Evidence map›Paper›PMID 41776413›Full record

ArticleBMC primary care2026

Challenges and opportunities in financing urban primary healthcare in Iran: pathways to universal health coverage.

Leila Zamani-Nezhad, Mahmood Nekoei-Moghadam, Mohammadreza Amiresmaili, Ali Akbar Haghdoost, Vahid Yazdi-Feyzabadi

Abstract read
In one paragraph

Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Leila Zamani-NezhadHealth Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.ORCID 0009-0000-0262-2194
Mahmood Nekoei-MoghadamHealth in Disaster and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.ORCID 0000-0003-1248-8755
Mohammadreza AmiresmailiHealth in Disaster and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.ORCID 0000-0002-9137-5873
Ali Akbar HaghdoostHIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.ORCID 0000-0003-4628-4849
Vahid Yazdi-FeyzabadiHealth Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. va.yazdi@gmail.com.ORCID 0000-0002-8009-470X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUrban primary health care (UPHC) seeks to address the growing health needs of urban populations and improve public health outcomes. However, its implementation faces significant barriers, particularly in financing mechanisms, which often hinder the attainment of key policy goals. This study aims to identify these challenges and propose solutions.

methodsThis qualitative study collected data through semi-structured interviews with twenty-six key informants between November 2023 and May 2024. A purposive sampling strategy, supplemented by snowball sampling, was used to identify participants. Data were analyzed using a directed content analysis approach guided by Kutzin’s framework on health financing sub-functions. All the data coding processes were conducted using MAXQDA 2020.

resultsChallenges in health financing were categorized under three core sub-functions: resource collection, pooling, and allocation and purchasing of healthcare services. Key issues included unsustainable financial resources, limited budgetary allocations for primary and preventive care, and an overall shortfall in available funds. Additionally, inefficiencies in basic health insurance systems, poorly regulated tariff structures, weak resource management, and non-strategic purchasing practices were identified as significant barriers. Addressing these challenges requires a prevention-oriented approach and the application of systems thinking to financing reforms.

conclusionStrengthening UPHC depends on aligning financial reforms with preventive health priorities. policy actions are recommended to include securing dedicated funding through earmarked taxes for preventive services, reforming the basic health insurance structures, expanding coverage for preventive interventions, and adopting outcome-based purchasing models. These strategies can support the expansion of access to urban primary health care (UPHC), promote universal health coverage, and enhance population health outcomes.

Indexed as

Healthcare FinancingPrimary Health CareUniversal Health InsuranceHumansIranQualitative ResearchUrban PopulationChallengesFinancing systemIranQualitative studyUrban primary health care

Identifiers

PMID41776413
PMCPMC13067443

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.