Volume 27, Issue 3 (11-2025)
yafte 2025, 27(3): 64-79 |
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ShahAli S, Behzadifar M, Shahabi S. Applying systems thinking to facilitate integrating physiotherapy services into primary health care in Iran. yafte 2025; 27 (3) :64-79
URL: http://yafte.lums.ac.ir/article-1-3834-en.html
URL: http://yafte.lums.ac.ir/article-1-3834-en.html
Shiraz University of Medical Sciences
Abstract: (160 Views)
Introduction: Despite all the successes of Iran's primary health care (PHC) network over the past decades and despite numerous reform programs, it still faces several challenges. Among these challenges is the lack of effective integration of rehabilitation services, including physiotherapy services, into this network. In response to such conditions, the aim of this study was to find critical policy points to facilitate the integration of physiotherapy services into Iran's PHC network, using a systems thinking approach.
Methods: In this study, the findings of the qualitative phase as well as the findings of the review section were used to develop systems thinking maps that represent the actors and their interactions in facilitating the integration of physiotherapy services into PHC. In the qualitative phase, 38 individuals including health policy makers, rehabilitation managers, physiotherapy faculty members, and physiotherapists participated. Also, in the second phase of the study, a review was conducted of all published qualitative studies related to the challenges and facilitators of the integration of physiotherapy services into primary health care around the world.
Results: Various factors play a role in the integration of physiotherapy services into PHC in Iran. The existing relationships between variables as well as the existing dynamics can affect the process of such integration. Based on the output of systems thinking, several macro factors play a role in this process, including the need for policymakers to be aware of physiotherapy services, attracting political support, seeking support from key stakeholders, participation of physiotherapy professionals in policy and decision-making processes, the existence of binding laws, and cross- and inter-sectoral collaborations. However, the existence of such facilitating factors requires the participation of the community, service recipients, and non-governmental organizations in the advocacy processes.
Conclusion: Several strategies can be used to strengthen the integration of these services into primary health care. These strategies include increasing awareness of physiotherapy services among policymakers and decision-makers, involving physiotherapists in policy-making processes, increasing community and non-governmental participation, seeking support from powerful and influential institutions, utilizing tele-rehabilitation, providing comprehensive educational services to physiotherapists, and providing a platform for professional and career development for physiotherapists..
Methods: In this study, the findings of the qualitative phase as well as the findings of the review section were used to develop systems thinking maps that represent the actors and their interactions in facilitating the integration of physiotherapy services into PHC. In the qualitative phase, 38 individuals including health policy makers, rehabilitation managers, physiotherapy faculty members, and physiotherapists participated. Also, in the second phase of the study, a review was conducted of all published qualitative studies related to the challenges and facilitators of the integration of physiotherapy services into primary health care around the world.
Results: Various factors play a role in the integration of physiotherapy services into PHC in Iran. The existing relationships between variables as well as the existing dynamics can affect the process of such integration. Based on the output of systems thinking, several macro factors play a role in this process, including the need for policymakers to be aware of physiotherapy services, attracting political support, seeking support from key stakeholders, participation of physiotherapy professionals in policy and decision-making processes, the existence of binding laws, and cross- and inter-sectoral collaborations. However, the existence of such facilitating factors requires the participation of the community, service recipients, and non-governmental organizations in the advocacy processes.
Conclusion: Several strategies can be used to strengthen the integration of these services into primary health care. These strategies include increasing awareness of physiotherapy services among policymakers and decision-makers, involving physiotherapists in policy-making processes, increasing community and non-governmental participation, seeking support from powerful and influential institutions, utilizing tele-rehabilitation, providing comprehensive educational services to physiotherapists, and providing a platform for professional and career development for physiotherapists..
Keywords: Physiotherapy, Rehabilitation, Primary health care, Health policy, Qualitative study, Systems thinking, Iran
Type of Study: Original Research |
Subject:
داخلی
Received: 2025/06/30 | Accepted: 2025/09/22 | Published: 2025/11/1
Received: 2025/06/30 | Accepted: 2025/09/22 | Published: 2025/11/1
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