Contribution of Community Health Workers to the Implementation of CPHC in Rural Settings, Iran

Community Health Workers have a potentially important role in the implementation of health programs, realization of community participation and in improving health outcomes particularly in low-income countries. After the Alma Ata Declaration, Iran has developed a new health system based on the primary health care approach. The primary aim of the system was to improve access to health care for disadvantaged group and to reduce urban-rural disparities in health outcomes. To reach the goal, rural community health worker program has been incorporated into the Iranian primary health care system.

A wide variety of health programs are delivered by the Iranian CHWs with significant improvement in many health indicators over the last decades. In addition CHWs in Iran play a crucial role in community engagement, mobilizing community resources, acting advocates for their community and built collaborative team for action, in summary as actors for change.

This study aims to investigate CHWs perceptions about the principles and practices of CPHC and their role in improving its implementation in rural settings. Existing enablers, barriers and remedial actions which strengthen or weaken their potential to contribute to implementing CPHC in rural settings are also investigated. To accomplish the aim of the study, qualitative methodology has been employed. Data has been collected by undertaking 90 qualitative interviews with a heterogeneous group of CHWs throughout the country (18 provinces). The findings of the study will contribute to the knowledge of CHWs perceptions about comprehensive primary health care and their role within the health system and community.