implementation of justice, eradication of  poverty, and provision of the healthcare needs of the community and this led to the establishment of the "National Health Network System". The goals of  health equity and equitable access to basic and universal healthcare services, for all people, materialized relatively quickly. The main goal was to provide healthcare to all regardless of  socio-economic status and locale, so that basic healthcare services may be rendered without difficulty.

Method: The relevant publications on  healthcare equity and social determinants of health were identified through a literature review of major local and international databases assessed and documented. 

Results: The important policies rendered  in the line of healthcare equity included the

establishment of the  primary national healthcare network, the integration of medical education into the healthcare delivery system, the generic drug project. and  the health insurance system. Further strengthening and development of these projects ensured equitable, accessible and essential healthcare services for all, especially those in remote areas of the country.

Conclusion: Maintaining, promoting and restoring health, establishing equity in healthcare and minimizing avoidable differences in rendering healthcare are among the most important goals of the healthcare system of Iran. The achievements now four decades  onward , were in line with the most fundamental goals of the healthcare system. Attaining ideal goals and seeking justice in all aspects of the healthcare system, is in line with  future efforts to be pursued in this regard.

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Background and aim: Forty years now after the Islamic revolution, Iran has witnessed important achievements, especially in the healthcare sector: however, important challenges are still pending.
Methods: This review article presents the views of the author on the challenges overcome by the healthcare system in Iran; the author’s view is based on the relevant literature reviews presented in published articles, as well as healthcare policies slated to be pursued by the Ministry of Health.
Results: Compared to other regional countries as well as in the global trend, one of the most important milestones reached by the Iranian healthcare system now 40 years after the Islamic Revolution relates to equity regarding provision of healthcare as well as elimination of gaps in provision for and utilization of universal healthcare. However, a master plan is lacking; especially in the era of dynamic healthcare requirements; the rapid transition from the burden of communicable diseases to non-communicable diseases is a major challenge facing health policy makers. The economic aspect of the healthcare system has been overwhelmed by the need for extending universal health coverage, improving , promoting and implementing healthcare policies nationwide without discrimination.
Conclusion: With the Islamic Revolution now entering its fifth decade, it is imperative that the current healthcare system be updated with emphasis on accountability to conform to the dynamic needs of the evolving Iranian society. This can only be achieved by changing the policy making strategies and planning for provision of a contemporary healthcare system.

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Background: Health is a basic need for all communities. At the present time, development of a community is judged based on the quality of health and health equity in protection of poor people from harmful agents.
Methods: This study was a descriptive (quantitative and qualitative) stady.
Results: After reviewing the literature and interviewing experts, structural requirements from the study literature were prioritized and 19 structural requirements were recognized and by analyzing the data, structural requirements for changing the health system of the Islamic Republic of Iran into the reference health system were obtained.
Conclusion: After summarizing the results, some of the most important points were described as specific and innovative structural requirements and the relevant effects of the health system over the next fifty years, many recommendations are suggested.

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This here is a brief historical account of charitable contributions in health care in Iran.

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Health Resistance Economy is based on general health policies. Comprehensive health and healthy human is its main purpose and in this approach human and Islamic principles and values are observed. This policy brief presents principles and values and practical strategies of resistance health economy

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Background: An economic crisis is any decrease in economic activity in the whole economy of a country that lasts more than a few months and is visible in GDP, income, employment, industrial production and major and minor sales. The poorare more susceptible to irreparable damage to health due to economic crises. Inability to finance health services may force them to neglect essential services. The purpose of this study was to identify the effects of economic crises on health spending, and utilization of services among thepoor.
Methods: In this qualitative study first, the major financial crises of the health system, budget shortages and financial protection policies in crises with focus on the poor over the past fourteen years were sought and identified through semi-systematic searches of valid databases. Then, a questionnaire based on the findings of a review of studies including the main topics of health system financial crises, the effects of crises on the health system and the health system response to them, designed by experts and Health system specialists selected by convenience and purposeful sampling were completed.
Results: A clear policy response to protect the poor has not been formulated in the health system to deal with financial crises, and laws and documents relate to conditions of economic stability. A review of the financial crises of the last four decades has shown that in crises with a foreign origin (war and sanctions), often reduce access to services and diminish the services having the most important effects on the health system and the austerity policies were the main policy response. Costs shifting has also been the most important policy response in domestic financial crises (caused by rising costs and lack of budget due to economic policies).
Conclusion: Governments that place greater focus on social safety net programs, justice and health financing, are more resilient to financial crises. Efficacy, cost reduction, and income support mechanisms can help governments maintain critical services for the poor and vulnerable. The country's health system must focus on ensuring the access of the poor to health services in times of crises.