Table 7 Themes, subthemes and codes identified from interviews with policy makers
Theme | Sub-theme | Code |
|---|---|---|
The effect of sanctions on health system | Impact of sanctions on health outcomes | - Reduced quality of life - Increased mortality rates - Increased burden of diseases |
Impact of sanctions on health system’s governance | - Inability to define clear future strategies and policies to achieve health improvement due to uncertainties - Inability to utilize legal, supervisory, and policy tools to lead health system functions - Increasing corruption in the healthcare sector as a result of information rents and monopolies created by sanctions - Decreased interpectoral collaborations | |
Impact of sanctions on service provision | - Investors’ reluctance to collaborate with healthcare sector - Weakened healthcare infrastructures - Reduced ratio of specialized human resources to the population preventing the provision of optimal health services - Increased inequality in distribution of hospital resources, especially Intensive Care Unit (ICU) and imaging equipment | |
Impact of sanctions on procurement of medicines, medical supplies, and equipment | - Increased barriers in financial transactions and import procedures for medicines and medical supplies - Reluctance of other countries to sell medical equipment to Iran due to sanctions-imposed consequences - Use of lower quality ingredients in manufacturing generic medicines - Higher prices paid for imported medicines, medical supplies, and equipment, through both imports or domestic production | |
Impact of sanctions on healthcare workforce (quality, quantity, and motivation) | - Reluctance of some medical staff to work within the country - Increased immigration rates out of the country among healthcare experts and staff - Inadequate patient services - Decreased motivation among healthcare staff - Decreased staff concentration due to multiple job commitments | |
Impact of sanctions on healthcare system’s financing | - Increased prices of services and medicines as a result of inflation in the health sector - Increased tariffs of healthcare services - Delayed reimbursements from health insurance organizations to healthcare providers, leading to heightened financial strain on providers - Deterioration of far financing contribution indicators, including increased impoverishment resulting from healthcare costs and the occurrence of catastrophic healthcare expenses. - Increased share of OOP in healthcare costs - Increased informal payments | |
The impacts of sanctions on infrastructures (health-related) | Impact of sanctions on economic factors | - Investments and their management - Financial transactions - Inflation - Increased economic instability |
Impact of sanctions on political factors | - Successful implementation of policies and regulations - Management stability - International relations and diplomacy | |
Impact of sanctions on social and cultural factors | - Social capital, happiness, and cooperation - Immigration rate - Social crimes | |
Impact of sanctions on education and research | - Scientific publications - Access to up-to-date scientific resources - Scientific exchange through international seminars and conferences |