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Health Legislation and Legal Structure in Iran. Nouradin Pirmoazen ,MD,FACS , Clinical Research Fellow, Harvard Medical School. Turning Point : Motivation. History of Ronak ! 12 Y/F Fever, Anorexia, Abdominal Pain Perforated Appendecitis Complications! Life-long infertility.
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Health Legislation and Legal Structure in Iran Nouradin Pirmoazen ,MD,FACS, Clinical Research Fellow, Harvard Medical School
Turning Point : Motivation History of Ronak! 12 Y/F Fever, Anorexia, Abdominal Pain Perforated Appendecitis Complications! Life-long infertility
``Declare the Past,Diagnose the Present,Foretell the Future.`` Hippocrates (c.470-277 BC)
Declarations History:Revolution in Thinking and Practice • 1978 :Declaration of Alma-Ata: Health for All -Health For All (HFA) by 2000 -Primary Health Care (PHC) -Protect and Promote the Health -Health is Fundamental Human Rights -National Health System (NHS) • 2000: Millennium Declaration: All for Health -Comprehensive Development Framework -MDG s Place a Central Focus on Public Health -Public Health Improvement Break `Poverty Vicious Cycle` -MDG s Depend Critically on Scaling up Public Health Investments in Developing Country (Sachs, Bulletin WHO
MDG s : Focused on Health • Eradicate Extreme Poverty and Hunger • Achieve Universal Primary Education • Promote Gender Equality and Empower W • Reduce Child Mortality • Improve Maternal Health • Combat HIV/AIDS, Malaria… • Ensure Environmental Sustainability • Develop Global Partnership for Development
Soviet Medicine Before the Fall • The Financing of the Health Services came last, after all expenditures had been met, and it had to take whatever was left, which was very little! `Residual Service` Chazov , Health Minister Harvard Medical Alumni Bulletin
Principles of Health Reform • Fair Access: to Essential Health Care Services, Equity, Universal Coverage • Efficiency: to Deliver with Maximum Outcome • Responsiveness to Society: Accountability, Quality ,Performance, Expectations, Protections • Innovations: on a Day to Day Basis, Products, Diagnostic, Therapeutic….
Council of Guardians • Six Faqih ,Cleric Islamic Canonists • Six Jurists Legislations Comply with Islamic Laws and Constitution
Laws Pathway • Government Bills: Presented to Parliament after approval in the Cabinet • Representatives Plans: Proposed by MPs if Sponsored by 15 MPs
Public Health Law in the Constitution • Article 3/12: Creating Welfare, Removing Poverty Eliminating any form of Deprivation in the field of Nutrition, Housing, Employment, Health Care Generalized Social Insurance
Public Health Law in the Constitution • Article 29: Universal Right of All in -Social Security covering Retirement, Unemployment, Old age, Disability, Destitution, Accidents, Calamities, -National Medical Insurance, Health Care Services and Treatments
Public Health Law in theConstitution • Article 43/1: -Satisfaction of Basic Needs: Housing, Nutrition, Clothing, Preventative Health, Medical Treatments, Services Education Family for All Setting
Health For All:Health Care Network System • Health Houses (HH) • Health Centers (HC) • `Behvarz` Training • Geographic Locations • Whole Country Distribution • Care Delivery Levels • Specialized Clinics, Hospital • Teaching Modern Hospitals • PHC System! Access!
National Health Policy:Principles • Accessibility • Equity • Quality • Insurance Coverage
Investing in Health means Investing in People and Development • Health Allocation from GDP: 2001-2004 5.7% 2005-2010 7.2% • Out-Of-Pocket 2001-2004 50-60% 2005-2010 30%
To Strive, To Seek, To Find, And not to Yield!
Thank You All! Thank YouAll!